PubMed Health⌕ Search

Biomedical subjects

E J Feskens

Publications and source records attributed to E J Feskens.

At least 19 recordsLinked to original sources
PubMed2001

[Prevention of diabetes mellitus type 2].

Diabetes mellitus type II is a major clinical and public health problem and is therefore a candidate for several primary and secondary preventive strategies. Further research on the effects and side effects of both types of prevention is required before it is possible to accurately determine which prevention strategy is most suitable. Research into primary prevention should not only focus on the effect of the strategy on diabetes itself, but also on its complications. With respect to diabetic screening, it is advisable to investigate the cost-effectiveness of several screening strategies. As opportunistic screening is becoming the predominant current practice, a cost-effectiveness study of screening strategies should be started in the short term due to increasing difficulties in selecting a control group.

Diabetes Mellitus, Type 2↗
PubMed2001

[Disease burden of diabetes mellitus type II in the Netherlands: incidence, prevalence and mortality ].

A consistent estimate of the prevalence, mortality and incidence of diabetes mellitus type II in the Netherlands was obtained by combining data from several sources using statistical and modelling techniques. In the Netherlands, the prevalence of diabetes in the age-group 30-74 years is 2.7-3.2%. The prevalence increases with age: for men by 7% per year of age and for women by almost 8% per year of age. This age-related increase will give rise to a 36% increase in the prevalence of diabetes in the period 1993-2010. Diabetic patients account for 12% of the total mortality in men and 18% in women; in 2.5% and 5% of the cases respectively, diabetes is the cause of mortality. If this excess mortality could be eliminated then the life expectancy for men with diabetes would increase by 4.7 years at the age of 45 and for women the corresponding increase would be 6.3 years. The estimated incidence per year increases from 8 per 10,000 men (7 for women) in the age group 40-44 years to 80 per 10,000 men (86 for women) in the age group 75-79 years.

Age Distribution↗
PubMed2001

Dietary catechins and epithelial cancer incidence: the Zutphen elderly study.

The flavonoids, a group of more than 4,000 polyphenolic antioxidants, are potential cancer preventive components of fruits and vegetables. Catechins, one of the 6 major groups of flavonoids, are present in high concentrations in tea as well. Our objective was to evaluate the association between intake of catechins and incidence of epithelial cancers with data from the Zutphen Elderly Study, a prospective cohort study among 728 men aged 65-84 years in 1985. The average catechin intake at baseline was 72 mg/day (range, 0-355 mg/day). After 10 years of follow-up, 96 incident epithelial cancers were recorded, including 42 cases of lung cancer. After multivariate adjustment, catechin intake was not associated with epithelial cancer (risk ratio [RR] from lowest to highest tertile: 1.00, 0.75, 0.94; p for trend: 0.82), or lung cancer (RR from lowest to highest tertile: 1.00, 0.72, 0.92; p for trend: 0.80). Catechins not from tea were borderline significantly inversely associated with lung cancer incidence (RR and 95% confidence interval [CI] for a 7.5-mg increase in intake: 0.66, 0.42-1.05), whereas catechins from tea were not. Catechins from apple, the major source of non-tea catechins, were also related to lung cancer incidence (RR and 95% CI for a 7.5-mg catechin increase: 0.67, 0.38-1.17). Because tea, the major catechin source in this population, was not associated with cancer risk, it seems unlikely that catechins are responsible for the observed inverse trend between non-tea catechins and lung cancer incidence. However, differences in bioavailability of the various catechins may play a role; effects on individual cancer sites cannot be excluded and merit further investigation.

Aged↗
PubMed2001

Association between trans fatty acid intake and 10-year risk of coronary heart disease in the Zutphen Elderly Study: a prospective population-based study.

BACKGROUND: Evidence on the relation between trans fatty acid intake and coronary heart disease is limited. We investigated this relation in a Dutch population with a fairly high trans fatty acid intake, including trans fatty acids from partly hydrogenated fish oils. METHODS: We prospectively studied 667 men of the Zutphen Elderly Study aged 64-84 years and free of coronary heart disease at baseline. We used dietary surveys to establish the participants' food consumption patterns. Information on risk factors and diet was obtained in 1985, 1990, and 1995. After 10 years of follow-up from 1985-95, there were 98 cases of fatal or non-fatal coronary heart disease. FINDINGS: Between 1985 and 1995, average trans fatty acid intake decreased from 4.3% to 1.9% of energy. After adjustment for age, body mass index, smoking, and dietary covariates, trans fatty acid intake at baseline was positively associated with the 10-year risk of coronary heart disease. The relative risk for a difference of 2% of energy in trans fatty acid intake at baseline was 1.28 (95% CI 1.01-1.61). INTERPRETATION: A high intake of trans fatty acids (all types of isomers) contributes to the risk of coronary heart disease. The substantial decrease in trans fatty acid intake, mainly due to industrial lowering of trans contents in Dutch edible fats, could therefore have had a large public-health impact.

Aged↗
PubMed2001

Parental history of myocardial infarction: lipid traits, gene polymorphisms and lifestyle.

To investigate the relationship between parental history of myocardial infarction (MI), lipid traits and gene polymorphisms involved in lipid metabolism, we examined Dutch men and women, who were selected from a large population-based study. Subjects whose father (n=112), mother (n=115) or both parents (n=115) suffered from a premature MI presented with significantly higher apolipoprotein B (apo B) levels than subjects without a parental history (n=114). Genetic analyses revealed that the apo E4 isoform and the D9N mutation of lipoprotein lipase (LPL) were more frequent among subjects with a parental history (P< or =0.05). A similar trend was found for the LPL N291S mutation. In contrast, the LPL S447X mutation and polymorphisms at the cholesteryl ester transfer protein (TaqIB) and apo CIII (SstI) loci proved to be noninformative. Body mass index and lifestyle could not explain differences in apo B levels between parental history groups. In contrast, the apo E polymorphism and the LPL D9N mutation accounted for some, but not all, of the higher apo B levels in subjects with a parental history. Therefore, other genetic or lifestyle-related factors must be responsible for the increased levels of apo B in individuals with a family history of myocardial infarction.

Adult↗
PubMed2001

Prevalence of morbidity and multimorbidity in elderly male populations and their impact on 10-year all-cause mortality: The FINE study (Finland, Italy, Netherlands, Elderly).

Older males are known to carry, more likely than younger people, one or more chronic diseases with an expected impact on mortality. This study was aimed at identifying the relationship of prevalent chronic diseases in elderly populations of different countries with all-cause mortality. Men aged 65-84 from defined areas were enrolled in Finland (N=716), the Netherlands (N=887) and Italy (N=682). They were survivors of cohorts studied for 25 years within the Seven Countries Study. Major chronic diseases were diagnosed at entry. Ten-year follow-up for mortality was completed. Entry prevalence of selected chronic diseases was higher in Finland (56%) than in Italy (51%) and the Netherlands (44%). Ten-year age-adjusted death rates from all causes were higher in Finland (565 per 1000) and lower in the Netherlands (478 per 1000) and Italy (445 per 1000). The absolute risk of death related to chronic disease was high in the three countries, but was higher in Finland than in the Netherlands and Italy. The most lethal condition was stroke, with 10-year death rates of 806 per 1000 in Finland and 707 and 729 per 1000 in the Netherlands and Italy, respectively. The relative risk of all-cause mortality for a set of seven chronic diseases (coronary heart disease, heart failure, claudicatio intermittens, cerebrovascular accidents, diabetes, COPD and cancer) adjusted by age, other diseases and cohort was less than two for each condition, except cerebrovascular accidents in the Netherlands (RR 2.20). In general, relative risk was higher in Finland, intermediate in the Netherlands and lower in Italy, where only cerebrovascular accidents, intermittent claudication, diabetes and the presence of any chronic condition had a significant relative risk. About one third of men had one chronic disease, and between 10% and 15% had two diseases. The coexistence of any two or three chronic conditions was associated with a relative risk of 2 or more in Finland and the Netherlands and less than 2 in Italy. In these elderly men prevalent morbidity and comorbidity was relatively common and it explained a large proportion of excess in all-cause mortality in 10 years of follow-up.

Aged↗
PubMed2001

Catechin intake and associated dietary and lifestyle factors in a representative sample of Dutch men and women.

OBJECTIVE: To study the intake of catechins in the Dutch population and to assess the relation between catechin intake and other dietary factors. Catechins, dietary components that belong to the flavonoid family, potentially protect against chronic diseases such as cancer and cardiovascular diseases. Catechins are the major components of tea, but they are present in many other plant foods as well. DESIGN: Data were used from a nationwide dietary survey carried out in 1998 among a representative sample of 6200 Dutch men and women aged 1-97y. Dietary data were collected using a 2 day dietary record method. RESULTS: The average daily catechin intake was 50 mg (s.d. 56 mg/day). Catechin intake increased with age, and the intake was higher in women (60 mg/day) than in men (40 mg/day). Tea was the main catechin source in all age groups, whereas chocolate was second in children, and apples and pears were second in adults and elderly. Catechin intake was lower in smokers than in non-smokers, and increased with socio-economic status. A high intake was associated with a high intake of fiber (r = 0.20), vitamin C (r = 0.17) and beta-carotene (r = 0.10). CONCLUSIONS: Catechins are quantitatively important bioactive components of the daily diet, which should be taken into account when studying the relation between diet and chronic diseases. Catechin intake is only moderately associated with the intake of other nutrients, but much stronger with certain health behaviours such as smoking.

Adolescent↗
PubMed2001

Catechin intake might explain the inverse relation between tea consumption and ischemic heart disease: the Zutphen Elderly Study.

BACKGROUND: Epidemiologic studies suggest that tea consumption may reduce the risk of cardiovascular diseases, but results are inconsistent. Catechins, which belong to the flavonoid family, are the main components of tea and may be responsible for the alleged protective effect. Taking catechin sources other than tea into account might clarify the reported associations. OBJECTIVE: The objective was to evaluate the association between catechin intake and the incidence of and mortality from ischemic heart disease and stroke. DESIGN: We evaluated the effect of a high catechin intake by using data from the Zutphen Elderly Study, a prospective cohort study of 806 men aged 65-84 y at baseline in 1985. RESULTS: The mean (+/-SD) catechin intake at baseline was 72 +/- 47.8 mg, mainly from black tea, apples, and chocolate. A total of 90 deaths from ischemic heart disease were documented. Catechin intake was inversely associated with ischemic heart disease mortality; the multivariate-adjusted risk ratio in the highest tertile of intake was 0.49 (95% CI: 0.27, 0.88; P for trend: 0.017). After multivariate adjustment, catechin intake was not associated with the incidence of myocardial infarction (risk ratio in the highest tertile of intake: 0.70; 95% CI: 0.39, 1.26; P for trend: 0.232). After adjustment for tea consumption and flavonol intake, a 7.5-mg increase in catechin intake from sources other than tea was associated with a tendency for a 20% reduction in ischemic heart disease mortality risk (P = 0.114). There was no association between catechin intake and stroke incidence or mortality. CONCLUSION: Catechins, whether from tea or other sources, may reduce the risk of ischemic heart disease mortality but not of stroke.

Aged↗
PubMed2001

alpha-Linolenic acid intake is not beneficially associated with 10-y risk of coronary artery disease incidence: the Zutphen Elderly Study.

BACKGROUND: Data on the relation between alpha-linolenic acid intake and coronary artery disease (CAD) are limited. Other dietary components appear to modify the reported relation between alpha-linolenic acid intake and CAD. OBJECTIVE: We examined whether dietary alpha-linolenic acid intake was inversely associated with risk of CAD. DESIGN: We prospectively studied 667 men aged 64-84 y from the Zutphen Elderly Study who were free of CAD at baseline. Dietary intake was assessed by using a cross-check dietary history method. RESULTS: During the 10-y follow-up, we documented 98 cases of CAD. After adjustment for age, standard coronary risk factors, and intake of trans fatty acids and other nutrients, alpha-linolenic acid intake was not significantly associated with CAD risk. The relative risk of CAD for the highest compared with the lowest tertile of alpha-linolenic acid intake was 1.68 (95% CI: 0.86, 3.29). alpha-Linolenic acid intake from sources containing trans fatty acids was also nonsignificantly, yet positively, associated with CAD risk. alpha-Linolenic acid intake from foods that did not contain trans fatty acids was not associated with CAD risk, the relative risk of CAD for the highest compared with the lowest tertile was 1.15 (95% CI: 0.63, 2.11). CONCLUSION: We did not observe a beneficial effect of dietary alpha-linolenic acid intake on the risk of 10-y CAD incidence. Investigating this hypothesis was complicated by the association between intakes of alpha-linolenic acid and trans fatty acids. Given the results of current prospective studies, a protective cardiac effect of alpha-linolenic acid is questionable.

Aged↗
PubMed2001

Alcohol consumption in relation to 20-year COPD mortality and pulmonary function in middle-aged men from three European countries.

Alcohol consumption shows a U-shaped relation with all-cause and cardiovascular mortality. To determine whether a similar relation exists between alcohol and chronic obstructive pulmonary disease mortality, we analyzed data on alcohol consumption in 1970 and 20-year mortality from chronic obstructive pulmonary disease among 2,953 middle-aged men from Finland, Italy, and the Netherlands. We also studied alcohol consumption in relation to pulmonary function (FEV1 or FEV0.75) at baseline. We used regression models adjusted for age, height (for pulmonary function only), body mass index, smoking habits, energy intake, and country. A smoothed spline-plot showed a U-shaped relation between alcohol and chronic obstructive pulmonary disease mortality. Compared with non-drinkers and occasional drinkers, the relative risk of chronic obstructive pulmonary disease mortality was 0.60 (95% CI = 0.33-1.09) in light drinkers (> 1 drink per week, < or = 3 drinks per day) and 1.25 (95% CI = 0.47-3.31) in moderate-to-heavy drinkers. Pulmonary function was lower in non-drinkers compared with occasional and light drinkers in Finland (75 ml, 95% CI = -2 to 151) and the Netherlands (93 ml, 95% CI = 0-186) and lower in very heavy (> 12 drinks per day) compared with moderate-to-heavy drinkers in Italy (99 ml, 95% CI = 9-189). In conclusion, we observed a U-shaped curve between alcohol consumption and 20-year chronic obstructive pulmonary disease mortality in middle-aged men that was supported by cross-sectional data on alcohol and pulmonary function.

Adult↗
PubMed2001

Physical activity and cognitive decline, the role of the apolipoprotein e4 allele.

PURPOSE: The purpose of this study was to investigate the association between level of physical activity and risk of cognitive decline at older age and its variation across carriers and noncarriers of the apolipoprotein e4 allele. METHODS: The association was studied in a cohort of 347 elderly Dutch men. Mean age of the study subjects was 74.6 +/- 4.3 yr in 1990. Physical activity was categorized in "maximal 1 h per day" versus "more than 1 h per day." Cognitive decline was defined as a drop MMSE score > 3 points between 1990 and 1993. RESULTS: After adjusting for age, education, alcohol consumption, smoking and cognitive functioning at baseline, subjects with maximal 1 h of physical activity per day had a two-fold increased risk of cognitive decline (OR 2.0, 95% CI: 0.9-4.8) as compared with the rest. Risk of cognitive decline was particularly strong in carriers of the APOE*4 allele (adjusted OR 3.7, 95% CI: 1.1-12.6). CONCLUSION: The authors conclude that promotion of physical activity at older age may reduce the risk of cognitive decline. The existence of subgroups with a particularly high risk may have important implications for prevention strategies.

Aged↗
PubMed2001

The association of silent electrocardiographic findings with coronary deaths among elderly men in three European countries. The FINE study.

OBJECTIVES: Ten-year coronary heart disease (CHD) mortality in elderly male cohorts in three European countries was evaluated as a function of silent resting Minnesota Code electrocardiographic (ECG) findings found at baseline. METHODS AND RESULTS: Men aged 65-84 at entry were enrolled, examined and followed up for 10 years in 5 cohorts of three countries: Finland (N=716), the Netherlands (N= 887), and Italy (N = 682). Men with symptomatic angina pectoris, a documented history of myocardial infarction or heart failure were excluded from analysis, leaving 505 men in Finland, 713 in the Netherlands and 567 in Italy. ECG abnormalities were arranged in different groupings. Multivariate analyses adjusted ECG prediction of CHD mortality for cohort, and baseline age, systolic blood pressure, serum cholesterol, body mass index and cigarette smoking. RESULTS: Silent ECG abnormalities of presumed severity were found in more than half of these elderly men, with higher prevalence in Finland, compared to the other two countries. Adjusted hazards ratios for CHD deaths as a function of major single or combined ECG abnormalities, such as QQS and ST-T abnormalities, arrhythmia, definite and possible myocardial infarction and an operative definition of ischaemia, are generally similar across areas varying according to severity from around 1.5 to almost 4. Groupings of minor and major ECG abnormalities in the pooled countries gave significant relative risks of 1.79 and 3.12 respectively, compared to the group without or with marginal abnormalities. Sensitivity and positive predictive value were low, while specificity was high. CONCLUSIONS: Silent ECG abnormalities in elderly people are common and they carry a high risk of coronary death in the next 10 years, with relative risk ranging from around 1.5 to almost 4 or more depending upon severity and combination of findings.

Aged↗
PubMed2001

Parental history of diabetes modifies the association between abdominal adiposity and hyperglycemia.

OBJECTIVE: To examine whether the association between abdominal obesity and hyperglycemia differs according to the presence of a parental history of diabetes. RESEARCH DESIGN AND METHODS: We conducted a cross-sectional study of 3,068 men and women, aged 20-65 years, without known diabetes who were fasting participants of a population-based study in three Dutch towns. Hyperglycemia was defined as a fasting plasma glucose concentration of 6.1 mmol/l (American Diabetes Association criterion). Waist circumference was categorized according to previously defined waist action levels. All estimates were adjusted for age and town. RESULTS: The regression coefficients for the association between waist circumference and fasting plasma glucose were larger in participants who had a parental history of diabetes than in those who did not (men beta = 0.31 vs. 0.16 mmol/SD, P [for interaction] = 0.003; women beta = 0.24 vs. 0.11 mmol/SD, P = 0.002). Furthermore, larger waist circumference (men > or = 94 vs. < 94 cm, women > or = 88 vs. < 80 cm) was associated with a greater excess prevalence of hyperglycemia in participants who had a parental history of diabetes than in those who did not (men 12.4 vs. 2.0%, P = 0.03; women 13.6 vs. 5.9%, P = 0.05). Adjustment for physical activity, alcohol intake, smoking, and educational level did not materially change the results. CONCLUSIONS: These findings indicate that the association between abdominal obesity and hyperglycemia is stronger in the presence of a parental history of diabetes. Blood glucose screening may be warranted at lower levels of waist circumference in individuals with a parental history of diabetes.

Abdomen↗
PubMed2000

Fish consumption and coronary heart disease mortality in Finland, Italy, and The Netherlands.

Fish consumption seems to protect against death from coronary heart disease (CHD). If this association is due to n-3 polyunsaturated fatty acids, especially fatty fish may be responsible for this protective effect. The association between total, lean, and fatty fish consumption and the risk of CHD mortality was examined in 1,088 Finnish, 1,097 Italian, and 553 Dutch men participants in the Seven Countries Study who were aged 50-69 years and free of CHD around 1970. After 20 years of follow-up, 242 (22.2%) men in Finland, 116 (10.6%) men in Italy, and 105 (19.0%) men in the Netherlands had died of CHD. Cox proportional hazards analysis showed no association between total fish consumption and CHD mortality. After adjustments were made for age, body mass index, smoking, energy intake, and relevant dietary variables, the pooled relative risk for the highest quartile of total fish compared with no fish consumption in the three countries was 1.08 (95% confidence interval: 0.76, 1.53). Lean fish consumption also was not associated with CHD mortality in any country. Fatty fish compared with non-fatty-fish consumption was associated with lower CHD mortality; the adjusted, pooled relative risk for fatty fish consumers was 0.66 (95% confidence interval: 0.49, 0.90). These data suggest that especially fatty fish is protective against CHD mortality.

Adult↗
PubMed2000

Underweight and overweight in relation to mortality among men aged 40-59 and 50-69 years: the Seven Countries Study.

This study investigated the relation between body mass index (BMI) and the all-cause mortality rate among 7,985 European men. Starting around 1960, when all men were aged 40-59 years, mortality was followed for 15 years (1960-1975); starting around 1970, the survivors were followed for an additional 15 years (1970-1985). For the first and second follow-up periods, a BMI of 18.5-25 kg/m2 around 1960 and 1970, respectively, was considered the reference category. The authors found that the hazard ratios of mortality for a BMI of <18.5 kg/m2 was 2.1 (95% confidence interval (CI): 1.5, 2.8) for the first follow-up period and 1.7 (95% CI: 1.3, 2.2) for the second. A BMI of 25-30 kg/m2 was not related to increased mortality. Among never smokers, the hazard ratios for a BMI of >30 kg/m2 were 1.8 (95% CI: 1.2, 2.8) for the 1960-1975 follow-up period and 1.4 (95% CI: 1.0, 1.9) for the 1970-1985 follow-up period. A BMI of >30 kg/m2 was not related to increased mortality among current smokers. When mortality was followed for more than 15 years, the hazard ratio for a BMI of <18.5 kg/m2 declined and the hazard ratios for a BMI of >30 kg/m2 did not change. Underweight among those in all smoking categories and severe overweight in never smokers remained predictors of increased mortality when middle-aged men became older.

Adult↗
PubMed2000

The relation between blood pressure and mortality due to coronary heart disease among men in different parts of the world. Seven Countries Study Research Group.

BACKGROUND: Elevated blood pressure is known to be a risk factor for death from coronary heart disease (CHD). However, it is unclear whether the risk of death from CHD in relation to blood pressure varies among populations. METHODS: In six populations in different parts of the world, we examined systolic and diastolic blood pressures and hypertension in relation to long-term mortality from CHD, both with and without adjustment for variability in blood pressure within individual subjects. Blood pressure was measured at base-line in 12,031 men (age range, 40 to 59 years) who were free of CHD. During 25 years of follow-up, 1291 men died from CHD. RESULTS: At systolic and diastolic blood pressures of about 140 and 85 mm Hg, respectively, 25-year rates of mortality from CHD (standardized for age) varied by a factor of more than three among the populations. Rates in the United States and northern Europe were high (approximately 70 deaths per 10,000 person-years), but rates in Japan and Mediterranean southern Europe were low (approximately 20 deaths per 10,000 person-years). However, the relative increase in 25-year mortality from CHD for a given increase in blood pressure was similar among the populations. The overall unadjusted relative risk of death due to CHD was 1.17 (95 percent confidence interval, 1.14 to 1.20) per 10 mm Hg increase in systolic pressure and 1.13 (95 percent confidence interval, 1.10 to 1.15) per 5 mm Hg increase in diastolic pressure, and it was 1.28 for each of these increments after adjustment for within-subject variability in blood pressure. CONCLUSIONS: Among the six populations we studied, the relative increase in long-term mortality due to CHD for a given increase in blood pressure is similar, whereas the absolute risk at the same level of blood pressure varies substantially. If the absolute risk of CHD is used as an indication for antihypertensive therapy, these findings will have major implications for treatment in different parts of the world.

Adult↗