Biomedical subjects

B L Heitmann

Publications and source records attributed to B L Heitmann.

At least 19 recordsLinked to original sources

PubMed2006

Intake of ruminant trans fatty acids in the Danish population aged 1-80 years.

OBJECTIVE: To estimate the intake of ruminant trans fatty acids (TFA) in the Danish population aged 1-80 years. DESIGN: Descriptive study. SUBJECTS: A sex- and age-stratified random sample drawn from the Danish Civil Registration System. A total of 3098 participants (51% female) aged 1-80 years were included. The participation was 66%. DIETARY INFORMATION: A 7-day dietary record. RESULTS: The estimated median intake of ruminant TFA was 1.4 g/day with the 80% central range being from 0.9 to 2.1 among children aged 1-6 years and 1.6 g/day (1.0-2.4) among children aged 7-14 years. The median TFA intake was 1.8 g/day (0.9-2.9) among adults aged 15-29 years and among adults aged 30-80 years. The intake expressed as percentage of energy intake was 0.8, 0.6, 0.7, and 0.7, respectively. Dairy products were the main source of ruminant TFA. CONCLUSIONS: The median intake of ruminant TFA in the Danish population aged 1-80 years is estimated to be 1.7 g/day (0.9-2.7), corresponding to 0.7% of energy intake (0.5-1.0), with dairy products being the main source of ruminant TFA. SPONSORSHIP: The Danish Heart Foundation (Grants 02-2-9-8-22010 and 03-2-9-4-22087) and the Female Researchers in Joint Action (FREJA) programme from the Danish Medical Research Council.

Adolescent↗

PubMed2005

The association between early menopause and risk of ischaemic heart disease: influence of Hormone Therapy.

UNLABELLED: Randomised clinical trials find no protection against development of ischaemic heart disease by use of Hormone Therapy (HT) after the age of 50 years. Observational studies suggest that early menopause is a risk factor for ischaemic heart disease. Yet, a clinical very relevant question is whether HT reduces this risk associated with early menopause. OBJECTIVE: To analyse whether early menopause based on various causes are independent risk factors for ischaemic heart disease, and to investigate whether the risks are modified by use of HT. METHODS: In a prospective cohort study questionnaires were mailed to Danish female nurses above 44 years of age in 1993. Information on menopause, use of HT and lifestyle was obtained. In total 19,898 (86%) nurses fulfilled the questionnaire, among them 10.533 were postmenopausal with definable menopausal age, free of previous ischaemic heart disease, stroke or cancer. Through individual linkage to national register incident cases of ischaemic heart disease were identified until end of 1998. RESULTS: Menopause below both age 40 and 45 was associated with an increased risk of ischaemic heart disease, seeming most pronounced for women who had an early ovariectomy but also among spontaneous menopausal women. Generally HT did not reduce the risk except for the early-ovariectomised women, where no increased risk of ischaemic heart disease for HT users was found. CONCLUSION: We found an increased risk of ischaemic heart disease associated with early removal of the ovaries that might be reduced with HT. The present study need confirmation from other studies but suggests that early ovariectomised women could benefit from HT.

Adult↗

PubMed2005

The relation between drinking pattern and body mass index and waist and hip circumference.

OBJECTIVES: To study the association between alcohol drinking pattern and obesity. DESIGN: Cross-sectional population study with assessment of quantity and frequency of alcohol intake, waist and hip circumference, height, weight, and lifestyle factors including diet. SUBJECTS: In all, 25 325 men and 24 552 women aged 50-65 y from the Diet, Cancer and Health Study, Denmark, 1993-1997 participated in the study. MEASUREMENTS: Drinking frequency, total alcohol intake, body mass index (BMI), and waist and hip circumference. RESULTS: Among men, total alcohol intake was positively associated with high BMI (>/=30 kg/m(2)), large waist circumference (>/=102 cm) and inversely associated with small hip circumference (<100 cm). Among women, the total alcohol was associated with high BMI, large waist (>/=88 cm), and small hips only for the highest intake (28+ drinks/week). The most frequent drinkers had the lowest odds ratios (OR) for being obese. Among men, OR for having a high BMI were 1.39 (95% confidence interval: 1.36-1.64), 1.17 (1.02-1.34), 1.00 (reference), 0.87 (0.77-0.98), and 0.73 (0.65-0.82) for drinking 1-3 days/month, 1 day/week, 2-4 days/week, 5-6 days/week, and 7 days/week, respectively. Similar estimates were found for waist circumference. Corresponding results were found for women. CONCLUSION: For a given level of total alcohol intake, obesity was inversely associated with drinking frequency, whereas the amount of alcohol intake was positively associated with obesity. These results indicate that frequent drinking of small amounts of alcohol is the optimal drinking pattern in this relation.

Aged↗

PubMed2005

Waist circumference and body composition in relation to all-cause mortality in middle-aged men and women.

OBJECTIVE: Waist circumference is directly related to all-cause mortality when adjusted for body mass index (BMI). Body fat and fat-free body mass, when mutually adjusted, show with increasing values an increasing and decreasing relation to all-cause mortality. We investigated the association of waist circumference and body composition (body fat and fat-free mass), mutually adjusted, to all-cause mortality. DESIGN: A Danish prospective cohort study with a median follow-up period of 5.8 y. SUBJECTS: In all, 27 178 men and 29 875 women, born in Denmark, aged 50-64 y, and without diagnosis of cancer at the time of invitation. MEASUREMENTS: Waist circumference and body composition estimated from impedance measurements. Cox's regression models were used to estimate the mortality rate ratios (RR). RESULTS: Waist circumference was strongly associated with all-cause mortality after adjustment for body composition; the mortality RR was 1.36 (95% confidence intervals (CI): 1.22-1.52) times higher per 10% larger waist circumference among men and 1.30 (95% CI: 1.17-1.44) times higher among women. Adjustment for waist circumference eliminated the association between high values of the body fat mass index (BFMI) and all-cause mortality. The association between fat-free mass index (FFMI) and mortality remained unaltered. CONCLUSION: Waist circumference accounted for the mortality risk associated with excess body fat and not fat-free mass. Waist circumference remained strongly and directly associated with all-cause mortality when adjusted for total body fat in middle-aged men and women, suggesting that the increased mortality risk related to excess body fat is mainly due to abdominal adiposity.

Abdomen↗

PubMed2004

Twin study of genetic and environmental influences on adult body size, shape, and composition.

OBJECTIVE: To investigate the genetic and environmental influences on adult body size, shape, and composition in women and men, and to assess the impact of age. MATERIALS AND METHODS: In this cross-sectional study of 325 female and 299 male like-sex healthy twin pairs, on average 38 y old (18-67 y), we determined zygosity by DNA similarity, and performed anthropometry and bioelectrical impedance analysis of body composition. The contribution to the total phenotypic variance of genetic, common environment, and individual environment was estimated in multivariate analysis using the FISHER program. Further, these variance components were analysed as linear functions of age. RESULTS: In both women and men genetic contributions were significant for all phenotypes. Heritability for body mass index was 0.58 and 0.63; for body fat%, 0.59 and 0.63; for total skinfolds, 0.61 and 0.65; for extremity skinfolds 0.65 and 0.62; for truncal skinfolds, 0.50 and 0.69; for suprailiac skinfolds, 0.49 and 0.48; for waist circumference, 0.48 and 0.61; for hip, 0.52 and 0.58; for lean body mass/height2, 0.61 and 0.56; and for height, 0.81 and 0.69, respectively. There was no strong evidence of common environmental effects under the assumptions of no nonadditive effect. The pattern of age trends was inconsistent. However, when significant there was a decrease in heritability with advancing age. DISCUSSION: These findings suggest that adult body size, shape, and composition are highly heritable in both women and men, although a decreasing tendency is seen with advancing age.

Adipose Tissue↗

PubMed2004

A longitudinal study of food intake patterns and obesity in adult Danish men and women.

OBJECTIVE: The aim of this study was to test the hypothesis that specific food intake patterns or changes in food intake patterns were related to future changes in body mass index (BMI). DESIGN: Longitudinal observational study, with clinical and questionnaire examinations at baseline and two follow-up surveys, after 5 and 11 years. SUBJECTS: In all, 3785 men and women attended at baseline, of which 2436 aged 30-60 y attended all three examinations. MEASUREMENTS: A 26-item food frequency questionnaire, standardised measurements of height and weight and a lifestyle questionnaire. Food intake patterns were identified by factor analysis. Regression models including: scores on each factor, BMI, smoking, leisure time physical activity, education, parity, age; and as outcomes: baseline BMI, BMI change between baseline, 5- and 11-y follow-up and obesity at 11-y follow-up, respectively. RESULTS: For men, three factors labelled 'Green', 'Sweet' and 'Traditional', and for women, two factors labelled 'Green' and 'Sweet-Traditional' were identified. Scores on the 'Sweet' and 'Sweet-Traditional' factors were inversely associated with baseline BMI. For men, baseline 'Traditional' factor score and, for women, baseline 'Sweet-Traditional' factor score was inversely associated with subsequent 11- and 5-y BMI change, respectively. Using the three examinations, a more advanced longitudinal model, which included preceding changes in BMI and factor scores, was tested but no significant associations between factor scores, changes in factor scores and subsequent BMI changes or obesity were found. CONCLUSION: In this longitudinal study of a Danish population, food intake factors could not consistently predict changes in BMI or obesity development.

Adult↗

PubMed2004

Waist and hip circumferences and all-cause mortality: usefulness of the waist-to-hip ratio?

OBJECTIVE: To investigate whether waist and hip circumferences, in addition to body mass index (BMI), are related to all-cause mortality. We studied these associations and tested the usefulness of the waist-to-hip ratio for mortality prediction. DESIGN: A Danish prospective cohort study with data collected between 1993 and 1997. SUBJECTS: A total of 27 179 men and 29 875 women born in Denmark and aged 50-64 years were followed for a median of 6.8 years. MEASUREMENTS: BMI, waist and hip circumferences at baseline. RESULTS: The associations between hip circumference and all-cause mortality were inverse for both men and women, but only after adjustment for waist circumference, or BMI, or both. The mortality rate ratios of mutually adjusted waist and hip circumferences were 0.63 (95% CI: 0.56, 0.71), and 0.70 (95% CI: 0.63, 0.79) times higher per 10% larger hip circumference in men and women, respectively, and 1.45 (95% CI: 1.34, 1.57) and 1.22 (95% CI: 1.14, 1.31) times higher per 10% larger waist circumference. The adequacy of the waist-to-hip ratio as a substitute for separate measurements of waist and hip circumferences depended on which other variables the analysis was adjusted for, indicating that the waist-to-hip ratio should be used with precaution. CONCLUSION: When mutually adjusted, waist and hip circumferences show opposite associations with all-cause mortality, probably due to different effects of adipose tissue in the abdominal and gluteofemoral regions. The waist-to-hip ratio cannot always capture these relations adequately.

Body Constitution↗

PubMed2004

Psychological workload is associated with weight gain between 1993 and 1999: analyses based on the Danish Nurse Cohort Study.

AIMS: To examine associations between psychological workload and subsequent 6-y weight changes. METHODS: In total, 6704 Danish nurses, aged 45-65 y and employed both in 1993 and 1999, answered questionnaires about psychological workload, including busyness in job, job speed and job influence, and lifestyle, as well as body weight and height at both examinations. RESULTS: Danish nurses who reported being almost always busy, or never busy, gained significantly more weight (3.1 and 3.5 kg, respectively) than nurses who reported being sometimes busy, who gained 2.5 kg in weight (P=0.04, 0.002). Job speed was not associated with subsequent weight gain. Job influence was inversely associated with subsequent weight changes after 6 y. The mean weight gain for nurses with no job influence was 4.1 kg, whereas those having major job influence had a mean weight gain of 2.6 kg (P=0.002). Nurses who stated they felt almost always busy in their jobs and who had no job influence gained significantly more weight than those who were never busy and those with major influence in their jobs (P=0.007). All results were essentially similar before and after adjustment for confounders for nurses reporting both high and low workload. Nurses whose workload remained stable (for instance, being sometimes busy) both in 1993 and 1999 gained less weight than nurses who changed their workload. Nurses who experienced minor/no influence in job, in both 1993 and in 1999, experienced a greater weight gain as compared to nurses who attained influence in job over the 6-y period. CONCLUSION: : Psychological workload, particularly both low and high busyness in job and low influence in job, was associated with higher 6-y weight gain among female Danish nurses.

Cohort Studies↗

PubMed2004

Night eating and weight change in middle-aged men and women.

OBJECTIVE: To examine the association between the habit of eating at night, and the 5-y preceding and 6-y subsequent weight changes in a middle-aged population, with particular focus on the obese. DESIGN: Prospective study with initial examination of the cohort in 1982-83, re-examination in 1987-88 and a third examination in 1992-93. SUBJECTS: The Danish MONICA cohort includes an age- and sex-stratified random sample of the population from the Western part of the Copenhagen County. Out of 2,987 subjects participating in 1987-88, a total of 1,050 women and 1,061 men had been examined in 1982-83, and 1993-94 too. Subjects working night shifts were excluded. MEASUREMENTS: Night eating in 1987-88, 5-y preceding and 6-y subsequent weight change. RESULTS: In total, 9.0% women and 7.4% men reported 'getting up at night to eat'. Obese women with night eating experienced an average 6-y weight gain of 5.2 kg (P=0.004), whereas only 0.9 kg average weight gain was seen among obese women who did not get up at night to eat. No significant associations were found among all women, or between night eating and the 5-y preceding weight change for women. Night eating and weight change were not associated among men. CONCLUSION: Night eating was not associated with later weight gain, except among already obese women, suggesting that getting up at night to eat may be a contributor to further weight gain among the obese.

Anthropometry↗

PubMed2004

Psychological workload and body weight: is there an association? A review of the literature.

BACKGROUND: According to Karasek's Demand/Control Model, workload can be conceptualized as job strain, a combination of psychological job demands and control in the job. High job strain may result from high job demands combined with low job control. Aim To give an overview of the literature on the association between obesity and psychological workload. METHOD: We carried out a review of the associations between psychological workload and body weight in men and women. In total, 10 cross-sectional studies were identified. RESULTS: The review showed little evidence of a general association between psychological workload and body mass index. Only weak positive associations were found, and only between elements of psychological workload and overall body weight. For body fat distribution, two out of three studies showed a positive association in men, but the associations became insignificant after adjustment for education. For women, there was no evidence of a consistent association. CONCLUSION: The reviewed articles were not supportive of any associations between psychological workload and either general or abdominal obesity. Future epidemiological studies in this field should be prospective or experimental, and should examine how chronic work stress affects eating and to what extent initial body weight is a predictor for individual differences in perceived psychological workload.

Body Mass Index↗

PubMed2003

Relation between hormone replacement therapy and ischaemic heart disease in women: prospective observational study.

OBJECTIVE: To investigate the risk of ischaemic heart disease and myocardial infarction among women using hormone replacement therapy, especially the potential modifying effect of cardiovascular risk factors. DESIGN: Prospective observational study. SETTING: Denmark. PARTICIPANTS: 19 898 nurses aged 45 and over completing a questionnaire on lifestyle and use of hormone replacement therapy in 1993. MAIN OUTCOME MEASURES: All cases of death and incident cases of ischaemic heart disease and myocardial infarction until the end of 1998. RESULTS: Current users of hormone replacement therapy smoked more, consumed more alcohol, had lower self rated health, but were slimmer and had a lower prevalence of diabetes than never users. In current users compared with never users, hormone replacement therapy had no protective effect on ischaemic heart disease (hazard ratio 1.2, 0.9 to 1.7) or myocardial infarction (1.0, 0.6 to 1.7), whereas current users with diabetes had an increased risk of death (3.2, 1.4 to 7.5), ischaemic heart disease (4.2, 1.4 to 12.5), and myocardial infarction (9.2, 2.0 to 41.4) compared with never users with diabetes. CONCLUSION: Hormone replacement therapy showed no protective effect on ischaemic heart disease, but there was a significantly increased risk of death from all causes and ischaemic heart disease among women with diabetes.

Aged↗

PubMed2002

Assessment of habitual energy and macronutrient intake in adults: comparison of a seven day food record with a dietary history interview.

OBJECTIVE: To examine the quantitative agreement between a 7 day food record and a diet history interview when these are conducted under the same conditions and to evaluate whether the two methods assess habitual diet intake differently among subgroups of age and body mass index (BMI). DESIGN: Cross-sectional study. SETTING: Population study, Denmark. SUBJECTS: A total of 175 men and 173 women aged 30-60 y, selected randomly from a larger population sample of Danish adults. INTERVENTIONS: All subjects had habitual diet intake assessed by a diet history interview and completed a 7 day food record within 3 weeks following the interview. The diet history interview and coding of records were performed by the same trained dietician. MAIN OUTCOME MEASURE: Median between-method difference in assessment of total energy intake, absolute intake of macronutrients, and nutrient energy percentages. Difference between reported energy intake from both methods and estimated energy expenditure in different subgroups. RESULTS: Energy and macronutrient intake was assessed slightly higher by the 7 day food record than by the diet history interview, but in absolute terms the differences were negligible. The between-method difference in assessment of total energy intake appeared to be stable over the range of age and BMI in both sexes. As compared to estimated total energy expenditure, both diet assessment methods underestimated energy intake by approximately 20%. For both methods the under-reporting increased by BMI in both sexes and by age in men. CONCLUSIONS: Energy and macronutrient intake data collected under even conditions by either a 7 day food record or a diet history interview may be collapsed and analysed independent of the underlying diet method. Both diet methods, however, appear to underestimate energy intake dependent on age and BMI. SPONSORSHIP: Danish Medical Research Council, the FREJA programme.

Adult↗

PubMed2001

Larger hip circumference independently predicts health and longevity in a Swedish female cohort.

OBJECTIVE: The waist circumference is widely viewed as a simple but effective measure for assessing obesity-related health risks, whereas measurement of the hip circumference is not currently prioritized. This study examines health risks associated specifically with hip circumference in a cohort of Swedish women, to determine whether information may be lost by excluding the hip circumference from health surveys. RESEARCH METHODS AND PROCEDURES: The subjects described in this report constitute a population-based sample of 38- to 60-year-old women who underwent anthropometric examinations in 1968. The 24-year incidence rates have been ascertained for myocardial infarction, combined cardiovascular diseases, and diabetes. All-cause, cardiovascular, and myocardial infarction mortality also were evaluated. RESULTS: Hip circumference was a significant independent inverse risk estimator for all endpoints studied. Using Cox regression with adjustment for age, smoking, body mass index, and waist circumference, the remaining variability associated with larger hips was associated with significantly fewer adverse health outcomes. The hip circumference became statistically informative after body mass index adjustment. The strongest protective associations were observed for cardiovascular disease and diabetes endpoints, although significant trends were also seen for total mortality. Considering hip and waist simultaneously, the strength of the inverse association for large hips generally exceeded the positive association for waist. DISCUSSION: Recent interest in the waist circumference as an effective screening tool has taken the focus off of the hip circumference. The present results suggest that collection of hip measurements should not be discontinued in assessment of obesity-related risk status and health promotion.

Adult↗

PubMed2001

Food intake patterns and body mass index in observational studies.

OBJECTIVE: To review studies of patterns of food intake, as assessed by diet index, factor analysis or cluster analysis, and their associations with body mass index or obesity (BMI/Ob). DESIGN: Systematic literature review MEDLINE search with crosscheck of references. STUDIES: Thirty observational studies relating food intake patterns to anthropometric information were identified and reviewed. Food intake patterns were defined using a diet index, factor or cluster analysis in 12, nine and nine studies, respectively. Measures of body mass were made concurrently with the diet assessment in all studies, and only in a few cases were the primary outcomes related to BMI/Ob. RESULTS: The food intake patterns identified could, in most factor or cluster analysis studies, be categorised as: (a) meat, fatty, sweet or energy dense foods; (b) vegetables, fruit, whole grain and low-fat foods; or (c) by high alcohol consumption. The diet indexes were designed to capture a high diversity and/or food combinations matching the recommendations. The relationships with BMI/Ob were inconsistent-ten studies found that intake patterns, which we categorised as fatty, sweet or energy dense were positively associated with BMI/Ob, while similar patterns in four other studies were negatively associated with BMI. The significant associations between diet index score and BMI/Ob were consistently negative, while the associations between factor scores or cluster membership and BMI/Ob were less clear in terms of food intake pattern. Men and women had similar food intake patterns, but food intake patterns were less often positively associated with BMI/Ob in women. In 11 studies, there were no significant associations between food intake pattern and BMI/Ob. CONCLUSION: This review showed that no consistent associations could be identified between BMI or Ob and food intake patterns, derived from diet index, factor analysis or cluster analysis. However, the heterogeneity of food intake patterns identified by such analyses and the lack of gold standards for the application of these techniques hampers consistent analysis of a relation between food intake patterns and health.

Adolescent↗

PubMed2001

Cardiovascular risk factors in men: The role of gonadal steroids and sex hormone-binding globulin.

Males have higher risk of cardiovascular disease (CVD) than premenopausal females. Gonadal steroids are probably involved in the gender difference in CVD, but previous results have been conflicting. We investigated the associations between CVD risk factors and sex hormones in a cross-sectional designed study of 508 healthy males, aged 41 to 72 years. We determined total testosterone (T), sex hormone-binding globulin (SHBG), free androgen index (FAI), and estradiol (E2) and studied their relationship to body fat mass (BF), blood pressure (BP), aortic compliance, left ventricular mass (LVM), and plasma lipids (total cholesterol, high-density lipoprotein [HDL], low-density lipoprotein [LDL], very--low-density lipoprotein [VLDL], and triglycerides). In quartile analyses after adjustment for confounders (age, body mass index [BMI], alcohol consumption, and smoking), SHBG and E2 were positively associated with HDL, while FAI was negatively associated with HDL. T and SHBG were negatively associated with VLDL and triglycerides, while FAI was positively associated with VLDL and triglycerides. T and SHBG were negatively associated with BMI and BF, while FAI and E2 were positively associated with BMI and BF. E2 was negatively associated with LVM. No hormone varied with total cholesterol, LDL, BP, and aortic compliance in the adjusted analyses. In multiple regression analyses, SHBG was the main predictive variable of HDL, VLDL, and triglycerides explaining 12%, 17%, and 17% of the variation, respectively. No other hormones were selected as predictive variables for VLDL and triglycerides, but E2, T, and FAI were selected in the HDL regression, explaining 3%, 2%, and less than 1%, respectively. Our regression analyses illustrate the diverging results when investigating associations between gonadal steroids and lipids with and without SHBG adjustment. Atherogenic lipid profile in males is associated with low SHBG, low T levels, and a high FAI. Males with high E2 levels may have a less atherogenic lipid profile and lower LVM. SHBG is a key hormone in the association between sex hormones and plasma lipids. We suggest that conflicting results of cross-sectional and intervention studies of sex hormones and lipids, in part, may be explained by interindividual differences or changes in SHBG. Thus, further studies on the potential role of SHBG in the development of ischemic heart disease (IHD) should be performed.

Adult↗

PubMed2001

Assessment of body composition by bioelectrical impedance analysis without the need for measurement of height.

Conventional whole-body single frequency bioelectrical impedance analysis (BIA) of body composition typically uses height as a surrogate measure of conductor length. A new method of BIA analysis for the prediction of body cell mass (BCM) and extracellular water (ECW, as % body weight) not using height has been introduced-the Soft Tissue Analyser (STA(TM), Akern Sri, Florence, Italy)-making it ideal for use in subjects where measurement of height is difficult or impossible. The performance of the new analytical method in predicting BCM and ECW in 139 normal control subjects was assessed by comparison with reference data obtained from a four-component (4-C) model of body composition and with predictions obtained from conventional BIA analysis. Both predicted BCM and ECW were strongly (r=0.82, SEE=6.3 kg and 0.89, SEE=1.3 kg respectively) correlated with the corresponding 4-C model measurements although differing significantly from the lines of identity (P<0.0001). Fat-free mass, calculated from STA estimates of BCM and ECW, was better predicted (r=0.91, SEE=5.6 kg). The significant differences in STA-group mean values for BCM and ECW and wide limits of agreement compared with the reference data indicate that the method cannot be used with confidence for prediction of these body compartments despite the obvious advantage of not requiring an accurate measurement of height.

Adult↗

PubMed2001

Dietary patterns and mortality in Danish men and women: a prospective observational study.

The analysis of dietary patterns emerged recently as a possible approach to examining diet-disease relation. We analysed the risk of all-cause and cardiovascular mortality associated with dietary patterns in men and women, while taking a number of potential confounding variables into account. Data were from a prospective cohort study with follow-up of total and cause-specific mortality. A random sample of 3698 men and 3618 women aged 30-70 years and living in Copenhagen County, Denmark, were followed from 1982 to 1998 (median 15 years). Three dietary patterns were identified from a twenty-eight item food frequency questionnaire, collected at baseline: (1) a predefined healthy food index, which reflected daily intakes of fruits, vegetables and wholemeal bread, (2) a prudent and (3) a Western dietary pattern derived by principal component analysis. The prudent pattern was positively associated with frequent intake of wholemeal bread, fruits and vegetables, whereas the Western was characterized by frequent intakes of meat products, potatoes, white bread, butter and lard. Among participants with complete information on all variables, 398 men and 231 women died during follow-up. The healthy food index was associated with reduced all-cause mortality in both men and women, but the relations were attenuated after adjustment for smoking, physical activity, educational level, BMI, and alcohol intake. The prudent pattern was inversely associated with all-cause and cardiovascular mortality after controlling for confounding variables. The Western pattern was not significantly associated with mortality. This study partly supports the assumption that overall dietary patterns can predict mortality, and that the dietary pattern associated with the lowest risk is the one which is in accordance with the current recommendations for a prudent diet.

Adult↗

PubMed2001

Food intake patterns, self rated health and mortality in Danish men and women. A prospective observational study.

OBJECTIVE: To examine whether self rated health confounds or modifies the relation between a prudent food intake pattern and mortality and to study whether the prudent food intake pattern predicts subsequent changes in self rated health. DESIGN: A prospective cohort study with follow up of total mortality and changes in self rated health. Food intake patterns were identified by principal component analysis from a 28 item food frequency questionnaire, collected at baseline. SETTING: MONICA surveys, Copenhagen County, Denmark. PARTICIPANTS: A random sample of 3698 men and 3618 women aged 30-70 years were followed up from 1982 to 1998 (median 15 years). MAIN RESULTS: Among participants with complete information on all variables 18% had rated their health as poor (average or bad) at the baseline examination. Poor self rated health was related to a low score on the prudent food intake pattern, which was characterised by a frequent intake of wholemeal bread, fruit and vegetables. Three hundred and seventy six men and 210 women died during follow up. Poor self rated health and a low prudent food score were associated with increased mortality in both men and women. Self rated health did not modify the relation between diet and mortality. Of the 1098 men and 1048 women with good self rated health at baseline, 243 men and 297 women reported poor health during follow up. Low prudent food score, smoking, and high BMI increased the risk of developing poor health in both men and women, but in multivariate analysis the associations attenuated and were only significant for BMI. CONCLUSION: Both prudent food intake pattern and self reported health are independent predictors of mortality. Self rated health does not seem to modify the relation between diet and mortality.

Adult↗