Very-long-chain n-3 fatty acids as biomarkers for intake of fish and n-3 fatty acid concentrates.

We examined how supplementation with very-long-chain n-3 fatty acids was reflected in the concentration of these fatty acids in plasma phospholipids of 363 Norwegian men and women. The concentration of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in plasma phospholipids was significantly higher among individuals supplemented with n-3 fatty acids after the supplementation period than before. We also examined the relation between dietary intake of fatty acids measured with a 180-item quantitative food-frequency questionnaire and the concentration of the same fatty acids in plasma phospholipids in 579 men and women. Correlation coefficients between plasma phospholipid fatty acids and dietary intake of fatty acids were 0.51 and 0.49 for EPA and DHA, respectively. The correlation between fish intake and n-3 fatty acids in plasma phospholipids was 0.37. These results suggest that dietary intake measured with our food-frequency questionnaire may be used to predict the biological availability of some of the essential n-3 fatty acids.

Under- and overreporting of energy intake related to weight status and lifestyle in a nationwide sample.

Desire for weight change and level of dietary consciousness may severely bias reported food intake in dietary surveys. We evaluated to what degree under- and overreporting of energy intake (EI) was related to lifestyle, sociodemographic variables, and attitudes about body weight and diet in a nationwide dietary survey. Data were gathered by a self-administered quantitative food-frequency questionnaire distributed to a representative sample of men and women aged 16-79 y in Norway, of whom 3144 subjects (63%) responded. Reported EI was related to estimated basal metabolic rate (BMR) based on self-reported body weight, age, and sex. An EI:BMR < 1.35 was considered to represent underreporting and an EI:BMR > or = 2.4 as overreporting of EI. Fewer men than women underreported EI (38% compared with 45%). The fraction of overreporters did not differ significantly between sexes (7% of the men compared with 5% of the women). A large proportion of underreporters was obese (9%) and wanted to reduce their weight (41%). Few overreporters were obese and 12% wanted to increase their weight. Underreporters consumed fewer foods rich in fat and sugar than did the other subjects. Multiple regression analysis showed that desire for weight change and physical activity score were significantly correlated with both EI and EI:BMR when adjusted for sociodemographic and lifestyle variables. Our findings indicated that attitudes about one's own body weight influenced reported EI. These attitudes are important in the interpretation of dietary data because many of the subjects (> 30%) wanted to change their body weight.

Effect of long-term changes in diet and exercise on plasma leptin concentrations.

BACKGROUND: Although it is known that plasma leptin concentrations correlate with the amount of adipose tissue in the body, little information is available on the long-term effects on leptin concentrations of changes in diet and exercise. OBJECTIVE: We wanted to examine whether changes in dietary energy sources and exercise-mediated energy expenditure, alone or in combination, affect plasma leptin concentrations. DESIGN: In a randomized, 2 x 2 factorial trial, 186 men with metabolic syndrome were divided into 4 groups: diet, exercise, a combination of diet and exercise, and control. Data on dietary intake, physical fitness, and demographics were collected and plasma leptin concentrations were measured before and after a 1-y intervention period. RESULTS: Plasma leptin concentrations, body mass index, and fat mass decreased in association with long-term reductions in food intake as well as increased physical activity. By adjusting for either body mass index or fat mass, we observed a highly significant reduction in plasma leptin concentration after both the diet and the exercise interventions. There was no interaction between the interventions, suggesting a direct and additive effect of changes in diet and physical activity on plasma leptin concentrations. CONCLUSION: Long-term changes in lifestyle consisting of decreased intake of dietary fat and increased physical activity reduced plasma leptin concentrations in humans beyond the reduction expected as a result of changes in fat mass.

Partially hydrogenated soybean oil reduces postprandial t-PA activity compared with palm oil.

The effects of dietary trans fatty acids on fasting and diurnal variation in hemostatic variables are not known. This study compares the effects of three diets with three different margarines, one based on palm oil (PALM-diet), one based on partially hydrogenated soybean oil (PHSO, TRANS-diet) and one with a high content of polyunsaturated fatty acids (PUFA-diet) on diurnal postprandial hemostatic variables. A strictly controlled dietary Latin square study was performed and nine young female participants consumed each of the diets for 17 days in a random order. The sum of the cholesterol-increasing fatty acids (C12:0, C14:0, C16:0) was 36.3% of total fatty acids in the PALM-diet, the same as the sum of saturated-(C12:0, C14:0, C16:0) (12.5%) and trans fatty acids (23.1%) in the TRANS-diet. The sum of C12:0, C14:0 and C16:0 was 20.7% in the PUFA-diet. The amount of fat made up 30-31% of energy in all diets. Nine participants completed the study. The diurnal postprandial state level of tissue plasminogen activator (t-PA) activity was significantly decreased on the TRANS-diet compared with the PALM-diet. t-PA activity was also decreased on the PUFA-diet compared with PALM-diet but the difference was below statistical significance (P=0.07, Bonferonni adjusted). There were no significant differences in either fasting levels or in circadian variation of t-PA antigen, PAI-1 activity, PAI-antigen, factor VII coagulant activity or fibrinogen between the three diets. Our results indicate that dietary trans fatty acids from PHSO has an unfavourable effect on postprandial t-PA activity and thus possibly on the fibrinolytic system compared with palm oil.

Reduced mortality among whole grain bread eaters in men and women in the Norwegian County Study.

OBJECTIVE: To study whether mortality is reduced among whole grain eaters in Norway. DESIGN: Non-interventional, prospective, baseline 1977-1983, followed for mortality through to 1994. SETTING: Three Norwegian counties. SUBJECTS: A total of 16,933 men and 16,915 women; systematic screening of all residents aged 35-56y at baseline, not disabled and free of cardiovascular disease (79% response rate). PREDICTOR VARIABLE: We combined self-report of type and number of bread slices (white, light whole grain, dense whole grain) to form a whole grain bread score, with range 0.05 (1 slice per day, made with 5% whole grain flour) to 5.4 (9 slices per day, made with 60% whole grain flour). RESULTS: Norwegian whole grain bread eaters were less likely to be smokers, were more physically active, had lower serum cholesterol and systolic blood pressure, and ate less total and saturated fat as a proportion of energy intake than white bread eaters. After adjustment for age, energy intake, sex, serum cholesterol, systolic blood pressure, smoking, body mass index, physical activity at leisure and work, and use of cod liver oil or other vitamin supplements, hazard rate ratios (HRR) for total mortality were inverse and graded across whole grain bread score categories (category 5 vs category 1 HRR: 0.75, 95% confidence interval 0.63-0.89 in men and 0.66, 0.44-0.98 in women). CONCLUSION: Protection by whole grain intake against chronic disease is suggested in Norway, where four times as much whole grain is consumed as in the United States.

Dietary habits among patients with atopic dermatitis.

OBJECTIVE: To evaluate the dietary habits among adult patients with moderate to severe atopic dermatitis and relate intake to clinical symptoms. DESIGN: Data were obtained from a clinical trial. SETTING: Five departments of dermatology at Norwegian University hospitals. SUBJECTS: Outpatients, 46 men (median age 27 y) and 92 women (median age 28 y). METHOD: A quantitative food frequency questionnaire was filled in before attending the clinical trial. The results were compared to the diet of age- and sex-matched reference groups. RESULTS: Male patients had higher content of refined sugar in their diet than reference men (P=0.014). Among female patients, the intake of saturated fatty acids was higher (P=0.049), whereas the intake of very long-chain n-3 fatty acids was lower (eicosapentaenoic acid, P=0.032, docosahexaenoic acid, P=0.017) than in the reference group. In both genders, more patients than reference subjects had vitamin D intake below recommended level. Furthermore, the female patients had significantly lower intake of fruit compared to the reference group (P=0.002). No correlation was found between nutrient intake of the patients and their clinical scores. CONCLUSIONS: The patients's diet were fairly similar to the diet of reference groups. The intake of vitamin D and very long-chain n-3 fatty acids was low, especially among female patients. Furthermore, we could not detect any association between dietary habits and clinical status. European Journal of Clinical Nutrition (2000) 54, 93-97

Intake of very-long-chain n-3 fatty acids related to social status and lifestyle.

OBJECTIVES: Little information is available about the intake of very-long-chain n-3 fatty acids in random samples of populations. We examined if the intake of these fatty acids was associated with gender, social status and lifestyle in a similar way as other indicators for a healthy diet in a nationwide survey. DESIGN AND SUBJECTS: Data were obtained from self-administered quantitative food frequency questionnaires filled in by a representative sample of Norwegian men and women, aged 16-79 y. 3144 (63%) of the invited subjects responded with acceptable questionnaires. RESULTS: Daily intake of very-long-chain n-3 fatty acids was on average 0.9 g/d and 0.4% of total energy was derived from these fatty acids. Energy derived from very-long-chain n-3 fatty acids was slightly higher among men than women, and two-fold higher among subjects aged 60-79 vs 16-29 y. White collar workers had higher intake of very-long-chain n-3 fatty acids than blue collar workers. Men and women in the highest quartile of intake of very-long-chain n-3 fatty acids had 2-3 E% higher fat intake (mostly mono- and polyunsaturated fatty acids), as compared to individuals in the lowest quartile. They also had 3-4 fold higher daily intake of retinol and vitamin D, as well as 20-50% higher intake of fruits and vegetables, dietary fibre and vitamin C. CONCLUSIONS: Intake of very-long-chain n-3 fatty acids was correlated to indicators for healthy dietary habits. However, contrary to many other indicators of a healthy diet, energy derived from very-long-chain n-3 fatty acids was not significantly associated with female gender or non-smoking.

Response rates with different distribution methods and reward, and reproducibility of a quantitative food frequency questionnaire.

OBJECTIVES: To evaluate the use of a self-administered quantitative food frequency questionnaire (QFFQ) in a national dietary survey concerning (a) response rates with different distribution methods and reward; (b) degree of underreporting of energy intake; (c) reproducibility of the QFFQ; and (d) seasonal variation on reported intake. DESIGN AND SUBJECTS: A pilot study was performed in 1992 to test response rates to the QFFQ with three different distribution methods, with and without reward, in a random sample of 1200 adults aged 16-79 y. In another study, the QFFQ was distributed to a nation-wide, representative random sample of 5008 adults aged 16-79 y during June, September, November 1993 and March 1994. Reproducibility was evaluated among 90 responders to the survey who answered another QFFQ six weeks later. RESULTS: The distribution method combining postal distribution and collecting the QFFQ by interviewer as well as an offer to participate in a lottery, gave the highest response rate (72%). The possibility to get a reward increased the response rate by 9, 14 and 57%, respectively, depending on the distribution method used. The mean daily energy intake and the percentage of subjects claiming to have unlikely low energy intake did not differ significantly between the different ways of distribution. In the main survey the mean ratio between energy intake and estimated basal metabolic rate was 1.58 among men and 1.47 among women, and 37% of men and 45% of women had a ratio below 1.35. Spearman rank correlations between the two QFFQ ranged from 0.48 (edible fats) to 0.91 (coffee) with a median coefficient of 0.70. For nutrients correlations ranged from 0.55 (carbohydrate E%) to 0.81 (alcohol), with a median coefficient of 0.72. The season of questionnaire administration was of minor importance for the reported intake of the main foods and nutrients. CONCLUSIONS: The QFFQ-method is suitable for use in a Norwegian nutritional surveillance system. SPONSORSHIP: National Nutrition Council, Ministry for Agriculture, Ministry for Health and Social Affairs and Norwegian Research Council.

Malignant epithelial tumours in the upper digestive tract: a dietary and socio-medical case-control and survival study.

OBJECTIVE: The aim of the present study was to elucidate the influence of social, dietary and environmental factors on the incidence of malignant epithelial tumours in the upper digestive tract and on the prognosis of patients with these cancers. DESIGN: A population-based case-control study was carried out, and the patients in the study were included in a survival analysis. SETTING: The study was carried out at the Department of Otorhinolaryngology at Ullevål University Hospital, Oslo, Norway. SUBJECTS: In the case-control study, 84 patients and 89 controls were included. Only the patients were included in the survival analysis. RESULTS: Smoking showed the highest odds ratio (OR) for morbidity (OR = 29). The patients had in general a lower social status, and a higher alcohol intake (OR = 6.6). For both beta-carotene and vitamin C, the ORs decreased with increasing intake (OR = 0.2 and 0.3, respectively). Increased ORs were associated with low values for haemoglobin, iron, TIBC, folic acid, magnesium and especially for albumin (OR = 14), and with high values for ferritin, vitamin B12 and thiocyanate (a marker for smoking). Stage of the disease was an important prognostic factor. The relative risk (RR) of dying for disseminated vs localised tumours being 3.2. A poorer prognosis was linked to higher age, to smoking vs no smoking (RR = 2.3), and to lower levels of haemoglobin, albumin, magnesium and thiocyanate. CONCLUSIONS: Strong beer, liquor, consumption of milk and table fat, low social status and smoking seemed to have a negative impact on both disease and survival. Fruit and vegetables might, however, reduce the risk. Whereas low serum albumin, iron and magnesium indicated a high OR for cancer, vitamin C and beta-carotene had the opposite implication. No significant implications on survival could be detected in blood chemistry beyond the stage of disease.

Accuracy of a quantitative food frequency questionnaire applied in elderly Norwegian women.

The accuracy (reproducibility and relative validity) of a self-administered quantitative food frequency questionnaire including 180 food items was evaluated. A total of 38 elderly women kept multiple weighed diet records for a total of 14 days over a 6-week period and filled in the questionnaire both before and after this period. Spearman rank correlations between the nutrient intakes from the two questionnaires varied from 0.43 for carbohydrate to 0.88 for energy percentage from alcohol. The median correlation was 0.70. Seven women whose recorded average energy intake was less than 1.17 times their measured basal metabolic rate were excluded from the analysis comparing the questionnaire and the diet records. The first questionnaire gave on the average 10% higher nutrient median values than the records, while the second questionnaire did not in general produce higher values. Unadjusted correlation coefficients comparing intakes measured by the two methods ranged from 0.31 for vitamin C to 0.79 for energy percentage from carbohydrate, the median coefficient being 0.61. On the average 77% of the subjects were classified in the same (+/- 1) quintile in the first food frequency questionnaire and the diet records. The present study indicates that the self-administered quantitative food frequency questionnaire is useful for measuring individual or group intakes for a variety of nutrients.

Coffee consumption and death from coronary heart disease in middle aged Norwegian men and women.

OBJECTIVE: To study the association between number of cups of coffee consumed per day and coronary death when taking other major coronary risk factors into account. DESIGN: Men and women attending screening and followed up for a mean of 6.4 years. SETTING: Cardiovascular survey performed by ambulatory teams from the National Health Screening Service in Norway. PARTICIPANTS: All middle aged people in three counties: 19,398 men and 19,166 women aged 35-54 years who reported neither cardiovascular disease or diabetes nor symptoms of angina pectoris or intermittent claudication. MAIN OUTCOME MEASURE: Predictive value of number of cups of coffee consumed per day. RESULTS: At initial screening total serum cholesterol concentration, high density lipoprotein cholesterol concentration, blood pressure, height, and weight were measured and self reported information about smoking history, physical activity, and coffee drinking habits was recorded. Altogether 168 men and 16 women died of coronary heart disease during follow up. Mean cholesterol concentrations for men and women were almost identical and increased from the lowest to highest coffee consumption group (13.1% and 10.9% respectively). With the proportional hazards model and adjustment for age, total serum and high density lipoprotein cholesterol concentrations, systolic blood pressure, and number of cigarettes per day the coefficient for coffee corresponded to a relative risk between nine or more cups of coffee and less than one cup of 2.2 (95% confidence interval 1.1 to 4.5) for men and 5.1 (0.4 to 60.3) for women. For men the relative risk varied among the three counties. CONCLUSIONS: Coffee may affect mortality from coronary heart disease over and above its effect in raising cholesterol concentrations.

Dietary iron supply in meningococcal disease patients and controls.

Dietary questions were directed to patients and controls in a follow-up study of incident meningococcal disease cases in Norway, winter 1981-1982. The questions emphasized the main iron sources in the usual diet. The daily intake of iron from some sources was estimated, and the various groups compared. The differences were small.

Tea consumption. relationship to cholesterol, blood pressure, and coronary and total mortality.

BACKGROUND AND METHODS: The relation of tea to cholesterol, systolic blood pressure, and mortality from coronary heart disease and all causes was studied in 9,856 men and 10,233 women without history of cardiovascular disease or diabetes. All men and women 35-49 years of age from the county of Oppland (Norway) were invited to participate; the attendance rate was 90%. RESULTS: Mean serum cholesterol decreased with increasing tea consumption, the linear trend coefficient corresponded to a difference of 0.24 mmol/liter (9.3 mg/dl) in men and 0.15 mmol/liter (5.8 mg/dl) in women between drinkers of less than one cup and those of five or more cups/day, when other risk factors were taken into account. Systolic blood pressure was inversely related to tea with a difference between the same two tea groups of 2.1 mm in men and 3.5 mm in women. Altogether 396 men and 237 women died from all causes, and of these 141 and 18, respectively, died from coronary heart disease during the 12-year follow-up period. The mortality rate was higher (not statistically significant) among persons drinking no tea or less than one cup compared with persons drinking one or more cups/day. This applies to men and women and to coronary heart disease and all-cause mortality. For men, the relative risk (one or more versus less than one cup) for coronary death from Cox regression was 0.64 (95% CI:0.38, 1.07).

Coffee consumption and the risk of breast cancer. A prospective study of 14,593 Norwegian women.

The association between coffee consumption and the incidence rate of breast cancer has been analysed in 152 incident cases of breast cancer that developed among 14,593 Norwegian women during a mean follow-up of 12 years. At the time of inquiry they were between 35 and 51 years of age, and at the end of follow-up between 46 and 63. There was an overall weak negative association between daily intake of coffee and risk of breast cancer, which was not statistically significant. However, the association with coffee varied, depending on the body mass index (BMI) of the women. In the lean (Quetelet less than 24; population mean) there was an inverse relation between coffee intake and risk of breast cancer (chi 2 trend = 5.07, P = 0.02). In this group, women who reported drinking 5 cups or more per day had an age-adjusted IRR of 0.5 (95% confidence intervals, 0.3 and 0.9) compared to women who had 2 cups or less. In women with Quetelet's index equal to or greater than 24 there was a positive relation between coffee intake and breast cancer risk (chi 2 trend = 2.33, P = 0.13), where the corresponding age-adjusted IRR was 2.1 (95% confidence intervals, 0.8 and 5.2). This interaction effect between coffee intake and BMI was statistically significant (chi 2 interaction = 10.2, 3 d.f., P = 0.02). In summary, the results of this study suggest that coffee consumption reduces the risk of breast cancer in lean women, whereas coffee might have the opposite effect in relatively obese women.

Frequency of meat and fish intake and risk of breast cancer in a prospective study of 14,500 Norwegian women.

The association between the frequency of meat and fish intake and the incidence rate of breast cancer has been analyzed in 152 incident cases that developed among 14,500 Norwegian women during 11 to 14 years of follow-up. At the time of dietary inquiry they were between 35 and 51 years of age. A positive association was observed between the frequency of overall meat intake and breast cancer risk. There was an age-adjusted incidence rate ratio (IRR) of 1.8 (95% confidence limits, 1.1 and 3.1) for women who had a main meal with meat 5 times or more per week compared to women who had 2 meat dinners or less per week, and this association displayed a linear trend (chi 2 trend = 4.30, p = 0.04). No association was detected between the overall frequency of fish for dinner and breast cancer risk (chi 2 trend = 1.39, p = 0.24), but there was an inverse relation with the frequency of main meals containing fish in poached form. The age-adjusted IRR was 0.7 (95% confidence limits, 0.4 and 1.0) for women who had poached fish for dinner at least 5 times per month compared to women who had fish in this form twice monthly or less often (chi 2 trend = 3.56, p = 0.06). The positive association with meat may be in accordance with the hypothesis that dietary fat increases the risk of breast cancer. Although there was no association with overall fish intake, the inverse relation with poached fish might deserve further investigation.

Norwegian case-control study testing the hypothesis that seafood increases the risk of thyroid cancer.

The hypothesis that consumption of seafood increases the risk of thyroid cancer has been tested by means of a matched case-control study. Linking the file of the National Health Screening Service (NHSS) containing dietary information about 60,000 Norwegians with the 1955-89 thyroid-cancer file of the Cancer Registry, by means of the 11-digit person-number, resulted in 92 cases--each of whom was matched with five controls with regard to age, gender, and place of residence. Forty-eight cases had answered questions on diet before diagnosis; 44 did so after diagnosis. Exposure data on seafood and seafood-related vitamins were recovered from the NHSS files for all 552 subjects. Odds ratios (OR) were computed by means of conditional logistic regression analysis. Univariate analysis of the 48 sets in which the case had answered the dietary questionnaire prior to the thyroid cancer diagnosis, as well as of all 92 sets, indicate that regular users of cod-liver oil, fish liver, or fish sandwich-spread run a higher risk of thyroid cancer than irregular and nonusers, and people eating more fish dinners per week also run a higher risk of thyroid cancer. Stepwise regression analysis corroborates the study hypothesis by showing that these two seafood variables increase the risk of thyroid cancer significantly. On the other hand, the results of a simultaneous regression analysis of these two seafood variables and a dietary vitamin-D index-variable tend to reduce the tenability of the above-mentioned conclusion since none of the OR estimates (all greater than one) reached significance in this part of the statistical analysis.

Healthy dietary habits in relation to social determinants and lifestyle factors.

The aim of the present study was to evaluate the importance of social status and lifestyle for dietary habits, since these factors may influence life expectancy. We studied the association of four indicators for healthy dietary habits (fruits and vegetables, fibre, fat and Hegsted score) with sex, age, socio-economic status, education, physical leisure exercise, smoking and personal attention paid to keeping a healthy diet. Data were gathered with a self-administered quantitative food-frequency questionnaire distributed to a representative sample of Norwegian men and women aged 16-79 years in a national dietary survey, of whom 3144 subjects (63%) responded. Age and female sex were positively associated with indicators for healthy dietary habits. By separate evaluation length of education, regular physical leisure exercise and degree of attention paid to keeping a healthy diet were positively associated with all four indicators for healthy dietary habits in both sexes. Socio-economic status, location of residence and smoking habits were associated with from one to three indicators for healthy dietary habits. In a multiple regression model, age, education and location of residence together explained from 1 to 9% of the variation (R2) in the four dietary indicators. Length of education was significantly associated with three of four dietary indicators both among men and women. By including the variable 'attention paid to keeping a healthy diet' in the model, R2 increased to between 4 and 15% for the four dietary indicators. Length of education remained correlated to three dietary indicators among women, and one indicator among men, after adjusting for attention to healthy diet, age and location of residence. Residence in cities remained correlated to two indicators among men, but none among women, after adjusting for age, education and attention to healthy diet. In conclusion, education was associated with indicators of a healthy diet. Attention to healthy diet showed the strongest and most consistent association with all four indicators for healthy dietary habits in both sexes. This suggests that personal preferences may be just as important for having a healthy diet as social status determinants.

Presence of ochratoxin A in human milk in relation to dietary intake.

Individual and geographical variations in ochratoxin A (OA) levels in human blood and milk samples may be due to differences in dietary habits. The purpose of this study was to examine the relationship between OA contamination of human milk and dietary intake. Human milk samples were collected from 80 Norwegian women. The usual food intake during the last year was recorded using a quantitative food frequency questionnaire. The concentration of OA in the human milk was determined by HPLC (detection limit 10 ng/l). Seventeen (21%) out of 80 human milk samples contained OA in the range 10-182 ng/l. The women with a high dietary intake of liver paste (liverwurst, liver pâté) and cakes (cookies, fruitcakes, chocolate cakes, etc.) were more likely to have OA-contaminated milk. The risk of OA contamination was also increased by the intake of juice (all kinds). In addition, the results indicate that breakfast cereals, processed meat products, and cheese could be important contributors to dietary OA intake. OA contamination of the milk was unrelated to smoking, age, parity, and anthropometric data other than body weight.

High intake of energy, sucrose, and polyunsaturated fatty acids is associated with increased risk of preeclampsia.

OBJECTIVE: Preeclampsia is associated with high body mass index, insulin resistance, and hypertriglyceridemia. Our objective was to investigate prospectively whether diet in the first half of pregnancy is associated with the risk for preeclampsia. STUDY DESIGN: This prospective, population-based, cohort study of pregnant women investigated dietary intake early in the second trimester with a quantitative food frequency questionnaire. RESULTS: The questionnaire was completed by 3133 women (83%). Preeclampsia developed in 85 women. Adjusted odds ratio (95% CI) for preeclampsia was 3.7 (1.5-8.9) for energy intake of >3350 kcal/d compared with < or =2000 kcal/d. Adjusted odds ratio (95% CI) for preeclampsia was 3.6 (1.3-9.8) for sucrose intake (percent of total energy) of >25% compared with < or =8.5% and 2.6 (1.3-5.4) for polyunsaturated fatty acids intake (percent of total energy) of >7.5% compared with < or =5.2%. Other energy-providing nutrients were not associated with the risk for preeclampsia. CONCLUSION: The current study suggests that high intakes of energy, sucrose, and polyunsaturated fatty acids independently increase the risk for preeclampsia.

Coffee, dietary habits, and serum cholesterol among men and women 35-49 years of age.

The relations between coffee and dietary habits and between coffee, dietary habits, and serum cholesterol were examined in 11,912 men and 12.328 women aged 35-49 years in the Cardiovascular Disease Risk Factor Study in Oppland, southern Norway, 1976-1978. Dietary data are based on results from a self-administered questionnaire. In both sexes, the dietary pattern of persons with a high coffee consumption differed from that of persons with a low coffee consumption: Heavy coffee drinkers had a higher consumption of bread, potatoes, and butter or margarine per slice of bread and more frequent use of hard margarine; men had a higher consumption of eggs and a lower consumption of skim milk. These results suggest a higher total food and fat consumption and a lower ratio of polyunsaturated to saturated fatty acids among heavy coffee drinkers. However, only 20% of the variation in coffee consumption was explained by dietary and lifestyle variables. The study confirmed a positive relation between serum cholesterol and use of butter or hard margarine (p less than 0.001) and between serum cholesterol and coffee consumption (p less than 0.001). Bread consumption and milk consumption were negatively correlated to serum cholesterol. The negative association with skim milk was significant only in women (p less than 0.01).