Low levels of antibodies for the oral bacterium Tannerella forsythia predict cardiovascular disease mortality in men with myocardial infarction: A prospective cohort study.

Antibody levels to periodontal pathogens in prediction of cardiovascular disease (CVD) mortality were explored using data from a health survey in Oslo in 2000 (Oslo II-study) with 12 1/2 years follow-up. IgG antibodies to four common periodontal pathogens; Tannerella forsythia (TF), Porphyromonas gingivalis (PG), and Treponema denticola (TD) all termed collectively the "red complex", and Aggregatibacter actinomycetemcomitans(AA) were analysed. The study sample consisted of 1172 men drawn from a cohort of 6,530 men who participated in the Oslo II-study, where they provided information on medical and dental history. Of the study sample, 548 men had reported prior myocardial infarction (MI) at baseline whereas the remaining 624 men were randomly drawn from the ostensibly healthy participants for comparative analyses. Dental anamnestic information included tooth extractions and oral infections. An inverse relation was found for trend by the quartile risk level of TF predicting CVD mortality, p-value for trend = 0.017. Comparison of the first to fourth quartile of TF antibodies resulted in hazard ratio (HR) = 1.82, 95% confidence interval 1.12-2.94, p = 0.015, adjusted for age, education, diabetes, daily smoking, and systolic blood pressure. Specificity comparing decile 1 to deciles 2-10 of TF predicting mortality was 92.3%. We found an increased HR by low levels of antibodies to the bacterium T. forsythia predicting CVD mortality in a 12 ½ years follow-up in persons who had experienced an MI but not among non-MI men. This novel finding constitutes a plausible causal link between oral infections and CVD mortality.

The "Saltin-Grimby Physical Activity Level Scale" and its application to health research.

The use of a four-level questionnaire to assess leisure time physical activity (PA) and its validation is reviewed in this paper. This questionnaire was first published in 1968 and has then been used by more than 600,000 subjects, especially in different population studies in the Nordic countries. A number of modifications to the questionnaire have been published. These are mostly minor changes, such as adding practical examples of activities to illustrate the levels of PA. Some authors have also added duration requirements that were not included for all levels of PA in the original version. The concurrent validity, with respect to aerobic capacity and movement analysis using objective measurements has been shown to be good, as has the predictive validity with respect to various risk factors for health conditions and for morbidity and mortality.

Mortality and years of potential life loss in systemic lupus erythematosus: a population-based cohort study.

Multiple sources were used to identify 325 systemic lupus erythematosus (SLE) patients within the city of Oslo during 1999-2009 who met ≥ 4 of the American College of Rheumatology (ACR) criteria. The survival, standard mortality rate (SMR), years of potential life loss before 60 years of age (YPLL60) and causes of death of these patients were examined and compared to a matched control population. Only inception cases (127) were studied in the calculation of survival. The analysis includes underlying, immediate and contributing causes of death. The five- and 10-year survival was 95% and 90%, respectively, which was significantly reduced when compared to the general population. A total of 50 SLE patients died during the study period. Overall SMR was 3.0 (95% confidence interval (CI) 2.2-3.8) with the highest SMR found for female patients aged 16-39 years old. SLE patients had a 10 times higher rate of YPLL60 compared to the control group. YPLL emphasizes active disease and reduces the importance of cancer as a cause of death in SLE. This study demonstrates that YPLL gives additional and useful information for the prognosis of SLE, supplementing traditional methods of measuring mortality.

Increased risk of atrial fibrillation among elderly Norwegian men with a history of long-term endurance sport practice.

Atrial fibrillation (AF) is the most common cardiac arrhythmia. The prevalence increases with increasing age. In middle-aged men, endurance sport practice is associated with increased risk of AF but there are few studies among elderly people. The aim of this study was to investigate the role of long-term endurance sport practice as a risk factor for AF in elderly men. A cross-sectional study compared 509 men aged 65-90 years who participated in a long-distance cross-country ski race with 1768 men aged 65-87 years from the general population. Long-term endurance sport practice was the main exposure. Self-reported AF and covariates were assessed by questionnaires. Risk differences (RDs) for AF were estimated by using a linear regression model. After multivariable adjustment, a history of endurance sport practice gave an added risk for AF of 6.0 percent points (pp) (95% confidence interval 0.8-11.1). Light and moderate leisure-time physical activity during the last 12 months reduced the risk with 3.7 and 4.3 pp, respectively, but the RDs were not statistically significant. This study suggests that elderly men with a history of long-term endurance sport practice have an increased risk of AF compared with elderly men in the general population.

The association between plasma homocysteine and coronary heart disease is modified by the MTHFR 677C>T polymorphism.

OBJECTIVE: An elevated level of total plasma homocysteine (tHcy) has been associated with risk of coronary heart disease (CHD). The level of tHcy is affected by lifestyle, in addition to genetic predisposition. The methylene tetrahydrofolate reductase (MTHFR) 677C>T polymorphism (rs1801133) is among the strongest genetic predictors of tHcy. We examined whether the association between tHcy and CHD is modified by the MTHFR 677C>T polymorphism. DESIGN AND SETTING: Data from two case-control studies of first-time myocardial infarction (MI), Stockholm Heart Epidemiology Programme (SHEEP), and for MI and unstable angina, INTERGENE, were analysed in parallel. PATIENTS: THcy was determined in a total of 1150 cases and 1753 controls. INTERVENTIONS: None. MAIN OUTCOME MEASURES: The outcome comprised first-time MI and unstable angina, subsumed as CHD. Logistic regression was used to investigate the association between tHcy and CHD, and its modification by genotype. RESULTS: High tHcy was confirmed to be a risk factor for CHD in both studies. In SHEEP, the association between tHcy and MI was observed in MTHFR 677 C-homozygotes (OR=1.4, 95% CI 1.2 to 1.6, for a difference by 1 SD of log tHcy) and in heterozygotes (OR=1.3, 95% CI 1.1 to 1.6) but not in T-homozygotes, independent of smoking, physical activity and obesity. An effect modification of similar magnitude was observed but not statistically significant in the smaller INTERGENE study, and confirmed in a meta-analysis of both studies. CONCLUSIONS: Two Swedish case-control studies showed that the association between elevated tHcy and CHD was confined to carriers of the MTHFR 677 C-allele, which could have implications for the efficiency of tHcy-lowering treatment.

High incidence and prevalence of systemic lupus erythematosus in Norway.

Our aim was to identify all patients with systemic lupus erythematosus (SLE) within the city of Oslo from 1999-2008 and to estimate the incidence and prevalence of SLE according to age, sex and ethnicity. Adults (16 years and over) with SLE were identified from five different sources. Only patients fulfilling four or more of the updated 1997 American College of Rheumatology (ACR) criteria were included. The incidence was stable during the nine year study period, with a mean annual incidence rate of 3.0 per 100,000 at risk (95% confidence interval (CI) 2.4-3.5). Females exhibited a bimodal pattern in age specific incidence with the first peak at 16-29 years of age and the second at 50-59 years of age. The overall prevalence was 51.8 per 100,000 population (95% CI 45.2-58.4), with 91.0 (95% CI 78.8-103.1) for females and 10.7 (95% CI 6.4-15.0) for males. The prevalence proportions for European descendants were similar to those for Asians but statistically significant lower than those for individuals adopted from non-European countries. The findings indicate a higher prevalence in Norwegians compared to Caucasians in Denmark and England. The higher prevalence of SLE in foreign adopted individuals warrants further examination.

Gender differences in the prevalence and determinants of the metabolic syndrome in screened subjects at risk for coronary heart disease.

BACKGROUND: The metabolic syndrome is prevalent among individuals with coronary heart disease (CHD) risk factors. This study's goal was to compare gender differences in the prevalence and determinants of the metabolic syndrome in subjects who were re-examined after a cardiovascular risk factor screening program. METHODS: In a population-based cross-sectional study of 14,811 screened men and women aged 30, 40, 45, and 59 to 60 years, 1,491 subjects in the predetermined risk categories of high glucose (n = 64, 69% male), cholesterol (n = 496, 66.3% male), and blood pressure (n = 362, 63.5% male) or Framingham risk score (n = 253, 93.7% male) or low HDL cholesterol (n = 316, 79.1% male) underwent further examination. RESULTS: The metabolic syndrome was more prevalent among women than among men in the same risk categories with the exception of the blood pressure category. Women with the metabolic syndrome had a higher BMI and C reactive protein (CRP) levels, and were more likely to meet the waist circumference criterion than men (92% versus 70%; P < 0.0001). In multivariate analysis, BMI (odds ration(OR) 25.8, 95% CI 14.3-46.3 for >/=30 kg/m(2) versus < 25 kg/m(2)), CRP (OR 1.9, 95% CI 1.3-2.7 for the highest versus the lowest tertile) and female gender (OR 1.7, 95% CI 1.2-2.3 versus male) were associated with the metabolic syndrome after adjustment for age, physical activity, smoking, and family history of premature cardiovascular disease. CONCLUSION: The metabolic syndrome was more prevalent and more strongly characterized by obesity and low grade inflammation in women than men. These findings underscore the need to study gender-specific approaches to screen for CHD risk.

Intake of milk fat, reflected in adipose tissue fatty acids and risk of myocardial infarction: a case-control study.

OBJECTIVE: To study the association between content of fatty acids from milk fat (14:0, 15:0 and 17:0) in adipose tissue and risk of a first myocardial infarction (MI). DESIGN AND SUBJECTS: A case-control study with 99 patients and 98 population controls both men and postmenopausal women, age 45-75 year. Adipose tissue fatty acids were determined by gas-liquid chromatography. RESULTS: The content of 14:0, 14:1, 15:0, 17:0 and 17:1 were all significantly higher in adipose tissue of controls than of the patients. Age and sex adjusted odds ratios (OR) for MI were significantly reduced with increasing quartiles of 14:0, 14:1, 15:0 and 17:1 in adipose tissue, but except for 15:0 (OR = 0.36, 95% CI 0.13-0.99), the trend was no longer significant after further adjustment for waist-to-hip ratio, smoking and family history for coronary heart disease. Correlations between 14:0 and 15:0 in adipose tissue, and waist-to-hip ratio were significantly negative (r = -0.22 for both, P < 0.01). CONCLUSION: Our study suggests that intake of dairy fat or some other component of dairy products, as reflected by C15:0 as marker in adipose tissue, may protect persons at increased risk from having a first MI, and that the causal effects may rely on other factors than serum cholesterol. SPONSORSHIP: Throne Holst's foundation for Nutrition Research, Research Council of Norway, The Norwegian Association of Margarine Producers, DeNoFa Fabriker A/S, TINE BA.

Trends in overweight and obesity from 1985 to 2002 in Göteborg, West Sweden.

OBJECTIVE: To study secular trends in overweight and selected correlates in men and women in Göteborg, Sweden. DESIGN: Cross-sequential population-based surveys. SUBJECTS: A total of 2931 female and 2691 male subjects aged 25-64 y participated in WHO MONICA surveys (1985, 1990, 1995) and the INTERGENE study (2002). MEASUREMENTS: Body mass index (BMI), waist-to-hip ratio (WHR), prevalence of overweight (BMI> or =25 kg/m(2)), and obesity (BMI> or =30 kg/m(2)). RESULTS: Mean body weight increased by 3.3 kg for women and 5 kg for men, with a significant upward trend for BMI in men but not women over the 17-y observation period. The prevalence of overweight and obesity increased significantly in both sexes over the period. The largest increase was observed in men, and in women aged 25-34 y. In 2002, the prevalence of overweight was 38% in women and 58% in men, and the prevalence of obesity was 11% in women and 15% in men. No significant secular trends were observed for WHR, but there was an upward trend in prevalence of WHR>0.85 in women. A decreased prevalence of smoking in both sexes was observed together with an increase in reported leisure time physical activity. No significant secular trends were observed in rates of self-reported diabetes, although the risk of diabetes attributable to obesity was 24%. CONCLUSION: The results indicate that 25-64-y-olds in the recent survey were more overweight and obese than earlier studied MONICA participants. The increase in BMI was more pronounced in men while abdominal obesity increased principally in women. Although obesity and overweight are clearly important risk factors for type 2 diabetes, the number of diabetics remains low and any secular increase is not yet apparent.

Hormone therapy and mortality during a 14-year follow-up of 14 324 Norwegian women.

OBJECTIVES: We evaluated mortality from cardiovascular disease (CVD), coronary heart disease (CHD) and all causes in relation to use of any hormone therapy (HT) and HT with oestradiol and norethisterone or levonorgestrel. DESIGN: Population-based cohort study. SETTING AND SUBJECTS: Women in three Norwegian counties were invited to a health survey in 1985-88 and 82.8% participated. In all 14 324 post- or perimenopausal women aged 35-62 years, including 702 HT users with a mean age of 48.8 years, were followed for 14 years. RESULTS: Women using HT had mortality from all causes and CVD comparable with that of nonusers. The relative risk (RRs) for CVD mortality amongst all women were 0.69 (95% CI: 0.35-1.33) for users of HT, and 0.96 (95% CI: 0.43-2.17) for users of HT with norethisterone or levonorgestrel. Amongst women free of self-reported cardiovascular health problems at baseline all-cause, CVD and CHD mortality tended to be lower amongst users of HT whilst HT use was linked with increased mortality amongst women with cardiovascular health problems. CONCLUSIONS: In this cohort of women around the usual age of menopause all-cause or CVD mortality amongst users of HT, most often oestradiol combined with norethisterone or levonorgestrel, was not markedly different from that of nonusers. Early CHD events amongst HT users prior to the baseline survey, together with selective inclusion of healthy subjects, may in part explain protective effects of HT on CHD reported from previous observational studies.

Possible angina detected by the WHO angina questionnaire in apparently healthy men with a normal exercise ECG: coronary heart disease or not? A 26 year follow up study.

OBJECTIVE: To determine whether men with possible angina (from their responses to the World Health Organization angina questionnaire) but a normal exercise ECG differ in long term rates of coronary heart disease events from men with no symptoms of angina. DESIGN: During 1972-75, 2014 apparently healthy men aged 40-59 years underwent an examination programme including case history, clinical examination, exercise ECG to exhaustion, and various other tests. All men completed the WHO angina questionnaire. SUBJECTS: Of 2014 men, 68 had possible angina, 1831 had no symptoms of angina, and 115 were excluded because they had definite angina or pathological exercise ECGs. All 68+1831 had normal exercise ECGs and none developed chest pain during the exercise test. RESULTS: At 26 years, men with possible angina had a coronary heart disease mortality of 25.0% (17/68) v 13.8% (252/1831) among men with no symptoms of angina (p < 0.013). They also had a higher incidence of coronary artery bypass grafting (CABG) (p < 0.0004) and acute myocardial infarction (p < 0.026). The excess coronary heart disease mortality among men with possible angina only started after 15 years, whereas differences in CABG/acute myocardial infarction started early. Multivariate analysis including well recognised coronary heart disease risk factors showed that possible angina was an independent risk factor (relative risk 1.79, 95% confidence interval 1.26 to 2.10). CONCLUSIONS: Men with possible angina, even with a normal exercise test, have a greater risk of dying from coronary heart disease, having an acute myocardial infarct, or needing a CABG than age matched counterparts with no symptoms of angina.

Coffee and incidence of diabetes in Swedish women: a prospective 18-year follow-up study.

OBJECTIVES: To examine the long-term incidence of diabetes in relation to coffee consumption in Swedish women. DESIGN: Prospective longitudinal cohort study. SETTING: City of Göteborg, Sweden. SUBJECTS: A random population sample of 1361 women, aged 39-65 years, without prior diabetes or cardiovascular disease took part in a screening study in 1979-1981 with questionnaires, physical examination and blood sampling. MAIN OUTCOME MEASURES: The development of diabetes until 1999 was identified by questionnaires in a second screening and the Swedish hospital discharge register. RESULTS: Altogether, there were 74 new cases of diabetes. The risk of developing diabetes was 475 per 100 000 person-years in women who consumed two cups of coffee or less per day, 271 in women who consumed three to four cups per day, 202 with a consumption of five to six cups per day, and 267 in drinkers of seven cups or more per day. Associated hazard ratios, after adjustment for age, smoking, low physical activity, education and body mass index were 0.55 (0.32-0.95), 0.39 (0.20-0.77) and 0.48 (0.22-1.06) for daily consumption of three to four, five to six and seven cups or more, respectively, with a consumption of less than two per day as reference. Additional adjustment for serum cholesterol and triglycerides attenuated the relation between coffee and diabetes slightly, indicating a possible mediating effect on the effect of coffee by serum lipids. CONCLUSIONS: The findings of the present study support the hypothesis that coffee consumption protects from the development of diabetes in women.

Folic acid supplement decreases the homocysteine increasing effect of filtered coffee. A randomised placebo-controlled study.

OBJECTIVE: Elevated levels of plasma total homocysteine (tHcy) are identified as independent risk factors for coronary heart disease and for fetal neural tube defects. tHcy levels are negatively associated with folic acid, pyridoxine and cobalamine, and positively associated with coffee consumption and smoking. A total of 600 ml of filtered coffee results in a tHcy increase that 200 mug of folic acid or 40 mg of pyridoxine supplementation might eliminate. DESIGN: Randomised, blinded study with two consecutive trial periods. SETTING: Free living population. Volunteers. SUBJECTS: A total of 121 healthy, nonsmoking men and women (78%) aged 29-65 y. INTERVENTIONS: (1) A coffee-free period of 3 weeks, (2) 600 ml coffee/day and a supplement of 200 mug folic acid/day or placebo for 4 weeks, (3) 3-week coffee-free period, (4) 600 ml coffee/day and 40 mg pyridoxine/day or placebo for 4 weeks. MAIN OUTCOME MEASURES: The difference between the change in tHcy in the supplement group and the change in tHcy in the placebo group during the 4-week trial period. RESULTS: Coffee abstention resulted in a tHcy decrease of 1.04 mumol/l for the whole group. In the subsequent coffee period, a further decrease of 0.17 mumol/l was observed in the folic acid group whereas an increase of 1.26 mumol/l was observed in the placebo group, the difference was 1.43 mumol/l (95% CI: 0.80, 2.07). Pyridoxine supplement had no impact on tHcy levels. CONCLUSIONS: Supplementation of 200 mug folic acid/day eliminates the tHcy increasing effect of 600 ml filtered coffee in subjects not already on folic acid supplements. A supplement of 40 mg pyridoxine/day does not have the same effect.

Filtered coffee raises serum cholesterol: results from a controlled study.

OBJECTIVE: Earlier studies and trials have shown a serum cholesterol raising effect of unfiltered coffee, which is reduced by about 80% in filtered coffee. Recent cross-sectional studies and trials, however, have indicated that filtered coffee may have a more pronounced serum cholesterol raising effect than previously anticipated. The objective of this controlled study was to assess the effects of the intake and abstention of filtered brewed coffee on blood lipids. DESIGN: A prospective, controlled study with four consecutive trial periods. The first and third periods were 3 weeks of total coffee abstention. The second and fourth periods consisted of 4 weeks with the subjects consuming 600 ml filter brewed coffee/day. SETTING: Free-living population. Volunteers. SUBJECTS: A total of 121 healthy, nonsmoking men and women aged 29-65 y. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Serum total cholesterol, serum HDL cholesterol, serum triglycerides, serum lipoprotein (a) (Lp(a)), blood pressure and heart rate. RESULTS: The two coffee abstention periods were associated with a decline in serum cholesterol of 0.22 mmol/l (95% CI -0.31, -0.13) and 0.36 mmol/l (95% CI -0.46, -0.26), respectively. Filtered coffee/day 600 ml increased serum cholesterol by 0.25 mmol/l (95% CI 0.15, 0.36) and 0.15 mmol/l (95% CI 0.04, 0.26) during the two coffee drinking periods. CONCLUSIONS: Coffee abstention for 3 weeks decreased total serum cholesterol by 0.22-0.36 mmol/l. A volume of 600 ml (about four cups) of filtered coffee/day during 4 weeks raised total serum cholesterol by 0.15-0.25 mmol/l.

Changing sex ratio in acute coronary heart disease: data from Swedish national registers 1984-99.

OBJECTIVES: To examine trends in sex ratios for different manifestations of coronary disease. DESIGN: National Swedish registers on hospital discharges and cause-specific deaths were used to calculate age- and sex-specific trends and sex ratios for coronary admissions and deaths. SETTING: Nineteen Swedish counties, average population 4.8-5.1 million in the investigated age groups. SUBJECTS: All patients aged 25-84 years with first hospital admissions or deaths as a result of coronary heart disease in 1984-99, in total 432,871 cases. MAIN OUTCOME MEASURES: Ratio men/women and rates (per 100,000) of acute myocardial infarction (AMI), acute admissions for angina and total of all acute admissions for any coronary disease. RESULTS: Below age of 65 years AMI incidence decreased more for men than for women and rates of acute admissions for angina increased more in women than in men. In men and women above 65 years trends were almost identical. In 1984-87 the ratio men/women with respect to myocardial infarction was 5.6 at age 25-44 years, but decreased to 3.7 in 1996-99. Corresponding sex ratios for angina decreased from 3.2 to 1.8 and for total coronary heart disease from 4.7 to 2.8. Amongst men and women aged 45-54 years, the sex ratio with respect to myocardial infarction decreased from 5.6 to 4.1, for angina from 2.4 to 1.7 and for total acute coronary disease from 4.2 to 2.7. Ratios men/women decreased less at higher ages and remained unchanged throughout the period in the oldest age group. CONCLUSIONS: Overall, we found decreasing sex ratios at ages below 65, but above age 65 years trends in men and women were similar. These developments could be due to changing criteria for admission and diagnosis, but true differences in the clinical manifestation of coronary disease, possibly in response to secular trends in risk factor levels, cannot be excluded.

Impact of childhood and adulthood socioeconomic position on cause specific mortality: the Oslo Mortality Study.

OBJECTIVE: To study the impact of childhood and adulthood social circumstances on cause specific adult mortality. DESIGN: Census data on housing conditions from 1960 and Personal Register income data for 1990 were linked to 1990-94 death registrations, and relative indices of inequality were computed for housing conditions in 1960 and for household income in 1990. PARTICIPANTS: The 128 723 inhabitants in Oslo aged 31-50 years in 1990. MAIN RESULTS: Adulthood mortality was strongly associated with both childhood and adulthood social circumstances among both men and women. Cardiovascular disease mortality was more strongly associated with childhood than with adulthood social circumstances, while the opposite was found for psychiatric and accidental/violent mortality. Smoking related cancer mortality was related to both adulthood and childhood social circumstances in men, but considerably more strongly to adult social circumstances. CONCLUSIONS: Childhood social circumstances have an important influence on cardiovascular disease risk in adulthood. Current increases in child poverty that have been seen in Norway over the past two decades could herald unfavourable future trends in adult health.

Parental age and coronary disease in the general male population.

OBJECTIVE: To investigate the role of achieved age in father or mother for long-term prognosis in men with respect to fatal and nonfatal coronary events, and mortality from cardiovascular disease, cancer, and all causes. DESIGN: Prospective follow-up study. SETTING: City of Göteborg, Sweden. SUBJECTS: A total of 6242 men aged 51-59 out of 7100 men who took part in the second screening of the Primary Prevention Study in 1974-77 and who had stated the age of both mother and father at death, or their current age, if they were still alive. MAIN OUTCOME MEASURES: Fatal and nonfatal coronary events, and mortality from cardiovascular disease, cancer, and all causes during follow-up until 1996. RESULTS: Of the men (n=2135) whose father had died before the age of 70, 8.4 per 1000 observation years died from coronary disease during follow-up. Coronary mortality decreased continuously with increasing age in the father and in those whose father had achieved an age of 90 or more 3.2 per 1000 years died [hazard ratio (HR) after adjustment for coronary risk factors, socio-economic status, and history of myocardial infarction in either parent, 0.41 (95% CI 0.23-0.73; P for trend <0.0001)]. This was reflected in reduced risk of mortality from any cause (P for trend after adjustment 0.003). No association with cancer death was found. With respect to hospitalization for myocardial infarction men whose father had survived to at least 90 had an adjusted HR of 0.60 (0.40-0.89) compared with men whose father died before 70 (P for trend 0.0006). The effect of achieved age in the mother was weaker and after adjustment trends were weakly significant for death from cardiovascular and all causes (P=0.01 and 0.03, respectively), but not for any other end-point. CONCLUSION: Paternal, but not maternal, longevity appears to protect against coronary disease, by mechanisms that are largely unknown.

Abstention from filtered coffee reduces the concentrations of plasma homocysteine and serum cholesterol--a randomized controlled trial.

BACKGROUND: Elevated concentrations of plasma total homocysteine (tHcy) and serum total cholesterol are risk factors for ischemic heart disease (IHD). Previous studies showed that the consumption of very high doses of unfiltered coffee increases tHcy and total cholesterol. OBJECTIVE: A prospective intervention study was performed to assess the effects of coffee consumption on the concentrations of tHcy and total cholesterol by using doses and brewing methods common in southeastern Norway. DESIGN: The study was an unblinded, controlled trial with 191 healthy, nonsmoking, coffee-drinking volunteers aged 24-69 y randomly assigned to 3 groups who were asked to consume for 6 consecutive weeks no coffee, 1-3 cups (approximately 175-525 mL)/d, or > or =4 cups (approximately 700 mL)/d prepared in the manner to which they were accustomed. Blood samples were drawn when the subjects were randomly assigned and at 3 and 6 wk of the trial. Dietary data were collected by questionnaire. RESULTS: Ninety-seven percent of the participants reported being regular consumers of caffeinated filtered coffee. Abstention from coffee for 6 wk was associated with a decrease in the tHcy concentration of 1.08 micromol/L and a decrease in the total cholesterol concentration of 0.28 mmol/L in participants who had been drinking on average 4 cups of filtered coffee daily for the past year. Adjustments for several possible confounders did not alter the results. CONCLUSION: Abstention from filtered coffee in doses that are commonly consumed was associated with lower concentrations of tHcy and total cholesterol.