Marja-Leena Ovaskainen

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.

Phyto-oestrogen database of foods and average intake in Finland

Information on phyto-oestrogen intake in various populations has been scanty until now, primarily because data on the content of these compounds in foods were lacking. We report here on expansion of the Finnish National Food Composition Database (Fineli) with values for the plant lignans matairesinol and secoisolariciresinol and the isoflavones daidzein and genistein. The values, expressed as aglycones, were based on food analyses (mainly GC-MS) or imputed from analytical data for 180 foods for lignans and 160 foods for isoflavones; additionally, over 1000 values were derived from the recipe database of Fineli. Average intake of these phyto-oestrogens was calculated using food consumption data of the National Dietary Survey FINDIET 1997, which was carried out in a random sample of the adult population in five areas in Finland. The dietary data were collected by 24 h recall =2862). The mean lignan intake was 434 (standard deviation (SD) 1575) microg/d and the mean isoflavone intake was 788 (SD 673) microg/d. Women had a higher lignan density (microg lignans/MJ) in their diet than men (P<0.05). Men had a higher mean daily isoflavone intake, 902 (SD 368) microg, than women, 668 (SD 963) microg (P<0.05). The sources of lignans were many: seeds, cereals, fruit, berries and vegetables. The main sources of isoflavones appeared to be processed meat products/sausages containing soya as an ingredient, and legumes as such. The average intake of lignans and isoflavones in Finland seems to be low, but intake varies throughout the population.

Estimation of plant sterol and cholesterol intake in Finland: quality of new values and their effect on intake

The Finnish national food composition database Fineli was updated with recent analytical values for plant sterols (PS) (sitosterol, campesterol, stigmasterol, avenasterol, brassicasterols and stanols) and cholesterol. The quality of the new analytical data was assessed. The aims of the present study were: (1) to compare the effect of old and new database values on PS and cholesterol intakes based on average per capita food consumption data; (2) to estimate the current intake and major sources of these compounds in various population groups according to the national FINDIET 1997 survey data. The intake of total PS was 305 mg/d for men and 237 mg/d for women. The respective intakes for cholesterol were 284 mg/d and 201 mg/d. Women had a higher density of PS in their diets than men, whereas the cholesterol density in the diets did not differ between genders. Cereals, margarine, vegetables and vegetable oils were the main food sources of PS. Meat, meat products and eggs were the main sources of cholesterol. A 9 % greater PS intake estimate was obtained with the new PS database compared with the old PS database, probably due to minor methodological differences between the new and old analyses. Notable changes in analytical methods suggest a lower value (-19 %) for cholesterol intake calculated from the new database compared with the old one. We conclude that researchers can have confidence in the new values for PS and cholesterol, because systematic evaluation of the new analytical values showed them to be of high quality.

Tendency Toward Eveningness Is Associated With Unhealthy Dietary Habits

Subjects with higher preference for evening hours in daily activities (eveningness) have been repeatedly shown to practice adverse health behaviors as compared to those preferring morning hours (morningness). However, associations between chronotype and dietary intake have not been explored intensively. The authors explored whether the human chronotype is associated with food and nutrient intakes in a random sample of the population aged 25 to 74 yrs. The cross-sectional study included 4493 subjects from the National FINRISK 2007 Study. Chronotype was assessed using a shortened version of Horne and Östbergs Morningness-Eveningness Questionnaire. Diet was assessed using a validated food frequency questionnaire. Associations between morningness-eveningness (ME) score and dietary intakes were analyzed by linear regression and difference between lowest (eveningness) and highest (morningness) ME score quintiles by Tukeys test. In the multivariable model, intakes of whole grain, rye, potatoes, and vegetables and roots decreased, whereas those of wine and chocolate increased with lower ME scores. Participants in the lowest ME score quintile consumed less fish (p < .001) and fruits (p = .025) and more chocolate (p = .001) and soft drinks (p = .015) compared to the highest quintile. No linear association was found between ME score and total energy intake. In regression analyses, intake of alcohol (as a percentage of total energy intake; E%) and sucrose (E%) increased, whereas intake of carbohydrates (E%), protein (E%), fiber, folic acid, and sodium decreased with lower ME scores. Furthermore, participants in the lowest ME score quintile ingested more fat (E%) (p < .001) and less vitamin D (p < .001) compared to the highest quintile, even though no linear trend between ME score and these nutrients emerged. In conclusion, these results support existing evidence that individuals with circadian preference toward eveningness have less healthy lifestyles, such as unfavorable dietary habits, than those with tendency toward morningness, which could put them at higher risk of several chronic diseases. (Author correspondence: noora.kanerva@thl.fi)

Dietary intake and use of dietary supplements in relation to demographic variables among pregnant Finnish women

Proper nutrition during pregnancy may be important for maternal health and fetal growth and development. In Finland, targeted recommendations are given to guide pregnant women in their food choice and dietary supplement use so that they may obtain adequate nutritional status and meet the increased need for nutrients. The aims of the present study were to examine food choices, nutrient intake and dietary supplement use of pregnant Finnish women in association with demographic variables. One thousand and seventy-five families were invited to a birth cohort study during 1998-9. Mothers of 797 newborns completed a validated 181-item food-frequency questionnaire from which the food and nutrient intakes were calculated. The information about supplement use was collected concerning the whole pregnancy. The results of the present study suggest that healthy food choices are rather common among pregnant Finnish women and the choices are positively correlated with age and education. Nutrient supplements were used by 85 % of the women. Supplements were favoured by the older and well-educated women and by those who had normal weight before pregnancy. Of the women in the present study, 31 % received vitamin A-containing supplements, although it is not recommended during pregnancy. Taking food and supplementation into account, the intake of vitamin D did not meet the dietary recommendation and folic acid intake was below recommendation in 44 % of the women. Therefore there seemed to be unnecessary nutrient supplementation and at the same time lack of relevant supplementation among these pregnant women.

Food consumption and advanced β cell autoimmunity in young children with HLA-conferred susceptibility to type 1 diabetes: a nested case-control design

BACKGROUND Evidence for the role of food consumption during childhood in the development of β cell autoimmunity is scarce and fragmentary. OBJECTIVE We set out to study the associations of longitudinal food consumption in children with the development of advanced β cell autoimmunity. DESIGN Children with advanced β cell autoimmunity (n = 232) (ie, with repeated positivity for antibodies against islet cells) together with positivity for at least one of the other 3 antibodies analyzed or clinical type 1 diabetes were identified from a prospective birth cohort of 6069 infants with HLA-DQB1-conferred susceptibility to type 1 diabetes who were born in 1996-2004, with the longest follow-up to the age of 11 y. Repeated 3-d food records were completed by the families and daycare personnel. Diabetes-associated autoantibodies and diets were measured at 3-12-mo intervals. Four control subjects, who were matched for birth date, sex, area, and genetic risk, were randomly selected for each case. RESULTS In the main food groups, only intakes of cow-milk products (OR: 1.05; 95% CI: 1.00, 1.10) and fruit and berry juices (OR: 1.09; 95% CI: 1.02, 1.12) were significantly, although marginally, associated with advanced β cell autoimmunity. The consumption of fresh milk products and cow milk-based infant formulas was related to the endpoint, whereas no evidence was shown for consumption of sour milk products and cheese. The intake of fat from all milk products and protein from fresh milk products was associated with risk of advanced β cell autoimmunity. CONCLUSION Intakes of cow milk and fruit and berry juices could be related to the development of advanced β cell autoimmunity. This trial was registered at clinicaltrials.gov as number NCT00223613.

The compilation of food analysis values as a database for dietary studies—the finnish experience

In dietary studies the food composition data are needed for assessing intake of study subjects. A database for this purpose should include content for foods as consumed, i.e. the database should include brands and dishes described by recipes. The progress made in developing the national Finnish food composition database for dietary studies at the National Public Health Institute is presented. The usefulness of a relational database model in database maintenance is considered and some gaps (e.g. missing foods and retention factors for loss) are discussed. As future challenges, setting priorities in analysis needs, co-operation on food description as well as on nutrient identification are emphasized.

Diet composition of pregnant Finnish women: changes over time and across seasons

OBJECTIVE To describe the diet of a population of pregnant Finnish women over a period of 7 years, with special attention paid to seasonal fluctuations in food consumption and nutrient intake. DESIGN A validated 181-item FFQ was applied retrospectively, after delivery, to assess the maternal diet during the 8th month of pregnancy. SETTING Type 1 Diabetes Prediction and Prevention Nutrition Study Cohort. SUBJECTS The cohort comprised a total of 4880 women who had newly delivered during the years 1997-2004, with the offspring carrying increased genetic risk for type 1 diabetes mellitus. RESULTS Over the study period, the proportion of energy derived from fat decreased while the intake from protein and carbohydrate increased. The intake of vitamin D increased from food sources. Seasonal variation was observed in the mean daily consumption of vegetables, fruits and berries and cereals. Intake of dietary fibre, total fat, MUFA, vitamins A, D, E and C, folate and iron also showed seasonal fluctuation. CONCLUSIONS These results show an overall positive trend in the diet of pregnant Finnish women through the study years. However, there is still room for improvement, particularly in the types of dietary fats. Although food fortification with vitamin D since 2003 was reflected in the increased intake of vitamin D from foods, the mean intake levels still fell below the recommendations. Seasonal changes in food consumption were observed and related to corresponding fluctuations in nutrient intakes. The mean folate intake fell below the recommendation throughout the year.

Sucrose in the diet of 3-year-old Finnish children: sources, determinants and impact on food and nutrient intake

The aim was to identify the important sources of added sucrose and determinants of high intake, and to evaluate what impact a high proportion of energy from added sucrose has on the intake of foods and nutrients. The subjects consisted of children invited to the nutrition study within the Type 1 Diabetes Prediction and Prevention birth cohort and born in 2001 (n 846). Of these, 471 returned 3 d food records at 3 years of age. The average daily intake of added sucrose was 35 (sd 17) g (11.3 % of energy intake) and that of total sucrose was 41 (sd 18) g (13.3 % of energy intake). Sucrose added by manufacturers accounted for 82 %, naturally occurring sucrose for 15 % and sucrose added by consumers for 3 % of the total sucrose. Juice drinks, yoghurt/cultured milks, and chocolate and confectionery were the main contributors to added sucrose intake. Consumption of rye bread, porridge, fresh vegetables, cooked potatoes, skimmed milk, hard cheeses, margarine and fat spread as well as intake of most nutrients decreased across the quartiles of added sucrose (P < 0.05). Being cared for at home, having a father with a vocational school degree, having at least two siblings and a milk-restricted diet increased the risk for a high-sucrose diet. The study implied that a high proportion of added sucrose in the diet had mainly an unfavourable impact on the intake of recommended foods and key nutrients in Finnish children. The rationale for the recommendation to reduce the intake of refined sugars to ensure adequate intakes of nutrients seems reasonable.

Changes in the contribution of snacks to the daily energy intake of Finnish adults.

This study presents data on the contribution of eating occasions to the daily intakes of energy and nutrients. The 48-h dietary data of Finnish adults were gathered from two independent, population-based health surveys undertaken in 2002 and 2007. Snack-dominated and main-meal dominated eating patterns were defined as the habit of obtaining the majority of daily energy from snacks or from main meals. The snack-dominated eating pattern increased in adults from 2002 to 2007, significantly in men. Mostly, similar changes in daily nutrient intakes were observed between study years within eating patterns. Higher alcohol intake in men and higher sucrose intake and lower fibre intake in women were associated with the snack-dominated eating pattern. Due to instability in the snack-dominated eating pattern we conclude that main meals and snacks seem to be parallel ways of composing daily diet with only a few dietary differences.