Biomedical subjects

E J Feskens

Publications and source records attributed to E J Feskens.

At least 37 records · Page 2Linked to original sources

PubMed2000

Prospective investigation of emotional control and cancer risk in men (the Zutphen Elderly Study) (The Netherlands).

OBJECTIVES: Emotional control is hypothesized to increase cancer incidence and cancer mortality risk. We tested the hypothesis prospectively on all cancers in elderly men. METHODS: The Zutphen Elderly Study on lifestyle and chronic diseases started in 1985. The total sample consisted of 939 men born between 1900 and 1920 and living in Zutphen (response 74%). In 1985, emotional control was measured by questionnaire with the Courtald Emotional Control Scale (CECS). The CECS consists of three dimensions (anger, anxiety and depression). Emotional control scores were grouped in tertiles. Information on cancer incidence and mortality was collected until December 1994 through general practitioners and hospital administration (119 incidence cases, and 71 deaths from cancer). Cox proportional hazards analyses were performed, adjusted for sociodemographic, psychosocial, and lifestyle-related factors. RESULTS: Overall emotional control and emotional control of anger and of anxiety were not convincingly related to cancer risk. Intermediate control of depression was related to cancer incidence (fully adjusted RR = 1.7, 95% CI = 1.0-2.8). Both intermediate and high control of depression were related to cancer mortality (RR = 2.2, 95% CI = 1.1-4.6 and RR = 2.1, 95% CI = 1.0-4.3, respectively). CONCLUSION: Our findings provide evidence that control of depression is related to cancer risk.

Aged↗

PubMed2000

Comparison of diets of diabetic and non-diabetic elderly men in Finland, The Netherlands and Italy.

OBJECTIVE: To evaluate whether dietary recommendations for subjects with diabetes are met among Finnish, Dutch and Italian elderly men with diabetes, and whether the diets of diabetic and non-diabetic men differ in these three countries. DESIGN: A dietary survey using cross-check dietary history method. A cross-sectional comparison. SETTING: Thirty-year follow-up of survivors from the Finnish, Dutch and Italian cohorts of the Seven Countries Study. SUBJECTS: 227 elderly men from Finland, 537 from The Netherlands, and 417 from Italy, of whom 8-9% had diabetes. MAIN RESULTS: The diets of non-diabetic men from the three countries differed markedly from each other. In all three countries diabetic men consumed less added sugar than non-diabetic men. In Italy, in addition, diabetic men consumed more fruits and berries and vegetables. The Dutch diabetic men ate relatively more cereal products, fruits and berries, milk and milk products, cheese, and meat and meat products and drank less alcoholic beverages than non-diabetic men. The diet of both diabetic and non-diabetic Finnish and Dutch men was characterized by high fat content (41% and 40% of energy, respectively). The fat content of the diet was even higher for diabetic than non-diabetic men in Finland and The Netherlands, but not in Italy. The fibre content of the diet was the highest among Dutch men and diabetic men received more dietary fibre than non-diabetic men in The Netherlands and Italy, but not in Finland. The diet of diabetic and non-diabetic Finnish men differed little from each other and was characterized by high nutrient density of several vitamins and minerals. The proportion of protein of energy intake was higher among diabetic than non-diabetic Dutch and Italian men. CONCLUSIONS: The diet of the diabetic men from Finland, the Netherlands, and Italy resembled more the diet of non-diabetic men from the respective countries than the diet of diabetic men from the other countries. In the diet of Italian diabetic men, the proportions of fat, saturated fatty acids and carbohydrates were nearest the recommended levels. SPONSORSHIP: The National Institute on Aging, Bethesda, USA, the Dutch Prevention Foundation, the Hague, The Netherlands, the Academy of Finland, and the Sandoz Gerontological Foundation.

Aged↗

PubMed2000

Dietary glycemic index in relation to metabolic risk factors and incidence of coronary heart disease: the Zutphen Elderly Study.

OBJECTIVE: To examine whether a high dietary glycemic index is associated with hyperinsulinemia, hyperglycemia, dyslipidemia and coronary heart disease (CHD) risk in elderly men. DESIGN: Prospective study of incidence of major CHD (non-fatal myocardial infarction or death due to CHD) between 1985 and 1995 in 646 men, and a cross-sectional analysis of metabolic risk factors in 1990 in 394 men. SETTING: Population based study in the Dutch town Zutphen. SUBJECTS: Men aged 64-84 y in 1985 without a history of CHD or diabetes, whose diet was assessed with the cross-check dietary history method. RESULTS: The dietary glycemic index was positively correlated with consumption (g carbohydrate) of wheat bread (r=0.47) and sugar products (r=0.41) and inversely with fruit (r=-0.37) and milk (r=-0.40) consumption. During 4527 person-years of follow-up, 94 cases of CHD were documented. The risk ratio for CHD was 1.11 (95% CI, 0.66-1.87) for the highest as compared to the lowest tertile of glycemic index after correction for age, body mass index, physical activity, cigarette smoking, and dietary factors (P (trend)=0.70). Furthermore, the glycemic index was not appreciably associated with blood concentrations of total cholesterol, HDL-cholesterol, triacylglycerols or (fasting or postload) insulin or glucose. CONCLUSIONS: Our findings do not support the hypothesis that a high-glycemic-index diet unfavorably affects metabolic risk factors or increases risk for CHD in elderly men without a history of diabetes or CHD.

Aged↗

PubMed2000

Associations of alpha-linolenic acid and linoleic acid with risk factors for coronary heart disease.

BACKGROUND: Prevention of coronary heart disease (CHD) in high-risk subjects. OBJECTIVE: To investigate the associations of dietary intake of alpha-linolenic acid (ALA) and linoleic acid (LA) as assessed by food frequency questionnaire and in the plasma cholesteryl ester (CE), with CHD risk factors. DESIGN: Baseline data of a double-blind, randomized placebo-controlled trial. Subjects have hypercholesterolemia (6.0-8.0 mmol/l) and at least two other CHD risk factors (n=266). RESULTS: The reported dietary ALA and LA intakes and the LA/ALA ratio were associated with the contents in the CE (r=0.37, r=0.21, and r=0.42, respectively; P<0.01). In multivariate analysis, CE ALA was inversely associated with diastolic blood pressure (r=-0.13; P<0.05) and positively with serum triacylglycerol (r=0.13; P<0.05), and CE LA was inversely associated with serum triacylglycerol (r=-0.32; P<0.01). The CE LA/ALA ratio was strongly inversely associated with CE ALA (r=-0.95; P<0.01). In the lowest quintile of CE ALA, mean dietary intake was 0.4 energy % ALA (1.2 g/day), 8.4 energy % LA and an LA/ALA ratio of 21, and in the highest quintile 0.6 energy % ALA (1.7 g/day), 6.8 energy % LA and 12 (ratio). In the lowest quintile of CE ALA the diastolic blood pressure was 4 mm Hg lower (P trend<0.05), and the serum triacylglycerol 0.3 mmol/l higher (P trend NS) when compared with the top quintile. CONCLUSIONS: In a CHD high-risk population with LA-rich background diet, these cross-sectional data suggest that replacing LA in the diet by ALA may decrease diastolic blood pressure, and may increase serum triacylglycerol concentration.

Adult↗

PubMed2000

Total but not high-density lipoprotein cholesterol is consistently associated with coronary heart disease mortality in elderly men in Finland, Italy, and The Netherlands.

We studied the relation between serum total and high-density lipoprotein (HDL) cholesterol and 10-year coronary heart disease mortality in elderly men in different European countries. The Finland, Italy and the Netherlands Elderly (FINE) Study is a prospective follow-up study in 2,132 elderly men ages 65-84 years in Finland, the Netherlands, and Italy. We estimated relative risks using Cox proportional hazard analysis with time-dependent covariates. Total cholesterol was positively related to coronary heart disease mortality in all three countries. The combined relative risk for the total population of the FINE Study was 1.17 (95% confidence interval = 1.06-1.29) for each 1.00 mmol/liter increase in total cholesterol. HDL cholesterol was inversely related to coronary heart disease mortality in Finland, but not in the Netherlands and Italy. In Italy we noted an interaction among HDL cholesterol, body mass index, and alcohol intake, with an inverse association for HDL cholesterol in lean men who drank <40 gm of alcohol daily and a positive association for HDL cholesterol among overweight men who drank > or =40 gm of alcohol per day. Serum total cholesterol remains an important predictor of coronary heart disease mortality in elderly men in different European countries. The effect of HDL cholesterol differed among the three countries.

Aged↗

PubMed2000

Arginine intake and risk of coronary heart disease mortality in elderly men.

From experimental studies, the hypothesis is derived that the amino acid arginine, the precursor of NO, could restore the impaired endothelial function and increased platelet activation observed in atherosclerosis. We investigated whether dietary intake of arginine is associated with reduced coronary heart disease risk in elderly persons. The study population consisted of 806 men aged 64 to 84 years at baseline who participated in the Zutphen Elderly Study, a population-based cohort followed up for 10 years. Information about habitual food consumption was collected by use of the cross-check dietary history method. Ninety (11.2%) of the 806 men died from coronary heart disease. Mean+/-SD baseline arginine intake was 4. 35+/-1.07 g/d. Meat was the main source of arginine intake (37.1%), followed by bread (13.1%) and milk and milk products (12.1%). Arginine intake was not associated with coronary heart disease mortality. After adjustment for age, the relative risk (RR) for the medium tertile of arginine intake was 0.72 (95% CI 0.44 to 1.18), and the RR for the highest tertile was 0.71 (95% CI 0.43 to 1.19, P: for trend=0.19) compared with the lowest tertile of arginine intake. After additional adjustment for history of coronary heart disease and diabetes mellitus, energy intake, body mass index, smoking habit, physical activity, and other relevant dietary and biological risk factors, the RR was 1.86 (95% CI 1.06 to 3.27) for the medium intake and 1.56 (95% CI 0.83 to 2.93) for the highest intake (P: for trend=0.17). These results do not support the hypothesis that dietary arginine intake lowers the risk of coronary heart disease mortality.

Aged↗

PubMed1999

Baseline and previous physical activity in relation to mortality in elderly men: the Zutphen Elderly Study.

Understanding the effect of changes in physical activity on mortality risk may help researchers clarify intervention strategies. This study investigated associations of physical activity at baseline and 5 years previously with all-cause mortality risk in a cohort of 472 elderly Dutch men. Relative risks were estimated for relations between mortality in 1990-1995 and physical activity levels in 1990 and 1985. Adjustments were made for baseline age, chronic diseases, functional status, and lifestyle factors. In contrast to previous levels of physical activity (adjusted p-trend = 0.39), baseline total time spent in physical activity was inversely associated with mortality risk (p-trend = 0.004; for the most active tertile vs. the least active, relative risk = 0.44; 95% confidence interval: 0.25, 0.80). No consistent associations were observed after fractionating total physical activity into activities of differing intensity or into four different types of activity. Relative to maintaining a physically active lifestyle (i.e., walking or bicycling for 20 minutes at least three times per week) in both survey years, a gradient of increasing risk was observed from adopting an active lifestyle to becoming sedentary to remaining sedentary (p-trend = 0.004). Recent levels of physical activity were more important for mortality risk among elderly men than activity 5 years previously. Becoming or remaining sedentary was significantly associated with increased mortality risk in comparison with remaining physically active.

Activities of Daily Living↗

PubMed1999

[Physical activity in relation to sociodemographic variables and health status of adult men and women in Amsterdam, Doetinchen and Maastricht].

OBJECTIVE: To gain insight into the physical activity level of a sample of the Dutch population, to identify groups with an increased prevalence of physical inactivity and to investigate if increased moderate activity is associated with a more favourable cardiovascular risk profile and a higher self-rated health. DESIGN: Descriptive. METHOD: In 1993-1997 a monitoring project on risk factors and health has been carried out in a random sample of inhabitants of Doetinchem, Amsterdam and Maastricht. Using a questionnaire, information was obtained from the participants about physical activity, demographic characteristics, smoking behaviour and self-rated health. Also, height, weight and blood pressure were measured and a blood sample was taken. In this sample, the serum concentrations of total and high density lipoproteins were determined. This article concerns the activity in 1997 and the trend in activity in the period 1994-1997. In 1997, 4,029 persons, aged 20-64 years, took part. RESULTS: In 1997 46% (n = 1864) of the study population were, on average, active in moderate activities for less than half an hour per day, and 21% (n = 831) for less than half an hour per week ('inactives'). Inactivity was most common in subjects aged 50-59 years (28%), subjects with a low educational level (38%), widowed subjects (34%) and unemployed (36%) or disabled (42%) subjects. Since 1994, the proportion of inactive subjects increased among individuals with a low level of education. Regular physical activity, whether moderate or strenuous, was associated with a more favourable risk profile and a better self-rated health. CONCLUSION: Almost half of the persons examined were little active, which was associated with a less favourable cardiovascular risk profile and a less good self-rated health.

Adult↗

PubMed1999

Physical activity in elderly subjects with impaired glucose tolerance and newly diagnosed diabetes mellitus.

The authors carried out a study to investigate the association between different indicators of physical activity and the prevalence of impaired glucose tolerance (IGT) and newly diagnosed diabetes (nDM) in a population-based cohort of elderly men and women in the Netherlands. A sample of participants of the Rotterdam Study (n = 1,016) aged 55-75 years who were not known to have diabetes mellitus underwent an oral glucose tolerance test. Physical activity was assessed by means of a self-administered questionnaire and expressed as time spent on activities per week. Associations with the prevalence of IGT and nDM were assessed by logistic regression analysis after adjustment for age, body mass index, waist-hip ratio, family history of diabetes, and smoking. A total of 745 subjects had normal glucose tolerance, 153 IGT, and 118 nDM. The total amount of time spent on physical activity decreased with increasing glucose intolerance. Adjusted for main confounders, vigorous activities such as bicycling (men: odds ratio (OR) = 0.26, 95% confidence interval (CI) 0.14-0.49; women: OR = 0.37, 95% CI 0.18-0.78) and sports (men: OR = 0.28, 95% CI 0.11-0.74) showed an inverse association with the presence of nDM. For IGT, the associations pointed in the same direction but did not reach statistical significance. These results indicate that physical inactivity and glucose intolerance are associated among older adults similar to the way they are associated among middle-aged adults.

Activities of Daily Living↗

PubMed1999

How to select a frail elderly population? A comparison of three working definitions.

Aim of this study was to compare three different working definitions for selecting a frail elderly population. Frailty was defined as inactivity combined with (1) low energy intake (n = 29), (2) weight loss (n = 26), or (3) low body mass index (n = 26). In the Zutphen Elderly Study (n = 450; age 69-89 years) differences in health, functioning, and diet in 1990 and functional decline and mortality in the following 3 years between "frail" and "nonfrail" participants, according to the working definitions, were studied using logistic regression analysis. Differences according to the inactivity/weight loss criterium were more pronounced than according to the other two criteria. Inactivity/weight loss was associated with lower subjective health and performance and more diseases and disabilities in 1990. Three-year relative risks of mortality (odds ratio [OR]: 4.1, 1.8-9.4) and functional decline (OR: 5.2, 1.04-25.8 for disabilities, OR: 3.7, 0.8-16.2 for performance) were higher as well. Inactivity in combination with weight loss seems a practicable working definition for selecting a frail elderly population.

Activities of Daily Living↗

PubMed1999

Physical activity modulates the effect of a lipoprotein lipase mutation (D9N) on plasma lipids and lipoproteins.

We investigated interactions between a mutation (D9N) in the lipoprotein lipase (LPL) gene and physical activity, as well as other lifestyle factors, on lipid traits in a population-based sample of Dutch men and women (n = 379). We used questionnaire information to classify physical activity, alcohol consumption, and smoking habits, while overweight was defined as a body mass index (BMI) > 25 kg/m2. Non-fasting blood samples were used for the determination of lipid traits and the D9N genotype. Fifteen subjects (4%) carried the mutation. They presented with higher levels of total cholesterol, apolipoprotein (apo) B and triglycerides compared to non-carriers. While no interactions with overweight, alcohol consumption, and smoking were found, a strong interaction between the D9N mutation and physical activity became apparent. Physically inactive D9N carriers (n = 5) had considerably higher total cholesterol (+2 mmol/l, p < or = 0.0001) and apo B levels (+63 mg/dl, p < or = 0.0001) compared to non-carriers of this mutation, whereas their high-density lipoprotein (HDL)-cholesterol concentrations were lower (-0.22 mmol/l, p < 0.05). This was not the case for physically active D9N carriers (n = 10). In conclusion, a common variant of the LPL gene (D9N) adversely affects plasma lipid and lipoprotein profiles. However, the unfavorable consequences may be counteracted by physical activity.

Adult↗

PubMed1999

Longitudinal study on glycaemic control and quality of life in patients with Type 2 diabetes mellitus referred for intensified control.

AIM: The aim of our study was to describe investigate and association between improved glycaemic control on quality of life (QoL) during 1 year of treatment in a sample of 94 Type 2 diabetic patients referred for insulin therapy to an outpatient department (OPD). Treatment was aimed at achieving acceptable glycaemic control by means of maximizing oral therapy, if necessary switching over to insulin therapy, and information and education provided by a diabetes specialist nurse and dietitian. METHODS: QoL was measured using a disease-specific (Diabetes Health Profile (DHP)) and a generic questionnaire (RAND-36). After 1 year the medical examination and QoL measurements were repeated. The association between 1-year changes in QoL and achievement of good metabolic control (final glycosylated haemoglobin (HbA1c) < or = 8%), switch to insulin therapy, and presence of hyperglycaemic complaints at baseline was analysed after adjustment for appropriate confounders. RESULTS: After 1 year, mean HbA1c was reduced from 10.4% to 7.8%. Also QoL improved in the total group. Patients who achieved good glycaemic control after 1 year (61%) improved in a similar manner as the others. Patients switched over to insulin (65%) improved in a similar manner as the others, but at the final examination they experienced more problems with social functioning and pain. Patients with hyperglycaemic complaints at baseline (49%) improved more in QoL than those without, especially in physical functioning, vitality and health change, but at the final examination still scored lower on a majority of the DHP and RAND-36 dimensions. CONCLUSION: Symptoms of hyperglycaemia predict the strength of an association between improvements of glycaemic control and QoL.

Adult↗

PubMed1999

Tea flavonols in cardiovascular disease and cancer epidemiology.

Tea is an important dietary source of flavonols in countries such as the Netherlands, the United Kingdom and Japan. Flavonols may have beneficial health effects because of their antioxidant properties and their inhibitory role in various stages of tumor development in animal studies. The association between flavonol intake and cancer risk was investigated in three prospective studies (Zutphen Elderly Study in the Netherlands, a Finnish cohort, and the Netherlands Cohort Study). Only one study (Finnish cohort) showed an inverse association with cancer mortality. The intake of flavonols with subsequent cardiovascular disease was studied in six prospective epidemiological studies. In some populations (Seven Countries Study, Zutphen Elderly Study, a Finnish cohort) a clear protective effect was observed. In a large US cohort, a protective effect was only found in a subgroup with previous history of coronary heart disease, whereas in Welsh men, flavonol intake, mainly from tea, was associated with an increased risk of coronary heart disease. These conflicting results may be due to confounding by coronary risk factors associated with tea consumption. The question of whether flavonols protect against cardiovascular disease remains still open; a protective effect of flavonols against cancer is less likely.

Antioxidants↗

PubMed1999

Changes in and factors related to loneliness in older men. The Zutphen Elderly Study.

AIM: To investigate (i) whether loneliness increases in old age, and if so, whether it relates to ageing itself, to time trends or to cohort effects and (ii) the relationship between changes in institutionalization, partner status and health and loneliness. METHODS: 939 men born between 1900 and 1920 completed the De Jong-Gierveld Loneliness Scale, and answered questions about their partner status, health and institutionalization in 1985, 1990 and 1995. RESULTS: For the oldest group (born between 1900 and 1910) loneliness scores increased, but not for the younger groups. The increase in loneliness was attributable to ageing. No birth cohort or time effects were found. Loneliness was related to changes in institutionalization, partner status and subjective health but not to limitations in activities of daily living or cognitive function. CONCLUSIONS: the increased loneliness experienced by very old men is influenced by loss of a partner, moving into a care home or not feeling healthy.

Aged↗

PubMed1999

The contribution of chronic conditions and disabilities to poor self-rated health in elderly men.

BACKGROUND: The aim of the study was to investigate the contribution of chronic conditions and disabilities to poor self-rated health from the perspectives of the patient and the population: (a) What is the impact of seven somatic chronic conditions on self-rated health, independent of disabilities? and (b) To what extent can poor self-rated health be attributed to the selected chronic conditions and disabilities? METHODS: Data came from the 1990 (n = 509), 1993 (n = 381), and 1995 (n = 340) surveys of the Zutphen Elderly Study. Odds ratios (OR) and population attributable risks (PAR) were calculated to quantify the contribution of chronic conditions and disabilities to poor self-rated health. RESULTS: From the patient perspective, stroke was most strongly associated with poor self-rated health (OR = 3.5, 95% confidence interval: 1.8-6.9). From the population perspective, 63% of poor self-rated health could be attributed to the selected chronic conditions, with respiratory symptoms (28%), musculoskeletal complaints (24%), and coronary heart disease (13%) making the largest contribution. A total of 73% could be attributed to chronic conditions and disabilities. CONCLUSIONS: In this population of elderly men, stroke resulted in the largest losses in self-rated health in individual patients, whereas the largest contributions to poor self-rated health in the population were made by respiratory symptoms and musculoskeletal complaints.

Aged↗

PubMed1999

Blood pressure and risk of myocardial infarction in elderly men and women: the Rotterdam study.

OBJECTIVE: To study the association between blood pressure and risk of myocardial infarction in elderly subjects. DESIGN: Prospective cohort study. SETTING: The Rotterdam Study, a Dutch population-based study. PARTICIPANTS: 6004 men and women aged > or = 55 years. MAIN OUTCOME MEASURES: Fatal or non-fatal myocardial infarction (n = 190) during a 4-year follow-up. RESULTS: After excluding participants using blood pressure-lowering medication and participants with a history of myocardial infarction, increasing levels of systolic blood pressure (SBP) were associated with increasing risk of first myocardial infarction (P for trend < 0.0001). The relative risk (RR) for an SBP of 160 mmHg or higher was 5.7 (95% confidence interval (CI) 1.9-17.1) compared with an SBP below 120 mmHg. Increasing diastolic blood pressure (DBP) was also associated with increasing risk of first myocardial infarction, with the RR reaching 2.5 (95% CI 1.4-4.5) in subjects with values of 80-90 mmHg compared with values below 70 mmHg (P for trend < 0.05). Analyses in subjects aged 70 years and over showed that the positive associations between SBP and DBP and risk of first myocardial infarction remained at older age. CONCLUSION: These findings in a relatively healthy cohort of elderly subjects do not provide evidence for a J- or U-shaped relation between SBP and DBP and risk of first myocardial infarction. They suggest that the risk of first myocardial infarction increases with increasing level of systolic and diastolic blood pressure and that this relationship persists into older age.

Aged↗

PubMed1999

Dietary factors and pulmonary function: a cross sectional study in middle aged men from three European countries.

BACKGROUND: Results of epidemiological studies relating individual dietary factors to chronic obstructive pulmonary disease (COPD) are inconsistent. To evaluate the cross sectional association of dietary factors with pulmonary function, data were collected from middle aged men in three European countries. METHODS: The data were collected in the 1960s in Finland (n = 1248), Italy (n = 1386), and the Netherlands (n = 691). Dietary intake was estimated using the cross-check dietary history method. Forced expiratory volume (FEV(0.75) or FEV(1), here called FEV) was measured by spirometry. Associations were adjusted for age, height, smoking, body mass index (BMI), alcohol consumption, and energy intake. RESULTS: FEV was positively associated with intake of vitamin E in Finland, with intake of fruit in Italy, and with intake of beta-carotene in the Netherlands. In all three countries men with intakes of both fruit and vegetables above the median had a higher FEV than those with a low intake of both foods. The difference in FEV ranged from 110 to 169 ml before and from 53 to 118 ml after energy adjustment. Differences in FEV for intake of three antioxidants (vitamins C and E and beta-carotene) above versus below the median ranged from 61 to 181 ml before and from -35 to 58 ml after energy adjustment. Intake of fish was not associated with FEV. CONCLUSIONS: In three European countries a high intake of fruit and vegetables was positively associated with pulmonary function. A high intake of all three antioxidants tended to be positively associated with pulmonary function before, but not after, adjustment for energy intake. Associations of individual antioxidants with pulmonary function were not consistent across countries.

Adult↗

PubMed1999

Consumption of plant foods and stomach cancer mortality in the seven countries study. Is grain consumption a risk factor? Seven Countries Study Research Group.

Plant foods are generally considered to be beneficial for health. A higher consumption of fruits, and to a lesser extent vegetables, is consistently associated with a lower risk of stomach cancer. Results on the association between stomach cancer and grain consumption are less clear. We associated plant food consumption with 25-year stomach cancer mortality at population level in the Seven Countries Study. Around 1960, > 12,000 men aged 40-59 years from 7 countries and 16 cohorts were enrolled. In each cohort, dietary information was collected in small random samples. Crude and adjusted associations were calculated for a change of 10% of mean intake. Results differed for the plant foods studied: an inverse association was observed for fruits (adjusted rate ratio = 0.96, 95% confidence interval = 0.91-0.99), a positive relation for refined grains (adjusted rate ratio = 1.07, 95% confidence interval = 1.03-1.12), and no association for total plant foods, vegetables, whole grains, and potatoes. A high intake of refined grains was correlated with a low consumption of fruits. In conclusion, high intake of refined grains may increase stomach cancer risk. However, because adjustment could only be limited in this study, high intake of refined grains may just reflect the deleterious effect of a diet low in fruits or other characteristics associated with low fruit consumption.

Adult↗