Boiled coffee consumption and the risk of prostate cancer: follow-up of 224,234 Norwegian men 20-69 years.

BACKGROUND: There is insufficient epidemiological evidence on the relationship between type of coffee and the risk of prostate cancer. METHODS: The risk of prostate cancer by use of boiled vs not boiled coffee were assessed in a prospective study of 224,234 men 20-69 years. 5740 incident prostate cancers were identified. RESULTS: With no coffee as reference group the hazard ratios of <1-4, 5-8 and 9+ cups per day of boiled coffee only were 0.84 (0.73-0.96), 0.80 (0.70-0.92) and 0.66 (0.55-0.80), P-trend=0.00. The corresponding figures for not boiled coffee were 0.89 (0.80-0.99), 0.91 (0.81-1.02) and 0.86 (0.74-1.00), P-trend=0.22. CONCLUSION: An inverse relationship between number of cups per day and the risk of prostate cancer was present only for the boiled coffee type.

Hip fracture and other predictors of anti-osteoporosis drug use in Norway.

UNLABELLED: This study aims to find predictors of anti-osteoporosis drug (AOD) use. Known risk factors of osteoporosis, i.e., age, hip fracture, and corticosteroid use were found to be predictors of AOD use, in addition to a number of other drugs used. Higher socioeconomic position did not favor the use of AOD. INTRODUCTION: This study deals with studying predictors of anti-osteoporosis drug treatment in Norwegian women and men. METHODS: All Norwegian women and men≥50 years were included (n=1,407,392). Data were taken from different data sources, (1) the Norwegian Prescription Database (drug use in 2004-2005); (2) the Nationwide Census 2001 (marital status, education and resident county); (3) the National Hip Fracture Database (hip fractures 2003-2005); and (4) the National Population Register (date of death/emigration). We estimated the hazard ratios (HR) for incident treatment by Cox proportional hazard regression. RESULTS: In 2005, 10,332 women (1.5%) and 1,387 men (0.2%) were new users of anti-osteoporosis drugs (incident treatment). Age was a statistically significant predictor of incident treatment in both women and men, with HR ranging from 1.7 to 3.2 (per 10 years). A middle educational level in men strongly predicted incident treatment [HR 2.0 (CI 1.1-3.8)], but not in women after full adjustment. A previous hip fracture, increasing number of drugs used and use of corticosteroids were all predictors of incident treatment in both genders after adjustments. Corticosteroid use [HRwomen=4.0 (CI 3.8-4.2)] had a higher HR for incident treatment than hip fracture [HRwomen=2.0 (CI 1.8-2.3)]. Marital status and area of residency were not predictors of incident treatment in either gender, after adjustments. The predictors of prevalent treatment were only slightly different from incident treatment in 2005. CONCLUSIONS: Age, previous hip fracture, number of drugs used, and use of corticosteroids were positively related to treatment in both genders. In men, a middle educational level predicted treatment.

Coffee intake and oral-oesophageal cancer: follow-up of 389,624 Norwegian men and women 40-45 years.

BACKGROUND: The evidence on the relationship between coffee intake and cancer of the oral cavity and oesophagus is conflicting and few follow-up studies have been done. METHODS: A total of 389,624 men and women 40-45 years who participated in a national survey programme were followed with respect to cancer for an average of 14.4 years by linkage to the Cancer Registry of Norway. Coffee consumption at baseline was reported as a categorical variable (0 or <1 cup, 1-4, 5-8, 9+ cups per day). RESULTS: Altogether 450 squamous oral or oesophageal cancers were registered during follow-up. The adjusted hazard ratios with 1-4 cups per day as reference were 1.01 (95% confidence interval: 0.70, 1.47), 1.16 (0.93, 1.45) and 0.96 (0.71, 1.14) for 0 or <1 cup, 5-8 and 9+ cups per day, respectively. Stratification by sex, type of coffee, smoking status and dividing the end point into oral and oesophageal cancers gave heterogeneous and non-significant estimates. CONCLUSION: This study does not support an inverse relationship between coffee intake and incidence of cancer in the mouth or oesophagus, but cannot exclude a weak inverse relationship.

Body mass index as predictor for asthma: a cohort study of 118,723 males and females.

The objective of the present study was to quantify the relationship between body mass index (BMI; in kilogrammes per metre squared) and asthma in middle-aged males and females, and to evaluate change in BMI as a risk factor for asthma. Asthma incidence was estimated from data on redeemed prescriptions of anti-asthmatic drugs during the period 2004-2007, retrieved from the nationwide Norwegian Prescription Database. BMI was measured during health surveys in 1994-1999 in >100,000 individuals born during 1952-1959. Change in BMI was based on self-report. Relative risks were estimated using Poisson regression. The relative risk associated with a 3-unit increase in BMI ranged from 1.14 (95% confidence interval 1.10-1.18) in current smokers to 1.27 (1.22-1.32) in never-smokers after adjusting for confounders. The relative risk associated with a 3-unit increase in BMI was 1.21 (1.16-1.26) after adjusting for confounders, including sex, smoking and BMI. Asthma incidence, as measured by anti-asthmatic drug use, was positively related to both BMI and change in BMI. For BMI, the association was stronger for never-smokers than for ex-smokers and current smokers.

Combined analyses and extended follow-up of two randomized controlled homocysteine-lowering B-vitamin trials.

OBJECTIVES: In the Norwegian Vitamin Trial and the Western Norway B Vitamin Intervention Trial, patients were randomly assigned to homocysteine-lowering B-vitamins or no such treatment. We investigated their effects on cardiovascular outcomes in the trial populations combined, during the trials and during an extended follow-up, and performed exploratory analyses to determine the usefulness of homocysteine as a predictor of cardiovascular outcomes. DESIGN: Pooling of data from two randomized controlled trials (1998-2005) with extended post-trial observational follow-up until 1 January 2008. SETTING: Thirty-six hospitals in Norway. SUBJECTS: 6837 patients with ischaemic heart disease. INTERVENTIONS: One capsule per day containing folic acid (0.8 mg) plus vitamin B12 (0.4 mg) and vitamin B6 (40 mg), or folic acid plus vitamin B12, or vitamin B6 alone or placebo. MAIN OUTCOME MEASURES: Major adverse cardiovascular events (MACEs; cardiovascular death, acute myocardial infarction or stroke) during the trials and cardiovascular mortality during the extended follow-up. RESULTS: Folic acid plus vitamin B12 treatment lowered homocysteine levels by 25% but did not influence MACE incidence (hazard ratio, 1.07; 95% CI, 0.95-1.21) during 39 months of follow-up, or cardiovascular mortality (hazard ratio, 1.12; 95% CI, 0.95-1.31) during 78 months of follow-up, when compared to no such treatment. Baseline homocysteine level was not independently associated with study outcomes. However, homocysteine concentration measured after 1-2 months of folic acid plus vitamin B12 treatment was a strong predictor of MACEs. CONCLUSION: We found no short- or long-term benefit of folic acid plus vitamin B12 on cardiovascular outcomes in patients with ischaemic heart disease. Our data suggest that cardiovascular risk prediction by plasma total homocysteine concentration may be confined to the homocysteine fraction that does not respond to B-vitamins.

Nonfasting triglycerides and risk of cardiovascular death in men and women from the Norwegian Counties Study.

The association between nonfasting triglycerides and cardiovascular disease (CVD) has recently been actualized. The aim of the present study was to investigate nonfasting triglycerides as a predictor of CVD mortality in men and women. A total of 86,261 participants in the Norwegian Counties Study 1974-2007, initially aged 20-50 years and free of CVD were included. We estimated hazard ratios (HRs) for deaths from CVD, ischemic heart disease (IHD), stroke and all causes by level of nonfasting triglycerides. Mean follow-up was 27.0 years. A total of 9,528 men died (3,620 from CVD, 2,408 IHD, 543 stroke), and totally 5,267 women died (1,296 CVD, 626 IHD, 360 stroke). After adjustment for CVD risk factors other than HDL-cholesterol, the HRs (95% CI) per 1 mmol/l increase in nonfasting triglycerides were 1.16 (1.13-1.20), 1.20 (1.14-1.27), 1.26 (1.19-1.34) and 1.09 (0.96-1.23) for all cause mortality, CVD, IHD, and stroke mortality in women. Corresponding figures in men were 1.03 (1.01-1.04), 1.03 (1.00-1.05), 1.03 (1.00-1.06) and 0.99 (0.92-1.07). In a subsample where HDL-cholesterol was measured (n = 40,144), the association between CVD mortality and triglycerides observed in women disappeared after adjustment for HDL-cholesterol. In a model including the Framingham CHD risk score the effect of triglycerides disappeared in both men and women. In conclusion, nonfasting triglycerides were associated with increased risk of CVD death for both women and men. Adjustment for major cardiovascular risk factors, however, attenuated the effect. Nonfasting triglycerides added no predictive information on CVD mortality beyond the Framingham CHD risk score in men and women.

Health consequences of sustained smoking cessation.

OBJECTIVES: To estimate the risk of dying from all causes and from specified smoking-related diseases in people who were ex-smokers at two consecutive examinations, compared with never smokers and with people who were ex-smokers at the first examination but who had resumed smoking at the following examination. DESIGN: A prospective cohort study. SETTING: Three counties in Norway. PARTICIPANTS: A total of 23 560 men and 25 122 women, aged 20-49, screened for cardiovascular disease risk factors in the mid 1970s, rescreened after 3-13 years and followed throughout 2005 participated in this study. OUTCOMES: Absolute mortality and relative risks adjusted for confounding variables, of dying from all causes, cardiovascular disease, ischaemic heart disease, stroke, lung cancer and other smoking-related cancer. RESULTS: With sustained never smokers as reference, the sustained ex-smokers had adjusted relative risk (95% CI), of dying from any cause, for men 0.97 (0.80 to 1.18), for women 0.98 (0.65 to 1.48). Corresponding risk for ex-smokers who resumed smoking was for men 1.59 (1.32 to 1.91), for women 1.40 (1.08 to 1.81). For the specified smoking-related diseases, the risk in sustained ex-smokers was not significantly different from the risk in sustained never-smokers, except for lung cancer in men. For ex-smokers who resumed smoking, the corresponding risk was on the whole significantly higher. CONCLUSIONS: A more valid and favourable picture of ex-smokers' risk will be obtained if exposure is being based upon people with two consecutive examinations, years apart. The study confirms clearly the large health benefit of quitting smoking for good.

Sperm DNA damage is related to field fertility of semen from young Norwegian Red bulls.

Flow cytometry was utilised for the first time to independently measure five sperm parameters of individual spermatozoa of bull ejaculates to differentiate between outcome successes after artificial insemination (AI). These parameters included plasma membrane and acrosome integrity, mitochondrial functionality and DNA damage measured by sperm chromatin structure assay (SCSA) and terminal deoxynucleotide transferase-mediated dUTP nick end labelling (TUNEL) assays. For each parameter, results of 142 ejaculates (30 bulls) were ranked into three groups according to their flow cytometric measures: (1) ejaculates with the 25% lowest measures; (2) the 50% middle measures; and (3) the 25% highest measures. In total, 20 272 first-service inseminations (18 ;10(6) spermatozoa per AI dose) were performed, where fertility was defined as non-return within 60 days after first insemination. While plasma membrane and acrosome integrity, and mitochondrial functionality were not significantly related to fertility, data from SCSA and TUNEL assays were significantly associated with fertility. Ejaculates in SCSA group 1 had higher odds of AI success (1.07, 95% CI = 1.02-1.12), whereas those in group 3 had lower odds of AI success (0.94, 95% CI = 0.89-0.99), compared with the average odds of all three groups. Ejaculates in group 2 did not have significantly higher odds of AI success compared with the average odds. For TUNEL-positive spermatozoa, the odds of AI success was higher in group 1 compared with the average odds (1.10, 95% CI = 1.02-1.13), whereas odds of AI success in groups 2 and 3 were not significant compared with the average odds. In conclusion, despite the high number of spermatozoa per AI dose from high-quality bulls, both SCSA and TUNEL assays were valuable measures in this study for evaluating sperm quality in relation to fertility after AI.

Development of body weight in the Norwegian population.

In Norwegian adult men, body mass index (BMI) increased from around 25 kg/m(2) in the late 1960s to around 26.5 kg/m(2) in the late 1990s, and the prevalence of obesity increased from about 5% to 15% in the same period. In women the prevalence of obesity actually decreased from around 13% in the late 1960s to 7% in the late 1980s. However, during the last years the prevalence has also increased reaching about 13% in the late 1990s. It is important to note that both mean and median BMI has increased with a shift in the distribution to the right. The proportion of normal weight individuals has thus decreased, whereas the proportion of obese has increased. The increase in BMI has occurred in different age groups. Although obesity is associated with low education and a sedentary lifestyle, the increase in BMI has also occurred in the more educated and physical active.

Health consequences of smoking 1-4 cigarettes per day.

OBJECTIVES: To determine the risk in men and women smoking 1-4 cigarettes per day of dying from specified smoking related diseases and from any cause. DESIGN: Prospective study. SETTING: Oslo city and three counties in Norway. PARTICIPANTS: 23,521 men and 19,201 women, aged 35-49 years, screened for cardiovascular disease risk factors in the mid 1970s and followed throughout 2002. OUTCOMES: Absolute mortality and relative risks adjusted for confounding variables, of dying from ischaemic heart disease, all cancer, lung cancer, and from all causes. RESULTS: Adjusted relative risk (95% confidence interval) in smokers of 1-4 cigarettes per day, with never smokers as reference, of dying from ischaemic heart disease was 2.74 (2.07 to 3.61) in men and 2.94 (1.75 to 4.95) in women. The corresponding figures for all cancer were 1.08 (0.78 to 1.49) and 1.14 (0.84 to 1.55), for lung cancer 2.79 (0.94 to 8.28) and 5.03 (1.81 to 13.98), and for any cause 1.57 (1.33 to 1.85) and 1.47 (1.19 to 1.82). CONCLUSIONS: In both sexes, smoking 1-4 cigarettes per day was associated with a significantly higher risk of dying from ischaemic heart disease and from all causes, and from lung cancer in women. Smoking control policymakers and health educators should emphasise more strongly that light smokers also endanger their health.

Rapid changes in the prevalence of obesity and known diabetes in an adult Norwegian population. The Nord-Trøndelag Health Surveys: 1984-1986 and 1995-1997.

OBJECTIVE: To determine whether changes in mean BMI and the prevalence of obesity in a total adult population during a short (11-year) period were associated with changes in the prevalence of diabetes. RESEARCH DESIGN AND METHODS: This study involved cross-sectional surveys of all inhabitants aged > or = 20 years of the county of Nord-Trøndelag from 1984 to 1986 (n = 85,100) and from 1995 to 1997 (n = 92,434). Attendance rates were 88.1 and 71.3%, respectively, and 90.0% in an additional survey of people aged 13-19 years from 1995 to 1997 (n = 9,593). Main outcome measures were age-specific mean BMI for the diabetic and nondiabetic subgroups and the prevalence of obesity and diabetes. For comparison, mean BMIs from 18 of 19 Norwegian counties for the group aged 40-42 years were examined. RESULTS: Mean BMI increased from 27.2 to 29.0 kg/m2 in the diabetic population and from 25.1 to 26.3 kg/m2 in the nondiabetic population. The BMI distribution curve shifted to the right, but homogeneity was also reduced. A comparison with other Norwegian counties indicated that this increase occurred during the last 6 years between the surveys. The prevalence of obesity (BMI > or = 30 kg/m2) increased from 7.5 to 14% in nondiabetic men and from 13 to 18% in nondiabetic women. The increase was particularly great in men aged < 60 years and in women aged < 50 years. The overall prevalence of known diabetes increased between the two surveys (from 2.9 to 3.2%) but only in men. The largest increase was observed in the corresponding younger sex and age-groups. CONCLUSIONS: A substantial increase in mean BMI and the prevalence of obesity occurred in the younger age-groups at the same time as an increase in the prevalence of diabetes. A greater increase in diabetes prevalence in this ethnically stable Western European population may follow if effective primary preventive strategies are not undertaken.

Plasma total homocysteine, pregnancy complications, and adverse pregnancy outcomes: the Hordaland Homocysteine study.

BACKGROUND: Total homocysteine (tHcy) measured in serum or plasma is a marker of folate status and a risk factor for cardiovascular disease. OBJECTIVE: Our objective was to investigate associations between tHcy and complications and adverse outcomes of pregnancy. DESIGN: Plasma tHcy values measured in 1992-1993 in 5883 women aged 40-42 y were compared with outcomes and complications of 14492 pregnancies in the same women that were reported to the Medical Birth Registry of Norway from 1967 to 1996. RESULTS: When we compared the upper with the lower quartile of plasma tHcy, the adjusted risk for preeclampsia was 32% higher [odds ratio (OR): 1. 32; 95% CI: 0.98, 1.77; P for trend = 0.02], that for prematurity was 38% higher (OR: 1.38; 95% CI: 1.09, 1.75; P for trend = 0.005), and that for very low birth weight was 101% higher (OR: 2.01; 95% CI: 1.23, 3.27; P for trend = 0.003). These associations were stronger during the years closest to the tHcy determination (1980-1996), when there was also a significant relation between tHcy concentration and stillbirth (OR: 2.03; 95% CI: 0.98, 4.21; P for trend = 0.02). Neural tube defects and clubfoot had significant associations with plasma tHcy. Placental abruption had no relation with tHcy quartile, but the adjusted OR when tHcy concentrations >15 micromol/L were compared with lower values was 3.13 (95% CI: 1.63, 6. 03; P = 0.001). CONCLUSION: Elevated tHcy concentration is associated with common pregnancy complications and adverse pregnancy outcomes.

Plasma total homocysteine and cardiovascular and noncardiovascular mortality: the Hordaland Homocysteine Study.

BACKGROUND: Few population-based studies have assessed relations between plasma or serum total homocysteine (tHcy) and all-cause mortality. OBJECTIVE: Our goal was to study associations between plasma tHcy and all-cause, cardiovascular, and noncardiovascular mortality. DESIGN: This was a prospective cohort study of 2127 men and 2639 women aged 65-67 y in 1992-1993 when they were recruited as part of a population-based national cardiovascular screening program carried out in Hordaland County, Norway. RESULTS: During a median of 4.1 y of follow-up, 162 men and 97 women died. A strong relation was found between plasma tHcy and all-cause mortality. The association was highly significant for noncardiovascular and for cardiovascular causes of death. In a comparison of individuals having tHcy concentrations of 9.0-11.9, 12.0-14.9, 15.0-19.9, or > or = 20 micromol/L with individuals having a tHcy concentration < 9 micromol/L, adjusted mortality ratios were 1.4, 1.9, 2.3, and 3.6 (P for trend = 0.0002) for noncardiovascular and 1.3, 2.1, 2.6, and 3.5 (P for trend = 0.0002) for cardiovascular causes of death. A tHcy increment of 5 micromol/L was associated with a 49% (95% CI: 28%, 72%) increase in all-cause mortality, a 50% (95% CI: 21%, 85%) increase in cardiovascular mortality (121 deaths), a 26% (95% CI: -2%, 63%) increase in cancer mortality (103 deaths), and a 104% (95% CI: 44%, 289%) increase in noncancer, noncardiovascular mortality (33 deaths). CONCLUSION: Plasma tHcy is a strong predictor of both cardiovascular and noncardiovascular mortality in a general population of 65-72-y-olds. These results should encourage studies of tHcy in a wider perspective than one confined to cardiovascular disease.

Height and body mass index in Oslo, Norway, compared to other regions of Europe: do they explain differences in the incidence of hip fracture? European Vertebral Osteoporosis Study Group.

Lean body stature and tallness have both been identified as risk factors for hip fracture. In this study, height and weight data from a multinational multicenter study were used to compare Oslo, which has some of the highest incidence rates of hip fracture ever reported, to other regions of Europe, with respect to height and body mass index. More than 17,000 subjects in six age strata (50-54, 55-59, 60-64, 65-69, 70-74, 75+ years) from 36 centers in 19 European countries were enrolled in the European Vertebral Osteoporosis Study (EVOS), which included standardized height and weight measurements. We found that men in Oslo were 4.3 cm taller than men in western Europe, 5.0 cm taller than men in eastern Europe, and 8.6 cm taller than men in southern Europe. Oslo women were also taller, by 2.2 cm compared to women in western Europe, 2.7 cm compared to women in eastern Europe, and 5.2 cm compared to women in southern Europe. In all age groups, except women aged 55-59 years, mean body mass index (BMI) was lowest in Oslo. Nearly twice as many had a BMI less than 22.0 kg/m2 in Oslo compared to the other regions combined (11.1% vs. 6.6% in men and 19.2% vs. 9.9% in women). This study indicates that the people of Oslo are taller and leaner than people in other regions of Europe. This may in part explain the higher incidence of hip fracture in the population of Oslo.

Is blood pressure treatment as effective in a population setting as in controlled trials? Results from a prospective study.

OBJECTIVE: To evaluate the effectiveness of treatment in situations in which general practitioners and patients use medication according to their own judgement, and where selection, compliance and follow-up varies. This prospective population study differs from the efficacy of treatment studied in randomized trials. DESIGN: Baseline (1974-1976) and repeat (1977-1981) cardiovascular screenings of all males aged 35-49 years in three counties in Norway, with mortality follow-up from the second screening until 1990. SETTING: A nationwide ambulatory screening service reporting community results and referring high-risk subjects to their local general practitioners. PARTICIPANTS: A total of 21,314 males (86%) attended both screenings, of whom 840 took blood pressure medication at the second screening. Males with cardiovascular disease, diabetes or blood pressure treatment at baseline were excluded. MAIN OUTCOME MEASURES: Changes in coronary risk factors, mortality from all causes, coronary heart disease and non-cardiovascular causes. RESULTS: The effect of treatment on blood pressure was small, and the attainment of reasonable target blood pressures was rare. The cholesterol level decreased and the level of triglycerides increased more in the treatment group than in the untreated group. Blood pressure treatment was associated with increased mortality in most risk strata, and at pretreatment systolic blood pressures up to 184 mmHg. A particularly high mortality rate was found when blood pressure increased despite treatment and at low pretreatment blood pressures. According to Cox proportional hazards analyses controlling for pretreatment blood pressure, cholesterol, age, smoking and body mass index, the relative risk of coronary heart disease death in the treatment group was 1.8 (95% confidence interval 1.3-2.6). CONCLUSION: The benefit experienced from the trials turned into an adverse effect of treatment in the population setting, particularly at low pretreatment blood pressure, and when blood pressure increased during treatment.

Compartments within the lymph node cortex of calves and adult cattle differ in the distribution of leukocyte populations: an immunohistochemical study using computer-assisted morphometric analysis.

The combination of an immunohistochemical technique and a panel of monoclonal antibodies was used to investigate the presence of leukocyte populations in the distal jejunal lymph node of 3-4 week old calves and adult cattle. The application of computer-assisted morphometric analysis enabled information to be obtained on the distribution of leukocyte populations in lymphoid compartments of the lymph node cortex. Semi-quantitative estimates of the areas of staining in histological sections showed that calves possessed significantly fewer B-cells and CD4+ cells in the outer cortex and significantly fewer T-cells (CD4+, CD8+ and gamma delta T-cells) in the deep cortex. These findings were interpreted to be a possible consequence of immunosuppression resulting from the passive transfer of maternal immunity in colostrum. The presence of some B-cell follicles in the region defined as the deep cortex suggested the on-going differentiation of this predominantly T-cell compartment. The larger presence of interdigitating cells (IDC) in the deep cortex of calves than adults was suggested by significantly larger CD1+ populations and it was argued that this could be the result of the confrontation with exogenous antigen faced by calves in early postnatal life. Antigen presenting populations, pan MHC II+ and MHC II DQ+ populations, were increased in all compartments of calf lymph nodes but were not significantly different from the populations in adult lymph nodes. Variance component analysis of the data generated in the present study showed that the image analysis technique was an effective and statistically powerful approach to investigate leukocyte populations within the specific microenvironments of the lymph node.

Cohort study of ethnic group and cardiovascular and total mortality over 15 years.

Altogether, 3365 men and 3266 women who attended two cardiovascular screenings in 1974-1975 and 1977-1978, have been followed with respect to death for an average of 15 years. The mortality from coronary heart disease was lower in men who reported being of Lappish origin than in men who reported Norse origin at both screenings (Rate ratio: 0.38 [0.20-0.71]), when other major risk factors were taken into account. Among men without history of cardiovascular disease or symptoms of angina pectoris the rate ratio became 0.24 (0.09-0.63). With cardiovascular death as the endpoint, the corresponding rate ratios were 0.42 (0.25-0.73) and 0.31 (0.15-0.67). In women, a non-significant lower mortality was seen in the Lappish group than in the Norse group. This study is suggestive of some protection from coronary heart disease in middle-aged men of Lappish origin.

The effect of coffee on blood lipids and blood pressure. Results from a Norwegian cross-sectional study, men and women, 40-42 years.

The association between boiled and filter coffee consumption and levels of cholesterol, triglycerides and blood pressure was studied, including 14168 men and 14859 women. A total of 94% drank coffee, 55% of the men and 48% of the women drank more than 4 cups per day. The type of coffee consumed varied between the counties, from 11 to 49% boiled and 49 to 87% filter coffee. Serum cholesterol increased linearly with increasing coffee consumption, and most strongly for boiled coffee. Controlling for other variables gave, for boiled coffee, an 8% increase for men and 10% for women. For filter coffee drinkers the coffee dose-cholesterol association remained significant only for women. Triglycerides showed a negative association with coffee, significant after adjustment for other variables. This effect was stronger for filter than for boiled coffee in both sexes. For men and women drinking 1 cup of coffee or more, a significant negative association between both systolic and diastolic blood pressure and number of cups of filter coffee was found. The influence of high consumption of different coffee-types on death rate from coronary heart disease is discussed.

Mortality in relation to smoking history: 13 years' follow-up of 68,000 Norwegian men and women 35-49 years.

A total of 44,290 men and 24,535 women aged 35-49 have been followed with respect to different causes of death during 13.3 years on average. A detailed history of smoking, together with other important risk factors, were recorded in a standardized way. Compared with the classical American and British studies, the excess mortality for the smokers was largely the same for the majority of causes. The exceptions were cerebrovascular mortality and suicides and accidents, which were more strongly related to smoking in this study. Furthermore, men who smoked only pipe, had nearly the same coronary heart disease mortality as men who smoked only cigarettes. The same applies to lung cancer mortality. Among men who had quit cigarette smoking, the coronary heart disease mortality decreased with time since quitting to almost the level of the never cigarette smokers after 5 years or more.

Serum lipids in postmenopausal or perimenopausal women using estrogen alone, estrogen with levonorgestrel, or estrogen with norethisterone, compared with nonusers: results from a cross-sectional study in two Norwegian counties 1985-1988.

The aim of this study was to compare, in a population setting of postmenopausal or perimenopausal women aged 40 to 54, the levels of serum lipids in women using different hormone replacement therapy (HRT) regimens with women using no sex hormones. There was no unequivocal tendency of a more healthy lifestyle among those using HRT than among nonusers. Any type of regimen was associated with a lower mean level of total and calculated low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol was 0.08 mmol/L (5.2%) higher in those using estrogen alone, 0.07 mmol/L (4.5%) higher in users of HRT with norethisterone, and 0.07 mmol/L (4.5%) lower in users of HRT with levonorgestrel, compared with nonusers. The ratio of total-to-HDL cholesterol was lower by 0.37 (6.1%) in those using estrogen alone, by 0.65 (12.3%) in those using HRT with norethisterone, and by 0.24 (5.3%) in those using estrogen with levonorgestrel. There was no association between body mass index and HDL-cholesterol among women who used HRT with norethisterone, whereas an inverse relationship was present in those using estrogen alone and in nonusers (P [interaction] < 0.05).