Traditional Eastern European diet and mortality: prospective evidence from the HAPIEE study.

PURPOSE: Cardiovascular disease (CVD) and cancer mortality rates in Eastern Europe are among the highest in the world. Although diet is an important risk factor, traditional eating habits in this region have not yet been explored. This analysis assessed the relationship between traditional dietary pattern and mortality from all-causes, CVD and cancer in Eastern European cohorts. METHODS: Data from the Health, Alcohol and Psychosocial factors in Eastern Europe prospective cohort were used, including participants from Russia, Poland and the Czech Republic. Based on food frequency questionnaire data, we constructed an Eastern European diet score (EEDS) from nine food groups which can be considered as traditional in this region. The relationship between categorical (low, moderate, high) and continuous (range 0-18) EEDS and mortality was estimated with Cox-regression. RESULTS: From 18,852 eligible participants, 2234 died during follow-up. In multivariable adjusted models, participants with high adherence to the traditional Eastern European diet had significantly higher risk of all-cause (HR 1.23; 95% CI 1.08-1.42) and CVD (1.34; 1.08-1.66) deaths compared to those with low adherence. The association with cancer mortality was only significant in Poland (high vs. low EEDS: 1.41; 1.00-1.98). From the specific EEDS components, high consumption of lard was significantly positively related to all three mortality outcomes, while preserved fruit and vegetable consumption showed consistent inverse associations. CONCLUSION: Our results suggest that traditional eating habits may contribute to the poor health status, particularly the high CVD mortality rates, of populations in Eastern Europe. Adequate public health nutritional interventions in this region are essential.

Does an early socialization into a food culture condition lifelong food preferences? Evidence from a retrospective study.

The influence of early formed dietary practices on food choices and preferences during adulthood has often been assumed but rarely adequately demonstrated given the difficulty of studying the subject matter with conventional laboratory or observational research designs. This article examines this assumption by analyzing the information from 31 structured interviews on the respondents' current preferences for combinations of six side dishes with bread or mamaliga (boiled cornmeal mush, similar to polenta). All the respondents had consumed mamaliga in their childhood but in their adulthood had switched to bread following the social and economic upheavals from 1960s Romania. The results show that a) for specific combinations, physiological factors and/or cultural norms that defined bread as a 'prestigious' food have been capable of overriding the effects of early socialization with mamaliga as the accompanying food and b) that consumers continue to prefer certain side dishes with mamaliga even after decades of predominant consumption of bread although confounding factors might account for such preferences. These findings qualify the expectation that an early familiarization with healthy eating habits will promote this desired lifestyle during adulthood by showing that physiological and socio-cultural factors are capable of overriding its effects on hedonic preferences.