Serum alpha tocopherol concentrations and cholesterol ester fatty acid composition in 70-year-old men reflect those 20 years earlier.

OBJECTIVE: It has been suggested that low serum alpha tocopherol concentrations and a low proportion of polyunsaturated fatty acids in the serum cholesterol esters may be associated with a high risk of developing coronary heart disease. DESIGN AND SUBJECTS: In this study the intraindividual reproducibility (biological 'tracking') of these variables was studied in 855 men at the ages of 50 and 70 years. RESULTS: The lipid adjusted tocopherol concentration was positively correlated (r = 0.28, P < 0.0001) between 50 and 70 years of age. Also the proportions of the serum cholesterol ester fatty acids were positively correlated between the same ages with r = 0.31 (P < 0.0001) for palmitic, r = 0.45 (P < 0.0001) for linoleic, and r = 0.58 (P < 0.0001) for arachidonic acid. The body weights of the men at 50 and 70 years of age were strongly correlated (r = 0.78, P < 0.0001). CONCLUSIONS: The tocopherol concentrations and the fatty acid composition are related to vitamin intake and to the dietary fat quality, respectively, and may be useful markers in prospective studies of diseases and of development of diseases. The correlations between the proportions of fatty acids and the body weights, respectively at the ages of 50 and 70 indicate, that changes in diet and body weight in men are probably relatively limited between these years.

Serum high density lipoprotein cholesterol, alcohol, and coronary mortality in male smokers.

OBJECTIVE: To determine whether the increase in mortality from coronary heart disease with high concentration (> 1.75 mmol/l) of high density lipoprotein cholesterol could be due to alcohol intake. DESIGN: Cohort study. SETTING: Placebo group of the alpha tocopherol, beta carotene cancer prevention (ATBC) study of south western population in Finland. PARTICIPANTS: 7052 male smokers aged 50-69 years enrolled to the ATBC study in the 1980s. MAIN OUTCOME MEASURES: The relative and absolute rates adjusted for risk factors for clinically or pathologically verified deaths from coronary heart disease for different concentrations of high density lipoprotein cholesterol with and without stratification for alcohol intake. Similar rates were also calculated for different alcohol consumption groups. RESULTS: During the average follow up period of 6.7 years 258 men died from verified coronary heart disease. Coronary death rate steadily decreased with increasing concentration of high density lipoprotein cholesterol until a high concentration. An increase in the rate was observed above 1.75 mmol/l. This increase occurred among those who reported alcohol intake. Mortality was associated with alcohol intake in a J shaped dose response, and those who reported consuming more than five drinks a day (heavy drinkers) had the highest death rate. Mortality was higher in heavy drinkers than in non-drinkers or light or moderate drinkers in all high density lipoprotein categories from 0.91 mmol/l upward. CONCLUSIONS: Mortality from coronary heart disease increases at concentrations of high density lipoprotein cholesterol over 1.75 mmol/l. The mortality was highest among heavy drinkers, but an increase was found among light drinkers also.

Objectively measured tobacco exposure among pregnant women in Finland in 1986 and 1990.

OBJECTIVE: First, to study tobacco exposure among pregnant Finnish women in 1986 and 1990. Second, to study the objectively measured exposure in different socioeconomic classes and in different geographical regions. Third, to assess the value of serum thiocyanate concentrations in estimating fetal tobacco exposure. DESIGN: Tobacco exposure was measured from maternal and umbilical serum samples by measuring the concentration of nicotine metabolite, cotinine. In addition, the concentrations of thiocyanate were measured from umbilical serum samples. The occupations of the mothers were obtained from the Finnish Birth Registry, and the area of residence from laboratory records. SETTING: Finland. SUBJECTS: 1323 infants born in late February-early March in 1991, 1263 mothers of these infants during antenatal visits in Autumn 1990, and 976 pregnant mothers during antenatal visits in Autumn 1986. The mothers and infants studied represented all newborn infants and their mothers during one week in one country. MEASUREMENTS AND MAIN RESULTS: In 1986, 21.3% of Finnish mothers and in 1990 21.2% were exposed to tobacco. In 1986, exposed mothers were on average 1.4 (95% confidence interval 0.9-1.8) years younger than nonexposed mothers, and in 1990, exposed mothers were on average 1.6 years (95% confidence interval 1.1-2.3) younger than nonexposed mothers. 28.5% of mothers classified as unskilled workers were exposed, but only 9.1% of those classified as upper white-collar. There were no significant geographical differences in exposure. Although umbilical serum thiocyanate levels were always elevated in exposed infants, high serum thiocyanate concentrations were detected in infants not exposed to tobacco. CONCLUSIONS: More than 20% of pregnant Finnish mothers and their fetuses were exposed to tobacco in 1986 and 1990. Young women and women in low socioeconomic classes were the most seriously exposed. Measurement of serum thiocyanate concentrations did not yield reliable estimates of exposure.

Seasonal variation of serum concentrations of beta-carotene and alpha-tocopherol.

We studied the seasonal variation in serum concentrations of beta-carotene and alpha-tocopherol (HPLC) in 17,247 Finnish men who smoked. Month of blood sampling was a statistically significant determinant of serum concentration of beta-carotene in a regression model including age, body mass index, alcohol and fat intakes, total serum cholesterol, and daily cigarettes as covariates. The serum concentrations were lowest in April-June and highest in October-November. The 1.5-fold increase in the serum concentration of beta-carotene during the fall reflects the seasonality of dietary sources of carotenoids in Finland. The serum concentrations of alpha-tocopherol demonstrated no seasonal variation but remained close to 27.6 mumol/L throughout the year. The results indicate that the seasonal variation of serum concentrations of beta-carotene should be taken into account in long-term studies in which comparison of groups or individuals is based on serum concentrations.

Dietary intake and thiamin, iron, and zinc status in elite Nordic skiers during different training periods.

This study evaluated how different training periods affect dietary intake and biochemical indices of thiamin, iron, and zinc status in elite Nordic skiers. Subjects were 17 skiers and 39 controls, ages 18-38 yrs. Dietary data were collected by 7-day food records at 3-month intervals. Coefficient of variation (CV) was used to indicate magnitude of seasonal changes. Energy intake for the year (28 food record days) was 3,802 kcal/day (CV 19.1%) in male skiers, 2,754 kcal/day (CV 3.7%) in male controls, 2,812 kcal/day (CV 9.1%) in female skiers, and 2,013 kcal/day (CV 5.9%) in female controls. CVs for thiamin, riboflavin, vitamin C, calcium, magnesium, iron, and zinc intake were 14.1-23.9% (male skiers), 2.9-15.0% (male controls), 4.8-24.5% (female skiers), and 4.3-11.5% (female controls). Seasonal changes in energy, carbohydrate, and micronutrient intakes reflected energy expenditure in male endurance athletes particularly. Erythrocyte transketolase activation coefficients and serum ferritin and zinc concentrations did not differ between skiers and controls. Seasonal variations in these biochemical indices of nutritional status were of the same magnitude in skiers and controls, despite large changes in skiers' physical activity.

Dietary and biochemical indices of nutritional status in male athletes and controls.

To determine whether physical exercise affects biochemical indices of nutritional status, we compared four groups of male athletes (total n = 427) with two control groups (n = 150). Data about their nutrient intake for 1 month were obtained from a 122-item food frequency questionnaire. An estimate for leisure energy expenditure (EE) was calculated from a 15-item physical activity questionnaire. Athletes were grouped according to their EE (ModEE and HighEE athletes) and weight (light = less than 75 kg; heavy = greater than or equal to 75 kg), and controls according to their weight. Mean energy intake in ModEE and HighEE athletes was 2805-3260 kcal/day. Leisure EE significantly (p less than 0.0001) affected energy and nutrient intakes. Energy, riboflavin and calcium intakes were also higher in heavy subjects (P = 0.0006-0.03). The estimated percentage of subjects with deficient dietary intakes, calculated from probability analyses, was 0-6, depending on group and nutrient. Erythrocyte transketolase activation coefficient (E-TKAC) was highest in controls (1.17 +/- 0.0008; p = 0.001). Serum magnesium was highest (p = 0.01) in ModEE athletes (0.85 +/- 0.006 mmol/L). No intergroup differences were found for plasma ascorbic acid, serum zinc or serum ferritin concentration, whereas blood hemoglobin was lowest (p less than 0.001) in HighEE athletes (149 +/- 0.5 g/L). Ten percent of the control subjects had E-TKAC greater than 1.24. Percentage of other values outside reference range was 0-4, depending on group and indicator. Since lowered blood hemoglobin concentration can be explained by hemodilution, we conclude that sports training did not have a negative effect on biochemical indices of thiamin, vitamin C, magnesium, iron, or zinc status in Finnish male athletes.

Serum beta-carotene before and after beta-carotene supplementation.

A two-month double-blind, placebo-controlled supplementation study of oral beta-carotene (20 mg daily) was conducted. Two hundred and twenty two 30-69 year old men were randomized into either a beta-carotene or placebo group, and serum samples were obtained at baseline, follow-up (2 months), and up to 12 weeks post-supplementation. Serum beta-carotene increased on average 10-fold in the beta-carotene group, from 0.53 +/- 0.32 mumol/l (mean +/- SD) at baseline to 4.99 +/- 2.47 mumol/l at follow-up (P less than 0.0001), and beta-carotene levels remained elevated up to 12 weeks post-supplementation (0.61 +/- 0.15 mumol/l). No changes in serum retinol, alpha-tocopherol, or total cholesterol were observed. At baseline, serum beta-carotene levels were positively correlated with dietary beta-carotene (r = 0.29) and inversely correlated with body mass index and serum gamma-glutamyltransferase (r = -0.33 and r = -0.40, respectively). The inverse association with body mass index and serum gamma-glutamyltransferase persisted during active supplementation, whereas the positive association with dietary beta-carotene disappeared. In multivariate analysis, serum cholesterol was also positively associated with serum beta-carotene levels both before and after supplementation. Baseline serum beta-carotene was the factor most strongly associated (positively) with serum beta-carotene after supplementation. Our study highlights the importance of several factors which affect serum beta-carotene.

Dose-dependent effect on serum cholesterol and apoprotein B concentrations by consumption of boiled, non-filtered coffee.

The effects of boiled coffee (BC) and filtered coffee (FC) on serum lipoproteins were compared in 41 healthy subjects whose serum cholesterol concentration was less than 7 mmol/l. The subjects consumed in random order BC and FC for 4-week periods in a crossover design. The individual daily consumption ranged from 2 to 14 cups (mean 5.7 cups per day) and was similar during both study periods. The serum total and LDL-cholesterol and apoprotein B concentrations were higher (P less than 0.001) and HDL-cholesterol lower (P less than 0.05) after BC than after FC. Bodyweight, apoprotein A-I and triglycerides remained unchanged. In the 16 subjects who consumed coffee less than 5 cups per day the difference in serum total cholesterol between the BC and FC periods was non-significant (P = 0.16). The differences in serum total cholesterol and LDL-cholesterol between the periods showed significant linear correlations with the amount of coffee consumed daily (r = 0.52, P less than 0.001 and r = 0.33, P less than 0.05, respectively) but no association was found between the difference in HDL-cholesterol and the amount of coffee (r = 0.14, P = 0.39). The results indicate a dose-dependent increasing effect on serum total and LDL-cholesterol and apoprotein B concentrations of boiled coffee.

Dietary vitamin c supplementation and common laboratory values in the elderly.

The effects of dietary supplementation with vitamin C on several common laboratory values were assessed in 27 elderly patients in long-stay wards. The patients had shown low plasma ascorbic acid concentrations before the study. During three consecutive periods of six weeks the patients received either placebo or moderate (200 mg/day) or high (2000 mg/day) doses of vitamin C. There was a significant rise of serum folate concentration after both doses of vitamin C. A decrease of serum uric acid concentration after high doses of vitamin C was found. Supplementation with vitamin C did not affect other values of laboratory examinations determined. The results suggest that dietary supplementation with either moderate or high doses of vitamin C has only very few and small influences on common laboratory values in elderly patients.

Serum cholesterol distribution, measurement frequency and cholesterol awareness in three geographical areas of Finland.

The serum cholesterol distribution in three geographical areas of Finland was examined during the first and the second FINMONICA surveys in 1982 and 1987. The mean serum cholesterol concentration changed very little during this observation period. In 1987 the population mean (+/- SD) was 6.12 +/- 1.26 mmoll-1 in men aged 25-64 years and 5.96 +/- 1.28 mmoll-1 in women. Only approximately 20% of the Finns had their serum cholesterol at the level which is regarded as desirable by recent international recommendations. The frequency of cholesterol measurements increased in Finland, especially in North Karelia, from 1972 to 1977 but since then no further increase has taken place. From 1982 to 1987 the proportion of subjects whose cholesterol level was over 6.5 mmoll-1 and who reported knowing that their cholesterol was high increased from 27% to 31% in men and from 24% to 34% in women, respectively. It is concluded that approximately 45% of the adult Finnish population is at moderately increased risk and further 33% at considerably increased risk of coronary heart disease because of the elevated serum cholesterol.

Gravimetric determination of ash in foods: NMKL collaborative study.

A gravimetric method for the determination of ash was collaboratively studied in 14 laboratories. The food is ashed at 550 degrees C to constant weight and the ash is determined by weighing. Seven samples of various food commodities with estimated ash contents varying between low and high (0.07-8.0 g/100 g) were included in the study. The relative standard deviations for reproducibility varied, ranging from 1.0 and 1.3 for ash contents of 7.2 and 8.0 g/100 g, to 11 +/- 1% for low ash contents of 0.07 and 0.27 g/100 g.

Serum amyloid A protein, apolipoprotein A-I, and apolipoprotein B during the course of acute myocardial infarction.

Serum amyloid A protein (SAA), apolipoprotein A-I (apoA-I), apolipoprotein B (apoB) concentrations, and creatine kinase (CK)-MB isoenzyme activity were serially measured in 10 patients during the course of acute myocardial infarction. Pronounced increases in SAA concentrations were observed in all patients during infarction. The highest SAA values were observed, on average, 67 hours after the onset of chest pain. After infarction both apoA-I and apoB concentrations decreased. The reduction in apoA-I concentration 67 to 72 hours after the onset of chest pain was (31%) (p less than 0.01) and the reduction in apoB concentration 55 to 60 hours after the onset of pain was (34%) (p less than 0.01). Negative correlations were found between the concentrations of SAA and apoproteins A-I and B; this inverse relation was stronger between SAA and apoB than between SAA and apo-AI.

Long term treatment of severe hypercholesterolaemia with guar gum.

The long term efficacy of granulated guar gum, 15-30 g per day, was studied in 23 patients with severe hypercholesterolaemia (serum cholesterol concentration between 8.0 and 14.3 mmol/l). Originally, 29 patients participated in the study. Two patients dropped out because of gastrointestinal side effects, two others were not willing to complete the study without any given reason, and two discontinued the study because of hospitalization. A 1-month placebo period preceded the guar gum treatment, and another 1-month placebo period followed after 50 weeks of active treatment. The serum total cholesterol concentration (mean +/- SEM) was reduced from 10.0 +/- 0.4 mmol/l to 8.2 +/- 0.3 mmol/l (P less than 0.001) after 8 weeks and to 9.0 +/- 0.4 mmol/l (P less than 0.001) after 50 weeks on guar gum. During the second placebo period serum cholesterol returned to the pretreatment level. After 34 weeks of active treatment the serum LDL-cholesterol concentration had fallen by 15% and that of apoprotein B by 14% from the baseline. The changes in lipid and lipoprotein levels were independent of the initial values and the type of hypercholesterolaemia. Serum triglycerides, HDL-cholesterol, body weight and blood pressure showed no significant changes during the trial. Of the study subjects, 20 reached the maximum intended dose of 30 g per day guar gum between 8 and 14 weeks and thereafter 11 subjects continued the dose of 30 g/day while 12 subjects reduced the dose to 15-25 g/day.(ABSTRACT TRUNCATED AT 250 WORDS)

Diuretics and hyperuricemia in the elderly.

Serum uric acid (SUA) was studied in a rural population of 420 males and 592 females aged 65 years or more. The mean SUA concentration was 0.313 mmol/l in males and 0.316 mmol/l in females. In males, 47 (11.2%) and in females 60 (10.1%) had a SUA level of 0.42 mmol/l or more. Both the mean serum values and the frequency of hyperuricemia were higher than 11 years earlier in another, similar study. The SUA concentration was 0.361 mmol/l in the 435 individuals using diuretics and 0.281 mmol/l in the remaining 578. Of the 107 hyperuricemic individuals, 82% used diuretics, and only 2 out of those 20 where the SUA level was 0.50 mmol/l or more did not use diuretics. Apart from diuretics, only the serum creatinine concentration, the Body Mass Index, body weight and the hematocrit level were significantly associated with hyperuricemia in both sexes.

No effect on serum lipids by moderate and high doses of vitamin C in elderly subjects with low plasma ascorbic acid levels.

The influence of dietary supplementation with moderate (200 mg/day) and high (2,000 mg/day) doses of vitamin C on serum lipid levels was studied in 27 female long-stay hospital patients characterized by low plasma ascorbic acid levels during the preceding year. The two doses of vitamin C were compared with placebo in a double-blind, cross-over design during randomly determined 6-week periods followed by 2-week washout intervals. No effect was observed on serum cholesterol, HDL cholesterol, and triglyceride levels. Plasma ascorbic acid levels were highly significantly increased (p less than 0.001) by both doses of vitamin C. It is concluded that dietary supplementation with moderate or high doses of vitamin C does not affect serum lipids of persons who have low plasma ascorbic acid levels suggestive of possible marginal deficiency of vitamin C.

Employed problem drinkers: a nutritional risk group?

Nutritional assessment was made in 26 employed Finnish men drinking excessively and in 49 control men. Because of their greater alcohol consumption, daily intake of energy of case men significantly exceeded that of control men; other dietary differences were negligible. Compared with control men, case men had thicker fatfolds but reduced mean body mass and arm muscle circumference. Mean circulating levels of vitamin C and alpha-tocopherol were normal and equal in case and control men, but serum retinol was raised and beta-carotene was reduced in case men. Serum concentration and 24-h urinary excretion of selenium were significantly lower in case than in control men. Serum levels of magnesium and zinc were similar in both groups, but urinary excretions were higher in case men. Heavy drinking does not result in florid nutritional deficiencies in socially intact men, but its role in subtle nutritional alterations deserves further studies.

Bioavailability of selenium to Finnish men as assessed by platelet glutathione peroxidase activity and other blood parameters.

Three groups of 10 men of low selenium status were given 200 micrograms Se/day as Serich wheat, Se-rich yeast, or sodium selenate for 11 wk. Twenty unsupplemented subjects served as controls. Plasma Se levels increased steadily in the wheat and yeast groups for 11 wk without plateauing, whereas in the selenate group, plasma Se plateaued around 110 ng/ml after 4 wk. Platelet glutathione peroxidase (GSH-Px) activities increased rapidly in the wheat and selenate groups for 4 wk and then plateaued. Platelet GSH-Px increased more slowly in the yeast group. Ten weeks after the supplements were discontinued, platelet GSH-Px was higher in the wheat and yeast groups than in the selenate group. Assessment of Se bioavailability requires a short-term platelet GSH-Px measurement to determine immediate availability, a medium-term plasma Se measurement to estimate retention, and a long-term platelet GSH-Px measurement after supplements are discontinued to determine the covertibility of tissue Se stores to biologically active Se.