Staff Publications

Staff Publications

  • external user (warningwarning)
  • Log in as
  • language uk
  • About

    'Staff publications' is the digital repository of Wageningen University & Research

    'Staff publications' contains references to publications authored by Wageningen University staff from 1976 onward.

    Publications authored by the staff of the Research Institutes are available from 1995 onwards.

    Full text documents are added when available. The database is updated daily and currently holds about 240,000 items, of which 72,000 in open access.

    We have a manual that explains all the features 

    Records 1 - 50 / 50

    • help
    • print

      Print search results

    • export

      Export search results

    Check title to add to marked list
    Comparative ecologic relationships of saturated fat, sucrose, food groups, and a Mediterranean food pattern score to 50-year coronary heart disease mortality rates among 16 cohorts of the Seven Countries Study
    Kromhout, Daan ; Menotti, Alessandro ; Alberti-Fidanza, Adalberta ; Puddu, Paolo Emilio ; Hollman, Peter ; Kafatos, Anthony ; Tolonen, Hanna ; Adachi, Hisashi ; Jacobs, David R. - \ 2018
    European Journal of Clinical Nutrition 72 (2018). - ISSN 0954-3007 - p. 1103 - 1110.

    Background/objectives: We studied the ecologic relationships of food groups, macronutrients, eating patterns, and an a priori food pattern score (Mediterranean Adequacy Index: MAI) with long-term CHD mortality rates in the Seven Countries Study. Subjects/methods: Sixteen cohorts (12,763 men aged 40–59 years) were enrolled in the 1960s in seven countries (US, Finland, The Netherlands, Italy, Greece, former Yugoslavia: Croatia/Serbia, Japan). Dietary surveys were carried out at baseline and only in a subsample of each cohort. The average food consumption of each cohort was chemically analyzed for individual fatty acids and carbohydrates. Results: Ecologic correlations of diet were computed across cohorts for 50-year CHD mortality rates; 97% of men had died in cohorts with 50-year follow-up. CHD death rates ranged 6.7-fold among cohorts. At baseline, hard fat was greatest in northern Europe, olive oil in Greece, meat in the US, sweet products in northern Europe and the US, and fish in Japan. The MAI was high in Mediterranean and Japanese cohorts. The 50-year CHD mortality rates of the cohorts were closely positively ecologically correlated (r = 0.68–0.92) with average consumption of hard fat, sweet products, animal foods, saturated fat, and sucrose, but not with naturally occurring sugars. Vegetable foods, starch, and the a priori pattern MAI were inversely correlated (r = −0.59 to −0.91) with CHD mortality rates. Conclusions: Long-term CHD mortality rates had statistically significant ecologic correlations with several aspects of diet consumed in the 1960s, the traditional Mediterranean and Japanese patterns being rich in vegetable foods, and low in sweet products and animal foods.

    The strength of the multivariable associations of major risk factors predicting coronary heart disease mortality is homogeneous across different areas of the Seven Countries Study during 50-year follow-up
    Menotti, Alessandro ; Puddu, Paolo Emilio ; Adachi, Hisashi ; Kafatos, Anthony ; Tolonen, Hanna ; Kromhout, Daan - \ 2018
    Acta Cardiologica 73 (2018)2. - ISSN 0001-5385 - p. 148 - 154.
    coefficients - Coronary heart disease - hazard ratios - homogeneity - mortality - prediction - risk factors

    Objectives: To compare the magnitude of multivariable coefficients and hazard ratios of four cardiovascular risk factors across five worldwide regions of the Seven Countries Study in predicting 50-year coronary deaths. Material and methods: A total of 13 cohorts of middle-aged men at entry (40–59 years old) were enrolled in the mid-1900s from five relatively homogeneous groups of cohorts (areas): USA, Finland and Zutphen – the Netherlands, Italy and Greece, Serbia, Japan for a total of 10,368 middle-aged men. The major risk factors measured at baseline were age, number of cigarettes smoked, systolic blood pressure and serum cholesterol. Cox proportional hazards models were solved for 50-year (45 years for Serbia) deaths from coronary heart disease (CHD), and the multivariable coefficients were compared for heterogeneity. Results: The highest levels of risk factors and CHD death rates were found in Finland and Zutphen – the Netherlands and the lowest in Japan. All four risk factors were predictive for long-term CHD mortality in all regions, except serum cholesterol in Japan where the mean levels and CHD events were lowest. Tests of heterogeneity of coefficients for single risk factors in predicting CHD mortality were non-significant across the five areas. The same analyses for the first 25 years of follow-up produced similar findings. Conclusions: The strength of the multivariable associations of four major traditional CHD risk factors with long-term CHD mortality appears to be relatively homogeneous across areas, pending needed further evidence.

    Re-calibration of coronary risk prediction : An example of the Seven Countries Study
    Puddu, Paolo Emilio ; Piras, Paolo ; Kromhout, Daan ; Tolonen, Hanna ; Kafatos, Anthony ; Menotti, Alessandro - \ 2017
    Scientific Reports 7 (2017)1. - ISSN 2045-2322
    We aimed at performing a calibration and re-calibration process using six standard risk factors from Northern (NE, N = 2360) or Southern European (SE, N = 2789) middle-aged men of the Seven Countries Study, whose parameters and data were fully known, to establish whether re-calibration gave the right answer. Greenwood-Nam-D'Agostino technique as modified by Demler (GNDD) in 2015 produced chi-squared statistics using 10 deciles of observed/expected CHD mortality risk, corresponding to Hosmer-Lemeshaw chi-squared employed for multiple logistic equations whereby binary data are used. Instead of the number of events, the GNDD test uses survival probabilities of observed and predicted events. The exercise applied, in five different ways, the parameters of the NE-predictive model to SE (and vice-versa) and compared the outcome of the simulated re-calibration with the real data. Good re-calibration could be obtained only when risk factor coefficients were substituted, being similar in magnitude and not significantly different between NE-SE. In all other ways, a good re-calibration could not be obtained. This is enough to praise for an overall need of re-evaluation of most investigations that, without GNDD or another proper technique for statistically assessing the potential differences, concluded that re-calibration is a fair method and might therefore be used, with no specific caution.
    Baseline fatty acids, food groups, a diet score and 50-year all-cause mortality rates. An ecological analysis of the Seven Countries Study
    Menotti, Alessandro ; Kromhout, Daan ; Puddu, Paolo Emilio ; Alberti-Fidanza, Adalberta ; Hollman, Peter ; Kafatos, Anthony ; Tolonen, Hanna ; Adachi, Hisashi ; Jacobs, David R. - \ 2017
    Annals of medicine 49 (2017)8. - ISSN 0785-3890 - p. 718 - 727.
    50-year follow-up - all-cause mortality - fatty acids - Seven Countries Study - socio-economic status
    Objectives: This analysis deals with the ecologic relationships of dietary fatty acids, food groups and the Mediterranean Adequacy Index (MAI, derived from 15 food groups) with 50-year all-cause mortality rates in 16 cohorts of the Seven Countries Study. Material and methods: A dietary survey was conducted at baseline in cohorts subsamples including chemical analysis of food samples representing average consumptions. Ecologic correlations of dietary variables were computed across cohorts with 50-year all-cause mortality rates, where 97% of men had died. Results: There was a 12-year average age at death population difference between extreme cohorts. In the 1960s the average population intake of saturated (S) and trans (T) fatty acids and hard fats was high in the northern European cohorts while monounsaturated (M), polyunsaturated (P) fatty acids and vegetable oils were high in the Mediterranean areas and total fat was low in Japan. The 50-year all-cause mortality rates correlated (r= −0.51 to −0.64) ecologically inversely with the ratios M/S, (M + P)/(S + T) and vegetable foods and the ratio hard fats/vegetable oils. Adjustment for high socio-economic status strengthened (r= −0.62 to −0.77) these associations including MAI diet score. Conclusion: The protective fatty acids and vegetable oils are indicators of the low risk traditional Mediterranean style diets.KEY MESSAGESWe aimed at studying the ecologic relationships of dietary fatty acids, food groups and the Mediterranean Adequacy Index (MAI, derived from 15 food groups) with 50-year all-cause mortality rates in the Seven Countries Study.The 50-year all-cause mortality rates correlated (r = −0.51 to −0.64) ecologically inversely with the ratios M/S [monounsaturated (M) + polyunsaturated (P)]/[saturated (S) + trans (T)] fatty acids and vegetable foods and the ratio hard fats/vegetable oils. After adjustment for high socio-economic status, associations with the ratios strengthened (r = −0.62 to −0.77) including also the MAI diet score.The protective fatty acids and vegetable oils are indicators of the low risk traditional Mediterranean style diets.
    Ten-year blood pressure trajectories, cardiovascular mortality and life years lost in two extinction cohorts
    Tielemans, S.M.A.J. ; Geleijnse, J.M. ; Menotti, A. ; Boshuizen, H.C. ; Soedamah-Muthu, S.S. ; Jacobs, David R. ; Blackburn, H. ; Kromhout, D. - \ 2015
    European Journal of Epidemiology 2015 (2015). - ISSN 0393-2990 - p. 728 - 728.
    Ten-Year Blood Pressure Trajectories, Cardiovascular Mortality, and Life Years Lost in 2 Extinction Cohorts: the Minnesota Business and Professional Men Study and the Zutphen Study
    Tielemans, S.M.A.J. ; Geleijnse, J.M. ; Menotti, A. ; Boshuizen, H.C. ; Soedamah-Muthu, S.S. ; Jacobs, D.R. ; Blackburn, H. ; Kromhout, D. - \ 2015
    Journal of the American Heart Association 4 (2015). - ISSN 2047-9980 - 12 p.
    follow-up - disease - risk - age - adulthood
    Background Blood pressure (BP) trajectories derived from measurements repeated over years have low measurement error and may improve cardiovascular disease prediction compared to single, average, and usual BP (single BP adjusted for regression dilution). We characterized 10-year BP trajectories and examined their association with cardiovascular mortality, all-cause mortality, and life years lost. Methods and Results Data from 2 prospective and nearly extinct cohorts of middle-aged men—the Minnesota Business and Professional Men Study (n=261) and the Zutphen Study (n=632)—were used. BP was measured annually during 1947–1957 in Minnesota and 1960–1970 in Zutphen. BP trajectories were identified by latent mixture modeling. Cox proportional hazards and linear regression models examined BP trajectories with cardiovascular mortality, all-cause mortality, and life years lost. Associations were adjusted for age, serum cholesterol, smoking, and diabetes mellitus. Mean initial age was about 50 years in both cohorts. After 10 years of BP measurements, men were followed until death on average 20 years later. All Minnesota men and 98% of Zutphen men died. Four BP trajectories were identified, in which mean systolic BP increased by 5 to 49 mm Hg in Minnesota and 5 to 20 mm Hg in Zutphen between age 50 and 60. The third systolic BP trajectories were associated with 2 to 4 times higher cardiovascular mortality risk, 2 times higher all-cause mortality risk, and 4 to 8 life years lost, compared to the first trajectory. Conclusions Ten-year BP trajectories were the strongest predictors, among different BP measures, of cardiovascular mortality, all-cause mortality, and life years lost in Minnesota. However, average BP was the strongest predictor in Zutphen.
    AbstractP044: Ten-Year Blood Pressure Trajectories and Long-Term Risk of Cardiovascular Mortality: The Minnesota Business and Professional Men Study
    Tielemans, S.M.A.J. ; Geleijnse, J.M. ; Boshuizen, H.C. ; Soedamah-Muthu, S.S. ; Menotti, A. ; Jacobs, D.R. ; Blackburn, H. ; Kromhout, D. - \ 2014
    Circulation 129 (2014)S1. - ISSN 0009-7322
    Introduction: We characterised 10[[Unable to Display Character: ‑]]year trajectories of annual blood pressure (BP) measurements and studied the added value on long-term cardiovascular disease (CVD) mortality in comparison to a single baseline BP measurement. Methods: This study is based on data from 266 men, aged 45 to 55 years, who participated in the Minnesota Business and Professional Men Study. BP was measured annually between 1947[[Unable to Display Character: ‑]]1957, a time when only very high levels of BP were treated. Men who did not die before 1957 and did not have a history of myocardial infarction or stroke were included. We identified BP trajectories by means of finite mixture group-based trajectory modelling (PROC TRAJ in SAS). For each individual, time to death was defined as the difference in years between 1957 and year of death (the last man died in 2002). Cox proportional hazards analysis was used to examine BP trajectories in relation to CVD mortality. Results: All 266 men died and 142 (53.4%) from CVD, with mean (± sd) time to death 21±10 years. We identified four systolic BP trajectories with baseline mean systolic BP levels ranging from 112 (SBP1) to 165 (SBP4) mmHg. This difference of 53 mmHg in baseline systolic BP level was associated with a hazard ratio (HR) of 2.4 (95% CI: 1.5-3.8) for CVD mortality. From age 45 to 65, mean systolic BP levels of the four trajectories (Figure 1A) increased from 0.4 to 2.1 mmHg/year for SBP1 to SBP4. For systolic BP trajectories, the HR of CVD mortality increased from 1.6 (SBP2) to 4.2 (SBP4), compared to men in SBP1 (Figure 1A). A similar pattern was observed for diastolic BP (Figure 1B). Conclusion: In this population of middle[[Unable to Display Character: ‑]]aged US men, the increase in BP was strongest in those with the highest BP levels. Trajectories of BP predicted CVD mortality much better than a single BP measurement.
    Ten-Year Blood Pressure Trajectories and Long-Term Risk of Cardiovascular Mortality: The Minnesota Business and Professional Men Study
    Tielemans, S.M.A.J. ; Geleijnse, J.M. ; Boshuizen, H.C. ; Soedamah-Muthu, S.S. ; Menotti, A. ; Jacobs, D.R. ; Blackburn, H. ; Kromhout, D. - \ 2014
    Circulation 129 (2014). - ISSN 0009-7322
    Introduction: We characterised 10[[Unable to Display Character: ‑]]year trajectories of annual blood pressure (BP) measurements and studied the added value on long-term cardiovascular disease (CVD) mortality in comparison to a single baseline BP measurement. Methods: This study is based on data from 266 men, aged 45 to 55 years, who participated in the Minnesota Business and Professional Men Study. BP was measured annually between 1947[[Unable to Display Character: ‑]]1957, a time when only very high levels of BP were treated. Men who did not die before 1957 and did not have a history of myocardial infarction or stroke were included. We identified BP trajectories by means of finite mixture group-based trajectory modelling (PROC TRAJ in SAS). For each individual, time to death was defined as the difference in years between 1957 and year of death (the last man died in 2002). Cox proportional hazards analysis was used to examine BP trajectories in relation to CVD mortality. Results: All 266 men died and 142 (53.4%) from CVD, with mean (± sd) time to death 21±10 years. We identified four systolic BP trajectories with baseline mean systolic BP levels ranging from 112 (SBP1) to 165 (SBP4) mmHg. This difference of 53 mmHg in baseline systolic BP level was associated with a hazard ratio (HR) of 2.4 (95% CI: 1.5-3.8) for CVD mortality. From age 45 to 65, mean systolic BP levels of the four trajectories (Figure 1A) increased from 0.4 to 2.1 mmHg/year for SBP1 to SBP4. For systolic BP trajectories, the HR of CVD mortality increased from 1.6 (SBP2) to 4.2 (SBP4), compared to men in SBP1 (Figure 1A). A similar pattern was observed for diastolic BP (Figure 1B). Conclusion: In this population of middle[[Unable to Display Character: ‑]]aged US men, the increase in BP was strongest in those with the highest BP levels. Trajectories of BP predicted CVD mortality much better than a single BP measurement
    Epidemiology of typical coronay heart disease versus heart disease of uncertain etiology (atypical) fatalities and their relationships with classic coronary risk factors
    Menotti, A. ; Puddu, P.E. ; Lanti, M. ; Kromhout, D. ; Tolonen, H. ; Parapid, B. - \ 2013
    International Journal of Cardiology 168 (2013)4. - ISSN 0167-5273 - p. 3963 - 3967.
    artery disease - myocardial lesions - total cholesterol - european cohorts - 7 countries - mortality - failure - serum - criteria - sudden
    Objectives: The relationships were explored of some cardiovascular risk factors to typical (TYP) and atypical (ATYP) fatal coronary events (CHD). Material and methods: Thirteen cohorts of 40-59 year-old men of the Seven Countries Study were followed-up for 40 years (N = 9704 heart disease free subjects). Fatal TYP-CHD were classified when manifested as myocardial infarction, other acute coronary syndromes, angina pectoris and sudden death; and as ATYP-CHD when manifested only as heart failure or arrhythmia in the absence of other clear etiologies. Death rates were computed for single countries separately for TYP and ATYP and for different lengths of follow-up. Cox models included: age, smoking habits, systolic blood pressure (SBP), serum cholesterol (CHOL), forced expiratory volume in 3/4 sec (FEV) and diabetes. Results: TYP-CHD was more common in North American and Northern European countries, while ATYP-CHD were more common in Southern and Eastern Europe. Age at death was 5 years greater for ATYP-CHD than for TYP-CHD. Cox models in the pool of 13 cohorts showed that coefficient for age was significantly larger for ATYP-CHD (hazard ratio, HR: 2.36; confidence intervals CI: 2.18 - 2.26) versus TYP-CHD (HR 1.50, CI 1.43-1.58) while coefficients for CHOL was larger and significant for TYP-CHD (HR 1.29, CI 1.22-1.35) but not for ATYP-CHD (HR 0.93, CI 0.85-1.03). SBP, smoking habits, FEV and diabetes all predicted both conditions almost equally. Conclusion: The different relationships of CHOL and age with the two types of fatal CHD suggest that the two groups of manifestations may belong to different diseases. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
    Influence of calendar period on the association between BMI and coronary heart disease: a meta-analysis of 31 cohorts : Review
    Hollander, E.L. de; Bogers, R.P. ; Boshuizen, H.C. ; Rosengren, A. ; Shipley, M.J. ; Knekt, P. ; Ducimetiere, P. ; Menotti, A. ; Groot, C.P.G.M. de; Bemelmans, W.J.E. - \ 2013
    Obesity 21 (2013)5. - ISSN 1930-7381 - p. 865 - 880.
    body-mass index - all-cause mortality - cardiovascular risk-factors - monica project populations - life-style factors - follow-up - physical-activity - blood-pressure - western-australia - abdominal obesity
    Objective: The association between obesity and coronary heart disease (CHD) may have changed over time, for example due to improved pharmacological treatment of CHD risk factors. This meta-analysis of 31 prospective cohort studies explores the influence of calendar period on CHD risk associated with body mass index (BMI). Design and Methods: The relative risks (RRs) of CHD for a five-BMI-unit increment and BMI categories were pooled by means of random effects models. Meta-regression analysis was used to examine the influence of calendar period (>1985 v =1985) in univariate and multivariate analyses (including mean population age as a covariate). Results: The age, sex, and smoking adjusted RR (95% confidence intervals) of CHD for a five-BMI-unit increment was 1.28(1.22:1.34). For underweight, overweight and obesity, the RRs (compared to normal weight) were 1.11(0.91:1.36), 1.31(1.22:1.41), and 1.78(1.55:2.04), respectively. The univariate analysis indicated 31% (95%CI: -56:0) lower RR of CHD associated with a five-BMI-unit increment and a 51% (95%CI: -78: -14)) lower RR associated with obesity in studies starting after 1985 (n = 15 and 10, respectively) compared to studies starting in or before 1985 (n = 16 and 10). However, in the multivariate analysis, only mean population age was independently associated with the RRs for a five-BMI-unit increment and obesity (-29(95%CI: -55: -5)) and -31(95%CI: -66:3), respectively) per 10-year increment in mean age). Conclusion: This study provides no consistent evidence for a difference in the association between BMI and CHD by calendar period. The mean population age seems to be the most important factor that modifies the association between the risk of CHD and BMI, in which the RR decreases with increasing age.
    The confusion about dietary fatty acids recommendations for CHD prevention
    Kromhout, D. ; Geleijnse, J.M. ; Menotti, A. ; Jacobs, D.R. - \ 2011
    The British journal of nutrition 106 (2011)5. - ISSN 0007-1145 - p. 627 - 632.
    coronary-heart-disease - cardiovascular-disease - serum-cholesterol - saturated fat - controlled-trials - risk-factors - metaanalysis - carbohydrate - association - cohort
    A recent meta-analysis of prospective cohort studies has not found an association between dietary saturated fat intake and CHD incidence. This funnelled the discussion about the importance of the recommendation to lower the intake of saturated fat for the prevention of CHD. At the same time a document of the European Food Safety Authority has suggested that specific quantitative recommendations are not needed for individual fatty acids but that more general statements can suffice. In this review, we discuss methodological aspects of the absence of association between SFA intake and CHD incidence in prospective cohort studies. We also summarise the results of the controlled dietary experiments on blood lipids and on CHD incidence in which saturated fat was replaced by either cis-unsaturated fat or carbohydrates. Finally, we propose a nutritionally adequate diet with an optimal fatty acid composition for the prevention of CHD in the context of dietary patterns. Such diets are characterised by a low intake of saturated fat, and as low as possible intake of trans-fat and fulfil the requirements for the intake of n-6 and n-3 fatty acids. No recommendation is needed for the intake of cis-MUFA
    Influence of calendar period on the association between body mass index and coronary heart disease in an adult population: a meta-analysis of 31 cohorts
    Hollander, E.L. de; Bogers, R.P. ; Boshuizen, H.C. ; Rosengren, A. ; Shipley, M.J. ; Knekt, P. ; Ducimetière, P. ; Menotti, A. ; Groot, C.P.G.M. de; Bemelmans, W.J.E. - \ 2010
    In: Book of Abstracts of the 3rd European Public Health Conference. - - p. 109 - 109.
    Respiratory function and other biological risk factors for completed suicide: 40 years of follow-up of European cohorts of the Seven Countries Study
    Giltay, E.J. ; Zitman, F.G. ; Menotti, A. ; Nissinen, A. ; Jacobs, D.R. ; Adachi, H. ; Kafatos, A. ; Kromhout, D. - \ 2010
    Journal of Affective Disorders 120 (2010)1-3. - ISSN 0165-0327 - p. 249 - 253.
    body-mass index - serum-cholesterol - united-states - lung-function - men - association - mortality - height - death - ideation
    Background - Prospective cohort studies on biological risk factors of completed suicide are scarce. We aimed to test which biological risk factors independently identify subjects at increased risk of suicidal death. Methods - In the prospective cohort of the Seven Countries Study, 5,321 middle-aged men from Finland, Serbia, Italy, and Greece were included. Completed suicide (ICD-8 codes E950-959) was assessed during 40 years of follow-up. Biological cardiovascular risk factors (including forced vital capacity [FVC] and height) were tested for their role as predictors in multivariable Cox models stratified by country. Results - There were 4518 deaths during follow-up, with 64 from suicide (1.4%). In univariable models, only FVC and height were strongly inversely related with suicide. Socio-economic status and being unmarried were potential confounders. In multivariable models taking these confounders into account, both a low FVC (0.30 for top vs. lowest quartile; 95% CI: 0.12–0.76; P = 0.006 for trend) and a low FVC/height ratio (0.37 for top vs. lowest quartile; 95% CI: 0.17–0.82; P = 0.004 for trend) were strongly inversely related with completed suicide. Limitations - Information on proximal causes, such as prior suicidal ideation, emotional distress and depression, was lacking at baseline. Conclusions - Poor respiratory function in middle-aged men was an independent risk factor for completed suicide
    Cardiovascular risk factors and dementia mortality: 40 years of follow-up in the Seven Countries Study
    Alonso, A. ; Jacobs, D.R. ; Menotti, A. ; Nissinen, A. ; Dontas, A. ; Kafatos, A. ; Kromhout, D. - \ 2009
    Journal of the Neurological Sciences 280 (2009)1-2. - ISSN 0022-510X - p. 79 - 83.
    alzheimers-disease - vascular dementia - cognitive decline - blood-pressure - midlife - smoking - cholesterol - life - atherosclerosis - metaanalysis
    Previous research shows that cardiovascular risk factors in mid-adulthood could increase the risk of dementia later in life, but studies with very long follow-up are still scarce. We assessed whether cardiovascular risk factors measured in midlife were associated with dementia mortality during a 40-year follow-up. 10,211 men, aged 40-59 at baseline, from 13 cohorts of the Seven Countries Study were followed for 40 years. Information on cardiovascular risk factors was obtained at baseline from questionnaires and a physical examination. Dementia death was assigned if there was any mention of dementia on the death certificate. Associations between cardiovascular risk factors and death from dementia were estimated through Cox proportional hazards models. We identified 160 dementia deaths during the follow-up. Smoking, hypercholesterolemia, high blood pressure, low forced vital capacity and previous history of cardiovascular disease at baseline were associated with a higher risk of death from dementia in the follow-up. The hazard ratio (HR) of dementia death among heavy smokers was 1.58 (95% confidence interval (CI) 1.03, 2.43) compared to non-smokers. Similarly, the HR (95% CI) among those with systolic BP -> 160 or diastolic BP -> 95 mm Hg compared to normotensives (<140/90) was 1.55 (1.02, 2.35). Individuals with the largest forced vital capacity had a lower risk of dying of dementia (HR 0.54, 95% CI 0.30, 0.98). Finally, total serum cholesterol was directly associated with higher risk of dementia mortality (p for trend = 0.03). In men, cardiovascular risk factors in midlife are associated with increased risk of dementia death later in life
    Homogeneity in the relationship of serum cholesterol to coronary deaths across different cultures: 40-year follow-up of the Seven Countries Study
    Menotti, A. ; Lanti, M. ; Kromhout, D. ; Blackburn, H. ; Jacobs, D. ; Nissinen, A. ; Dontas, A. ; Kafatos, A. ; Nedeljkovic, S. ; Adachi, H. - \ 2008
    European Journal of Cardiovascular Prevention and Rehabilitation 15 (2008)6. - ISSN 1741-8267 - p. 719 - 725.
    heart-disease - europe - risk - prediction - mortality - project - score
    Background: The aim was to investigate whether multivariate coefficients of serum cholesterol in the prediction of coronary heart disease (CHD) deaths were similar across different cultures in a long-term follow-up. Design: Thirteen cohorts for a total of 10 157 men aged 40¿59 years at entry, enrolled in seven countries (USA, Finland, the Netherlands, Italy, Serbia, Greece, Japan) were repeatedly examined and followed up for 40 years. Methods: Serum cholesterol measured at baseline, and then on repeated occasions, was studied, using multivariate models, in relation with the occurrence of CHD deaths during a 40-year follow-up. Results: Homogeneity of multivariate serum cholesterol coefficients was found considering cholesterol levels at baseline, as average of up to three measurements during the first 10 years, as average of up to six measurements in 35 years, using the time-dependent technique with up to three measurements in 10 years, and with up to six measurement in 35 years. Conclusion: The strength of the association between serum cholesterol and CHD death seems homogeneous across different cultures characterized by different levels of serum cholesterol and different absolute risk of CHD death.
    Effects of Past and Recent Blood Pressure and Cholesterol Level on Coronary Heart Disease and Stroke Mortality, Accounting for Measurement Error - Reply ( letter to the editor
    Boshuizen, H.C. ; Lanti, M. ; Menotti, A. ; Moschandreas, J. ; Tolonen, H. ; Nissinen, A. ; Nedeljkovic, S. ; Kafatos, A. ; Kromhout, D. - \ 2008
    American Journal of Epidemiology 167 (2008)4. - ISSN 0002-9262 - p. 503 - 504.
    The authors aimed to quantify the effects of current systolic blood pressure (SBP) and serum total cholesterol on the risk of mortality in comparison with SBP or serum cholesterol 25 years previously, taking measurement error into account. The authors reanalyzed 35-year follow-up data on mortality due to coronary heart disease and stroke among subjects aged 65 years or more from nine cohorts of the Seven Countries Study. The two-step method of Tsiatis et al. (J Am Stat Assoc 1995;90:27-37) was used to adjust for regression dilution bias, and results were compared with those obtained using more commonly applied methods of adjustment for regression dilution bias. It was found that the commonly used univariate adjustment for regression dilution bias overestimates the effects of both SBP and cholesterol compared with multivariate methods. Also, the two-step method makes better use of the information available, resulting in smaller confidence intervals. Results comparing recent and past exposure indicated that past SBP is more important than recent SBP in terms of its effect on coronary heart disease mortality, while both recent and past values seem to be important for effects of cholesterol on coronary heart disease mortality and effects of SBP on stroke mortality. Associations between serum cholesterol concentration and risk of stroke mortality are weak.
    Forty-year coronary mortality trends and changes in major risk factors in the first 10 years of follow-up in the seven countries study
    Menotti, A. ; Lanti, M. ; Kromhout, D. ; Blackburn, H. ; Nissinen, A. ; Dontas, A. ; Kafatos, A. ; Nedeljkovic, S. ; Adachi, H. - \ 2007
    European Journal of Epidemiology 22 (2007)11. - ISSN 0393-2990 - p. 747 - 754.
    monica project populations - heart-disease mortality - blood-pressure changes - all-cause mortality - cardiovascular-diseases - european cohorts - serbian cohorts - event rates - deaths - cholesterol
    Time trends in coronary heart disease (CHD) mortality during a 40-year follow-up were studied in the Seven Countries Study. Thirteen cohorts of men aged 40¿59 at entry were enrolled in seven countries (USA, Finland, the Netherlands, Italy, Serbia, Greece and Japan) for a total of 10,628 subjects. Cardiovascular risk factors were measured at entry and at the 10-year follow-up examination and coronary heart disease mortality data collected during 40 years. During the 40-year follow-up, the hazard rate of the Weibull parametric distribution (annual conditional risk of death) for CHD mortality tended to slightly decline in the US, Finnish, Dutch and Japanese cohorts, moderately increased in Italy and exponentially increased in cohorts of Serbia and Greece. A strong positive association was found between the shape of the hazard curve, describing the acceleration of the hazard, and a score of population mean risk factor changes (serum cholesterol, systolic blood pressure and smoking prevalence) observed during the first 10 years of follow-up, with a correlation coefficient of 0.91 between the two indicators. The countries with a relative decline in the annual hazard function were the same where, during the same historical period, large decreases in official death rate from CHD were recorded, and viceversa. The acceleration in mortality risk for CHD mortality in different countries, described by the shape of the Weibull distribution, is related to changes in mean levels of major coronary risk factors.
    Effects of Past and Recent Blood Pressure and Cholesterol Level on Coronary Heart Disease and Stroke Mortality, Accounting for Measurement Error
    Boshuizen, H.C. ; Lanti, M. ; Menotti, A. ; Moschandreas, J. ; Tolonen, H. ; Nissinen, A. ; Nedeljkovic, S. ; Kafatos, A. ; Kromhout, D. - \ 2007
    American Journal of Epidemiology 165 (2007)4. - ISSN 0002-9262 - p. 398 - 409.
    regression dilution bias - serum total cholesterol - all-cause mortality - cardiovascular-disease - follow-up - risk-factors - 7 countries - metaanalysis - age - underestimation
    The authors aimed to quantify the effects of current systolic blood pressure (SBP) and serum total cholesterol on the risk of mortality in comparison with SBP or serum cholesterol 25 years previously, taking measurement error into account. The authors reanalyzed 35-year follow-up data on mortality due to coronary heart disease and stroke among subjects aged 65 years or more from nine cohorts of the Seven Countries Study. The two-step method of Tsiatis et al. (J Am Stat Assoc 1995;90:27¿37) was used to adjust for regression dilution bias, and results were compared with those obtained using more commonly applied methods of adjustment for regression dilution bias. It was found that the commonly used univariate adjustment for regression dilution bias overestimates the effects of both SBP and cholesterol compared with multivariate methods. Also, the two-step method makes better use of the information available, resulting in smaller confidence intervals. Results comparing recent and past exposure indicated that past SBP is more important than recent SBP in terms of its effect on coronary heart disease mortality, while both recent and past values seem to be important for effects of cholesterol on coronary heart disease mortality and effects of SBP on stroke mortality. Associations between serum cholesterol concentration and risk of stroke mortality are weak.
    Determinants of longevity and all-cause mortality among middle-aged men. Role of 48 personal characteristics in 40-year follow-up of Italian Rural Areas in the Seven Countries Study.
    Menotti, A. ; Lanti, M. ; Maiani, G. ; Kromhout, D. - \ 2006
    Aging clinical and experimental research 18 (2006)5. - ISSN 1594-0667 - p. 394 - 406.
    coronary-heart-disease - cardiovascular risk-factors - factor intervention trial - body-mass index - physical-activity - blood-pressure - cholesterol - women - survival - smoking
    Background and aims: Forty-year all-cause mortality and its association with entry risk factor levels are reported for men enrolled in the Italian Rural Areas of the Seven Countries Study of Cardiovascular Diseases. Methods: Forty-eight potential risk factors were measured in 1712 men aged 40-59 at entry examination in 1960. Mortality data were collected during 40 years of follow-up. The relationship of entry risk factor levels with all-cause mortality was studied by univariate and multivariate approaches. Results: Overall death rate was 83.7%. The main causes of death were cardiovascular diseases, followed by cancer and others. The 48 risk factors were tested with univariate and multivariate approaches. In the final model, 15 risk factors were strongly and significantly related to all-cause mortality and survival. They were age, father and mother history of premature mortality, cigarette smoking, job-related physical activity (protective), body mass index (BMI) (in an inverse J-shaped fashion), mid-arm circumference (protective), mean blood pressure, forced respiratory volume in 314 seconds (protective), serum cholesterol, corneal arcus, xanthelasma, presence of cardiovascular diseases, cancer and diabetes at entry examination, Conclusions: During a 40-year period 15 mainly cardiovascular risk factors were highly predictive of all-cause mortality and survival in middle-aged men. (c) 2006, Editrice Kurtis.
    The relationship of age, blood pressure, serum cholesterol and smoking habits with the risk of typical and atypical coronary heart disease death in the European cohorts of the Seven Countries Study
    Menotti, A. ; Lanti, M. ; Nedeljkovic, S. ; Nissinen, A. ; Kafatos, A. ; Kromhout, D. - \ 2006
    International Journal of Cardiology 106 (2006)2. - ISSN 0167-5273 - p. 157 - 163.
    7 countries - population - failure
    Objective: To explore whether "typical" coronary heart disease (CHD) such as fatal myocardial infarction and sudden death relate to major cardiovascular risk factors in the same way as the "atypical" CHD, such as fatal heart failure and chronic arrhythmias. Design and setting: Ten cohorts (6633 cardiovascular disease-free men, aged 40-59) in five European countries were examined, age and three major risk factors were measured (systolic blood pressure, serum cholesterol, and smoking habits) and 35-year mortality data were collected. Proportional hazard models were solved with typical and atypical CHD deaths treated separately. Results: Death rates from typical and atypical CHD were inversely related among the five countries. Mean age at death was significantly higher for atypical than typical (75.8 versus 71.6 years; p <0.001). In the multivariate analysis conducted on pools of 5 countries (adjusted for countries), the relationship of risk factors with typical CHD was direct and significant for age (hazard ratio-HR-for 5 years of age 1.44 (95% CI 1.36-1.52)), systolic blood pressure (HR for 20 mm Hg, 1.39 (95% CI 1.32-1.47)), serum cholesterol (HR for 1 mmol/l of 1.22 (95% CI 1.16-1.27)) and smoking habits (HR smokers versus non-smokers of 1.39 (95% CI 1.24-1.57)). For atypical CHD, age had a larger HR of 2.27 (95% CI 2.05-2.52), systolic blood pressure had a smaller HR of 1.28 (95% CI 1.16-1.41), serum cholesterol had an inverse non-significant HR of 0.90 (0.58-1.58) and smoking habits had a larger HR of 1.54 (95% CI 1.26-1.89). Conclusions: Age and serum cholesterol were differently related with typical and atypical CHD deaths, suggesting different etiologies for these coronary diseases
    Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women: The HALE project
    Knoops, K.T.B. ; Groot, C.P.G.M. de; Kromhout, D. ; Perrin, A.E. ; Moreiras-Varela, O. ; Menotti, A. ; Staveren, W.A. van; Roth, Z. ; Brown, G. - \ 2005
    Evidence-Based Ophthalmology 6 (2005)1. - ISSN 1555-9203 - p. 48 - 49.
    Short and long term association of a single serum cholesterol measurement in middle-aged men in prediciton of fatal coronary and other cardiovascular events: a cross-cultural comparison through Europe
    Menotti, A. ; Lanti, M. ; Kromhout, D. ; Kafatos, A. ; Nedeljkovic, S. ; Nissinen, A. - \ 2005
    European Journal of Epidemiology 20 (2005)7. - ISSN 0393-2990 - p. 597 - 604.
    heart-disease mortality - all-cause mortality - major risk-factors - blood-pressure - follow-up - 7 countries - cohorts - stroke - deaths - people
    Aims: The purpose was to study the association of a single serum cholesterol measurement with early and late coronary and other cardiovascular deaths during 35 years of follow-up in samples of men aged 40¿59 years in five European countries. Methods and results: A single serum total cholesterol measurement was considered in samples from Finland (N = 1563), the Netherlands (N = 811), Italy (N = 1642), Serbia (N = 1537) and Greece (N = 1158) (total = 6711). Seven partitioned proportional hazards models were solved, one for each of seven independent 5-year blocks, to predict coronary, stroke, cardiovascular disease and all-cause mortality risk. Partitioned hazard scores were cumulated. The resulting curves showed a relatively constant strength in risk for coronary deaths as a function of baseline serum cholesterol levels, although a strong relationship during the first 10-year period was followed by a weaker relationship later on. The pooled estimates for the five countries gave a relative risk for 1 mmol/l of serum cholesterol (95% confidence intervals) of 1.44 (1.23¿1.68) for the first period; 1.52 (1.31¿1.76) for the second period; and 1.16 (1.02¿1.32) for the third period; 1.18 (1.05¿1.32) for the forth period; 1.17 (1.05¿1.31) for the fifth period; 1.22 (1.10¿1.35) for the sixth period; 1.18 (1.05¿1.32) for the seventh 5-year period of follow-up. No significant relationship were found between serum cholesterol and stroke and all-cause mortality, while intermediate findings were obtained for cardiovascular diseases. Conclusion: A single serum cholesterol measurement in middle aged-men maintains a strong relationship with the occurrence of coronary heart disease (CHD) deaths during 35 years of follow-up.
    Long-term predictors of survival for the Seven Countries Study cohort from Crete : from 1960 to 2000
    Moschandreas, J. ; Kafatos, A. ; Aravanis, C. ; Dontas, A. ; Menotti, A. ; Kromhout, D. - \ 2005
    International Journal of Cardiology 100 (2005)1. - ISSN 0167-5273 - p. 85 - 91.
    coronary-heart-disease - all-cause mortality - blood-pressure - risk-factors - 25-year mortality - stroke mortality - corfu cohort - follow-up - cholesterol - population
    Background: In 1960, all male inhabitants of a series of villages in rural Crete, born between 1900 and 1919, were invited to participate in the Seven Countries Study. Analysis of 25-year mortality data from the 16 cohorts of participants indicated that the cohort from Crete had the lowest age-standardised all-cause and coronary heart disease death rates. Methods: At baseline, 686 Cretan men (98% of those invited) participated in health examinations. Mortality data were collected over 40 years. Time-fixed and updated covariate survival analysis techniques were applied to assess eight cardiovascular disease risk factors as long-term predictors of all-cause and cardiovascular disease mortality. Results: The median survival time was 32 years. All-cause and cardiovascular mortality rates were 26 and I I per 1000 person-years, respectively. Age (relative risk 1.11, 95% CI 1.09-1.13), diastolic blood pressure (relative risk 1.02, 95% CI 1.01-1.03), and smoking (relative risk 1.37, 95% CI 1.14-1.64) were positively associated and forced expiratory volume (relative risk 0.50, 95% Cl 0.36-0.68) was negatively associated with all-cause mortality. Age (relative risk 1.13, 95%CI 1.09-1.16), diastolic blood pressure (relative risk 1.01, 95%CI 1.001-1.03), and forced expiratory volume (relative risk 0.53, 95% CI 0.32-0.89) were independent predictors of cardiovascular mortality. Serum cholesterol concentration and body mass index were not independently associated with death risk. Conclusions: The Cretan cohort displays favourable 40-year survival. Even so, long-term predictors of the hazard of both all-cause and cardiovascular disease mortality are present. (c) 2005 Elsevier Ireland Ltd. All rights reserved.
    Mediterranean Diet, Lifestyle Factors, and 10-year Mortality in Elderly European Men and Women. The HALE Project
    Knoops, K.T.B. ; Groot, L.C.P.G.M. de; Kromhout, D. ; Perrin, A.E. ; Moreiras-Varela, O. ; Menotti, A. ; Staveren, W.A. van - \ 2004
    JAMA: The Journal of the American Medical Association 292 (2004)12. - ISSN 0098-7484 - p. 1433 - 1439.
    coronary-heart-disease - physical-activity - smoking-cessation - health behaviors - risk-factors - older men - cohort - survival - questionnaire - prevention
    Context Dietary patterns and lifestyle factors are associated with mortality from all causes, coronary heart disease, cardiovascular diseases, and cancer, but few studies have investigated these factors in combination. Objective To investigate the single and combined effect of Mediterranean diet, being physically active, moderate alcohol use, and nonsmoking on all-cause and cause-specific mortality in European elderly individuals. Design, Setting, and Participants The Healthy Ageing: a Longitudinal study in Europe (HALE) population, comprising individuals enrolled in the Survey in Europe on Nutrition and the Elderly: a Concerned Action (SENECA) and the Finland, Italy, the Netherlands, Elderly (FINE) studies, includes 1507 apparently healthy men and 832 women, aged 70 to 90 years in 11 European countries. This cohort study was conducted between 1988 and 2000. Main Outcome Measures Ten-year mortality from all causes, coronary heart disease, cardiovascular diseases, and cancer. Results During follow-up, 935 participants died: 371 from cardiovascular diseases, 233 from cancer, and 145 from other causes; for 186, the cause of death was unknown. Adhering to a Mediterranean diet (hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.68-0.88), moderate alcohol use (HR, 0.78; 95% Cl, 0.67-0.91), physical activity (HR, 0.63; 95% Cl, 0.55-0.72), and nonsmoking (HR, 0.65; 95% Cl, 0.57-0.75) were associated with a lower risk of all-cause mortality (HRs controlled for age, sex, years of education, body mass index, study, and other factors). Similar results were observed for mortality from coronary heart disease, cardiovascular diseases, and cancer. The combination of 4 low risk factors lowered the all-cause mortality rate to 0.35 (95% Cl, 0.28-0.44). In total, lack of adherence to this low-risk pattern was associated with a population attributable risk of 60% of all deaths, 64% of deaths from coronary heart disease, 61% from cardiovascular diseases, and 60% from cancer. Conclusion Among individuals aged 70 to 90 years, adherence to a Mediterranean diet and healthful lifestyle is associated with a more than 50% lower rate of all-causes and cause-specific mortality.
    Cohort analysis of fruit and vegetable consumption and lung cancer mortality in European men
    Jansen, M.C.J.F. ; Bueno-de Mesquita, H.B. ; Rasanen, L. ; Fidanza, F. ; Nissinen, A.M. ; Menotti, A. ; Kok, F.J. - \ 2001
    International Journal of Cancer 92 (2001)9. - ISSN 0020-7136 - p. 913 - 918.
    Our aim was to examine the relationship between fruit and vegetable consumption and lung cancer mortality in a cohort of European males. Around 1970, dietary intake of Finnish, Italian and Dutch middle-aged men was assessed using a cross-check dietary history. Complete baseline information was available for 3,108 men, of whom 1,578 were baseline smokers. We used Cox proportional hazard analyses to calculate risk estimates for the consumption in country-specific tertiles on lung cancer in smokers. During 25 years of follow-up, 149 lung cancer deaths occurred in the smokers. Fruit consumption was inversely associated with lung cancer mortality among smokers; compared with the lowest, adjusted RRs for the intermediate and highest tertiles were 0.56 (0.37-0.84) and 0.69 (0.46-1.02), p-trend 0.05. Only in the Dutch cohort was this association statistically significant [adjusted relative risks (RRs) 1.00, 0.33 (0.16-0.70) and 0.35 (0.16-0.74), p-trend 0.004]. In Finland lung cancer risk was lower with higher fruit intake but not significantly, whereas in Italy no association was observed. Stratifying on cigarette smoking intensity (non, light and heavy) revealed an inverse association in the heavy smokers only [adjusted RRs (95␌onfidence intervals [CI]) 1; 0.47 (0.26-0.84); 0.40 (0.20-0.78)). Vegetable consumption was not related to lung cancer risk in smokers. However, analyses stratified on cigarette smoking intensity gave some indication for a lower lung cancer risk with higher intake. In conclusion, in this prospective analysis among European smoking men, fruit intake was inversely related to lung cancer mortality. This association was confined to heavy cigarette smokers.
    Role of smoking and diet in the cross-cultural variation in lung-cancer mortality : the Seven Countries Study
    Mulder, I. ; Jansen, M.C.J.F. ; Smit, H.A. ; Jacobs, D.R. ; Menotti, A. ; Nissinen, A. ; Kromhout, D. - \ 2000
    International Journal of Cancer 88 (2000). - ISSN 0020-7136 - p. 665 - 671.
    We examined the role of smoking and diet in the cross-cultural variation in lung-cancer mortality, using aggregated data of the Seven Countries Study, a follow-up study comprising 12,763 middle-aged men in 16 cohorts in Europe, the United States and Japan, which started around 1960. Smoking habits were assessed with a standardised questionnaire. Dietary intake was collected in random sub-samples of each cohort by the dietary record method. Cohort-specific 25-year lung-cancer mortality among all men and among categories of smoking behaviour was related to smoking prevalence and population average dietary intake, respectively, using Poisson regression. Smoking prevalence was positively associated with lung-cancer mortality [risk ratio 1.47, 95␌onfidence interval (CI) 1.05-2.07, for an increase of 10 percentage points]. Lung-cancer mortality among smokers, which varied significantly among cultures, was positively associated with average fat intake, especially saturated fat intake (rate ratio 1.10, 95␌I 1.04-1.17, for an increase of 4.6 g) but not with unsaturated fat intake. Average fruit and vegetable intake were not related to lung-cancer mortality. Among never-smokers, the power to detect associations was low. In conclusion, both smoking prevalence and average fat intake, especially saturated fat, may play a role in the cross-cultural variation in lung-cancer mortality, either independently or by effect modification
    Fruit and vegetable consumption and lung cancer among smokers in Finland, Italy and The Netherlands
    Jansen, M.C.J.F. ; Bueno-de Mesquita, H.B. ; Nissinen, A.M. ; Fidanza, F. ; Menotti, A. ; Kok, F.J. ; Kromhout, D. - \ 2000
    In: Dietary anticarcinogens and antimutagens : Food and Cancer Prevention III, East Anglia 1999 / Johnson, I.T., Fenwick, G.R., Cambridge : RSC - p. 31 - 32.
    Dietary factors and pulmonary function : a cross-sectional study in middle-aged men from three European countries
    Tabak, C. ; Smit, H.A. ; Rasanen, L. ; Fidanza, F. ; Menotti, A. ; Nissinen, A. ; Feskens, E.J.M. ; Heederik, D. - \ 1999
    Thorax 54 (1999). - ISSN 0040-6376 - p. 1021 - 1026.
    Dietary fiber and plant foods in relation to colorectal cancer mortality: the seven countries study
    Jansen, M.C.J.F. ; Bueno-de-Mesquita, H.B. ; Buzina, R. ; Fidanza, F. ; Menotti, A. ; Kok, F.J. ; Kromhout, D. - \ 1999
    International Journal of Cancer 81 (1999). - ISSN 0020-7136 - p. 174 - 179.
    The cross-sectional association between fruit consumption and pulmonary function in middle-aged men.
    Tabak, C. ; Smit, H.A. ; Feskens, E.J.M. ; Heederik, D. ; Rasanen, L. ; Nissinen, A. ; Fidanza, F. ; Menotti, A. ; Kromhout, D. - \ 1998
    European Respiratory Journal 12 (1998). - ISSN 0903-1936 - p. 402S - 402S.
    Fruit and fish consumption: a possible explanation for population differences in COPD mortality (The Seven Countries Study).
    Tabak, C. ; Feskens, E.J.M. ; Heederik, D. ; Kromhout, D. ; Menotti, A. ; Blackburn, H.W. - \ 1998
    European Journal of Clinical Nutrition 52 (1998). - ISSN 0954-3007 - p. 819 - 825.
    The effect of changes in smoking behaviour on the prediction of mortality.
    Mulder, I. ; Smit, H.A. ; Menotti, A. - \ 1998
    Irish Journal of Medical Science 167 (1998). - p. 16S - 16S.
    Potential markers for fruit and vegetable intake.
    Jansen, M.C.J.F. ; Ocke, M.C. ; Menotti, A. - \ 1998
    European Journal of Clinical Nutrition 52 (1998). - ISSN 0954-3007 - p. S47 - S47.
    Adherence to the European code against cancer in relation to long-term cancer mortality: intercohort comparisons from the Seven Countries Study.
    Ocke, M.C. ; Bueno-de Mesquita, H.B. ; Feskens, E.J.M. ; Kromhout, D. ; Menotti, A. ; Blackburn, H. - \ 1998
    Nutrition and Cancer 30 (1998). - ISSN 0163-5581 - p. 14 - 20.
    De Europese code tegen kanker in relatie tot kankersterfte: tussencohort vergelijkingen in de zeven landen studie.
    Ock, M.C. ; Bueno de Mesquita, H.B. ; Feskens, E.J.M. ; Menotti, A. ; Blackburn, H. ; Kromhout, D. - \ 1997
    Tijdschrift voor sociale geneeskunde 3 (1997). - ISSN 0040-7607 - p. 19 - 19.
    Dietary pattern and 20 year mortality in elderly men in Finland, Italy and the Netherlands: Longitudinal cohort study.
    Huijbregts, P. ; Feskens, E.J.M. ; Résénen, L. ; Fidanza, F. ; Nissinen, A. ; Menotti, A. ; Kromhout, D. - \ 1997
    BMJ: British Medical Journal 315 (1997)7099. - ISSN 0959-8138 - p. 13 - 17.
    OBJECTIVE: To investigate the association of dietary pattern and mortality in international data. DESIGN: Cohort study with 20 years' follow up of mortality. SETTING: Five cohorts in Finland, the Netherlands, and Italy. SUBJECTS: Population based random sample of 3045 men aged 50-70 years in 1970. MAIN OUTCOME MEASURES: Food intake was estimated using a cross check dietary history. In this dietary survey method, the usual food consumption pattern in the 6-12 months is estimated. A healthy diet indicator was calculated for the dietary pattern, using the World Health Organisation's guidelines for the prevention of chronic diseases. Vital status was verified after 20 years of follow up, and death rates were calculated. RESULTS: Dietary intake varied greatly in 1970 between the three countries. In Finland and the Netherlands the intake of saturated fatty acids and cholesterol was high and the intake of alcohol was low; in Italy the opposite was observed. In total 1796 men (59%) died during 20 years of follow up. The healthy diet indicator was inversely associated with mortality (P for trend < 0.05). After adjustment for age, smoking, and alcohol consumption, the relative risk in the group with the healthiest diet indicator compared with the group with the least healthy was 0.87 (95% confidence interval 0.77 to 0.98). Estimated relative risks were essentially similar within each country. CONCLUSIONS: Dietary intake of men aged 50-70 is associated with a 20 year, all cause mortality in different cultures. The healthy diet indicator is useful in evaluating the relation of mortality to dietary patterns.
    Alcohol, fish, fibre and antioxidant vitamins intake do not explain population differences in coronary heart diseases mortality.
    Kromhout, D. ; Bloemberg, B.P.M. ; Feskens, E.J.M. ; Hertog, M.G.L. ; Menotti, A. ; Blackburn, H. - \ 1996
    International Journal of Epidemiology 25 (1996). - ISSN 0300-5771 - p. 753 - 759.
    Twenty-five-year prediction of stroke deaths in the seven countries study: the role of blood pressure and its changes.
    Menotti, A. ; Blackburn, H. ; Jacobs Jr., D.R. ; Kromhout, D. ; Nissinen, A. ; Nedeljkovic, S. ; Buzina, R. ; Mohacek, I. ; Seccareccia, F. ; Giampaoli, S. ; Dontas, A. ; Aravanis, C. ; Toshima, H. - \ 1996
    Stroke 27 (1996). - ISSN 0039-2499 - p. 381 - 387.
    Short term all-cause mortality and its determinants in elderly populations in Finland, The Netherlands and Italy, The FINE study.
    Menotti, A. ; Kromhout, D. ; Nissinen, A. ; Giampaoli, S. ; Seccareccia, F. ; Feskens, E.J.M. ; Pekkanen, J. ; Tervahanta, M. - \ 1996
    Preventive Medicine 25 (1996). - ISSN 0091-7435 - p. 319 - 327.
    Comparison of multivariate predictive power of major risk factors for coronary heart diseases in different countries: results from eight nations of the Seven Countries Study, 25-year follow-up
    Menotti, A. ; Keys, A. ; Blackburn, H. ; Kromhout, D. ; Karvonen, M. ; Nissinen, A. ; Pekkanen, J. ; Punsar, S. ; Fidanza, F. ; Giampaoli, S. ; Seccareccia, F. ; Buzina, R. ; Mohacek, I. ; Nedeljkovic, S. ; Aravanis, C. ; Dontas, A. ; Toshima, H. ; Lanti, M. - \ 1996
    Journal of Cardiovascular Risk 3 (1996). - ISSN 1350-6277 - p. 69 - 75.
    Twenty-five year mortality from coronary heart disease and its prediction in two Croatian cohorts of middle-aged men.
    Buzina, R. ; Mohacek, I. ; Menotti, A. ; Seccareccia, F. ; Lanti, M. ; Kromhout, D. ; Keys, A. - \ 1995
    European Journal of Epidemiology 11 (1995). - ISSN 0393-2990 - p. 259 - 267.
    Erratum: Flavonoid intake and long-term risk of coronary heart disease and cancer in the seven countries study.
    Hertog, M.G. ; Kromhout, D. ; Aravanis, C. ; Blackburn, H. ; Buzina, R. ; Fidanza, F. ; Giampaoli, S. ; Jansen, A. ; Menotti, A. ; Nedeljkovic, S. ; Pekkarinen, M. ; Simic, B.S. ; Toshima, H. ; Feskens, E.J.M. ; Hollman, P.C.H. ; Katan, M.B. - \ 1995
    Archives of Internal Medicine 155 (1995). - ISSN 0003-9926 - p. 1184 - 1184.
    Dietary saturated and trans fatty acids and cholesterol and 25-year mortality from coronary heart disease: the seven countries study.
    Kromhout, D. ; Menotti, A. ; Bloemberg, B. ; Aravanis, C. ; Blackburn, H. ; Buzina, R. ; Dontas, A.S. ; Fidanza, F. ; Gianpaolo, S. ; Jansen, A. ; Karvonen, M. ; Katan, M.B. ; Nissinen, A. ; Nedeljkovic, S.I. ; Pekkanen, J. ; Pekkarinen, M. ; Punsar, S. ; Räsänen, L. ; Simic, B. ; Toshima, H. - \ 1995
    Preventive Medicine 24 (1995). - ISSN 0091-7435 - p. 308 - 315.
    Background. In the Seven Countries Study associations between intake of individual fatty acids and dietary cholesterol were studied in relation to serum cholesterol and 25-year mortality from coronary heart disease. All analyses concern only intercohort comparisons. Methods. In the baseline surveys carried out between 1958 and 1964, risk factors for coronary heart disease were measured among 12,763 middle-aged men constituting 16 cohorts in seven countries. In 1987 and 1988 equivalent food composites representing the average food intake of each cohort at baseline were collected locally and analyzed in a central laboratory. The vital status of all participants was verified at regular intervals during 25 years of follow-up. Results. Of the individual saturated fatty acids, the average population intake of lauric and myristic acid was most strongly related to the average serum cholesterol level (r > 0.8, P < 0.001). Strong positive associations were observed between 25-year death rates from coronary heart disease and average intake of the four major saturated fatty acids, lauric, myristic, palmitic, and stearic acid (r > 0.8, P < 0.001); the trans fatty acid elaidic acid (r = 0.78, P < 0.001); and dietary cholesterol (r = 0.55, P < 0.05). Conclusions. Interpreted in the light of experimental and clinical studies, the results of these cross-cultural analyses suggest that dietary saturated and trans fatty acids and dietary cholesterol are important determinants of differences in population rates of coronary heart disease death.
    Changes in body weight in relation to mortality in 6441 European middle-aged men: the seven countries study.
    Peters, E.Th.J. ; Seidell, J.C. ; Menotti, A. ; Aravanis, C. ; Dontas, A. ; Fidanza, F. ; Karvonen, M. ; Nedeljkovic, S. ; Nissinen, A. ; Bloemberg, B. ; Kromhout, D. - \ 1995
    International Journal of Obesity 19 (1995). - ISSN 0307-0565 - p. 862 - 868.
    Average intake of anti-oxidant(pro)vitamins and subsequent cancer mortality in the 16 cohorts of the Seven Countries Study.
    Ocke, M.C. ; Kromhout, D. ; Menotti, A. ; Aravanis, C. ; Blackburn, H. ; Buzina, R. ; Fidanza, F. ; Jansen, A. ; Nedeljkovic, S. ; Pekkarinen, M. ; Toshima, H. - \ 1995
    International Journal of Cancer 61 (1995). - ISSN 0020-7136 - p. 480 - 484.
    Flavonoid intake and long-term risk of coronary heart disease and cancer in the seven countries study.
    Hertog, M.G.L. ; Kromhout, D. ; Aravanis, C. ; Blackburn, H. ; Buzina, R. ; Fidanza, F. ; Giampaoli, S. ; Jansen, A. ; Menotti, A. ; Nedeljkovic, S.I. ; Pekkarinen, M. ; Simic, B.S. ; Toshima, H. ; Feskens, E.J.M. ; Hollman, P.C.H. ; Katan, M.B. - \ 1995
    Archives of Internal Medicine 155 (1995). - ISSN 0003-9926 - p. 381 - 386.
    To determine whether flavonoid intake explains differences in mortality rates from chronic diseases between populations. DESIGN: Cross-cultural correlation study. SETTING/PARTICIPANTS: Sixteen cohorts of the Seven Countries Study in whom flavonoid intake at baseline around 1960 was estimated by flavonoid analysis of equivalent food composites that represented the average diet in the cohorts. MAIN OUTCOME MEASURES: Mortality from coronary heart disease, cancer (various sites), and all causes in the 16 cohorts after 25 years of follow-up. RESULTS: Average intake of antioxidant flavonoids was inversely associated with mortality from coronary heart disease and explained about 25 f the variance in coronary heart disease rates in the 16 cohorts. In multivariate analysis, intake of saturated fat (73 P = 0.0001), flavonoid intake (8°P = .01), and percentage of smokers per cohort (9 P = .03) explained together, independent of intake of alcohol and antioxidant vitamins, 90 f the variance in coronary heart disease rates. Flavonoid intake was not independently associated with mortality from other causes. CONCLUSIONS: Average flavonoid intake may partly contribute to differences in coronary heart disease mortality across populations, but it does not seem to be an important determinant of cancer mortality.
    Dietary patterns and 20-year mortality in elderly men in Finland, Italy and the Netherlands.
    Huijbregts, P.P.C.W. ; Feskens, E.J.M. ; Rasanen, L. ; Fidanza, F. ; Nissinen, A. ; Menotti, A. ; Kromhout, D. - \ 1995
    In: Perspectives on epidemiology in Europe. Abstracts IEA Regional Meeting, The Hague (1995) 22.05
    Serum total cholesterol and long-term coronary heart disease mortality in different cultures. Twenty-five-year follow-up of the seven countries study.
    Verschuren, W.M.M. ; Jacobs, D.R. ; Bloemberg, B.P.M. ; Kromhout, D. ; Menotti, A. ; Aravanis, C. ; Blackburn, H. ; Buzina, R. ; Dontas, A.S. ; Fidanza, F. ; Karvonen, M.J. ; Nedeljkovic, S. ; Nissinen, A. ; Toshima, H. - \ 1995
    JAMA: The Journal of the American Medical Association 274 (1995). - ISSN 0098-7484 - p. 131 - 136.
    Changes in major risk factors for cardiovascular diseases over 25 years in the Serbian cohorts of the Seven Countries Study.
    Kromhout, D. ; Nedeljkovic, S.I. ; Grujic, M.Z. ; Ostojic, M.C. ; Keys, A. ; Menotti, A. ; Katan, M.B. ; Oostrom, M.A. van; Bloemberg, B.P.M. - \ 1994
    International Journal of Epidemiology 23 (1994). - ISSN 0300-5771 - p. 5 - 11.
    The Serbian cohorts of the Seven Countries Study were examined four times during a 25-year period. Large changes were observed in average serum cholesterol, blood pressure and the prevalence of smoking in these ageing cohorts. Comparison of men of the same age strata e.g. men aged 50-59 examined at baseline and after 10 years of follow-up and of men aged 65-69 examined after 10 and 25 years of follow-up showed that serum cholesterol increased by about 45% in Zrenjanin, 35% in Velika Krsna and 15% in Belgrade over the last 25 years. Systolic blood pressure increased by 9% in Zrenjanin and 7% in Velika Krsna. No significant increase in systolic blood pressure was observed in Belgrade. There was no major secular trend in smoking and the changes observed during 25 years were mainly due to ageing. No major change was observed in body mass index. The increases in serum cholesterol and blood pressure observed in the Serbian cohorts during the last 25 years are compatible with the increase in cardiovascular disease mortality observed in Yugoslavian men aged 30-69 during the period 1970-1984.
    Letter: Serum cholesterol and long-term death rates from suicide, accidents, or violence.
    Kromhout, D. ; Katan, M.B. ; Menotti, A. ; Keys, A. ; Bloemberg, B.P. - \ 1992
    The Lancet 340 (1992). - ISSN 0140-6736 - p. 317 - 317.
    Check title to add to marked list

    Show 20 50 100 records per page

     
    Please log in to use this service. Login as Wageningen University & Research user or guest user in upper right hand corner of this page.