Background. Iron can induce lipid peroxidation in vitro and in vivo in humans and has promoted ischemic myocardial injury in experimental animals. We tested the hypothesis that high serum ferritin concentration and high dietary iron intake are associated with an excess risk of acute myocardial infarction.Methods and Results. Randomly selected men (n=1,931), aged 42, 48, 54, or 60 years, who had no symptomatic coronary heart disease at entry, were examined in the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) in Eastern Finland between 1984 and 1989. Fifty-one of these men experienced an acute myocardial infarction during an average follow-up of 3 years. On the basis of a Cox proportional hazards model adjusting for age, examination year, cigarette pack-years, ischemic ECG in exercise test, maximal oxygen uptake, systolic blood pressure, blood glucose, serum copper, blood leukocyte count, and serum high density lipoprotein cholesterol, apolipoprotein B, and triglyceride concentrations, men with serum ferritin 2200 ,g/l had a 2.2-fold (95% CI, 1.2-4.0; p<0.01) risk factor-adjusted risk of acute myocardial infarction compared with men with a lower serum ferritin. An elevated serum ferritin was a strong risk factor for acute myocardial infarction in all multivariate models. This association was stronger

Flavonoids are effective antioxidants and, in theory, may provide protection against cancer, although direct human evidence of this is scarce. The relation between the intake of antioxidant flavonoids and subsequent risk of cancer was studied among 9,959 Finnish men and women aged 15-99 years and initially cancer free. Food consumption was estimated by the dietary history method, covering the total habitual diet during the previous year. During a follow-up in 1967-1991, 997 cancer cases and 151 lung cancer cases were diagnosed. An inverse association was observed between the intake of flavonoids and incidence of all sites of cancer combined. The sex- and age-adjusted relative risk of all sites of cancer combined between the highest and lowest quartiles of flavonoid intake was 0.80 (95% confidence interval 0.67-0.96). This association was mainly a result of lung cancer, which presented a corresponding relative risk of 0.54 (95% confidence interval 0.34-0.87). The association between flavonoid intake and lung cancer incidence was not due to the intake of antioxidant vitamins or other potential confounding factors, as adjustment for factors such as smoking and intakes of energy, vitamin E, vitamin C, and beta-carotene did not materially alter the results. The association was strongest in persons under 50 years of age and in nonsmokers with relative risks of 0.33 (95% confidence interval 0.15-0.77) and 0.13 (95% confidence interval 0.03-0.58), respectively. Of the major dietary flavonoid sources, the consumption of apples showed an inverse association with lung cancer incidence, with a relative risk of 0.42 (95% confidence interval 0.23-0.76) after adjustment for the intake of other fruits and vegetables. The results are in line with the hypothesis that flavonoid intake in some circumstances may be involved in the cancer process, resulting in lowered risks.

Oxidation of lipoproteins is hypothesized to promote atherosclerosis and, thus, a high intake of antioxidant nutrients may protect against coronary heart disease. The relation between the intakes of dietary carotene, vitamin C, and vitamin E and the subsequent coronary mortality was studied in a cohort of 5,133 Finnish men and women aged 30-69 years and initially free from heart disease. Food consumption was estimated by the dietary history method covering the total habitual diet during the previous year. Altogether, 244 new fatal coronary heart disease cases occurred during a mean follow-up of 14 years beginning in 1966-1972. An inverse association was observed between dietary vitamin E intake and coronary mortality in both men and women with relative risks of 0.68 (p for trend = 0.01) and 0.35 (p for trend < 0.01), respectively, between the highest and lowest tertiles of the intake. Similar associations were observed for the dietary intake of vitamin C and carotenoids among women and for the intake of important food sources of these micronutrients, i.e., of vegetables and fruits, among both men and women. The associations were not attributable to confounding by major nondietary risk factors of coronary heart disease, i.e., age, smoking, serum cholesterol, hypertension, or relative weight. The results support the hypothesis that antioxidant vitamins protect against coronary heart disease, but it cannot be excluded that foods rich in these micronutrients also contain other constituents that provide the protection.

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Summary The relationship between intake of dairy products and risk of breast cancer was studied in 4697 initially cancer-free women, aged 15 years or over. During a 25 year follow-up period after the collection of food consumption data, 88 breast cancers were diagnosed. Intakes of foods were calculated from dietary history interviews covering the habitual diet of examinees over the preceding year. There was a significant inverse gradient between milk intake and incidence of breast cancer, the age-adjusted relative risk of breast cancer being 0.42 (95% confidence interval=0.24-0.74) between the highest and lowest tertiles of milk consumption. The associations with respect to other dairy products were not significant. Keywords: breast, dairy product; diet; follow-up; neoplasmThe importance of dietary factors in breast cancer development has been suggested by animal studies and correlation studies between countries and in migrant populations (Rohan and Bain, 1987). A high intake of fat in particular has been suspected of being a risk factor for breast cancer. In a comparison of different countries, a higher intake of milk products, representing an important fat source in developed countries, was associated with increased breast cancer mortality (Armstrong and Doll, 1975). Analytical epidemiological studies in individuals have, however, provided less consistent results. Both the cohort and casecontrol studies on fat (Hunter and Willett, 1994) or milk intake (Boyd et al., 1993) and breast cancer risk have been conflicting. In a small Finnish prospective study on dietary fat and breast cancer incidence in initially 20-69 years old women we, unexpectedly, found an inverse association between milk intake and breast cancer (Knekt et al., 1990). Since milk intake in Finland has been among the highest in the world during the past decade we decided to investigate the associations between intake of different dietary products and breast cancer risk in greater detail during a longer follow-up period. Population and methodsThe Mobile Health Clinic of the Social Insurance Institution carried out multiphasic screening examinations in different areas of Finland during 1966-72 (Knekt, 1988. Food consumption data were obtained from 4697 women aged 15-90 years old (mean = 39 years and s.d. = 16) and free from cancer. A modified dietary history interview method was used to survey the total habitual diet of examinees during the past year (Jarvinen et al., 1993). A structured interview guided by a preformed questionnaire was performed by trained interviewers. The amounts of food items consumed were assessed per day, week, month and year. Food models were used to facilitate estimation of the size of portions consumed. The amount of each individual food item per day was calculated by combining the amount of food directly reported in the interview with that derived from mixed dishes. The nutrient intakes of food items were computed using a food composition database compiled at the Social Insurance Institution. Engery intake was calculated ...