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H Kesteloot

Publications and source records attributed to H Kesteloot.

At least 73 records · Page 4Linked to original sources
PubMed1995

The sex ratio of mortality and its secular trends.

BACKGROUND: The mortality level from all causes is different between populations and it has decreased for both men and women in most countries in the last decades. However, there is a difference in the male/female sex ratio of mortality between populations and its time trends and the reasons for these differences remain unclear. METHODS: The sex ratio of all-cause mortality and the main causes of death, i.e. total cardiovascular disease and cancer, for 30 populations in 1988 (mean of 1987-1989), and the time trends of the sex ratio for 27 populations are analysed. RESULTS: Large differences in the sex ratio of mortality exist among the studied populations. The sex ratio of all-cause, total cardiovascular and cancer mortality markedly increased in most countries during recent decades. CONCLUSIONS: The sex ratio of all-cause mortality and its time trends correlated significantly and positively with the sex ratio of mortality and its time trends from total cardiovascular disease and cancer. The differences of the sex ratio of mortality and their time trends between populations cannot be explained by genetic factors. They could be attributed to differences in life style. A different exposure and different reaction to the risk factors of cardiovascular diseases and cancer, e.g. saturated fat intake, alcohol intake and smoking habits, between men and women are considered to be the main causes for these differences in the sex ratio of mortality.

Aged↗
PubMed1995

Changes in the sex ratio of stroke mortality in the period of 1955 through 1990.

BACKGROUND AND PURPOSE: Stroke mortality worldwide has decreased in men and women in most industrialized countries, except in eastern European countries. The purpose of this study was to compare the sex ratio of stroke mortality between populations and over time. This approach may help to determine the factors influencing this ratio. METHODS: The sex ratios (men to women) of stroke mortality between ages 55 to 64, 65 to 74, and 75 to 84 years from 27 populations between 1955 and the latest available year were analyzed using World Health Organization data. The relationship between log stroke mortality and age and the relationships between alcohol, animal fat, cigarette consumption, and urinary cation excretion and the sex ratio of stroke mortality were also analyzed. RESULTS: The mean sex ratio of stroke mortality increased 50%, 34%, and 15% in the three age classes, respectively, over 35 years. Highly significant relationships of log stroke mortality with age exist, which vary between men and women and among countries. In general, stroke mortality changed in the same direction in both sexes but decreased earlier and more rapidly in women than in men. Alcohol consumption and urinary sodium excretion correlated positively and significantly with the sex ratio. The time trends of the sex ratio also correlated positively and significantly with the time trends of cigarette consumption. No relationship with animal fat consumption was found. CONCLUSIONS: The sex ratio of stroke mortality is increasing with time and decreasing with age. Differences in lifestyle among countries and over the last three decades may contribute partially to these differences in sex ratio.

Adult↗
PubMed1995

Dietary sodium, potassium, saturated fat, alcohol, and stroke mortality.

BACKGROUND AND PURPOSE: Although positive relationships between blood pressure, dietary sodium, and stroke risk have been reported, studies on the relationship between dietary sodium and stroke mortality are scarce. A significant relationship between dietary saturated fatty acids (SFA) and stroke risk has not been reported in epidemiological studies. The purpose of this study was to examine the relationship between dietary sodium and SFA together with dietary potassium, alcohol, and stroke risk. METHODS: The sex- and age-specific stroke mortality rates (log-transformed) for the age classes 45 to 54, 55 to 64, and 65 to 74 years for the period between 1986 and 1988 were obtained from World Health Organization statistics. The 24-hour urinary excretion levels of sodium (U-Na) and of potassium (U-K), dietary SFA intake levels, and alcohol consumption levels were obtained from dietary surveys performed in 17 countries. The relationships between stroke mortality and the dietary variables were examined by Pearson correlation and multiple regression analysis. RESULTS: The highest degree of correlation, both in Pearson correlation and multiple regression analysis, was found between U-Na and log-stroke mortality (P < .01 to P < .001). In multiple regression analysis, U-Na (P < .01 to P < .001), SFA (P < .05 to P < .01), and alcohol (P < .05) independently, significantly, and positively correlated with log-stroke mortality rates, and U-K correlated negatively (P < .05). The exceptions were SFA in both sexes in the age class 45 to 54 years, alcohol in both sexes in the age class 45 to 54 years and in women in the age class 55 to 64 years, and U-K in women in the age class 65 to 74 years. CONCLUSIONS: These results suggest that dietary factors, especially sodium and SFA, are of primary importance as determinants of stroke mortality at the population level.

Age Factors↗
PubMed1994

Alcohol and blood pressure: the INTERSALT study.

OBJECTIVES: To assess the relation between alcohol intake and blood pressure in men and women and in men at younger and older ages; to examine the influence of amount and pattern of alcohol consumption, as well as of acute effects, taking into account body mass index, smoking, and urinary sodium and potassium excretion. DESIGN: Subjects reported alcohol consumption for each of seven days before standardised blood pressure measurement, and whether they had consumed any alcohol in the 24 hours before measurement. SETTING: 50 centres worldwide. SUBJECTS: 4844 men and 4837 women aged 20-59. MAIN OUTCOME MEASURES: Effect of alcohol on blood pressure estimated by taking a weighted average of regression coefficients from centres. Acute effect assessed by examining mean differences in blood pressure of non-drinkers and of heavy drinkers who had and had not consumed alcohol in the 24 hours before measurement. Effect of pattern of consumption assessed by examining mean differences in blood pressure of non-drinkers compared with drinkers (i) whose intake was concentrated in fewer days or who were drinking more frequently, and (ii) whose alcohol intake varied little over the seven days or varied more substantially, as indicated by the standard deviation of daily consumption. RESULTS: Of the 48 centres in which some people reported consuming at least 300 ml/week of alcohol, 35 had positive regression coefficients linking heavy alcohol consumption to blood pressure. Overall, alcohol consumption was associated with blood pressure, significantly at the highest intake. After account was taken of key confounders, men who drank 300-499 ml alcohol/week had systolic/diastolic blood pressure on average 2.7/1.6 mmHg higher than non-drinkers, and men who drank > or = 500 ml alcohol/week had pressures of 4.6/3.0 mmHg higher. For women, heavy drinkers (> or = 300 ml/week) had blood pressures higher by 3.9/3.1 mmHg than non-drinkers. Heavy drinking and blood pressure were strongly associated in both sexes, and in men at both younger (20-39 years) and older (40-59 years) ages. In men who were heavy drinkers, episodic drinkers (those with great variation in daily alcohol consumption) had greater differences in blood pressure compared with non-drinkers than did regular drinkers of relatively constant amounts. CONCLUSION: The significant relation of heavy drinking (3-4 or more drinks/day) to blood pressure, observed in both men and women, and in younger and older men, was independent of and added to the effect on blood pressure of body mass index and urinary excretion of sodium and potassium. The findings indicate the usefulness of targeting those at high risk as well as the general population to reduce the adverse effects of alcohol on blood pressure.

Adult↗
PubMed1994

Cancer mortality and age: relationship with dietary fat.

Highly significant correlations exist between total cancer mortality and age expressed by a log total cancer mortality-log age equation (mean r2 0.991 in men and 0.996 in women) or by a second-order polynomial equation including age and age2 (mean r2 0.999 in men and 0.998 in women). In all countries considered (n = 32), the second-order term of age is negative, indicating a decrease in the rate of rise of log cancer mortality at older age. This could be explained by a lesser accuracy of the diagnosis of cancer at older age, by selective survival of subjects resistant to cancer, by a cohort effect, or by a decrease in the rate of growth of cancer at older age. The decrease in the rate of rise of cancer mortality after 65 years of age occurs in all countries and applies to nearly all cancers except breast cancer in women after 75 years of age. A high cancer mortality in a country is characterized by a low intercept and a steep slope of the log mortality-log age equation. These parameters are influenced by dietary fat intake in men and women, with saturated fat increasing total cancer mortality and the ratio of polyunsaturated to saturated fat and the ratio of unsaturated to saturated fat decreasing it. The data on dietary fat were obtained from the Food and Agriculture Organization of the United Nations (FAO) food balance sheets (n = 32) and from dietary surveys (n = 21). Both vary in the same direction, but only the dietary data from the FAO correlate significantly with cancer mortality. This finding points toward a relationship between the level of dietary fat intake and total cancer mortality at the population level.

Adult↗
PubMed1994

Bread as a source of salt: an international comparison.

OBJECTIVE: The salt (NaCl) content of bread, obtained from Belgium and 25 other regions or countries worldwide, was analyzed to evaluate the importance of bread as a source of dietary salt in a population. METHODS: A total of 1166 dried bread samples were analyzed using a hot HCl extraction technique followed by flame photometry and performed by the same laboratory technician in Leuven (Belgium); 534 samples from Leuven were analyzed over 10 time periods from 1967-73 to 1992 together with 562 samples from 11 other European countries, 44 from the United States and Peru, and 26 from Asia. RESULTS: The average mean salt content of fresh bread (= dried bread times 0.6) in European countries was 12.4 +/- 1.7 g/kg for white and 13 +/- 1.0 g/kg for brown bread. In Japan and Korea it was about 8.5 g/kg and in Pakistan, Thailand, Nepal, and Laos about 5 g/kg. The mean sodium/potassium ratio with Na and K in mmol was 8.0 for white and 4.5 for brown bread, much higher than the recommended value of 1.0. Bread with a very low salt content was found in certain areas of Peru, Spain, and Italy. CONCLUSION: The overall salt content of bread in Western countries is excessive, and a gradual reduction is highly desirable.

Asia↗
PubMed1994

Secular trends in cerebrovascular mortality.

Since 1950 a marked decrease in cerebrovascular mortality has occurred in most Western countries. To evaluate whether changes in the pharmacological treatment of hypertension, introduced during the period observed (1950-87), have influenced this downward trend the linear time-trends over the period considered were calculated. Mass treatment of hypertension at the population level started in the early 1970s. Before this period a marked decrease in cerebrovascular mortality had already occurred. Moreover, the linear time trends were highly significant over the whole period with several correlation coefficients of > 0.98. The decrease in cerebrovascular mortality can best be explained by a decreased salt and saturated fat intake in the populations considered. In several Eastern European countries cerebrovascular mortality has increased. This runs parallel with an increase in all-cause mortality and an increase in ischaemic heart disease mortality and can be explained by the high saturated fat intake of these populations. The data show that important changes in cerebrovascular mortality are also occurring in the older age groups, e.g. 70-74 and 80-84 years. Epidemiological data point towards nutrition as playing an important role in the evolution of cerebrovascular mortality over the period considered.

Aged↗
PubMed1994

The Inter-regional Belgian Bank Employee Nutrition Study (IBBENS).

OBJECTIVE: This study compares the dietary intake in different geographical areas in Belgium. DESIGN: Food habits were examined by the 3-day food record with additional intervieW. SETTING: The study was performed in the head offices of one bank situated in seven Dutch-speaking cities (spread over two districts) in the north and one French-speaking city in the south of Belgium. SUBJECTS: 371 male and 192 female healthy employees participated in the survey. RESULTS: The results show a difference in fat consumption between north and south. Men in the French-speaking district consumed on average 18.8 E% (SD = 3.2) of saturated fat, compared to 16.2 (2.8) and 16.7 (2.9) E% for the two Dutch-speaking districts (P < 0.001). For women the respective data are 18.9 (3.2), 16.4 (3.0) and 17.1 (3.1) E% (P < 0.01). The E% of polyunsaturated fat in the three districts equals respectively 5.2 (1.8), 7.2 (2.4) and 6.7 (2.5) (P < 0.001) for men; 4.9 (1.8), 7.2 (2.7) and 6.6 (2.2) (P < 0.001) for women. A significantly lower P/S ratio (P < 0.001, for both sexes) and U/S ratio (P < 0.001, for both sexes) was found in the south. The intake of cholesterol (mg per 4.18 MJ) was significantly higher in the south (P = 0.01, for both sexes). The differences between the Dutch-speaking centres were relatively small. For men significant differences in P/S ratio, 0.48 (0.22) in the east versus 0.43 (0.20) in the west (P < 0.001), and in E% of monounsaturated fat, 15.2 (2.7) versus 16.3 (3.1) (P < 0.01), could be established. CONCLUSION: Differences in fat intake exist between the north and the south of Belgium. Within the north significant differences exist in P/S ratio and in intake of monounsaturated fat.

Adult↗
PubMed1993

An ecological study of the relationship between dietary fat intake and breast cancer mortality.

METHODS: An ecologic study of the relationship between the per person supply of animal fat, vegetable fat, and fish fat obtained from the Food and Agricultural Organizations of the United Nations food balance sheets and female breast cancer mortality rates from 1961 to 1986 was carried out using data from 30 countries. RESULTS: In univariate analysis, a lag period of about 10 years was found for the highest correlations between breast cancer mortality rates and animal fat minus fish fat intake in the age groups 50 years and above. Age classes 50 years and above showed higher correlations between fat intake and breast cancer mortality than those below 50 years over the periods examined. In multiple regression analysis, animal fat minus fish fat intake showed a highly significant positive relationship with the breast cancer mortality rates (P < 0.001) in age groups 50 years and above for all the periods examined. Whenever significant, dietary fish fat intake correlated negatively (P < 0.001) and vegetable fat positively (P < 0.01) with breast cancer mortality. Moreover, a significant positive relationship (P < 0.001) between the change over time in animal fat minus fish fat intake and that in breast cancer mortality was found. To confirm these findings we also examined the correlation between breast cancer mortality and fat consumption data obtained from 46 dietary surveys performed in 17 countries. CONCLUSIONS: Although slightly less significant, the findings corroborate the relationships obtained by using FAO data. Our findings confirm the highly significant positive association between dietary fat and breast cancer mortality. The effect differs according to the type of fat consumed.

Age Factors↗
PubMed1993

Nutrition and health: an epidemiological approach.

Large differences in mortality from all causes exist between populations. These mortality differences cannot be explained by differences in the level of medical care, of cigarette smoking, of stress, of pollution nor by genetic differences. The level of saturated fat intake is linked both to the prevalence of ischaemic heart disease and cancer. The slope of the equation linking log mortality to age can be used as an index of the aging rate of populations. This slope is significantly linked to the level of saturated fat intake. Women are more resistant to atheromatous disease presumably because they are able to raise their HDL-cholesterol levels on a diet high in saturated fat, while men cannot. Nutrition appears to be the most important determinant of mortality from all causes both between and within countries.

Aged↗
PubMed1993

On the relationship between nutrition, sex hormones and high-density lipoproteins in women.

Western women have significantly higher high-density lipoprotein (HDL) cholesterol levels than Oriental women whereas in men HDL-cholesterol levels are very similar. Oriental women have HDL-cholesterol levels similar to those of both Western and Oriental men. Western women show a markedly higher resistance against atheromatous diseases than men. Evidence is provided demonstrating that women are able to increase their HDL-cholesterol levels on a nutrition high in saturated and monounsaturated fat. This could be explained by a concurrent dietary fat related increase in female sex hormone levels (e.g. estradiol and estrone), hormones which are known to increase HDL-cholesterol levels.

Dietary Fats↗
PubMed1993

Worldwide mortality changes from all causes and from cardiovascular diseases between 1968 and 1988.

The worldwide changes in mortality from 35 countries, between 1968 and 1988, have been analyzed in four age classes between 45 and 85+ years and in both sexes, together with years gained in life expectancy at age one between 1967 and 1990. The most important decreases have been seen in populations with important changes in life style, primarily nutritional, such as in East Asia, Australia, Finland, Austria, France, Switzerland, Portugal, Belgium, F.R.G. and Spain. Less beneficial changes were observed in Sweden and The Netherlands. Unsatisfactory changes were observed in Norway, Denmark and especially in the East European countries. The small increase in life expectancy at age one (+1.5 year) observed in Denmark between 1967 and 1990 was situated between that of the former German Democratic Republic and of Czechoslovakia, +1.6 and +0.3, respectively. However, marked differences exist among sexes and age classes. The changes obtained for all-cause mortality in the 75-84 years age class are better than in the 45-64 years age class. All these observations cannot be explained by better medical treatment only and point towards nutrition as the most important causal factor.

Aged↗
PubMed1992

Serum lipoprotein(a) levels in racially different populations.

Lipoprotein(a) is an atherogenic lipoprotein which has been studied predominantly in white populations. Serum lipoprotein(a), serum lipids, and apolipoproteins A-I and B were quantified in 1991 in a total of 300 sex-matched samples derived from five different ethnic groups. Three population samples of Asian origin (Tibet, Korea, and China), one population sample of West African origin (Nigeria), and one Western population sample (Belgium) were included. All serum samples had been collected in the past (3-11 years previously) and had been stored at -80 degrees C since then. Thirty serum samples from males and 30 serum samples from females were analyzed from each ethnic group. Overall median lipoprotein(a) levels in Koreans, Chinese, Tibetans, Nigerians, and Belgians were 99, 89, 49, 134, and 80 mg/liter, respectively. Lipoprotein(a) frequency distributions were highly skewed to the right in all populations, with the Nigerian distribution showing less skewness than the Asian and Western plots. All distributions became nearly gaussian after logarithmic transformation. No statistical difference was found between the mean log lipoprotein(a) values of the sexes (4.43 +/- 1.01 mg/liter (standard deviation) in men; 4.44 +/- 1.08 mg/liter in women). Pearson correlation analysis of both sexes combined revealed no statistically significant correlation (at the p less than 0.01 level) of log lipoprotein(a) with age, height, weight, body mass index, cholesterol, high density lipoprotein cholesterol, apolipoprotein A-I, or apolipoprotein B within any of the population groups studied or after pooling of all population groups.

Apolipoproteins↗