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Background: Analyzing the impact of the intake of many foods simultaneously provides additional knowledge about analyses of nutrients and might make it easier to implement recommendations for the public. Objective: The objective was to examine food patterns in a Swedish population and determine how they are related to metabolic risk factors for cardiovascular disease. Design: The study is based on data from the INTERGENE population study of women and men aged 25-74 y in western Sweden. Dietary patterns were identified with cluster analysis of 93 food frequencies reported by 3452 participants. Associations with features of the metabolic syndrome, including blood lipids, blood pressure, and anthropometric measures, were analyzed. Results: Five distinct food patterns were identified, of which one was interpreted as a 'healthy' reference pattern. This healthy cluster was distinguished by more frequent consumption of high-fiber and low-fat foods and lower consumption of products rich in fat and sugar. The 4 other clusters differed significantly from the reference cluster with respect to prevalence of cardiovascular disease risk factors and the metabolic syndrome. For example, body mass index and waist-to-hip ratio were significantly higher in a cluster characterized by high consumption of energy-dense drinks and white bread and low consumption of fruit and vegetables (P < 0.0001 and P = 0.004, respectively). Conclusions: It is possible to distinguish food patterns that are related to obesity and obesity-related cardiovascular disease risk factors in contrast with a more healthy pattern conforming with current dietary guidelines. Thus, the results indicate no reason for questioning the current recommendations.

Introduction Coronary heart disease represents an important health problem in most industrialised countries. There is strong evidence that lowering serum cholesterol concentration will reduce the incidence of the disease. [1-4] [...]

Aim The aim of this study was to investigate whether the coffee brewing method is associated with any death and cardiovascular mortality, beyond the contribution from major cardiovascular risk factors.Methods and results Altogether, 508,747 men and women aged 20–79 participating in Norwegian cardiovascular surveys were followed for an average of 20 years with respect to cause-specific death. The number of deaths was 46,341 for any cause, 12,621 for cardiovascular disease (CVD), 6202 for ischemic heart disease (IHD), and 2894 for stroke. The multivariate adjusted hazard ratios (HRs) for any death for men with no coffee consumption as reference were 0.85 (082–0.90) for filtered brew, 0.84 (0.79–0.89) for both brews, and 0.96 (0.91–1.01) for unfiltered brew. For women, the corresponding figures were 0.85 (0.81–0.90), 0.79 (0.73–0.85), and 0.91 (0.86–0.96) for filtered, both brews, and unfiltered brew, respectively. For CVD, the figures were 0.88 (0.81–0.96), 0.93 (0.83–1.04), and 0.97 (0.89–1.07) in men, and 0.80 (0.71–0.89), 0.72 (0.61–0.85), and 0.83 (0.74–0.93) in women. Stratification by age raised the HRs for ages ≥60 years. The HR for CVD between unfiltered brew and no coffee was 1.19 (1.00–1.41) for men and 0.98 (0.82–1.15) for women in this age group. The HRs for CVD and IHD were raised when omitting total cholesterol from the model, and most pronounced in those drinking ≥9 of unfiltered coffee, per day where they were raised by 9% for IHD mortality.Conclusion Unfiltered brew was associated with higher mortality than filtered brew, and filtered brew was associated with lower mortality than no coffee consumption.

Background: Elevated concentrations of plasma total homocysteine (tHcy) and serum total cholesterol are risk factors for ischemic heart disease (IHD). Previous studies showed that the consumption of very high doses of unfiltered coffee increases tHcy and total cholesterol. Objective: A prospective intervention study was performed to assess the effects of coffee consumption on the concentrations of tHcy and total cholesterol by using doses and brewing methods common in southeastern Norway. Design: The study was an unblinded, controlled trial with 191 healthy, nonsmoking, coffee-drinking volunteers aged 24-69 y randomly assigned to 3 groups who were asked to consume for 6 consecutive weeks no coffee, 1-3 cups ([approximately equals] 175-525 mL)/d, or [is greater than or equal to] 4 cups([approximately equals] 700 mL)/d prepared in the manner to which they were accustomed. Blood samples were drawn when the subjects were randomly assigned and at 3 and 6 wk of the trial. Dietary data were collected by questionnaire. Results: Ninety-seven percent of the participants reported being regular consumers of caffeinated filtered coffee. Abstention from coffee for 6 wk was associated with a decrease in the tHcy concentration of 1.08 [micro]mol/L and a decrease in the total cholesterol concentration of 0.28 mmol/L in participants who had been drinking on average 4 cups of filtered coffee daily for the past year. Adjustments for several possible confounders did not alter the results. Conclusion: Abstention from filtered coffee in doses that are commonly consumed was associated with lower concentrations of tHcy and total cholesterol. Am J Clin Nutr 2001;74:302-7. KEY WORDS Filtered coffee, homocysteine, cholesterol, folate, ischemic heart disease

Although commonly associated with cardiovascular disease or other medical conditions, atrial fibrillation may also occur in individuals without any known underlying conditions. This manifestation of atrial fibrillation has been linked to extensive and long-term exercise, as prolonged endurance exercise has shown to increase prevalence and risk of atrial fibrillation. In contrast, more modest physical activity is associated with a decreased risk of atrial fibrillation, and current research indicates a J-shaped association between atrial fibrillation and the broad range of physical activity and exercise. This has led to the hypothesis that the mechanisms underlying an increased risk of atrial fibrillation with intensive exercise are different from those underlying a reduced risk with moderate physical activity, possibly linked to distinctive characteristics of the population under study. High volumes of exercise over many years performed by lean, healthy endurance trained athletes may lead to cardiac (patho)physiological alterations involving the autonomic nervous system and remodelling of the heart. The mechanisms underlying a reduced risk of atrial fibrillation with light and moderate physical activity may involve a distinctive pathway, as physical activity can potentially reduce the risk of atrial fibrillation through favourable effects on cardiovascular risk factors.

The relation between salt intake and blood pressure is no news to the food industry, nor to the expert committees in the United States, Norway, and elsewhere recommending reductions in [...]

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Several studies have demonstrated an association between obesity and asthma. However, it is uncertain if fraction of exhaled nitric oxide (Feno), which is used as a marker of airway inflammation, and atopy are associated with BMI. The aim of this study was to examine if obese subjects with asthma symptoms have a different phenotype of asthma than nonobese subjects as indicated by Feno.

Introduction: Central ghrelin signaling is required for the rewarding effects of alcohol in mice. Because ghrelin is implied in other addictive behaviors such as eating disorders and smoking, and because there is co‐morbidity between these disorders and alcohol dependence, the ghrelin signaling system could be involved in mediating reward in general. Furthermore, in humans, single nucleotide polymorphisms (SNPs) and haplotypes of the pro‐ghrelin gene (GHRL)and the ghrelin receptor gene (GHSR) have previously been associated with increased alcohol consumption and increased body weight. Known gender differences in plasma ghrelin levels prompted us to investigate genetic variation of the ghrelin signaling system in females with severe alcohol dependence (n= 113) and in a selected control sample of female low‐consumers of alcohol from a large cohort study in southwest Sweden (n= 212).

Alzheimers disease AD and agerelated macular degeneration AMD share several epidemiological and biochemical features. The present study aimed to assess the possible influence of the AMDassociated complement factor H CFH Y402H 1277T > C polymorphism on the risk of AD. Caucasian subjects n  800 meeting the criteria for probable n  717 or definite n  83 AD and Caucasian nondemented controls n  1265 were included in this multicenter casecontrol study, in which genotype and allele frequencies of the CFH1277T > C polymorphism were determined and related to diagnosis, APOEgenotype, MiniMental State Examination score MMSE and the cerebrospinal fluid CSF biomarkers totaltau Ttau, phosphotau181Ptau181, and βamyloid1–42Aβ1–42. The AMDassociated CFHgenotypes 1277CC and 1277TC were overrepresented in subjects with AD as compared to control individuals P  0.029. Positive C carrier status was associated with an odds ratio OR for AD of 1.24 95 confidence interval CI 1.02–1.50. When APOE4 carrier status was included in the regression model, this association was even stronger OR 1.34, 95 CI: 1.08–1.65, P  0.007. Subgroup analysis showed that the association between CFHC allele positivity and AD was only evident for individuals carrying the APOE4 allele. Positive C carrier status was also associated with lower levels of CSF Aβ1–42selectively in the control group in an APOE4independent manner P  0.003. In conclusion, the CFH1277T > C polymorphism seems to influence the risk of AD and there appears to be an interaction between CFH1277C and APOE4 alleles. The CFH1277C allele may predispose patients for comorbidity in AD and AMD. © 2007 WileyLiss, Inc.

Much has happened in the past decade of 'coffee studies,' and a new consensus has emerged. 'It is that drinking coffee brewed by mixing coffee grounds with hor or boiling [...]

The association between blood pressure treatment, blood pressure level and mortality, taking other cardiovascular risk factors into account was studied. A 12-year follow-up of a cardiovascular risk factor screening performed by the Oslo study group in Oslo and by ambulatory teams from the National Health Screening Survey in three counties in Norway was done. All men in Oslo and all men and women in the three counties, (age 40–49) participated, of these 33154 men and 16407 women have complete data on blood pressure and treatment, including subjects reporting previous myocardial infarction or stroke. Mortality from coronary heart disease, stroke and all causes by blood pressure treatment and blood pressure level were studied. At the initial screening 1058 men and 817 women reported taking blood pressure medication, of which 201 and 41 died during follow-up. Total number of deaths were 2341 in men and 421 in women, of these 131 deaths in men and 47 in women reporting previous infarction or stroke. Those reporting blood pressure treatment had a marked excess mortality from cardiovascular disease and all causes of death. A J-shaped association between blood pressure and mortality was marked in the treated group, but weak in those not on treatment. It is concluded that blood pressure treatment is associated with excess mortality from all causes. This may indicate that “real life” treatment outcomes are inferior to those reported from controlled clinical trials. There is a J-shaped association between all cause mortality and blood pressure in men on treatment.

The relationship between incidence of prostate cancer and intake of dietary fat and foods rich in fat was studied in 25,708 men aged 16–56 years attending a Norwegian health screening in 1977–1983. Linkage to the Cancer Registry of Norway and the Central Bureau of Statistics of Norway ensured a complete follow-up until December 31, 1992. Diet was recorded on a semi-quantitative food-frequency questionnaire at the time of screening, and 72 cases of prostate cancer were identified during follow-up. At the end of follow-up, mean age of the total study sample was 56 years (range 19–68), while mean age at diagnosis of prostate cancer was 60 years (range 47–67). No association was found between energy-adjusted intake of total fat, saturated fat, mono-unsaturated fat or poly-unsaturated fat and the incidence of prostate cancer. Significant positive associations were found for body mass index (BMI) and consumption of hamburgers/meatballs, while no association was found with consumption of frankfurters/sausages and a significant negative association with the weekly number of main meals with meat. A significantly increased risk of prostate cancer was associated with skim milk as compared to whole milk. Milk preference (skim vs. whole) was associated significantly positively with BMI. Our study of a relatively young cohort does not confirm previous case-control and cohort studies suggesting that dietary fat, especially from animal sources, is associated positively with risk of prostate cancer. Int. J. Cancer 73:634–638, 1997. © 1997 Wiley-Liss, Inc.

Univariate analysis of the cross-sectional data of the Tromsø Heart Study revealed group differences in the levels of blood pressure and serum lipids. In order to isolate the contribution from each of the physical and social variables which characterized these groups, a multiple variate analysis was carried out with serum triglycerides, serum cholesterol, systolic and diastolic blood pressure as dependent variables. Besides age, height and weight, seasonal variation contributed substantially to the explanation of the variance of the dependent variables. The influence of the social variables was somewhat reduced compared to the univariate analysis, though most of them did remain significant also in the multivariate analysis. The explained percentage of the total variance ranged from 13% for systolic blood pressure to 26% for serum cholesterol.

The relationship between dietary habits and subsequent risk of cutaneous malignant melanoma (CMM) was studied in 25,708 men and 25,049 women aged 16-56 years attending a Norwegian health screening in 1977-1983. Linkage to the Cancer Registry of Norway and the Central Bureau of Statistics of Norway ensured a complete follow-up until December 31, 1992. Diet was recorded through a semi-quantitative food-frequency questionnaire at the time of screening, and 108 cases of CMM were identified during follow-up. Use of cod liver oil supplementation and intake of polyunsaturated fat were associated with significant increased risk and drinking coffee with significant decreased risk of CMM in women. Adjusting for height, body mass index, body surface area, education, smoking or occupational or recreational physical activity did not change the results. No significant association was found between the incidence of CMM and any of the dietary factors in men. Important aspects are residual confounding by sun exposure and social class, as well as concern with multiple comparisons. Int. J. Cancer 71:600-604, 1997. © 1997 Wiley-Liss, Inc.

In 1988/89, 10,497 men and women aged 40–42 were invited to a health screening in the County of Nordland in northern Norway. The screening procedure comprised completion of a questionnaire, measurement of blood pressure, weight, height and collection of a non-fasting blood sample. Eighty-two percent of the invited population attended the screening. They were given another questionnaire which covered a broad spectrum of relevant topics. Eighty-seven percent of the attenders returned this questionnaire by mail. Non-attenders to the screening tended to be single. Non-responders to the second questionnaire did not differ much from responders, the most consistent finding was a slightly higher heart rate in non-responders. Non-responding men had somewhat higher serum total cholesterol and tended to be smokers.

The most likely cholesterol-raising factors in unfiltered coffee are kahweol and cafestol. Different brewing methods alter the concentrations of these diterpenes and have caused discrepant results in studies from different parts of the world. The effect of tea on the risk of coronary heart disease is much less clear but some studies have found a protective effect, possibly caused by flavonoids acting as antioxidants.

Associations between food habits and total serum cholesterol, high density lipoprotein (HDL) cholesterol, and serum triglycerides were examined in 7,410 men and 7,257 women in Tromsø, Norway, following a screening in 1979–1980. High body mass index was associated with high serum cholesterol, high triglycerides, and low HDL cholesterol. Positive associations were observed between high serum cholesterol and high coffee consumption, use of butter or hard margarine, not selecting low-fat milk, and low bread consumption. The HDL cholesterol level was virtually independent of the dietary items recorded. Use of low-fat milk and frequent use of fish dishes for dinner seemed to be related to low serum triglyceride levels.

In a population survey for risk factors associated with coronary heart disease among 6595 men aged 20–49 years of age, a family history of myocardial infarction (MI) was obtained by interview. A high degree of concurrence (78%) was found between the reported and confirmed diagnoses. Subjects who had evidence of a previous Ml had a significantly higher frequency of first degree relatives with MI compared to healthy men of the same age. In subjects with first degree relatives of either sex suffering from MI before age 50, the mean serum cholesterol concentration was found to be slightly but not significantly elevated. However, when the relatives were females below age 50, the subjects had significantly elevated mean systolic blood pressure (0.05 > p > 0.01). The differences between subjects with a positive and negative family history of MI were surprisingly small. Correspondingly, there was no difference in the frequency of MI relatives in subjects belonging to the upper and lower quintiles of the serum cholesterol and blood pressure distribution. The slight elevations in serum cholesterol and blood pressure contribute only to a very small extent to the increased risk to subjects with a positive family history.