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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.
Eur J Clin Nutr 2018; 72(8):1103-1110EJ

Abstract

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.

Authors+Show Affiliations

Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.Association for Cardiac Research, Rome, Italy.Human Nutrition Section, Department of Neurosciences, University of Rome, Rome, Italy.Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University of Rome, Rome, Italy. paoloemilio.puddu@uniroma1.it.Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.Department of Social Medicine, Preventive Medicine and Nutrition Clinic, University of Crete, Heraklion, Greece.Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland.Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University, School of Medicine, Kurume, Japan.Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29769748

Citation

Kromhout, Daan, et al. "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." European Journal of Clinical Nutrition, vol. 72, no. 8, 2018, pp. 1103-1110.
Kromhout D, Menotti A, Alberti-Fidanza A, et al. 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. Eur J Clin Nutr. 2018;72(8):1103-1110.
Kromhout, D., Menotti, A., Alberti-Fidanza, A., Puddu, P. E., Hollman, P., Kafatos, A., ... Jacobs, D. R. (2018). 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. European Journal of Clinical Nutrition, 72(8), pp. 1103-1110. doi:10.1038/s41430-018-0183-1.
Kromhout D, et al. 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. Eur J Clin Nutr. 2018;72(8):1103-1110. PubMed PMID: 29769748.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Kromhout,Daan, AU - Menotti,Alessandro, AU - Alberti-Fidanza,Adalberta, AU - Puddu,Paolo Emilio, AU - Hollman,Peter, AU - Kafatos,Anthony, AU - Tolonen,Hanna, AU - Adachi,Hisashi, AU - Jacobs,David R,Jr Y1 - 2018/05/17/ PY - 2017/06/09/received PY - 2018/03/20/accepted PY - 2018/03/16/revised PY - 2018/5/18/pubmed PY - 2019/5/14/medline PY - 2018/5/18/entrez SP - 1103 EP - 1110 JF - European journal of clinical nutrition JO - Eur J Clin Nutr VL - 72 IS - 8 N2 - 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. SN - 1476-5640 UR - https://www.unboundmedicine.com/medline/citation/29769748/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_ L2 - http://dx.doi.org/10.1038/s41430-018-0183-1 DB - PRIME DP - Unbound Medicine ER -