In our understanding, the very purpose of a meta-analysis is to arrive at a judgment of an associ... more In our understanding, the very purpose of a meta-analysis is to arrive at a judgment of an association from analyzing a large base of evidence, which usually means several original studies—surely more than a single study, and preferably 2 studies. However, the analysis by Barclay et al of the association of GI and GL with stroke risk, for example, is based on a single study by Oh et al (2). A quick look at Figure 3 (on page 635 of the meta-analysis) suggests that several studies have been summed up, but a closer look reveals that the first point estimate is for lean subjects and the second is for overweight subjects from the study by Oh et al, and that the last 2 figures give fixed-and random-effects estimates based on the first 2 figures. Heart disease (also in Figure 3) does not fare much better: only 2 studies are referenced (3, 4). Furthermore, although the label "heart disease" is a good approximation of coronary heart disease (3, 4), the label "eye disease"...
Sample pretreatment and chromatographic method for urinary plant and mammalian lignans is present... more Sample pretreatment and chromatographic method for urinary plant and mammalian lignans is presented. HPLC with Coulometric Electrode Array Detection (CEAD) was used for measuring. Effects of controlled diet on plant and mammalian lignan excretion are compared to the effects of habitual diet. Also some preliminary data of urinary plant and mammalian lignans of the ASAP study is presented.
Low vitamin D status increases the risk of death. Magnesium plays an essential role in vitamin D ... more Low vitamin D status increases the risk of death. Magnesium plays an essential role in vitamin D metabolism and low magnesium intake may predispose to vitamin D deficiency and potentiate the health problems. We investigated whether magnesium intake modifies the serum 25(OH)D3 concentration and its associations with mortality in middle-aged and older men. We included 1892 men aged 42-60 years without cardiovascular disease or cancer at baseline in 1984-1989 from the prospective, population-based Kuopio Ischaemic Heart Disease Risk Factor Study. Serum 25(OH)D3 was measured with the high-performance liquid chromatography using coulometric electrode array detection. Magnesium intake was assessed with 4-day food recording. Deaths were ascertained by a computer linkage to the national cause of death register. Deaths due accidents and suicides were excluded. Cox proportional hazards regression models were used to analyze the associations. The multivariate-adjusted hazard ratio (HR) for dea...
The diode array detector in our high-performance liquid chromatography (HPLC) method for 25-hydro... more The diode array detector in our high-performance liquid chromatography (HPLC) method for 25-hydroxyvitamin D(3) (25OHD(3)) and 25-hydroxyvitamin D(2) (25OHD(2)) did not perform satisfactorily for measuring human serum concentrations below 30nM. Because of a need for a reliable self-managed method in ongoing and starting vitamin D studies of the laboratory, we decided to develop a chromatographic method applying coulometric electrode array detector (CEAD) and evaluate reliability of the method by participating in the Vitamin D External Quality Assessment Scheme (DEQAS). The limit of quantification for 25OHD(3) and 25OHD(2) of the new method was 0.36pmol on column (3.6nM), and linearity ranged from 5 to 2400nM. Accuracy of the method was 90% for 25OHD(3) and 69% for 25OHD(2). The HPLC-CEAD results from five DEQAS rounds were in line with those of the other participating laboratories using HPLC methods. The HPLC-CEAD results for 25OHD(3) also corresponded to the results obtained with the Chromsystems HPLC method in a certified laboratory. The long-term coefficients of variation for 25OHD(3) were 6.2%, 7.8%, 5.2%, 6.7%, and 7.3% in concentrations of 27.5, 38.7, 48.4, 78.4, and 88.0nM, respectively. The developed HPLC-CEAD method was shown to be applicable for determining 25OHD(3) and 25OHD(2) in human serum samples.
Background: Several, but not all, prospective studies have shown that low folate intakes, low cir... more Background: Several, but not all, prospective studies have shown that low folate intakes, low circulating folate concentrations, or high plasma total homocysteine (tHcy) concentrations are associated with an increased risk of coronary artery disease (CAD). Objective: We examined the relations of both serum folate and serum tHcy concentrations with acute coronary events in middle- aged men from eastern Finland who
Cardiovasculardisease(CVD)isthemaincauseofdeathinWestern countries. Nutrition has a significant r... more Cardiovasculardisease(CVD)isthemaincauseofdeathinWestern countries. Nutrition has a significant role in the prevention of many chronic diseases such as CVD, cancers, and degenerative brain dis- eases. The major risk and protective factors in the diet are well recognized, but interesting new candidates continue to appear. It is well known that a greater intake of fruit and vegetables can help prevent heart diseases and
The prevalence of type 2 diabetes (T2D) is increasing around the world. Eggs are a major source o... more The prevalence of type 2 diabetes (T2D) is increasing around the world. Eggs are a major source of cholesterol, which has been associated with elevated blood glucose and an increased risk of T2D. However, there are limited and conflicting data from prospective population studies on the association between egg consumption and risk of T2D. We investigated the association between egg consumption and risk of incident T2D in middle-aged and older men from eastern Finland. The study included 2332 men aged 42-60 y in 1984-1989 at the baseline examinations of the prospective, population-based Kuopio Ischemic Heart Disease Risk Factor Study. Dietary intakes were assessed with 4-d food records at baseline. Incident T2D was assessed by self-administered questionnaires; by fasting and 2-h oral-glucose-tolerance-test blood glucose measurement at re-examination rounds 4, 11, and 20 y after baseline; and by record linkage to a hospital discharge registry and reimbursement register of diabetes medi...
Arteriosclerosis, thrombosis, and vascular biology, 2014
The epidemiological evidence of the role of dietary saturated fatty acids (SFA) in the developmen... more The epidemiological evidence of the role of dietary saturated fatty acids (SFA) in the development of coronary heart disease (CHD) is inconsistent. We investigated the associations of dietary fatty acids with the risk of CHD and carotid atherosclerosis in men with high SFA intake and high rates of CHD. In total, 1981 men from the population-based Kuopio Ischemic Heart Disease Risk Factor Study (KIHD), aged 42 to 60 years and free of CHD at baseline in 1984 to 1989, were investigated. Food consumption was assessed with 4-day food recording. Multivariate nutrient-density models were used to analyze isocaloric replacement of nutrients. CHD events were ascertained from national registries. Carotid atherosclerosis was assessed by ultrasonography of the common carotid artery intima-media thickness in 1015 men. During the average follow-up of 21.4 years, 183 fatal and 382 nonfatal CHD events occurred. SFA or trans fat intakes were not associated with CHD risk. In contrast, monounsaturated ...
Intake of lignans has been assessed in different study populations, but so far none of the studie... more Intake of lignans has been assessed in different study populations, but so far none of the studies has compared the daily intake of lignans and the urinary excretion of plant and enterolignans. We assessed the intake of lariciresinol, pinoresinol, secoisolariciresinol and matairesinol in 100 Finnish men consuming their habitual omnivorous diet, and measured the 24 h urinary excretion of plant and enterolignans to compare the intake and metabolism. Dietary determinants of lignan intake and their urinary excretion were also determined. The mean intake of lignans was 1224 (sd 539) mug/d, of which lariciresinol and pinoresinol covered 78 %. Almost half (47 %) of the intake of lignans was explained by the intake of rye products, berries, coffee, tea and roots. The urinary excretion of plant lignans corresponded to 17 % and enterolignans to 92 % of the intake of lignans. The urinary excretion of plant lignans was explained 14 % by the intake of rye products and intake of coffee, and conse...
... Cancer Epidemiol Biomarkers Prev 2004;13:6570. 7. Jonas CR, McCullough ML, Teras LR, Walker-... more ... Cancer Epidemiol Biomarkers Prev 2004;13:6570. 7. Jonas CR, McCullough ML, Teras LR, Walker-Thurmond KA, Thun MJ, Calle EE. Dietary glycemic index, glycemic load, and risk of inci-dent breast cancer in postmenopausal women. ...
The long-term longitudinal evidence for a relation between coffee intake and hypertension is rela... more The long-term longitudinal evidence for a relation between coffee intake and hypertension is relatively scarce. The objective was to assess whether coffee intake is associated with the incidence of hypertension. This study was conducted on a cohort of 2985 men and 3383 women who had a baseline visit and follow-up visits after 6 and 11 y. Baseline coffee intake was ascertained with questionnaires and categorized into 0, >0-3, >3-6, and >6 cups/d. Hypertension was defined as a mean systolic blood pressure (SBP) >or=140 mm Hg over both follow-up measurements, a mean diastolic blood pressure (DBP) >or=90 mm Hg over both follow-up measurements, or the use of antihypertensive medication at any follow-up measurement. Coffee abstainers at baseline had a lower risk of hypertension than did those with a coffee intake of >0-3 cups/d [odds ratio (OR): 0.54; 95% CI: 0.31, 0.92]. Women who drank >6 cups/d had a lower risk than did women who drank >0-3 cups/d (OR: 0.67; 95%...
Cardiovascular disease (CVD) is the main cause of death in Western countries. Nutrition has a sig... more Cardiovascular disease (CVD) is the main cause of death in Western countries. Nutrition has a significant role in the prevention of many chronic diseases such as CVD, cancers, and degenerative brain diseases. The major risk and protective factors in the diet are well recognized, but interesting new candidates continue to appear. It is well known that a greater intake of fruit and vegetables can help prevent heart diseases and mortality. Because fruit, berries, and vegetables are chemically complex foods, it is difficult to pinpoint any single nutrient that contributes the most to the cardioprotective effects. Several potential components that are found in fruit, berries, and vegetables are probably involved in the protective effects against CVD. Potential beneficial substances include antioxidant vitamins, folate, fiber, and potassium. Antioxidant compounds found in fruit and vegetables, such as vitamin C, carotenoids, and flavonoids, may influence the risk of CVD by preventing the ...
Diets rich in fruits and vegetables have been of interest because of their potential health benef... more Diets rich in fruits and vegetables have been of interest because of their potential health benefits against chronic diseases such as cardiovascular disease (CVD) and cancer. The aim of this work was to assess the association of the dietary intake of a food group that includes fruits, berries and vegetables with all-cause, CVD-related and non-CVD-related mortality. The subjects were Finnish men aged 42-60 y examined in 1984-1989 in the prospective Kuopio Ischaemic Heart Disease Risk Factor (KIHD) Study. Dietary intakes were assessed by 4-d food intake record during the baseline phase of the KIHD Study. The risk of all-cause and non-CVD-related deaths was studied in 2641 men and the risk of CVD-related death in 1950 men who had no history of CVD at baseline. During a mean follow-up time of 12.8 y, cardiovascular as well as noncardiovascular and all-cause mortality were lower among men with the highest consumption of fruits, berries and vegetables. After adjustment for the major CVD r...
The role of flavonoids in CVD, especially in strokes, is unclear. Our aim was to study the role o... more The role of flavonoids in CVD, especially in strokes, is unclear. Our aim was to study the role of flavonoids in CVD. We studied the association between the intakes of five subclasses (flavonols, flavones, flavanones, flavan-3-ols and anthocyanidins), a total of twenty-six flavonoids, on the risk of ischaemic stroke and CVD mortality. The study population consisted of 1950 eastern Finnish men aged 42-60 years free of prior CHD or stroke as part of the prospective population-based Kuopio Ischaemic Heart Disease Risk Factor Study. During an average follow-up time of 15.2 years, 102 ischaemic strokes and 153 CVD deaths occurred. In the Cox proportional hazards model adjusted for age and examination years, BMI,systolic blood pressure, hypertension medication, serum HDL- and LDL-cholesterol, serum TAG, maximal oxygen uptake, smoking, family history of CVD, diabetes, alcohol intake, energy-adjusted intake of folate, vitamin E, total fat and saturated fat intake (percentage of energy), men in the highest quartile of flavonol and flavan-3-ol intakes had a relative risk of 0.55 (95% CI 0.31, 0.99) and 0.59 (95% CI 0.30, 1.14) for ischaemic stroke, respectively, as compared with the lowest quartile. After multivariate adjustment, the relative risk for CVD death in the highest quartile of flavanone and flavone intakes were 0.54 (95% CI 0.32, 0.92) and 0.65 (95% CI 0.40, 1.05), respectively. The present results suggest that high intakes of flavonoids may be associated with decreased risk of ischaemic stroke and possibly with reduced CVD mortality.
In our understanding, the very purpose of a meta-analysis is to arrive at a judgment of an associ... more In our understanding, the very purpose of a meta-analysis is to arrive at a judgment of an association from analyzing a large base of evidence, which usually means several original studies—surely more than a single study, and preferably 2 studies. However, the analysis by Barclay et al of the association of GI and GL with stroke risk, for example, is based on a single study by Oh et al (2). A quick look at Figure 3 (on page 635 of the meta-analysis) suggests that several studies have been summed up, but a closer look reveals that the first point estimate is for lean subjects and the second is for overweight subjects from the study by Oh et al, and that the last 2 figures give fixed-and random-effects estimates based on the first 2 figures. Heart disease (also in Figure 3) does not fare much better: only 2 studies are referenced (3, 4). Furthermore, although the label "heart disease" is a good approximation of coronary heart disease (3, 4), the label "eye disease"...
Sample pretreatment and chromatographic method for urinary plant and mammalian lignans is present... more Sample pretreatment and chromatographic method for urinary plant and mammalian lignans is presented. HPLC with Coulometric Electrode Array Detection (CEAD) was used for measuring. Effects of controlled diet on plant and mammalian lignan excretion are compared to the effects of habitual diet. Also some preliminary data of urinary plant and mammalian lignans of the ASAP study is presented.
Low vitamin D status increases the risk of death. Magnesium plays an essential role in vitamin D ... more Low vitamin D status increases the risk of death. Magnesium plays an essential role in vitamin D metabolism and low magnesium intake may predispose to vitamin D deficiency and potentiate the health problems. We investigated whether magnesium intake modifies the serum 25(OH)D3 concentration and its associations with mortality in middle-aged and older men. We included 1892 men aged 42-60 years without cardiovascular disease or cancer at baseline in 1984-1989 from the prospective, population-based Kuopio Ischaemic Heart Disease Risk Factor Study. Serum 25(OH)D3 was measured with the high-performance liquid chromatography using coulometric electrode array detection. Magnesium intake was assessed with 4-day food recording. Deaths were ascertained by a computer linkage to the national cause of death register. Deaths due accidents and suicides were excluded. Cox proportional hazards regression models were used to analyze the associations. The multivariate-adjusted hazard ratio (HR) for dea...
The diode array detector in our high-performance liquid chromatography (HPLC) method for 25-hydro... more The diode array detector in our high-performance liquid chromatography (HPLC) method for 25-hydroxyvitamin D(3) (25OHD(3)) and 25-hydroxyvitamin D(2) (25OHD(2)) did not perform satisfactorily for measuring human serum concentrations below 30nM. Because of a need for a reliable self-managed method in ongoing and starting vitamin D studies of the laboratory, we decided to develop a chromatographic method applying coulometric electrode array detector (CEAD) and evaluate reliability of the method by participating in the Vitamin D External Quality Assessment Scheme (DEQAS). The limit of quantification for 25OHD(3) and 25OHD(2) of the new method was 0.36pmol on column (3.6nM), and linearity ranged from 5 to 2400nM. Accuracy of the method was 90% for 25OHD(3) and 69% for 25OHD(2). The HPLC-CEAD results from five DEQAS rounds were in line with those of the other participating laboratories using HPLC methods. The HPLC-CEAD results for 25OHD(3) also corresponded to the results obtained with the Chromsystems HPLC method in a certified laboratory. The long-term coefficients of variation for 25OHD(3) were 6.2%, 7.8%, 5.2%, 6.7%, and 7.3% in concentrations of 27.5, 38.7, 48.4, 78.4, and 88.0nM, respectively. The developed HPLC-CEAD method was shown to be applicable for determining 25OHD(3) and 25OHD(2) in human serum samples.
Background: Several, but not all, prospective studies have shown that low folate intakes, low cir... more Background: Several, but not all, prospective studies have shown that low folate intakes, low circulating folate concentrations, or high plasma total homocysteine (tHcy) concentrations are associated with an increased risk of coronary artery disease (CAD). Objective: We examined the relations of both serum folate and serum tHcy concentrations with acute coronary events in middle- aged men from eastern Finland who
Cardiovasculardisease(CVD)isthemaincauseofdeathinWestern countries. Nutrition has a significant r... more Cardiovasculardisease(CVD)isthemaincauseofdeathinWestern countries. Nutrition has a significant role in the prevention of many chronic diseases such as CVD, cancers, and degenerative brain dis- eases. The major risk and protective factors in the diet are well recognized, but interesting new candidates continue to appear. It is well known that a greater intake of fruit and vegetables can help prevent heart diseases and
The prevalence of type 2 diabetes (T2D) is increasing around the world. Eggs are a major source o... more The prevalence of type 2 diabetes (T2D) is increasing around the world. Eggs are a major source of cholesterol, which has been associated with elevated blood glucose and an increased risk of T2D. However, there are limited and conflicting data from prospective population studies on the association between egg consumption and risk of T2D. We investigated the association between egg consumption and risk of incident T2D in middle-aged and older men from eastern Finland. The study included 2332 men aged 42-60 y in 1984-1989 at the baseline examinations of the prospective, population-based Kuopio Ischemic Heart Disease Risk Factor Study. Dietary intakes were assessed with 4-d food records at baseline. Incident T2D was assessed by self-administered questionnaires; by fasting and 2-h oral-glucose-tolerance-test blood glucose measurement at re-examination rounds 4, 11, and 20 y after baseline; and by record linkage to a hospital discharge registry and reimbursement register of diabetes medi...
Arteriosclerosis, thrombosis, and vascular biology, 2014
The epidemiological evidence of the role of dietary saturated fatty acids (SFA) in the developmen... more The epidemiological evidence of the role of dietary saturated fatty acids (SFA) in the development of coronary heart disease (CHD) is inconsistent. We investigated the associations of dietary fatty acids with the risk of CHD and carotid atherosclerosis in men with high SFA intake and high rates of CHD. In total, 1981 men from the population-based Kuopio Ischemic Heart Disease Risk Factor Study (KIHD), aged 42 to 60 years and free of CHD at baseline in 1984 to 1989, were investigated. Food consumption was assessed with 4-day food recording. Multivariate nutrient-density models were used to analyze isocaloric replacement of nutrients. CHD events were ascertained from national registries. Carotid atherosclerosis was assessed by ultrasonography of the common carotid artery intima-media thickness in 1015 men. During the average follow-up of 21.4 years, 183 fatal and 382 nonfatal CHD events occurred. SFA or trans fat intakes were not associated with CHD risk. In contrast, monounsaturated ...
Intake of lignans has been assessed in different study populations, but so far none of the studie... more Intake of lignans has been assessed in different study populations, but so far none of the studies has compared the daily intake of lignans and the urinary excretion of plant and enterolignans. We assessed the intake of lariciresinol, pinoresinol, secoisolariciresinol and matairesinol in 100 Finnish men consuming their habitual omnivorous diet, and measured the 24 h urinary excretion of plant and enterolignans to compare the intake and metabolism. Dietary determinants of lignan intake and their urinary excretion were also determined. The mean intake of lignans was 1224 (sd 539) mug/d, of which lariciresinol and pinoresinol covered 78 %. Almost half (47 %) of the intake of lignans was explained by the intake of rye products, berries, coffee, tea and roots. The urinary excretion of plant lignans corresponded to 17 % and enterolignans to 92 % of the intake of lignans. The urinary excretion of plant lignans was explained 14 % by the intake of rye products and intake of coffee, and conse...
... Cancer Epidemiol Biomarkers Prev 2004;13:6570. 7. Jonas CR, McCullough ML, Teras LR, Walker-... more ... Cancer Epidemiol Biomarkers Prev 2004;13:6570. 7. Jonas CR, McCullough ML, Teras LR, Walker-Thurmond KA, Thun MJ, Calle EE. Dietary glycemic index, glycemic load, and risk of inci-dent breast cancer in postmenopausal women. ...
The long-term longitudinal evidence for a relation between coffee intake and hypertension is rela... more The long-term longitudinal evidence for a relation between coffee intake and hypertension is relatively scarce. The objective was to assess whether coffee intake is associated with the incidence of hypertension. This study was conducted on a cohort of 2985 men and 3383 women who had a baseline visit and follow-up visits after 6 and 11 y. Baseline coffee intake was ascertained with questionnaires and categorized into 0, >0-3, >3-6, and >6 cups/d. Hypertension was defined as a mean systolic blood pressure (SBP) >or=140 mm Hg over both follow-up measurements, a mean diastolic blood pressure (DBP) >or=90 mm Hg over both follow-up measurements, or the use of antihypertensive medication at any follow-up measurement. Coffee abstainers at baseline had a lower risk of hypertension than did those with a coffee intake of >0-3 cups/d [odds ratio (OR): 0.54; 95% CI: 0.31, 0.92]. Women who drank >6 cups/d had a lower risk than did women who drank >0-3 cups/d (OR: 0.67; 95%...
Cardiovascular disease (CVD) is the main cause of death in Western countries. Nutrition has a sig... more Cardiovascular disease (CVD) is the main cause of death in Western countries. Nutrition has a significant role in the prevention of many chronic diseases such as CVD, cancers, and degenerative brain diseases. The major risk and protective factors in the diet are well recognized, but interesting new candidates continue to appear. It is well known that a greater intake of fruit and vegetables can help prevent heart diseases and mortality. Because fruit, berries, and vegetables are chemically complex foods, it is difficult to pinpoint any single nutrient that contributes the most to the cardioprotective effects. Several potential components that are found in fruit, berries, and vegetables are probably involved in the protective effects against CVD. Potential beneficial substances include antioxidant vitamins, folate, fiber, and potassium. Antioxidant compounds found in fruit and vegetables, such as vitamin C, carotenoids, and flavonoids, may influence the risk of CVD by preventing the ...
Diets rich in fruits and vegetables have been of interest because of their potential health benef... more Diets rich in fruits and vegetables have been of interest because of their potential health benefits against chronic diseases such as cardiovascular disease (CVD) and cancer. The aim of this work was to assess the association of the dietary intake of a food group that includes fruits, berries and vegetables with all-cause, CVD-related and non-CVD-related mortality. The subjects were Finnish men aged 42-60 y examined in 1984-1989 in the prospective Kuopio Ischaemic Heart Disease Risk Factor (KIHD) Study. Dietary intakes were assessed by 4-d food intake record during the baseline phase of the KIHD Study. The risk of all-cause and non-CVD-related deaths was studied in 2641 men and the risk of CVD-related death in 1950 men who had no history of CVD at baseline. During a mean follow-up time of 12.8 y, cardiovascular as well as noncardiovascular and all-cause mortality were lower among men with the highest consumption of fruits, berries and vegetables. After adjustment for the major CVD r...
The role of flavonoids in CVD, especially in strokes, is unclear. Our aim was to study the role o... more The role of flavonoids in CVD, especially in strokes, is unclear. Our aim was to study the role of flavonoids in CVD. We studied the association between the intakes of five subclasses (flavonols, flavones, flavanones, flavan-3-ols and anthocyanidins), a total of twenty-six flavonoids, on the risk of ischaemic stroke and CVD mortality. The study population consisted of 1950 eastern Finnish men aged 42-60 years free of prior CHD or stroke as part of the prospective population-based Kuopio Ischaemic Heart Disease Risk Factor Study. During an average follow-up time of 15.2 years, 102 ischaemic strokes and 153 CVD deaths occurred. In the Cox proportional hazards model adjusted for age and examination years, BMI,systolic blood pressure, hypertension medication, serum HDL- and LDL-cholesterol, serum TAG, maximal oxygen uptake, smoking, family history of CVD, diabetes, alcohol intake, energy-adjusted intake of folate, vitamin E, total fat and saturated fat intake (percentage of energy), men in the highest quartile of flavonol and flavan-3-ol intakes had a relative risk of 0.55 (95% CI 0.31, 0.99) and 0.59 (95% CI 0.30, 1.14) for ischaemic stroke, respectively, as compared with the lowest quartile. After multivariate adjustment, the relative risk for CVD death in the highest quartile of flavanone and flavone intakes were 0.54 (95% CI 0.32, 0.92) and 0.65 (95% CI 0.40, 1.05), respectively. The present results suggest that high intakes of flavonoids may be associated with decreased risk of ischaemic stroke and possibly with reduced CVD mortality.
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