Biomedical subjects

D Kromhout

Publications and source records attributed to D Kromhout.

At least 235 records · Page 13Linked to original sources

PubMed1990

Changes in food and nutrient intake in middle-aged men from 1960 to 1985 (the Zutphen Study).

Within the Zutphen Study dietary surveys using the cross-check dietary history method were carried out in 1960, 1965, 1970, and 1985. Of the 872 men aged 40-59 y examined in 1960, 315 participated in all four surveys. In 1985 a small random sample of 51 men aged 40-59 y was also investigated. Between 1960 and 1985 the consumption of bread, potatoes, and edible fats decreased and the consumption of fruits, pastries, nuts, and alcoholic beverages increased in both the aging cohort and in the two independent samples of middle-aged men examined 25 y apart. These changes were accompanied by a substantial decrease in the intake of monounsaturated fat, polysaccharides, and potassium and a substantial increase in animal protein and alcohol. Small changes were observed in the intake of saturated fatty acids, polyunsaturated fatty acids, dietary cholesterol, and dietary fiber. Since 1960 some changes in a nutritionally desirable direction were observed but the diet of the Zutphen men in 1985 departs substantially from the guidelines for a healthy diet formulated by The Netherlands Nutrition Council in 1986.

Adult↗

PubMed1990

Twenty-year stroke mortality and prediction in twelve cohorts of the Seven Countries Study.

Twelve cohorts of men aged 40-59 for a total of 8287 individuals in six countries (Finland, the Netherlands, Italy, Yugoslavia, Greece and Japan) were examined in the late 1950s or early 1960s for the measurement of some risk factors and then followed up for mortality and causes of death through 20 years. Large differences in 20-year death rates from stroke were recorded among cohorts, with the highest levels in the pool of the Yugoslavia (67 per 1000) and Japanese cohorts (62 per 1000) and the lowest in the Dutch cohort (22 per 1000). The simple linear correlation (among cohorts) of stroke mortality on mean levels at entry of some factors showed inverse significant coefficients for systolic (-0.63) diastolic (-0.51) and mean blood pressure (-0.72), and for serum cholesterol (-0.72), whereas no significant coefficients were found for mean body mass index, mean cigarette consumption and mean physical activity. The Cox model solved for six national pools of cohorts showed that only age and mean blood pressure carry significant positive coefficients, whereas all the other available factors (cigarette consumption, serum cholesterol, body mass index, physical activity) did not approach significant levels except the negative coefficients of smoking habits in Greece.

Adult↗

PubMed1990

Educational level and mortality in a 32-year follow-up study of 18-year-old men in The Netherlands.

Social inequities and their relation to health form a topic of growing concern in the Netherlands. The present investigation on educational level and mortality was carried out in a cohort of men born in 1932, examined for military service in 1950/1951 and for whom vital statistics could be obtained. In the group of 78,505 men, 3456 deaths occurred during the follow-up until 31 December 1981. A life table analysis revealed an inverse relation between educational level and survival. In a multivariate logistic regression model the confounding effects of height and health score were taken into account. In addition to all-cause mortality, the relationships of educational level and mortality from coronary heart disease, cancer and accidents consistently showed an inverse pattern. The applicability of the results elsewhere is discussed.

Accidents↗

PubMed1990

Occupational exposure and 25-year incidence rate of non-specific lung disease: the Zutphen Study.

Information gathered in the Zutphen Study, the Dutch contribution to the Seven Countries Study that started in the 1960s, was used for the present study. In 1960 878 men participated in the physical examination and they were followed for 25 years until 1 July 1985. During this follow-up, their morbidity status was verified regularly. With this information the occurrence of chronic non-specific lung disease (CNSLD) at a specific time was coded by one physician, using strict criteria. The CNSLD diagnosis was based on the following criteria: episodes of respiratory symptoms such as regular cough and phlegm for longer than three months or episodes of wheezing and shortness of breath reported to the survey physician, or: diagnosis of CNSLD, including chronic bronchitis or emphysema by a clinical specialist. Occupation in 1960 was coded and used to generate specific occupational exposures with a Job Exposure Matrix. Because the exact time of diagnosis of CNSLD was known, incidence densities could be calculated. For 804 men a complete set of data was available. A Poisson regression analysis was used to analyse the relationships between the incidence density and independent variables like age, calendar period, occupation and specific occupational exposures. Blue collar workers had a significantly elevated incidence density ratio (IDR) compared to white collar workers (1.82, 95% confidence limits (CL): 1.35, 2.46). Subgroups of blue collar workers, wood and paper workers, textile workers, and tailors, construction workers and transport workers had significantly elevated IDRs also. Of the specific exposures heavy metals, mineral dust and adhesives had a significantly elevated IDR.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1990

Habitual dietary intake and glucose tolerance in euglycaemic men: the Zutphen Study.

Relationships between specific dietary factors and aspects of glucose tolerance were examined using data from the Zutphen Study. In 1970, an oral glucose tolerance test was carried out in 394 non-diabetic men aged 50-70. Habitual dietary intake was assessed using the cross-check dietary history method. In univariate analyses, positive associations were observed between fasting glucose and the intake of saturated fat (correlation coefficient (r) = 0.13, p less than 0.01) and dietary cholesterol (r = 0.16, p less than 0.01), and also reflected by an association with egg consumption. These results were confirmed in multivariate analyses, taking into account total energy intake, subscapular skinfold thickness and age. In univariate analyses, significant inverse associations were found between the incremental area under the curve (IAUC) and the intake of mono- and disaccharides (r = -0.22, p less than 0.001) and pectin (r = -0.15, p less than 0.01), as well as the consumption of sugar products. Similar results were obtained in multivariate analyses. The change in saturated fat intake in the period 1960-1970 was positively associated with IAUC, independent of concurrent intake in 1970, age, subscapular skinfold and change in energy intake. In a similar model the change in pectin intake was inversely associated with IAUC. These findings suggest that the intake of saturated fat and dietary cholesterol may be detrimental to glucose tolerance, in contrast to the intake of pectin and mono- and disaccharides.

Age Factors↗

PubMed1990

Total and HDL cholesterol and their correlates in elderly men in Finland, Italy, and The Netherlands.

In 1984 and 1985, 25-year follow-up studies were carried out in the Italian, Finnish, and Dutch cohorts of men originally examined around 1960 in the Seven Countries Study. Risk factors for coronary heart disease were determined in 2,255 men aged 65-84 years. The average serum total cholesterol levels of the elderly men in Finland and the Netherlands were similar, at around 236 mg/dl (6.10 mmol/liter). The average serum total cholesterol levels of the elderly men in Italy were about 10 mg/dl (0.26 mmol/liter) lower. During 25 years of follow-up, the average serum total cholesterol level increased by 29 mg/dl (0.75 mmol/liter) among the Italian survivors, decreased by 23 mg/dl (0.59 mmol/liter) in the Finnish survivors, and did not change in the Dutch survivors. Age, Quetelet index, and coffee consumption were the most important correlates of total cholesterol in these elderly men. Quetelet index, alcohol consumption, age, and cigarette smoking were significantly associated with high density lipoprotein (HDL) cholesterol. The results of this study suggest that modifiable risk factors are related to total and HDL cholesterol in elderly men in different cultures.

Age Factors↗

PubMed1989

Habitual fish consumption, fatty acids of serum phospholipids and platelet function.

To clarify whether the inverse relation between habitual fish consumption and cardiovascular mortality in the Dutch town of Zutphen could be explained by changes in platelet function or fibrinolysis, 40 healthy elderly men were selected from the Zutphen study population on the basis of their fish consumption over the last 26 years. In the high-fish group (n = 25) fish consumption was on average 33 g per person per day; in the low-fish group (n = 15) it was on average 2 g per person per day. This difference was reflected by significant differences in the concentrations of timnodonic acid (20:5n - 3) and cervonic acid (22:6n - 3) in the serum phospholipids of the participants. Between both groups no significant differences were observed in cutaneous bleeding time, platelet number, and collagen-induced platelet aggregation and ATP-release in whole blood. The same holds for the actual as well as the potential thromboxane B2 formation of activated platelets and for the activity of the plasminogen activator inhibitor. For most of the platelet-related variables a trend was found for a lower activity in the high-fish group. Therefore changes in platelet function might not explain, but may have slightly contributed to the inverse relationship between coronary heart disease and fish consumption, as observed in Zutphen.

Adenosine Triphosphate↗

PubMed1989

The relative validity of retrospectively assessed energy intake data in cases with myocardial infarction and controls (the Zutphen Study).

The relative validity of energy intake data, retrospectively collected after a 15-year period, was investigated. In 1970 dietary data were obtained by the cross-check dietary history method among 615 men aged 50-69. Between 1970 and 1985, 43 of these men had a non-fatal myocardial infarction. As controls 86 healthy men were selected. Of these 129 men, 112 were interviewed about their usual food intake in 1985 and in 1970. The retrospectively collected food intake data were compared with the data obtained in 1970. Retrospectively the average energy intake was overestimated by approximately 300 kcal/day. The amount of overestimation was statistically associated with change in energy intake, education and interviewer. The data collected in 1970 showed a significantly lower energy intake in cases compared with controls. However, the retrospectively assessed energy intake data showed no significant difference. A difference in energy intake between cases and controls may not be found when dietary intake data are assessed retrospectively.

Aged↗

PubMed1989

Body Mass Index at the age of 18 and its effects on 32-year-mortality from coronary heart disease and cancer. A nested case-control study among the entire 1932 Dutch male birth cohort.

In a nested case-control design the Body Mass Index at 18 years of age was related to 32-year mortality from coronary heart disease (ICD-codes: 410-414) and cancer (ICD-codes: 140-208) among the 1932 Dutch male birth cohort. By means of a logistic regression model the risk ratios were estimated for four BMI-categories: less than or equal to 18.99, 19.00-19.99, 20.00-24.99, greater than or equal to 25.00. Information on blood pressure, resting heart rate, initial health status, education and region of origin was available and these factors were taken into account as possible confounders. The mortality rate for coronary heart disease was highest for the men in the fattest group, while the leanest group showed an excess cancer mortality. The adjusted coronary heart disease mortality risk ratio was elevated for both BMI-categories above the reference category of 19.00-19.99, with an estimate of 2.5 for the men with a BMI greater than or equal to 25.00 at the age of 18. An increased cancer mortality risk ratio of 1.4, mainly due to lung cancer, was observed during the last 20 years of the 32-year follow-up period for the men with a BMI less than or equal to 18.99. The importance of age and differentiation of causes of death in interpreting the results of prospective studies is discussed.

Adolescent↗

PubMed1989

Food consumption patterns in the 1960s in seven countries.

At the end of the 1950s the Seven Countries Study was designed to investigate the relations between diet and cardiovascular diseases. Sixteen cohorts were selected in Finland, Greece, Italy, Japan, The Netherlands, United States, and Yugoslavia. During the 1960s food consumption data were collected from random samples of these cohorts by use of the record method. In Finland the intake of milk, potatoes, edible fats, and sugar products was very high. A similar but lower intake pattern was observed in The Netherlands. Fruit, meat, and pastry consumption was high in the United States; cereal and alcoholic drink consumption was high in Italy; and bread consumption high in Yugoslavians except for those in Belgrade. In Greece the intake of olive oil and fruit was high and the Japanese cohorts were characterized by a high consumption of fish, rice, and soy products. These differences in food consumption patterns have lessened during the past 25 y.

Adult↗

PubMed1989

Effects of body fat and its development over a ten-year period on glucose tolerance in euglycaemic men: the Zutphen Study.

The relationship between body fat and different aspects of glucose tolerance was examined within the Zutphen Study. In 1970 an oral glucose tolerance test (OGTT) was carried out in 404 non-diabetic men aged 50-70. None of the subjects could be classified as having impaired glucose tolerance. Body mass index (BMI), subscapular and triceps skinfold were positively related with fasting and 60 min serum glucose. Weak positive associations were found between 30 min glucose, BMI, and subscapular skinfold. For 120 min glucose, only the relationship with subscapular skinfold was significant. After adjustment for age and the other body fat indicators, the positive associations between body fat and fasting, 60 min and 120 min glucose were confirmed for subscapular skinfold only. Correlations between these glucose measurements and measurements of subscapular skinfold in the years between 1960 and 1970 were also significant and increased with time. Independent from subscapular skinfold in 1970 and age, changes in skinfold during the period 1960-70 were in general not significantly associated with glucose levels, except for 30 min glucose. The findings could to a large extent be explained by current knowledge of glucose metabolism.

Adipose Tissue↗

PubMed1989

Chronic non-specific lung disease and occupational exposures estimated by means of a job exposure matrix: the Zutphen Study.

Information gathered in the Zutphen Study, the Dutch contribution to the Seven Countries Study that started in the 1960s, was used in this study. Of the 1266 men invited to take part in the 1985 survey, 939 (74%) participated. All participants were interviewed according to the BMRC chronic non-specific lung disease (CNSLD) questionnaire and medically examined for CNSLD complaints by a trained physician. The physician also filled in a questionnaire containing questions concerning previous treatments for asthma, bronchitis and emphysema. Exposures were generated by means of a job exposure matrix on the basis of the longest performed job and the gain and grouped into 12 exposure categories. A logistic regression analysis was performed using the occupational exposures as the sector of industry dependent variables in allowing for smoking habits, age and socioeconomic status. For the diagnosis by the physician and treatment for emphysema and or bronchitis, the strongest elevated odds ratios were found, indicating an adverse effect of the occupational exposures. In contrast, the variable 'ever treated for asthma' had odds ratios smaller than one with most of the exposure variables indicating a selection effect. In an analysis in which everyone who was ever treated for asthma was excluded an increase in the odds ratios compared with the first analysis was seen. The relationships between occupational exposures as generated by the job exposure matrix and CNSLD were stronger than those recently reported in the literature.

Aged↗

PubMed1989

Inter-mediating risk factors in the relation between socioeconomic status and 25-year mortality (the Zutphen Study).

In the Zutphen Study data were collected on occupation, smoking habits, blood pressure, serum cholesterol, height and weight of 856 men who were 40-59 years old in 1960. Between 1960 and 1985 detailed information was collected on mortality. The effect of socioeconomic status as indicated by occupation on 25-year mortality was studied in relation to cigarette smoking, systolic blood pressure, serum cholesterol and Body Mass Index. It was found that socioeconomic status was an important determinant of mortality only in the men who were 40-49 years old in 1960. The risk of all-cause mortality among small business owners and manual workers was more than twice as high as that of men in the highest social class. After adjustment for the influence of cigarette smoking and systolic blood pressure these relationships remained. It can be concluded that socioeconomic status was an independent risk factor for long-term all-cause mortality, in men aged 40-49.

Adult↗

PubMed1989

The reproducibility of dietary intake data assessed with the cross-check dietary history method.

The reproducibility of food intake data from elderly men in the Zutphen Study (Zutphen, The Netherlands) was investigated in repeated dietary surveys carried out three (n = 115) and 12 (n = 145) months after the initial survey (April 1985). The differences in the reproducibility estimations for the two different time periods were generally small. The ratios of the interindividual and intraindividual variance were large for carbohydrates (2.6 and 2.7 for three months and 12 months, respectively) and small for vitamin A (1.1 and 0.4 for three months and 12 months, respectively). The larger this ratio, the higher the probability of detecting an existing relation. Information about inter- and intraindividual variation was used to calculate the attenuation factor. For most nutrients, the attenuation factor was about 0.8. This implies that a simple correlation between a nutrient and a risk factor will be only slightly lowered because of measurement error and the temporal variability of the dietary measurement when the cross-check dietary history method is applied once (e.g., a "real" correlation of 0.40 would be expected to be lowered to 0.32).

Aged↗

PubMed1989

Cardiovascular risk factors and the 25-year incidence of diabetes mellitus in middle-aged men. The Zutphen Study.

The association between classical cardiovascular risk factors, including diet, and the 25-year incidence of non-insulin-dependent diabetes mellitus was examined in 841 middle-aged men within the Zutphen Study. The incidence rate was 3.8/1,000 person-years. In univariate analyses, baseline measurements of subscapular and tricipital skinfold thicknesses, body mass index (weight (kg)/height (m)2), cigarette use, resting heart rate, and systolic blood pressure were significantly associated with diabetes incidence. In multivariate survival analyses also taking age, energy intake, and alcohol consumption into account, subscapular skinfold thickness, resting heart rate, and cigarette use were independently related to diabetes incidence. The effect of subscapular skinfold thickness was shown among subjects free of cardiovascular disease at baseline and during follow-up and among cases who developed cardiovascular disease. Cigarette smoking was an independent risk factor only in men who remained free of cardiovascular disease, while the effect of resting heart rate was stronger within incident cases of cardiovascular disease. No associations were found between dietary factors and diabetes incidence.

Adult↗

PubMed1989

Serum sodium, potassium, calcium and magnesium and blood pressure in a Dutch population.

The relationships between the serum cations sodium, potassium, calcium and magnesium and blood pressure were investigated in a population-based sample of 182 Dutch persons aged 20-59 years. Age, Quetelet index (weight/height2), albumin and gamma-glutamyl transpeptidase (gamma-GT) were taken into account as confounders in the analyses. In univariate and multivariate analyses, serum calcium was strongly positively related to both systolic and diastolic blood pressure in women. These relationships were weaker in men. In the combined analysis, including both men and women and adjusting for the confounders (also including sex), a strong independent positive association was observed between serum calcium and blood pressure. In the combined analysis, a weak inverse relationship was found between serum potassium and diastolic blood pressure; this relationship was also found in women. No relationship was found between either serum sodium or serum magnesium and blood pressure. These results suggest that serum calcium concentrations particularly could play an important role in the regulation of blood pressure.

Adult↗

PubMed1989

N-3 fatty acids and coronary heart disease: epidemiology from Eskimos to Western populations.

The original cross-cultural comparisons between Greenland Eskimos and Danes and between Japan and Western countries suggested that a high fish intake was associated with low mortality rates from coronary heart disease. More comprehensive cross-cultural studies, e.g. the Seven Countries Study showed that the saturated fat content of the diet is more important than the amount of fish in explaining differences in coronary heart disease mortality between countries. Cohort studies carried out in cultures with a low level of fish consumption showed that persons who eat fish once or twice a week had lower mortality rates from coronary heart disease than persons who did not eat fish. The results of the epidemiological studies carried out so far suggest that a diet low in saturated fat in combination with a low level of fish consumption may be of importance for coronary heart disease prevention.

Animals↗

PubMed1989

Seven Countries Study. First 20-year mortality data in 12 cohorts of six countries.

Out of the original 16 cohorts in the Seven Countries Study on Cardiovascular Diseases, 12 population samples in six countries have reached the 20 year follow-up deadline. Data on mortality became fully available for a total of 8287 men aged 40-59 at entry examination (two cohorts in Finland, one in the Netherlands, three in Italy, two in Yugoslavia, two in Greece, and two in Japan). Death rates from CHD as well as from all causes follow the traditional falling north to south trend (18 fold between the extremes for CHD; 2.7 fold for total mortality). The differences in all causes mortality are, however, largely accounted for by the variation in CHD mortality. The mean entry levels of serum cholesterol and representative levels of the consumption of saturated fats, mono-unsaturated fats, poly-unsaturated fats and carbohydrates explain a large proportion of inter-cohort difference in CHD mortality (81% for saturated fats). By applying the proportional hazards model to the pools of national cohorts, with CHD deaths as end-point and five risk factors as covariates, only age and mean blood pressure are universally significant predictors of fatal events. Cholesterol, smoking habits, body mass index and physical activity play some part but not in all the pools. Age and mean blood pressure are also the only universal risk factors for all causes of death.

Adult↗