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P Pietinen

Publications and source records attributed to P Pietinen.

At least 19 recordsLinked to original sources
PubMed2002

Intakes of fruits and vegetables, carotenoids and vitamins A, E, C in relation to the risk of bladder cancer in the ATBC cohort study.

We examined the relation between dietary fruit and vegetables, carotenoids and vitamin intakes and the risk of bladder cancer among male smokers in a prospective cohort study. Over a median of 11 years, we followed 27 111 male smokers aged 50-69 years who were initially enrolled in the Alpha-Tocopherol Beta-Carotene Cancer Prevention Study. During this period, 344 men developed bladder cancer. All of these men had completed a 276-food item dietary questionnaire at baseline. Cox proportional hazards models were used to estimate the relative risks and 95% confidence intervals and to simultaneously adjust for age, smoking history, energy intake and intervention group. Consumption of fruits and vegetables was not associated with the risk of bladder cancer (relative risk=1.28; 95% confidence intervals CI: 0.89-1.84, for highest vs lowest quintile). Similarly, no associations were observed for groups of fruits or vegetables (berries and cruciferous vegetables), or for specific fruits and vegetables. Dietary intakes of alpha-carotene, beta-carotene, lycopene, lutein/zeaxanthin, beta-cryptoxanthin, vitamins A, E, and C, and folate were not related to the risk of bladder cancer. These findings suggest that fruit and vegetable intakes are not likely to be associated with bladder cancer risk. However, these results may not be generalisable to non-smokers.

Aged↗
PubMed2002

Dietary and serum alpha-tocopherol, beta-carotene and retinol, and risk for colorectal cancer in male smokers.

OBJECTIVE: To study the association between dietary and serum antioxidant vitamins and carotenoids and risk for colorectal cancer in male smokers. DESIGN: A prospective cohort study within a randomised, double-blind, placebo-controlled trial testing supplementation with alpha-tocopherol (50 mg/day), beta-carotene (20 mg/day) or both in preventing cancer. SUBJECTS AND METHODS: Participants of the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study with complete dietary data and serum samples available from baseline. These included 26,951 middle-aged male smokers among whom 184 colorectal cancer cases were diagnosed during 8 y of follow-up. Relative risks were calculated with Cox proportional hazards models adjusting for trial supplementation, age, body mass index, serum cholesterol, cigarettes smoked per day and physical activity. RESULTS: There was no significant association between dietary vitamin C or E, alpha-or gamma-tocopherol, retinol, alpha- or beta-carotene, lycopene or lutein+zeaxanthin and risk for colorectal cancer. Serum alpha-tocopherol, beta-carotene or retinol was also not associated with the risk, neither did the season when baseline blood was drawn modify the relationship between serum beta-carotene and colorectal cancer risk. CONCLUSIONS: Our data support the results from previous studies in which no association between dietary antioxidant vitamins and carotenoids and risk for colorectal cancer has been observed. Likewise, no association between baseline serum antioxidant concentrations and colorectal cancer risk was evident. SPONSORSHIP: The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study was supported by a contract with the US National Cancer Institute (N01-CN-45165).

Aged↗
PubMed2001

Dietary and other methyl-group availability factors and pancreatic cancer risk in a cohort of male smokers.

The authors examined prospectively whether dietary folate and other factors known to influence methyl-group availability were associated with the development of exocrine pancreatic cancer within the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study cohort. Of the 27,101 healthy male smokers aged 50--69 years who completed a self-administered dietary questionnaire at baseline, 157 developed pancreatic cancer during up to 13 years of follow-up from 1985 to 1997. Cox proportional hazards models were used to estimate the hazards ratios and 95% confidence intervals. The adjusted hazards ratio comparing the highest with the lowest quintile of dietary folate intake was 0.52 (95% confidence interval: 0.31, 0.87; p-trend = 0.05). Dietary methionine, alcohol intake, and smoking history did not modify this relation. No significant associations were observed between dietary methionine, vitamins B(6) and B(12), or alcohol intake and pancreatic cancer risk. Consistent with prior studies, this study shows that cigarette smoking was associated with an increased risk (highest compared with lowest quintile, cigarettes per day: hazards ratio = 1.82; 95% confidence interval: 1.10, 3.03; p-trend = 0.05). These results support the hypothesis that dietary folate intake is inversely associated with the risk of pancreatic cancer and confirm the risk associated with greater cigarette smoking.

Age Distribution↗
PubMed2001

Urinary sodium excretion and cardiovascular mortality in Finland: a prospective study.

BACKGROUND: The evidence that high salt intake increases the risk of cardiovascular disease has been challenged. We aimed to find out whether salt intake, measured by 24 h urinary sodium excretion, is an independent risk factor for cardiovascular disease frequency and mortality, and all-cause mortality. METHODS: We prospectively followed 1173 Finnish men and 1263 women aged 25-64 years with complete data on 24 h urinary sodium excretion and cardiovascular risk factors. The endpoints were an incident coronary and stroke event, and death from coronary heart disease, cardiovascular disease, and any cause. Each endpoint was analysed separately with the Cox proportional hazards model. FINDINGS: The hazards ratios for coronary heart disease, cardiovascular disease, and all-cause mortality, associated with a 100 mmol increase in 24 h urinary sodium excretion, were 1.51 (95% CI 1.14-2.00), 1.45 (1.14-1.84), and 1.26 (1.06-1.50), respectively, in both men and women. The frequency of acute coronary events, but not acute stroke events, rose significantly with increasing sodium excretion. When analyses were done separately for each sex, the risk ratios were significant in men only. There was a significant interaction between sodium excretion and body mass index for cardiovascular and total mortality; sodium predicted mortality in men who were overweight. Correction for the regression dilution bias increased the hazards ratios markedly. INTERPRETATION: High sodium intake predicted mortality and risk of coronary heart disease, independent of other cardiovascular risk factors, including blood pressure. These results provide direct evidence of the harmful effects of high salt intake in the adult population.

Adult↗
PubMed2001

Flavonol and flavone intake and the risk of cancer in male smokers (Finland).

OBJECTIVE: To study the associations between the intake of flavonols and flavones and the risk of cancer. METHODS: The study cohort consisted of 27,110 male smokers, aged 50-69 years, without history of cancer. They were participants of the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study in Finland. The men completed a validated dietary questionnaire at baseline. Incident cases of cancers were identified through national registers. During an average 6.1-year follow-up, 791 lung cancers, 226 prostate cancers, 156 urothelial cancers, 133 colorectal cancers, 111 stomach cancers, and 92 renal cell cancers were diagnosed. RESULTS: Intake of flavonols and flavones was inversely associated with the risk of lung cancer; multivariate relative risk in the highest vs. the lowest quartile 0.56, 95% confidence interval 0.45-0.69, p for trend 0.0001. The risk was similar in all histological types of lung cancer. No association was found between flavonol and flavone intake and the risk of other cancers. CONCLUSIONS: Intake of flavonols and flavones seemed to be inversely associated with the risk of lung cancer, but not with that of other cancers.

Aged↗
PubMed2001

Secular trends in body mass index by birth cohort in eastern Finland from 1972 to 1997.

OBJECTIVE: To describe changes in body mass index (BMI) with age over a 25 y period, and to investigate whether those changes differed by birth cohort, gender or education. DESIGN: Six cross-sectional population surveys repeated in eastern Finland every fifth year between 1972 and 1997. Synthetic birth cohorts were created by dividing subjects into twelve 5 y groups according to birth year. SUBJECTS: Independent random samples from the national population register including men and women aged 25-64 y, the final sample comprising 18 439 men and 19 501 women. The oldest birth cohort included subjects born in 1913-1917 and the youngest were born in 1968-1972. MEASUREMENTS: Weight and height were measured, and data on educational level were collected by a self-administered questionnaire. RESULTS: A BMI increase with age was more prominent in women (4.2 kg/m(2) in 25 y) than in men (3.3 kg/m(2) in 25 y), and was very similar in all birth cohorts. In men, the BMI increase with age varied across cohorts. Among birth cohorts participating in each survey, the BMI increase over the 25 y period was most prominent (3.9 kg/m(2) in 25 y) in men born between 1943 and 1947. Among all birth cohorts, the strongest upward trend (0.2 kg/m(2) per year) was observed in men born between 1953 and 1957. CONCLUSIONS: Weight gain with age has remained unchanged in women over the 25 y period, whereas in men, the younger the birth cohort, the more prominent was the BMI increase with age.

Adult↗
PubMed2001

Determinants of serum enterolactone concentration.

BACKGROUND: The lignan enterolactone, which is produced by the intestinal microflora from dietary precursors, may protect against hormone-dependent cancers and cardiovascular diseases. OBJECTIVE: We examined the cross-sectional associations between the serum enterolactone concentration and variables related to diet and health in Finnish adults. DESIGN: Serum enterolactone was measured by using time-resolved fluoroimmunoassay in 2380 Finnish men and women aged 25-64 y who were participating in a cross-sectional national survey in 1997. Background information was collected with self-administered questionnaires and the diet was assessed with a food-frequency questionnaire. RESULTS: The median serum enterolactone concentration was 13.8 nmol/L (range: 0-95.6 nmol/L) in men and 16.6 nmol/L (range: 0-182.6 nmol/L) in women. Multiple regression analyses showed positive associations in men between the serum enterolactone concentration and constipation, consumption of whole-grain products, and intake of fruit and berries. In women, the serum enterolactone concentration was positively and independently associated with consumption of vegetables, subject age, and constipation and was negatively associated with smoking. Furthermore, female subjects of normal weight had significantly higher serum enterolactone concentrations than did their underweight or obese peers. CONCLUSIONS: The serum enterolactone concentration varies widely in the population. Of the variables we examined, the most important determinants of the serum enterolactone concentration were consumption of lignan-containing foods and constipation; however, these appeared to explain only a small part of the variation. Therefore, the role of gut microflora in the metabolism of lignans might be very important. Further studies will also be needed to determine the bioavailability and absorption rate of lignans.

4-Butyrolactone↗
PubMed2001

Intake of flavonols and flavones and risk of coronary heart disease in male smokers.

Flavonols and flavones are antioxidant polyphenolic compounds found in tea, vegetables, fruits, and wine. In experimental studies they have been effective free radical scavengers, metal chelators, and antithrombotic agents. In the few epidemiologic studies of these agents, some have suggested an inverse association between intake of flavonols and flavones and the risk of cardiovascular disease. Our study population comprised 25,372 male smokers, 50-69 years of age, with no previous myocardial infarction. They were participants of the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study, which was a randomized, double-blind, placebo-controlled trial with daily supplementation of alpha-tocopherol (50 mg per day) and/or beta-carotene (20 mg per day). The men completed a validated dietary questionnaire at baseline. After 6.1 years of follow-up, there were 1,122 nonfatal myocardial infarctions and 815 coronary deaths. In the multivariate model, the relative risk of nonfatal myocardial infarction was 0.77 (95% confidence interval = 0.64-0.93) among men in the highest (median 18 mg per day) compared with the lowest (median 4 mg per day) quintile of flavonol and flavone intake. The respective relative risk for coronary death was 0.89 (95% confidence interval = 0.71-1.11). Thus, intake of flavonols and flavones was inversely associated with nonfatal myocardial infarction, whereas there was a weaker association with coronary death.

Aged↗
PubMed2001

Physical activity in relation to cancer of the colon and rectum in a cohort of male smokers.

We examined the association between occupational and leisure physical activity and colorectal cancer in a cohort of male smokers. Among the 29,133 men aged 50-69 years in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention study,152 colon and 104 rectal cancers were documented during up to 12 years of follow-up. For colon cancer, compared with sedentary workers, men in light occupational activity had a relative risk (RR) of 0.60 [95% confidence interval (CI), 0.34-1.04], whereas those in moderate/heavy activity had an RR of 0.45 (CI, 0.26-0.78; P for trend, 0.003). Subsite analysis revealed a significant association for moderate/heavy occupational activity in the distal colon (RR, 0.21; CI, 0.09-0.51) but not in the proximal colon (RR, 0.87; CI, 0.40-1.92). There was no significant association between leisure activity and colon cancer (active versus sedentary; RR, 0.82; CI, 0.59-1.13); however, the strongest inverse association was found among those most active in both work and leisure (RR, 0.33; CI, 0.16-0.71). For rectal cancer, there were risk reductions for those in light (RR, 0.71; CI, 0.36-1.37) and moderate/heavy occupational activity (RR, 0.50; CI, 0.26-0.97; P for trend, 0.04), and no association for leisure activity. These data provide evidence for a protective role of physical activity in colon and rectal cancer.

Age Distribution↗
PubMed2001

Serum enterolactone and risk of breast cancer: a case-control study in eastern Finland.

Phytoestrogens have been linked to a risk of breast cancer. The main phytoestrogens in the Finnish diet are lignans, and enterolactone is quantitatively the most important circulating lignan. The purpose of this study was to examine the association between serum enterolactone and risk of breast cancer in Finnish women. The subjects were participants of the Kuopio Breast Cancer Study: This analysis concerns 194 breast cancer cases (68 premenopausal and 126 postmenopausal) who entered the study before diagnosis and 208 community-based controls. They completed a validated food frequency questionnaire referring to the previous 12 months and gave serum samples before the examinations. The measurement of serum enterolactone was performed by time-resolved fluoroimmunoassay. The statistical analyses were done by the logistic regression method. The mean serum enterolactone concentration was 20 nmol/l for the cases and 26 nmol/l for the controls (P 0.003). The mean serum enterolactone concentration in the lowest quintile was 3.0 nmol/l and 54.0 nmol/l in the highest. The odds ratio in the highest quintile of enterolactone values adjusted for all of the known risk factors for breast cancer was 0.38 (95% confidence interval,0.18-0.77; P for trend, 0.03). The inverse association between serum enterolactone and risk of breast cancer was seen both among premenopausal and postmenopausal women. High enterolactone level was associated with higher consumption of rye products and tea and higher intake of dietary fiber and vitamin E compared with those with low serum enterolactone values. Serum enterolactone level was significantly inversely associated with risk of breast cancer.

4-Butyrolactone↗
PubMed2001

Nutrition and cardiovascular disease in Finland since the early 1970s: a success story.

This paper describes the Finnish experience on the population strategy to prevent cardiovascular disease with special reference to diet. Systematic work to lower the risk factors of cardiovascular disease started in the early 1970s with the North Karelia project and rapidly expanded to cover the whole country. The main aims were to change the type of fats used, to lower sodium intake and to increase vegetable and fruit consumption. Concurrently, a comprehensive monitoring system was developed including regular population surveys every five years. During the period 1972-1997 major changes took place in the diet as well as in blood pressure and serum cholesterol levels. At the same time, cardiovascular mortality decreased dramatically. The Finnish experience shows that dietary changes are possible but require a persistent and comprehensive intervention.

Animals↗
PubMed2000

Lifetime alcohol consumption and breast cancer: a case-control study in Finland.

OBJECTIVE: To study the association between lifetime alcohol consumption and the risk of breast cancer. DESIGN AND SETTING: A case-control study carried out in eastern Finland. Information about alcohol consumption was obtained by two methods: a self-administered food frequency questionnaire (FFQ) including alcohol consumption during the previous 12 months, and a lifetime alcohol consumption questionnaire (AQ) which was administered by the study nurse. SUBJECTS: The study consisted of 301 breast cancer cases (25-75 years old) and 443 population controls. RESULTS: The subjects reported higher current alcohol consumption in the AQ compared to the FFQ. According to the AQ, premenopausal cases consumed on average 28 g and controls 24 g alcohol week(-1); in postmenopausal women the values were 15 and 14 g, respectively. About 30% of premenopausal and 60% of postmenopausal women were classified as non-drinkers. The correlation for current alcohol consumption between the FFQ and the AQ was 0.80 in premenopausal women but only 0.40 in postmenopausal women. Current alcohol consumption seemed to influence the reporting of total lifetime alcohol consumption. Current alcohol consumption was not associated with the risk of breast cancer either in premenopausal or postmenopausal women; neither were associations found between alcohol consumption at age of first use, use before the age of 30, or total lifetime alcohol consumption and the risk of breast cancer. CONCLUSIONS: On average, one to three drinks per week did not increase the risk of breast cancer in this study. Consumption levels were, however, too low to exclude increased risk with high regular consumption. Further research is necessary on lifetime alcohol consumption.

Adult↗
PubMed2000

Effects of supplemental alpha-tocopherol and beta-carotene on colorectal cancer: results from a controlled trial (Finland)

BACKGROUND: Some epidemiological investigations suggest that higher intake or biochemical status of vitamin E and beta-carotene might be associated with reduced risk of colorectal cancer. METHODS: We tested the effects of alpha-tocopherol and beta-carotene supplementation on the incidence of colorectal cancer in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study, a double-blind, placebo-controlled trial among 29,133 50-69-year-old male cigarette smokers. Participants were randomly assigned to receive alpha-tocopherol (50 mg), beta-carotene (20 mg), both agents, or a placebo daily for 5-8 years. Incident colorectal cancers (n = 135) were identified through the nationwide cancer registry, and 99% were histologically confirmed. Intervention effects were evaluated using survival analysis and proportional hazards models. RESULTS: Colorectal cancer incidence was somewhat lower in the alpha-tocopherol arm compared to the no alpha-tocopherol arm, but this finding was not statistically significant (relative risk (RR) = 0.78, 95% confidence interval (CI) 0.55-1.09; log-rank test p = 0.15). Beta-carotene had no effect on colorectal cancer incidence (RR = 1.05, 95% CI 0.75-1.47; log-rank test p = 0.78). There was no interaction between the two substances. CONCLUSION: Our study found no evidence of a beneficial or harmful effect for beta-carotene in colorectal cancer in older male smokers, but does provide suggestive evidence that vitamin E supplementation may have had a modest preventive effect. The latter finding is in accord with previous research linking higher vitamin E status to reduced colorectal cancer risk.

Aged↗
PubMed2000

Diet and prostate cancer risk in a cohort of smokers, with a specific focus on calcium and phosphorus (Finland).

BACKGROUND: Calcium, phosphorus, fructose, and animal protein are hypothesized to be associated with prostate cancer risk, potentially via their influence on 1,25-dihydroxyvitamin D3. We examined these nutrients and overall diet and prostate cancer risk in the Alpha-Tocopherol Beta-Carotene Cancer Prevention Study (ATBC Study). MATERIALS AND METHODS: The ATBC Study was a randomized 2 x 2 trial of alpha-tocopherol and beta-carotene on lung cancer incidence conducted among Finnish male smokers; 27,062 of the men completed a food-use questionnaire at baseline, and comprise the current study population. There were 184 incident clinical (stage 2-4) prostate cancer cases diagnosed between 1985 and 1993. We used Cox proportional hazards models to examine associations between dietary intakes and prostate cancer. RESULTS: We did not observe significant independent associations for calcium and phosphorus and prostate cancer risk. However, men with lower calcium and higher phosphorus intake had a multivariate relative risk of 0.6 (95% CI 0.3-1.0) compared to men with lower intakes of both nutrients, adjusting for age, smoking, body mass index, total energy, education, and supplementation group. Of the other foods and nutrients examined, none was significantly associated with risk. DISCUSSION: This study provides, at best, only weak evidence for the hypothesis that calcium and phosphorus are independently associated with prostate cancer risk, but suggests that there may be an interaction between these nutrients.

Age Factors↗
PubMed2000

Toenail selenium and breast cancer-a case-control study in Finland.

OBJECTIVE: Low levels of selenium have been associated with a higher risk of cardiovascular diseases and cancer in humans. Since 1984, selenium supplementation through fertilizers has been employed in Finland to increase the very low concentration of selenium in the nation's food supply. As a result, the selenium concentration of Finnish foods became one of the highest in Europe. A decade after selenium supplementation began, the association between toenail selenium and the risk of breast cancer was examined. DESIGN: Case-control study. SETTING: Eastern Finland. SUBJECTS: 289 pre- and postmenopausal breast cancer cases and 433 community controls. The diagnosis was unknown at the time the toenail samples were collected. RESULTS: The mean toenail selenium concentration was 0.80 mg/kg in premenopausal cases and 0.84 mg/kg in premenopausal controls: and 0. 77 mg/kg in postmenopausal cases and 0.80 mg/kg in postmenopausal controls. The odds ratio (OR) comparing the highest with the lowest quintiles of toenail selenium concentration was 1.1 (95% CI 0.4-3.2) in premenopausal women and 0.7 (95% CI 0.3-1.5) in postmenopausal women. The intake of retinol, beta-carotene, vitamin E and vitamin C did not change the association between toenail selenium and breast cancer. CONCLUSIONS: A decade after selenium supplementation, selenium seems not to be an important factor in the etiology of breast cancer, neither in premenopausal nor postmenopausal women. SPONSORSHIP: This work was supported by the EVO funds from the Kuopio University Hospital and by research grants from the Academy of Finland, Yrjö Jahnsson Foundation and Juho Vainio Foundation. European Journal of Clinical Nutrition (2000) 54, 98-103

Adult↗
PubMed2000

Age, education and occupation as determinants of trends in body mass index in Finland from 1982 to 1997.

OBJECTIVE: To investigate trends in body mass index (BMI) and prevalence of obesity among adults in Finland from 1982 to 1997, and to identify population groups with increasing obesity. SUBJECTS: Random samples from the national population register including men and women aged 25-64 y (n = 24604, total). DESIGN: Four cross-sectional surveys carried out in three areas in Finland every fifth year since 1982. MEASUREMENTS: Weight and height were measured, and data on occupation and education level were collected by a self-administered questionnaire. RESULTS: The mean BMI increased in both genders. In men, the upward trend was greatest (the increase of 1.3 kg/m2 in 15 y) in the oldest age group (55-64 y), and was found also (the increase of 0.6 kg/m2) in the youngest age group (25-34 y), whereas in women, the upward trend was most prominent (the increase of 0.9 kg/m2) in the youngest age group. BMI increased in all educational groups in men, but in women the upward trend seemed to be greatest in the lowest educational group. The upward trends were most prominent among retired and unemployed men, while in women changes in BMI were similar in all occupational groups. CONCLUSION: The strongest upward trend in BMI was found in the oldest men, in the youngest age group in both genders and, in particular, among men who were outside the labor force. Education is still a strong determinant of obesity, especially in women, although the social gradient in BMI has not widened in the 1990s.

Adult↗