PubMed Health⌕ Search

Biomedical subjects

J Virtamo

Publications and source records attributed to J Virtamo.

At least 19 recordsLinked to original sources
PubMed1996

Serum high density lipoprotein cholesterol, alcohol, and coronary mortality in male smokers.

OBJECTIVE: To determine whether the increase in mortality from coronary heart disease with high concentration (> 1.75 mmol/l) of high density lipoprotein cholesterol could be due to alcohol intake. DESIGN: Cohort study. SETTING: Placebo group of the alpha tocopherol, beta carotene cancer prevention (ATBC) study of south western population in Finland. PARTICIPANTS: 7052 male smokers aged 50-69 years enrolled to the ATBC study in the 1980s. MAIN OUTCOME MEASURES: The relative and absolute rates adjusted for risk factors for clinically or pathologically verified deaths from coronary heart disease for different concentrations of high density lipoprotein cholesterol with and without stratification for alcohol intake. Similar rates were also calculated for different alcohol consumption groups. RESULTS: During the average follow up period of 6.7 years 258 men died from verified coronary heart disease. Coronary death rate steadily decreased with increasing concentration of high density lipoprotein cholesterol until a high concentration. An increase in the rate was observed above 1.75 mmol/l. This increase occurred among those who reported alcohol intake. Mortality was associated with alcohol intake in a J shaped dose response, and those who reported consuming more than five drinks a day (heavy drinkers) had the highest death rate. Mortality was higher in heavy drinkers than in non-drinkers or light or moderate drinkers in all high density lipoprotein categories from 0.91 mmol/l upward. CONCLUSIONS: Mortality from coronary heart disease increases at concentrations of high density lipoprotein cholesterol over 1.75 mmol/l. The mortality was highest among heavy drinkers, but an increase was found among light drinkers also.

Adult↗
PubMed1996

Effect of vitamin E and beta carotene on the incidence of angina pectoris. A randomized, double-blind, controlled trial.

OBJECTIVE: To examine the effect of supplementation with vitamin E (alpha tocopherol), beta carotene, or both on the incidence of angina pectoris in men without known previous coronary heart disease. DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING AND PARTICIPANTS: Participants in the Alpha Tocopherol, Beta Carotene Cancer Prevention Study (N=29133) were male smokers aged 50 through 69 years who were living in southern and western Finland. Of these men, 22269 were considered free of coronary heart disease at baseline and were followed up for the incidence of angina pectoris. INTERVENTION: Participants were randomized to receive 50 mg/d of alpha tocopherol, 20 mg/d of beta carotene, both, or placebo in a 2x2 design. OUTCOME MEASURES: An incident case was defined as the first occurrence of typical angina pectoris identified in administering the annually repeated World Health Organization (Rose) Chest Pain Questionnaire. RESULTS: During a median follow-up time of 4.7 years (96427 person-years), 1983 new cases of angina pectoris were detected. Comparing alpha tocopherol-supplemented subjects with non-alpha tocopherol-supplemented subjects showed a relative risk (RR) of angina pectoris incidence of 0.91 (95% confidence interval[CI], 0.83 to 0.99; P=.04). The RR for incidence of angina pectoris for the beta carotene- supplemented subjects compared with those not receiving beta carotene was 1.06 (95% CI, 0.97 to 1.16; P=.19). Compared with those receiving placebo, the RRs for incidence of angina pectoris were 0.97 (95% CI, 0.85 to 1.10) and 0.96 (95% CI, 0.85 to 1.09) in the alpha tocopherol and alpha tocopherol plus beta carotene groups, respectively, and 1.13 (95% CI, 1.00 to 1.27) in the beta carotene group (P=.06). Baseline dietary intakes and serum levels of alpha tocopherol and beta carotene did not predict incidence of angina pectoris. CONCLUSIONS: Supplementation with alpha tocopherol was associated with only a minor decrease in the incidence of angina pectoris. Beta carotene had no preventive effect and was associated with a slight increase of angina.

Aged↗
PubMed1996

Alcohol consumption and risk of colorectal cancer in a cohort of Finnish men.

We investigated the association between self-reported alcohol ingestion and colorectal cancer in a cohort of male smokers in Finland. Among 27,109 men aged 50 to 69 years, 87 colon and 53 rectal cases were diagnosed during the five to eight years of follow-up. Among drinkers, colorectal cancer risk increased with the amount of alcohol consumed (P trend = 0.01) with risk increasing by 17 percent for each drink consumed. Both beer and spirits contributed to this increased risk. Further analyses revealed that the positive association with alcohol was primarily for colon cancer (P trend = 0.01). Interestingly, risk of colorectal cancer associated with drinking (cf self-reported abstinence) changed with follow-up time, suggesting an inverse association for alcohol early in follow-up, and a positive association after about three-and-a-half years of follow-up. Follow-up time did not modify the positive association with amount of alcohol among drinkers, however. Results also indicated that beta-carotene supplementation may attenuate the effect of alcohol on colorectal cancer risk among drinkers. In conclusion, this study supports a role for alcohol in colon carcinogenesis and suggests that similar studies should evaluate carefully the effects of lifetime drinking habits and recent abstinence.

Aged↗
PubMed1996

Reported alcohol intake, diet and body mass index in male smokers.

OBJECTIVE: The study was carried out to determine associations of reported alcohol intake with diet and body mass index. Type and frequency of consumed alcohol were also considered. DESIGN: A cross-sectional study. SETTING: The baseline examination of the participants of the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study in 1985-1988. SUBJECTS: 27215 middle-aged Finnish male smokers. INTERVENTIONS: The diet was assessed by a self-administered food use questionnaire: Subject's habitual diet and alcohol intake over the previous 12 months were asked. Body mass index was used as the measure of adiposity. RESULTS: Energy intake from food was not related to alcohol intake. Although alcohol consumption was associated with food selection (eg berry and coffee consumption), this only slightly influenced daily nutrient intakes. Intake of spirits was more consistently related to higher body mass index than that of other alcoholic beverages. Daily alcohol intake had a much smaller association with body mass index than less frequent use, independently of the total consumption. CONCLUSIONS: The differences in nutrient intake between abstainers, light and moderate alcohol consumers were small although the consumption of many foods varied with alcohol consumption. Even if alcohol consumption is one noteworthy factor associated with weight, the energy from alcohol increases body weight less than expected; both the type and frequency of consumed alcohol may explain why energy from alcohol is utilized less efficiently than non-alcoholic energy.

Aged↗
PubMed1996

Colorectal cancer and folate status: a nested case-control study among male smokers.

Evidence is accumulating that folate, a B vitamin found in green leafy vegetables, may affect the development of neoplasia. We examined the relationship between folate status and colorectal cancer in a case-control study nested within the Alpha-Tocopherol Beta-Carotene Study cohort of male smokers 50-69 years old. Serum folate was measured in 144 incident cases (91 colon, 53 rectum) and 276 controls matched to cases on baseline age, clinic, and time of blood collection. Baseline dietary folate was available from a food-use questionnaire for 386 of these men (92%). Conditional logistic regression modeling was used. No statistically significant association was observed between serum folate and colon or rectal cancer. Although a 2-fold increase in rectal cancer risk was suggested for men with serum folate > 2.9 ng/ml and those in the highest quartile of energy-adjusted folate intake, there was no evidence of a monotonic dose-response, and all confidence intervals included unity. For dietary folate and colon cancer, odds ratios of 0.40 [95% confidence interval (CI), 0.16-0.96], 0.34 (95% CI, 0.13-0.88), and 0.51 (95% CI, 0.20-1.31) were obtained for the second through fourth quartiles of energy-adjusted folate intake, respectively, compared to the first (P for trend = 0.15). Furthermore, men with a high-alcohol, low-folate, low-protein diet were at higher risk for colon cancer than men who consumed a low-alcohol, high-folate, high-protein diet (OR, 4.79; 95% CI, 1.36-16.93). This study suggests a possible association between low folate intake and increased risk of colon cancer (but not rectal cancer) and highlights the need for further studies that measure dietary folate and methionine, along with biochemical measures of folate (i.e., erythrocyte and serum), homocysteine, and vitamin B12.

Aged↗
PubMed1995

Effects of alpha-tocopherol and beta-carotene supplements on cancer incidence in the Alpha-Tocopherol Beta-Carotene Cancer Prevention Study.

The Alpha-Tocopherol Beta-Carotene (ATBC) Cancer Prevention Study was a placebo-controlled, randomized intervention trial testing the hypothesis that beta-carotene and alpha-tocopherol (vitamin E) supplements prevent lung and other cancers. The study is predicated on a substantial body of evidence supporting a role in cancer prevention for these micronutrients. Based on the 2 x 2 factorial study design, 29,133 eligible male cigarette smokers aged 50-69 y were randomly assigned to receive beta-carotene (20 mg), alpha-tocopherol (50 mg), beta-carotene and alpha-tocopherol, or placebo daily for 5-8 y. Capsule compliance was high (median = 99%). beta-Carotene treatment did not result in a decrease in cancer at any of the major sites but rather in an increase at several sites, most notably lung, prostate, and stomach (number of cases 474 compared with 402, 138 compared with 112, and 70 compared with 56, respectively). The vitamin E group had fewer incident cancers of the prostate and colorectum compared with the group not receiving vitamin E (number of cases 99 compared with 151 and 68 compared with 81, respectively), but more cancers of the stomach (70 compared with 56). In contrast to these intervention-based findings for beta-carotene and vitamin E supplements, we observed lower lung cancer rates in men with higher amounts of both serum and dietary beta-carotene and vitamin E at baseline.

Aged↗
PubMed1994

Risk factors for histologically confirmed benign breast tumors.

A case-control study of 156 cases of various types of benign breast disease (BBD) and 156 population controls was conducted to investigate the role of various behavioral, reproductive, and hormonal factors in the etiology of these breast disorders. Our results indicate that the distinct histological groups of BBD differ from each other in respect to possible risk factors. Small sample size poses severe restrictions on the conclusiveness of the results and thus they should be considered as preliminary and suggestive. Our results do not support the notion that BBD could be considered as a uniform entity with common risk factors.

Adult↗
PubMed1994

HDL cholesterol and mortality in Finnish men with special reference to alcohol intake.

BACKGROUND: There is substantial evidence that a low serum level of HDL cholesterol (HDLC) is a risk factor for coronary deaths. However, data on older people are scarce, and previous studies have not examined this association in relation to alcohol intake. METHODS AND RESULTS: Coronary mortality, all-cause mortality, and mortality due to alcohol and violence were related to HDLC levels among 7052 male smokers 50 to 69 years old in south and west Finland enrolled from 1984 to 1988 in the ATBC (AT, alpha-tocopherol; BC, beta-carotene) Study placebo group. During the average follow-up period of 4.7 years, 620 men died; 222 of these deaths were from coronary heart disease and 82 from causes related alcohol and violence. HDLC levels were inversely associated with coronary mortality, irrespective of age, whereas high total cholesterol was positively associated with coronary mortality among the younger men, 50 to 59 years of age, but not among the older men, 60 to 69 years old. Correction for temporal variation in HDLC measurement indicated a 43% stronger inverse association between HDLC and coronary mortality compared with that based only on a single value. The inverse association of HDLC and coronary mortality was less marked at higher levels of alcohol intake. All-cause and alcohol- and violence-related mortality were positively associated with HDLC among the younger men. All-cause mortality showed a U-shaped dose response among men > or = 60 years old. CONCLUSIONS: Previous studies may have underestimated the beneficial effect of high HDLC because of regression-dilution bias and the confounding effect of heavy alcohol intake. This study supports the view that, particularly among older men, lipoprotein fractions may be more appropriate for screening than total cholesterol.

Aged↗
PubMed1993

Lifetime menstrual activity--indicator of breast cancer risk.

A case-control study of 67 cases of breast cancer and 157 controls was conducted to investigate the role of different behavioral, reproductive, and hormonal factors and to develop a unifying indicator of breast cancer risk. The results confirm previous reports of the influence of smoking on the risk of breast cancer. Age at menarche was found to be a risk factor among the premenopausal women. Late age at menopause was suggestive of an increase in risk. Long use of oral contraceptive or estrogen supplementation were risk-enhancing both pre- and postmenopausally. Lifetime duration of menstrual activity (LMA) combines age at menarche and menopause, parity, and lactation into a biologically plausible model. Our findings concerning LMA support its role as a determinant of breast cancer.

Adult↗
PubMed1993

Seasonal variation of serum concentrations of beta-carotene and alpha-tocopherol.

We studied the seasonal variation in serum concentrations of beta-carotene and alpha-tocopherol (HPLC) in 17,247 Finnish men who smoked. Month of blood sampling was a statistically significant determinant of serum concentration of beta-carotene in a regression model including age, body mass index, alcohol and fat intakes, total serum cholesterol, and daily cigarettes as covariates. The serum concentrations were lowest in April-June and highest in October-November. The 1.5-fold increase in the serum concentration of beta-carotene during the fall reflects the seasonality of dietary sources of carotenoids in Finland. The serum concentrations of alpha-tocopherol demonstrated no seasonal variation but remained close to 27.6 mumol/L throughout the year. The results indicate that the seasonal variation of serum concentrations of beta-carotene should be taken into account in long-term studies in which comparison of groups or individuals is based on serum concentrations.

Aged↗
PubMed1993

Toenail selenium as an indicator of selenium intake among middle-aged men in an area with low soil selenium.

Toenail selenium concentration has been proposed as a long-term (6-12 mo) indicator of human selenium status. This study investigated the association between toenail selenium concentration and selenium intake and other dietary factors among 166 urban men aged 55-69 y. The dietary information was collected by food records covering a 6-mo period. Toenail clippings were collected by mail 9-10 mo after food recording. The mean selenium intake from food was 42.5 micrograms/d and the dietary intake was equal to that of users and nonusers of selenium supplements. The mean toenail selenium concentration was 0.47 mg/kg. The mean selenium intake from supplements was 29.7 micrograms/d among supplement users. In the analysis of covariance the best predictors of toenail selenium concentration were selenium intake from supplements and food, and among supplement users dietary beta-carotene also.

Aged↗
PubMed1992

Serum beta-carotene before and after beta-carotene supplementation.

A two-month double-blind, placebo-controlled supplementation study of oral beta-carotene (20 mg daily) was conducted. Two hundred and twenty two 30-69 year old men were randomized into either a beta-carotene or placebo group, and serum samples were obtained at baseline, follow-up (2 months), and up to 12 weeks post-supplementation. Serum beta-carotene increased on average 10-fold in the beta-carotene group, from 0.53 +/- 0.32 mumol/l (mean +/- SD) at baseline to 4.99 +/- 2.47 mumol/l at follow-up (P less than 0.0001), and beta-carotene levels remained elevated up to 12 weeks post-supplementation (0.61 +/- 0.15 mumol/l). No changes in serum retinol, alpha-tocopherol, or total cholesterol were observed. At baseline, serum beta-carotene levels were positively correlated with dietary beta-carotene (r = 0.29) and inversely correlated with body mass index and serum gamma-glutamyltransferase (r = -0.33 and r = -0.40, respectively). The inverse association with body mass index and serum gamma-glutamyltransferase persisted during active supplementation, whereas the positive association with dietary beta-carotene disappeared. In multivariate analysis, serum cholesterol was also positively associated with serum beta-carotene levels both before and after supplementation. Baseline serum beta-carotene was the factor most strongly associated (positively) with serum beta-carotene after supplementation. Our study highlights the importance of several factors which affect serum beta-carotene.

Administration, Oral↗
PubMed1991

Dietary cholesterol, fatty acids, and the risk of lung cancer among men.

The relation between dietary cholesterol and fatty acids and the incidence of lung cancer was studied among 4,538 Finnish men aged 20-69 years and initially free of cancer. During 20 years of follow-up, 117 lung cancer cases were diagnosed. Cholesterol intake was not associated with lung cancer risk, the age-, smoking-, and energy-adjusted relative risk between the lowest and highest tertiles being 1.0 [95% confidence interval (CI) = 0.6-1.9]. The intake of saturated fatty acids was nonsignificantly related with lung cancer incidence, the relative risk for the lowest compared with the highest tertile being 1.6 (CI = 0.8-3.2). The association was stronger among smokers than among nonsmokers, the relative risks being 2.1 (CI = 1.0-4.3) and 1.3 (CI = 0.4-4.1), respectively. The relative risk among smokers, however, decreased to 1.5 after adjustment for the amount they smoked. In the total cohort, there was a significantly elevated risk of lung cancer among men with a high intake of butter, one of the main sources of saturated fatty acids, the relative risk being 1.9 (CI = 1.1-3.2). The present data do not confirm previous results suggesting that dietary cholesterol predicts the occurrence of lung cancer among men. The association between intake of saturated fatty acids and lung cancer observed in the present study may be partly due to heavy smoking among high consumers of saturated fat.

Adult↗
PubMed1990

Effect of sampling site on fatty acid composition of human breast adipose tissue.

The effect of sampling site and proximity of malignant tumor on the relative fatty acid composition of human breast adipose tissue was studied in 10 cases of breast cancer. The four anatomic quadrants of breast did not statistically significantly differ from each other in relation to any of the 30 fatty acids studied. Proximity of the malignant tumor did not affect the relative fatty acid composition of fat when compared with more distant sampling sites. Representative samples of breast adipose tissue for fatty acid composition analysis can be obtained from tissue adjacent to the tumor.

Adipose Tissue↗
PubMed1990

Variability in nutrient and food intakes among older middle-aged men. Implications for design of epidemiologic and validation studies using food recording.

The authors conducted a dietary methodology study in 1984 in Finnish men aged 55-69 years in order to validate two dietary assessment instruments being used in the US-Finland Alpha-Tocopherol, Beta-Carotene Lung Cancer Prevention Trial. Twelve 2-day food records collected from 162 men over a 6-month period, including every day of the week, served as the reference measure. This report focuses on three important questions for investigating diet and disease relations: 1) How many days are necessary to classify "usual" intake? 2) Is there loss as a result of using consecutive days? 3) Which days are necessary for assessment and classification of "usual" diet? A repeated-measures regression model was used to estimate the variance components and the effects of consecutive days, weekday (weekday vs. weekend), and season. Correlations between the averages of different numbers of days of food records and "true" usual intake were examined along with the resulting attenuations in relative risk. Results suggest that 7-14 days are required to adequately classify most individuals into categories of intake for most nutrients and some foods. There appears to be some loss of information from using consecutive days rather than days further apart. Weekday/weekend differences in mean intakes are slight, and the rank ordering of individuals appears to be preserved. A moderate seasonal effect is shown for classification of fruits, but only a slight one is seen for micronutrients and berries. Implications for the design of epidemiologic and validation studies are discussed.

Aged↗
PubMed1988

Reproducibility and validity of dietary assessment instruments. I. A self-administered food use questionnaire with a portion size picture booklet.

A self-administered food use questionnaire which included 276 food items and mixed dishes and a portion size picture booklet with 122 photographs was developed for a large lung cancer intervention trial among approximately 27,000 Finnish men aged 50-69 years. The reproducibility and validity of this questionnaire were studied from March to October 1984. In the reproducibility study, 121 men aged 55-69 years completed the questionnaire three times, at three-month intervals. The intraclass correlations varied from 0.56 for vitamin A to 0.88 for alcohol, with most falling between 0.60 and 0.70. In the validity study, 190 men of similar age kept food consumption records for 12 two-day periods, distributed evenly over a period of six months, and filled in the questionnaire both before and after this period. Correlations between nutrient intake values from the food records and the food use questionnaires ranged from 0.40 for selenium to 0.80 for alcohol. Among subjects who belonged to the lowest quintile on the basis of the food record measurement, an average of 51 per cent fell into the same quintile and 76 per cent fell into the lowest two quintiles when they were categorized on the basis of the food use questionnaire. Findings were similar for the upper tail of the distribution. These data indicate that the self-administered food use questionnaire is useful for measuring individual or group intakes for a variety of nutrients.

Aged↗