Changes in Major Risk Factors for Cardiovascular Diseases over 25 Years in the Serbian Cohorts of the Seven Countries Study

Kromhout, Daan; Nedeljković, S; Grujić, M; Ostojić, Miodrag; Keys, Ancel; Menotti, A; Katan, Martijn B.; Oostrom, Mart; Bloemberg, Bennie

doi:10.1093/ije/23.1.5

“…In contrast a 6 mmHg increase was observed in Serbia. This is compatible with the longitudinal changes observed in the Serbian cohorts of the Seven Countries Study 18 . A consistent increase in mean BMI was observed in populations from different parts of Europe.…”

Section: Biological Risk Factors For Cardiovascular Diseasessupporting

confidence: 89%

Epidemiology of cardiovascular diseases in Europe

Kromhout

¹

2001

Public Health Nutr.

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Within Europe large differences exist in mortality from coronary heart disease and stroke. These diseases show a clear West-East gradient with high rates in Eastern Europe. In spite the decreasing trend in age-adjusted cardiovascular disease mortality in Western European countries an increase in the number of cardiovascular patients is expected because of the ageing of the population. Consequently the health care cost for these diseases will increase. Total and HDL cholesterol are major determinants of coronary heart disease. Saturated and trans fatty acids have a total and LDL cholesterol elevating effect and unsaturated fatty acids a lowering effect. N-3 polyunsaturated fatty acids seem to have a protective effect on coronary heart disease occurrence independent of their effect on cholesterol. Dietary antioxidants could be of importance because they may prevent oxidation of the atherogenic cholesterol rich LDL lipoproteins. There is however no convincing evidence that either vitamin E, carotenoids or vitamin C protect against coronary heart disease. Observational research has shown that flavonols, polyphenols with strong antioxidant properties present in plant foods, may protect against coronary heart disease. Blood pressure is a major determinant of coronary heart disease and stroke. Historically salt is viewed as the most important dietary determinant of blood pressure. Recent research shows that also a low-fat diet rich in potassium, calcium and magnesium lowers blood pressure substantially. This suggests a multifactorial influence of different nutrients on blood pressure. It can be concluded that a diet low in saturated and trans fatty acids and rich in plant foods in combination with regular fish consumption is associated with a low risk of cardiovascular mortality.

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“…In contrast a 6 mmHg increase was observed in Serbia. This is compatible with the longitudinal changes observed in the Serbian cohorts of the Seven Countries Study 18 .…”

Section: Biological Risk Factors For Cardiovascular Diseasessupporting

confidence: 89%

Social inequalities and the burden of food-related ill-health

Robertson

¹

2001

PHN

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Within Europe large differences exist in mortality from coronary heart disease and stroke. These diseases show a clear West-East gradient with high rates in Eastern Europe. In spite the decreasing trend in age-adjusted cardiovascular disease mortality in Western European countries an increase in the number of cardiovascular patients is expected because of the ageing of the population. Consequently the health care cost for these diseases will increase. Total and HDL cholesterol are major determinants of coronary heart disease. Saturated and trans fatty acids have a total and LDL cholesterol elevating effect and unsaturated fatty acids a lowering effect. N-3 polyunsaturated fatty acids seem to have a protective effect on coronary heart disease occurrence independent of their effect on cholesterol. Dietary antioxidants could be of importance because they may prevent oxidation of the atherogenic cholesterol rich LDL lipoproteins. There is however no convincing evidence that either vitamin E, carotenoids or vitamin C protect against coronary heart disease. Observational research has shown that flavonols, polyphenols with strong antioxidant properties present in plant foods, may protect against coronary heart disease. Blood pressure is a major determinant of coronary heart disease and stroke. Historically salt is viewed as the most important dietary determinant of blood pressure. Recent research shows that also a low-fat diet rich in potassium, calcium and magnesium lowers blood pressure substantially. This suggests a multifactorial influence of different nutrients on blood pressure. It can be concluded that a diet low in saturated and trans fatty acids and rich in plant foods in combination with regular fish consumption is associated with a low risk of cardiovascular mortality.

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“…During 25 years of follow-up the prevalence of smoking decreased from 44 to 15%. 24 was 12.3% (41.8 versus 29.5%) higher than the observed mortality rate. This may be due to the substantial decrease in the prevalence of smokers during 25 years of follow-up.…”

Section: Discussioncontrasting

confidence: 51%

Saturated fat, vitamin C and smoking predict long-term population all-cause mortality rates in the Seven Countries Study

Kromhout¹,

Bloemberg²,

Feskens³

et al. 2000

International Journal of Epidemiology

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IntroductionWithin Europe large difference exist in all-cause mortality with high rates in Eastern Europe and low rates in Western Europe. 1 In men aged 45-74 there is a more than twofold difference in all-cause mortality between men in Iceland and the Ukraine. From a public health point of view it is important to know what the determinants of these population differences in all-cause mortality are.This question could be addressed by using data of the Seven Countries Study. In this study that started in 1958, 13 European cohorts were enrolled, one from the US and two from Japan. Associations between nutrient intake, cigarette smoking and alcohol intake were investigated at the population level because only nutrient and alcohol intake data representing the average intake of each cohort were available. Earlier reports on the results of the Seven Countries Study addressed the associations between nutrient intake and major diet-related chronic diseases e.g. coronary heart disease, colon cancer and stomach cancer. The population intake of saturated fat was positively associated with population coronary heart disease mortality rates. 2 Flavonoids, powerful dietary antioxidants, present in tea, onions, apples and red wine, were protective against coronary heart disease at the population level. 3 Population colorectal cancer rates were inversely related with dietary fibre 4 and population stomach cancer rates with vitamin C intake. 5 These diet-related diseases are major causes of death in developed countries. Therefore it may be hypothesized that dietary determinants of these diseases are also major determinants of all-cause mortality. In addition the effect of other important lifestyle-related determinants of population all-cause Background The Seven Countries Study has shown that population mortality rates for various chronic diseases are related to diet and smoking. This paper addresses the associations between diet, smoking and 25-year all-cause mortality.

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Changes in Major Risk Factors for Cardiovascular Diseases over 25 Years in the Serbian Cohorts of the Seven Countries Study

Cited by 22 publications

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Epidemiology of cardiovascular diseases in Europe

Epidemiology of cardiovascular diseases in Europe

Social inequalities and the burden of food-related ill-health

Saturated fat, vitamin C and smoking predict long-term population all-cause mortality rates in the Seven Countries Study

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