['Public health status and perspectives' 1997. II. Developments in health status]. / 'Volksgezondheid toekomst verkenning' 1997. II. Ontwikkelingen in de gezondheidstoestand.

As a part of the report 'Public health status and forecasts' 1997 recent developments in the health status of the Dutch population and its determinants are described. Developments until the year 2015 are forecast on the basis of expected demographic and epidemiologic trends, according to expert opinions. Important findings are the unfavourable trends in lifestyle factors in adolescents and the expected increase by 25-60% in 2015 of the prevalence of diseases of old age like cancer, cardiovascular diseases, diabetes mellitus, dementia, chronic nonspecific lung diseases, visual and hearing impairments and diseases of the locomotor system.

DDT (dicophane) and postmenopausal breast cancer in Europe: case-control study.

OBJECTIVE: To examine any possible links between exposure to DDE (1,1-dichloro-2,2-bis (p-chlorophenyl)ethylene), the persistent metabolite of the pesticide dicophane (DDT), and breast cancer. DESIGN: Multicentre study of exposure to DDE by measurement of adipose tissue aspirated from the buttocks. Laboratory measurements were conducted in a single laboratory. Additional data on risk factors for breast cancer were obtained by standard questionnaires. SETTING: Centres in Germany, the Netherlands, Northern Ireland, Switzerland, and Spain. SUBJECTS: 265 postmenopausal women with breast cancer and 341 controls matched for age and centre. MAIN OUTCOME MEASURE: Adipose DDE concentrations. RESULTS: Women with breast cancer had adipose DDE concentrations 9.2% lower than control women. No increased risk of breast cancer was found at higher concentrations. The odds ratio of breast cancer, adjusted for age and centre, for the highest versus the lowest fourth of DDE distribution was 0.73 (95% confidence interval 0.44 to 1.21) and decreased to 0.48 (0.25 to 0.95; P for trend = 0.02) after adjustment for body mass index, age at first birth, and current alcohol drinking. Adjustment for other risk factors did not materially affect these estimates. CONCLUSIONS: The lower DDE concentrations observed among the women with breast cancer may be secondary to disease inception. This study does not support the hypothesis that DDE increases risk of breast cancer in postmenopausal women in Europe.

Diterpene composition of oils from Arabica and Robusta coffee beans and their effects on serum lipids in man.

OBJECTIVES: The cholesterol-raising effect of boiled coffee is caused by diterpenes from coffee oil. In order to identify the diterpene responsible, we analysed the diterpene composition of oils from Arabica (Coffea arabica) and Robusta (Coffea canephora robusta) beans and their effects on serum lipids and thyroid function. DESIGN, SUBJECTS, AND INTERVENTION: During the first 3-week period of a randomized, cross-over trial, 11 healthy, normolipaemic volunteers received per day either 2 g of coffee oil (n = 5) or placebo oil (n = 6). After a 2-week wash-out, the reverse treatments were applied for another 3 weeks. Six subjects received Arabica oil, supplying 72 mg day-1 cafestol and 53 mg day-1 kahweol, and five received Robusta oil, which provided 40 mg of cafestol, 19 mg of 16-O-methyl-cafestol, and 2 mg of kahweol per day. Background diets were constant. RESULTS: The average serum cholesterol levels rose by 0.65 mmol L-1 (13%) on Arabica oil (P < 0.025; 95% CI, 0.21-1.09 mmol L-1) and by 0.53 mmol L-1 (13%) on Robusta oil (NS; 95% CI -0.36-1.42 mmol L-1). The triglycerides levels rose by 0.54 mmol L-1 (71%) on Arabica (P < 0.005; 95% CI, 0.22-0.76 mmol L-1) and 0.49 mmol L-1 (61%) on Robusta oil (P < 0.005; 95% CI, 0.30-0.68 mmol L-1). None of the effects on serum lipids or lipoprotein cholesterol levels was significantly different between Arabica and Robusta oil. Concentrations of serum total and free thyroxine (T4), triiodothyronine (T3), and thyroid-stimulating hormone (TSH) were largely unaffected. CONCLUSIONS: Both Arabica and Robusta oil elevated serum lipid levels; therefore, cafestol must be involved and kahweol cannot be the sole cholesterol-raising diterpene. The mode of action of coffee diterpenes does not involve induction of hypothyroidism.