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23. A review of clinical trials in dietary interventions to decrease the incidence of coronary artery disease

Author

Miettinen Tatu A and Gylling Helena

Subjects
coronary artery disease, cholesterol, diet, fatty acids, plant stanols, plant sterols, Medicine (General), R5-920
Abstract

Abstract Of the associations between dietary elements and coronary artery disease (CAD), the greatest body of evidence deals with the beneficial effect of reducing the dietary intake of saturated fatty acids and cholesterol. Furthermore, it is well established, on the basis of convincing evidence, that reduction in serum total cholesterol results in reduction in coronary morbidity and mortality, as well as in regression of other atherosclerotic manifestations.In fact, dietary intervention studies revealed that it is possible to reduce the incidence of coronary death and nonfatal myocardial infarction, as well as manifestations of atherosclerosis in cerebral and peripheral arteries, by reducing dietary intake of saturated fat and cholesterol. In two recently reported dietary interventions the incidence of coronary events, especially coronary mortality, and total mortality were reduced by increased intake of n-3 long-chain polyunsaturated fatty acids and by a modification of the diet toward a Mediterranean-type diet (rich in α-linolenic acid. In addition to those findings, the potential efficacy of the dietary newcomers phytostanol and phytosterol esters on reducing coronary incidence is discussed in the present review.

Published
2001
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25. Cholestanol and Survival with Simvastatin

Author

Wallis, E. J., Williamson, R., Ramsay, L. E., Yeo, W. W., Jackson, P. R., Miettinen, Tatu A., Gylling, Helena, Strandberg, Timo, and Sarna, Seppo

Published
1998

39. Alcoholic beverage preference, 29-year mortality, and quality of life in men in old age

Author

Strandberg, Timo E., Strandberg, Arto Y., Salomaa, Veikko V., Pitkala, Kaisu, Tilvis, Reijo S., and Miettinen, Tatu A.

Subjects
Mortality -- Evaluation, Mortality -- Risk factors, Mortality -- United States, Quality of life -- Evaluation, Drinking of alcoholic beverages -- Physiological aspects, Drinking of alcoholic beverages -- Health aspects, Aged men -- Alcohol use, Aged men -- Physiological aspects, Aged men -- Health aspects, Alcoholic beverages -- Health aspects, Alcoholic beverages -- Physiological aspects, Cardiovascular diseases -- Risk factors, Health, Seniors
Abstract

Background. Harms of excessive alcohol consumption are obvious, but moderate wine consumption is frequently advocated for prevention of cardiovascular diseases. We compared 29-year mortality and quality of life in old age by alcoholic beverage preference (beer, wine, or spirits) in a cohort of men whose socioeconomic status was similar in their adult life. Methods. In 1974, cardiovascular risk factors and beverage preference were assessed in 2468 businessmen and executives aged 40-55 years. Of them, 131 did not use alcohol, 455 did not report a single preference, and 694, 251, and 937 preferred beer, wine, and spirits, respectively. Quality of life with a RAND-36 Short Form (SF)-36 instrument was surveyed in 2000 in survivors. Mortality was retrieved from registers during the 29-year follow-up. Results. Alcoholic beverage preference tracked well during the follow-up. Total alcohol consumption was not significantly different between preference groups. Men with wine preference had the lowest total mortality due to lower cardiovascular mortality. With the spirits group as the reference category and age, cardiovascular risk factors, and total alcohol consumption as covariates, wine drinkers had a 34% lower total mortality (relative risk 0.66; 95% confidence interval, 0.45-0.98); relative risk for beer preferers was 0.91 (95% confidence interval, 0.68-1.14). In 2000, wine preferers had the highest scores in all RAND-36 scales; general health (p = .007) and mental health (p = .01) were also significantly different. Conclusion. In this male cohort from the highest social class, wine preference was associated with lower mortality and better quality of life in old age. Mortality advantage was independent of overall alcohol consumption and cardiovascular risk factors, but contributing personal characteristics or early life differences cannot be excluded.

Published
2007

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