The impacts of partial replacement of red and processed meat with legumes or cereals on protein and amino acid intakes: a modelling study in the Finnish adult population.

BACKGROUND: A shift towards more plant-based diets is considered healthy and environmentally sustainable but may cause a concern regarding protein and amino acid intakes. This modelling study aimed to assess the impacts of partial replacement of red and processed meat with legumes or cereals on the protein and indispensable amino acid intakes in the Finnish adult population. MATERIALS AND METHODS: We used the cross-sectional data of the National FinDiet 2017 Survey (two non-consecutive 24-h recalls, n = 1655, 47% men, aged 18-74 years). Six replacement scenarios were created in which the amount of red and processed meat exceeding 70 g/day (Finnish nutrition recommendation), or 30 g/day (EAT-Lancet recommendation) was replaced with the same amounts of legumes, cereals or their combination. Differences to the reference diet were evaluated based on non-overlapping 95% confidence intervals. Population shares (%) below estimated average requirements (EAR) were calculated using the usual intake modelling methodology (SPADE). RESULTS: The replacement scenarios decreased the protein and indispensable amino acid intakes depending on gender and age. At the 70-g level, decreases were observed only in men aged 18-64 years. At the 30-g level, decreases were observed in other gender and age groups except women aged 65-74 years. In the scenarios, the mean daily protein intake was 15-18% of total energy intake (E%) (reference 17-18 E%), and the proportions below the EAR were 7-10% in men and 8-10% in women aged 18-64 years (reference 5-7%) and 20-25% in men and 16-20% in women aged 65-74 years (reference 14-17%). For total indispensable amino acids, the proportions below the EAR were <5% in the reference diet and the scenarios. CONCLUSIONS: The mean daily protein intake remained sufficient when red and processed meat was partially replaced with legumes or cereals in the Finnish adult population. However, protein adequacy in the elderly population warrants attention and more research.

This modelling study supports global efforts towards more plant-based diets, essential to human and planetary health, by providing insight into the impacts of partial replacement of red and processed meat with legumes or cereals on protein and indispensable amino acid intakes in the Finnish adult population.In general, the mean daily protein and indispensable amino acid intakes decreased but remained sufficient also when substantial amounts of red and processed meat were replaced with legumes or cereals.Some elderly men and women, however, had protein intake below the estimated average requirement, which needs to be considered particularly in the transition towards more plant-based and sustainable diets.

Use of plant stanol ester margarine among persons with and without cardiovascular disease: early phases of the adoption of a functional food in Finland.

BACKGROUND: The plant stanol ester margarine Benecol is a functional food that has been shown to lower effectively serum total and LDL-cholesterol. The purpose of this post-marketing study is to characterize users of plant stanol ester margarine with and without cardiovascular disease. METHODS: A cohort of plant stanol ester margarine users was established based on a compilation of 15 surveys conducted by the National Public Health Institute in Finland between 1996-2000. There were 29,772 subjects aged 35-84 years in the cohort. The users of plant stanol ester margarine were identified by the type of bread spread used. RESULTS: The plant stanol ester margarine was used as bread spread by 1332 (4.5%) subjects. Almost half (46%) of the users reported a history of cardiovascular disease. Persons with cardiovascular disease were more likely to use plant stanol ester margarine (8%) than persons without cardiovascular disease (3%). Users with and without cardiovascular disease seemed to share similar characteristics. In particular, they were elderly people with otherwise healthy life-styles and diet. They were less likely smokers, more likely physically active and less likely obese than nonusers. The users reported being in good or average health in general and having used cholesterol-lowering drugs. CONCLUSION: Plant stanol ester margarine seems to be used by persons for whom it was designed and in a way it was meant: as part of efforts for cardiovascular disease risk reduction.

The combined use of cholesterol-lowering drugs and cholesterol-lowering bread spreads: health behavior data from Finland.

BACKGROUND: Cholesterol-lowering drugs may metabolically interact with cholesterol-lowering bread spreads. This study analyses the prevalence of use of drugs, bread spreads or the combination of both in people aware of their high/elevated cholesterol level, and compares users of the three therapies on health behavior and demographics. METHODS: Participants (9581, 25-74 years) from The National FINRISK 2002 Study filled out a questionnaire on demographics and health (related) issues. Blood samples, blood pressure, body weight and height were measured. RESULTS: Of those who reported to have a high cholesterol level (31% of the study population), 19% used cholesterol-lowering drugs, 11% used cholesterol-lowering bread spreads and 5% combined both therapies. On a population level, only 1% jointly used a drug and bread spread therapy. The combination was used by especially highly educated people and those having a healthy diet. CONCLUSION: Combining a cholesterol-lowering drug with a bread spread regimen is relatively rare, even among those being aware of their high cholesterol levels. The combined usage was most frequent among 'the better off'. Public health risks of a metabolic interaction between both therapies may not be of major importance yet, but future follow-up is recommended.

Consistency of use of plant stanol ester margarine in Finland.

OBJECTIVE: The aims of this study were to investigate the consistency of use of plant stanol ester margarine and to characterise consistent and inconsistent users. DESIGN: A cohort of plant stanol ester margarine users was established based on 14 national surveys conducted by the National Public Health Institute in Finland between 1996 and 1999. A follow-up study questionnaire was developed and sent to 1294 users in 2000. SETTING: Subjects who reported using plant stanol ester margarine in both the original survey and the follow-up study were classified as consistent users, and the rest as inconsistent users. SUBJECTS: The study population consisted of 1094 subjects aged 18-87 years, 590 men and 504 women. RESULTS: There were 357 (33%) consistent and 737 (67%) inconsistent users of plant stanol ester margarine in the study population. Consistent users were more likely to be men and to have a higher household income than inconsistent users. Both consistent and inconsistent users were predominantly middle-aged persons with a healthy lifestyle and diet as well as a history of cardiovascular disease. Healthfulness was the main factor affecting bread spread choice among 94% of the consistent users and 59% of the inconsistent users. CONCLUSIONS: The use of plant stanol ester margarine is more often inconsistent than consistent. There is nevertheless a relatively large subgroup of long-term users of plant stanol ester margarine. It is important to examine the health effects especially among these regular users.