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Suvi M Virtanen,
Jaakko Nevalainen,
Carina Kronberg-Kippilä,
Suvi Ahonen, Heli Tapanainen,
Liisa Uusitalo,
Hanna-Mari Takkinen,
Sari Niinistö,
Marja-Leena Ovaskainen,
Michael G Kenward,
Riitta Veijola,
Jorma Ilonen,
Olli Simell,
Mikael Knip
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ABSTRACT: Evidence for the role of food consumption during childhood in the development of β cell autoimmunity is scarce and fragmentary.
We set out to study the associations of longitudinal food consumption in children with the development of advanced β cell autoimmunity.
Children with advanced β cell autoimmunity (n = 232) (ie, with repeated positivity for antibodies against islet cells) together with positivity for at least one of the other 3 antibodies analyzed or clinical type 1 diabetes were identified from a prospective birth cohort of 6069 infants with HLA-DQB1-conferred susceptibility to type 1 diabetes who were born in 1996-2004, with the longest follow-up to the age of 11 y. Repeated 3-d food records were completed by the families and daycare personnel. Diabetes-associated autoantibodies and diets were measured at 3-12-mo intervals. Four control subjects, who were matched for birth date, sex, area, and genetic risk, were randomly selected for each case.
In the main food groups, only intakes of cow-milk products (OR: 1.05; 95% CI: 1.00, 1.10) and fruit and berry juices (OR: 1.09; 95% CI: 1.02, 1.12) were significantly, although marginally, associated with advanced β cell autoimmunity. The consumption of fresh milk products and cow milk-based infant formulas was related to the endpoint, whereas no evidence was shown for consumption of sour milk products and cheese. The intake of fat from all milk products and protein from fresh milk products was associated with risk of advanced β cell autoimmunity.
Intakes of cow milk and fruit and berry juices could be related to the development of advanced β cell autoimmunity. This trial was registered at clinicaltrials.gov as number NCT00223613.
American Journal of Clinical Nutrition 02/2012; 95(2):471-8. · 6.67 Impact Factor
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Mirka Lumia,
Päivi Luukkainen, Heli Tapanainen,
Minna Kaila,
Maijaliisa Erkkola,
Liisa Uusitalo,
Sari Niinistö,
Michael G Kenward,
Jorma Ilonen,
Olli Simell,
Mikael Knip,
Riitta Veijola,
Suvi M Virtanen
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ABSTRACT: Fatty acids (FA) modulate the immune system, and it has been proposed that they affect the incidence of IgE-mediated allergic diseases. We explored the association of maternal dietary FA composition during pregnancy with the risk of asthma in the offspring.
We analyzed data from the Finnish Type 1 Diabetes Prediction and Prevention (DIPP) Nutrition Study. Maternal dietary intake during pregnancy (8th month) was assessed by a validated 181-item food frequency questionnaire. The occurrence of asthma was assessed at the age of 5 yr with a questionnaire modified from the International Study of Asthma and Allergies in Childhood (ISAAC). Cox proportional hazards regression was used for the statistical analyses.
Low maternal intakes of α-linolenic acid (18:3n-3) [lowest quarter vs. mid-half HR 1.67 (95% CI 1.12-2.48)] and total n-3-polyunsaturated fatty acids (PUFA) [HR 1.66 (95% CI 1.11-2.48)] during pregnancy were associated with an increased risk of asthma in the offspring, while a low intake of arachidonic acid (20:4n-6) [HR 0.52 (95% CI 0.32-0.84)] and high intake of total saturated fatty acids [highest quarter vs. mid-half HR 0.55 (95% CI 0.34-0.90)] and palmitic acid (16:0) [HR 0.51 (95% CI 0.31-0.83)] were associated with a decreased risk of asthma. The ratios of n-6 to n-3-PUFA and 18:2n-6 to 18:3n-3, and the maternal intake of oils, fish and fish products, showed no association with the risk of asthma. The associations found were independent of several perinatal and clinical confounders.
Maternal intake of FA during pregnancy was associated with childhood asthma. Maternal α-linolenic acid, total n-3 PUFA and palmitic acid intake may decrease, while arachidonic acid intake may increase the risk of asthma in the offspring.
Pediatric Allergy and Immunology 09/2011; 22(8):827-35. · 2.46 Impact Factor
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ABSTRACT: FFQ require validation as part of epidemiological research of diet-disease relationships. Studies exploring associations between carbohydrate type and chronic diseases are rapidly increasing, but information on the validity of carbohydrate fractions, dietary glycaemic index (GI) and the glycaemic load (GL) estimated by FFQ is scarce. Likewise, the effects of subject characteristics on FFQ validity have been poorly documented. The present study evaluates the relative validity of an 131-item FFQ in relation to two 3 d food records (FR) performed 6 months apart focusing on the intake of carbohydrate fractions, dietary GI and the GL. Furthermore, we assessed the extent to which subjects' age, education and BMI explain differences between these methods. The study sample comprised 218 men and 292 women aged 25-74 years participating in a large population-based survey in Finland. Energy-adjusted Spearman's rank correlations ranged from 0·27 (sugars) to 0·70 (lactose) for men and from 0·37 (sugars) to 0·69 (lactose) for women. On average, 73 % of the subjects were categorised into the same or adjacent distribution quintile based on the two methods. In general, the FFQ overestimated the intakes compared with FR. Especially in women, FFQ validity for some nutrients was associated with the level of intake, subjects' age and, to a lesser extent, education but not BMI. In conclusion, the FFQ appears to be reasonably valid in the assessment of carbohydrate exposure variables, but the findings show a need for adjustment of diet-disease relationships for subjects' age and education.
The British journal of nutrition 09/2011; · 3.45 Impact Factor
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Bright Ibeabughichi Nwaru,
Mirka Lumia,
Minna Kaila,
Päivi Luukkainen, Heli Tapanainen,
Maijaliisa Erkkola,
Suvi Ahonen,
Juha Pekkanen,
Timo Klaukka,
Riitta Veijola,
Olli Simell,
Mikael Knip,
Suvi Mirjami Virtanen
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ABSTRACT: Valid identification of childhood asthma at the population level for epidemiological purposes remains a challenge. We aimed at validating the Finnish version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire based on parental-reported childhood asthma.
The ISAAC questionnaire has been validated against anti-asthmatic medication reimbursement data of the Finnish Social Insurance Institution, being the gold standard, among 2236 5-year-old consecutively born children (1996-2004) carrying human leukocyte antigen (HLA)-conferred susceptibility to type 1 diabetes. Two combined questionnaire questions (any wheezing symptom or use of asthma medication during the preceding 12 months plus ever asthma; any wheezing symptom or use of asthma medication during the preceding 12 months plus ever doctor-diagnosed asthma) were validated against valid reimbursement with purchase of at least one anti-asthmatic medication during a 12-month period. The validity of the questionnaire was estimated as the sensitivity, specificity, positive predictive value, negative predictive value, and Youden's index.
The sensitivity 0.98 [95% confidence interval (CI) = 0.92-0.99]; specificity 0.98 (95% CI = 0.97-0.98); negative predictive value 1.00 (95% CI = 1.00-1.00); and Youden's index 0.96 (95% CI = 0.96-0.96) were the same for each of the two sets of combined questions. The positive predictive value for the first combined question was 0.63 (95% CI = 0.55-0.71), while it was 0.64 (95% CI = 0.57-0.72) for the second combined question.
The Finnish ISAAC questionnaire was highly valid and is an acceptable instrument for the survey of the prevalence of parental-reported childhood asthma for epidemiological purposes.
The Clinical Respiratory Journal 09/2010; 5(4):211-8. · 1.06 Impact Factor
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Ibeabughichi Bright,
Nwaru,
Mirka Lumia,
Minna Kaila,
Päivi Luukkainen, Heli Tapanainen,
Maijaliisa Erkkola,
Suvi Ahonen,
Juha Pekkanen,
Timo Klaukka,
Riitta Veijola,
Olli Simell,
Mikael Knip,
Suvi Mirjami Virtanen,
Nwaru Bi
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ABSTRACT: Background: Valid identification of childhood asthma at the population level for epidemiological purposes remains a challenge. We aimed at validating the Finnish version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire based on parental-reported childhood asthma. Materials and Methods: The ISAAC questionnaire has been validated against anti-asthmatic medication reimbursement data of the Finnish Social Insurance Institu-tion, being the gold standard, among 2236 5-year-old consecutively born children (1996–2004) carrying human leukocyte antigen (HLA)-conferred susceptibility to type 1 diabetes. Two combined questionnaire questions (any wheezing symptom or use of asthma medication during the preceding 12 months plus ever asthma; any wheezing symptom or use of asthma medication during the preceding 12 months plus ever doctor-diagnosed asthma) were validated against valid reimbursement with purchase of at least one anti-asthmatic medication during a 12-month period. The validity of the questionnaire was estimated as the sensitivity, specificity, posi-tive predictive value, negative predictive value, and Youden's index. Results: The sensitivity 0.98 [95% confidence interval (CI) = 0.92–0.99]; specificity 0.98 (95% CI = 0.97–0.98); negative predictive value 1.00 (95% CI = 1.00–1.00); and Youden's index 0.96 (95% CI = 0.96–0.96) were the same for each of the two sets of combined questions. The positive predictive value for the first combined question was 0.63 (95% CI = 0.55–0.71), while it was 0.64 (95% CI = 0.57–0.72) for the second combined question. Conclusion: The Finnish ISAAC questionnaire was highly valid and is an acceptable instrument for the survey of the prevalence of parental-reported childhood asthma for epidemiological purposes.
The Clinical Respiratory Journal 09/2010; · 1.06 Impact Factor
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ABSTRACT: The National FINDIET surveys are carried out every 5 years to monitor dietary habits and nutrient intake of the adult Finnish population. The latest survey was carried out in 2007.
Cross-sectional population-based study. Dietary assessment was carried out using 48 h recall interviews. A picture book of food portions was used to estimate portion sizes and the national Food Composition Database Fineli(R) to calculate nutrient intakes.
A representative sample taken in five regions in Finland.
A total of 730 men and 846 women aged 24-64 years.
The percentage contribution of fat to the total energy intake was 33 % in men and 31 % in women. The respective percentages for SFA in men and women were 13 % and 12 %, respectively, and 0.4 % for trans fatty acids in both genders. The average intakes of folate, vitamin D and fibre fell below the recommended levels, whereas the average salt intake was somewhat higher than the recommendations. Women's diet was higher in protein, dietary fibre and sucrose compared to that of men.
According to the FINDIET 2007 Survey, the dietary habits of the adult Finnish population have headed in a positive direction overall. However, although the quality of the fats consumed has continued to improve, and the intake of salt has decreased, they still do not meet the recommended levels of intake. Similarly, the average intakes of folate and vitamin D continue to fall below the recommendations. There is also a need to increase fibre intake and to cut down the intake of sucrose.
Public Health Nutrition 06/2010; 13(6A):920-4. · 2.17 Impact Factor
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ABSTRACT: The aim of the study is to elucidate differences in adults' diet by education, and to analyse the associations between dietary facilitators, education and dietary fat quality.
In all, one-third of subjects from the national FINRISK health survey were invited to participate in the FINDIET 2007 Survey. A 48 h dietary interview was used for dietary data and personal background data were collected by the health survey questionnaire.
Representative sample from five regions in Finland in spring 2007.
A total of 1576 adults, participation rate 60 %.
Oil used in cooking differed by education. Instead perception of cardiovascular risk, or the following of a cholesterol-lowering diet, were equal across all educational categories. The diet of men with low education contained less protein and carbohydrates, more fat and more SFA and MUFA than that of highly educated men. The diet of women with low education contained less PUFA, vitamin C and vitamin E than in the highly educated category. High education remained a significant determinant for the lower intake of SFA in men, and for the higher intake of PUFA in women, after adjusting for the determinants and facilitators of dietary behaviour and age. The lower intake of SFA was also associated with following a cholesterol-lowering diet in both genders. In addition to education, the intake of unsaturated fatty acids was determined by the oil used in cooking by women, and by frequent lunches served by caterers for men.
In dietary behaviour, awareness and reporting of cholesterol-lowering diet seem to indicate a tendency to control the intake of saturated fat. Health messages are likely to enhance tools for increasing the intake of PUFA, in addition to reducing the intake of SFA.
Public Health Nutrition 06/2010; 13(6A):925-31. · 2.17 Impact Factor
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ABSTRACT: To assess to what extent the observed dietary changes and increased use of lipid-lowering medication can explain the almost 20 % decline in serum cholesterol (referring to serum total cholesterol) level observed from 1982 to 2007 in Finland.
Predicted changes of serum cholesterol were calculated by the Keys' equation assuming the effect of trans fatty acids to be similar to SFA and using the dietary intake data of the national dietary surveys between 1982 and 2007. The effect of medication was estimated based on the information on use of lipid-lowering medication among survey participants. The predicted serum cholesterol levels were compared with observed changes in analysed serum cholesterol levels.
Four cross-sectional population surveys, in 1982, 1992, 2002 and 2007, in the provinces of North Karelia, Northern Savo and Southwestern Finland.
A total of 2325 men and 2638 women aged 26-64 years selected randomly from the national population register for the four surveys.
Changes in dietary fat quality and cholesterol intake explain 0.70 mmol/l (65 %) of the decrease in men and 0.65 mmol/l (60 %) of the decrease in women in all subjects. Decline in dietary SFA intake is the main explanatory factor (47 % in men and 41 % in women) for the changes. The impact of lipid-lowering medication on observed cholesterol levels was found to be 16 % among men and 7 % among women.
The decrease in serum cholesterol levels in Finland can be explained mainly by dietary changes, especially changes in fat quality. The effect of lipid-lowering medication is less significant.
Public Health Nutrition 06/2010; 13(6A):932-8. · 2.17 Impact Factor
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Marianne Prasad,
Mirka Lumia,
Maijaliisa Erkkola, Heli Tapanainen,
Carina Kronberg-Kippilä,
Jetta Tuokkola,
Ulla Uusitalo,
Olli Simell,
Riitta Veijola,
Mikael Knip,
Marja-Leena Ovaskainen,
Suvi M Virtanen
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ABSTRACT: To describe the diet of a population of pregnant Finnish women over a period of 7 years, with special attention paid to seasonal fluctuations in food consumption and nutrient intake.
A validated 181-item FFQ was applied retrospectively, after delivery, to assess the maternal diet during the 8th month of pregnancy.
Type 1 Diabetes Prediction and Prevention Nutrition Study Cohort.
The cohort comprised a total of 4880 women who had newly delivered during the years 1997-2004, with the offspring carrying increased genetic risk for type 1 diabetes mellitus.
Over the study period, the proportion of energy derived from fat decreased while the intake from protein and carbohydrate increased. The intake of vitamin D increased from food sources. Seasonal variation was observed in the mean daily consumption of vegetables, fruits and berries and cereals. Intake of dietary fibre, total fat, MUFA, vitamins A, D, E and C, folate and iron also showed seasonal fluctuation.
These results show an overall positive trend in the diet of pregnant Finnish women through the study years. However, there is still room for improvement, particularly in the types of dietary fats. Although food fortification with vitamin D since 2003 was reflected in the increased intake of vitamin D from foods, the mean intake levels still fell below the recommendations. Seasonal changes in food consumption were observed and related to corresponding fluctuations in nutrient intakes. The mean folate intake fell below the recommendation throughout the year.
Public Health Nutrition 06/2010; 13(6A):939-46. · 2.17 Impact Factor
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ABSTRACT: To study food consumption and nutrient intake in Finnish children aged 1-6 years and to assess the effect of age and sex on food consumption and nutrient intake.
Cross-sectional samples of children participating in the Type 1 Diabetes Prediction and Prevention (DIPP) birth cohort study in Finland.
The study population comprised healthy children recruited in the nutrition study within the DIPP study in 1998-2003. Three-day food records (2535 in total) from 1-, 2-, 3-, 4- and 6-year-old children were kept between the years 2003 and 2005.
The energy-adjusted consumption of fruits and berries, cereal products, infant formulas and meat dishes was higher and the consumption of vegetables, salads, breads, dairy products, fat spreads, drinks, sweets and sugar was lower among 1-year-old children than older age groups (P for all <0.05). The mean daily energy intake increased with age and was higher among boys than girls in all age groups, except among the 2-year-olds (P for all <0.05). The diet of the 2-6-year-old children contained too much saturated fat and sucrose, and too little PUFA compared with the current Nordic Nutrition Recommendations. The intakes of most vitamins and minerals met the recommendations. However, the intakes of vitamin D, E and iron fell below the recommended levels. The nutrient density of the diet decreased after the age of 1 year at the time that the children adapted to the regular family diet.
In order to improve the diet of young children, it is essential to evaluate the diet of the whole family.
Public Health Nutrition 06/2010; 13(6A):947-56. · 2.17 Impact Factor
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ABSTRACT: To assess and compare the food consumption and nutrient intake between 3-year-old children cared for at home full-time and those attending day care outside the home. Nutrient intake on weekdays and weekends was also studied.
Cross-sectional sample of children invited to the nutrition study within the Type 1 Diabetes Prediction and Prevention (DIPP) birth cohort born in 2001. Families returned 3-d food record completed close to the child's third birthday.
A total of 471 pre-school children aged 3 years of whom 285 had only been cared for at home during the recording time and 186 had attended day care outside the home.
Among the children cared for outside the home, there were more consumers of recommendable foods as fresh vegetables, fruits, berries, rye bread, fish, skimmed milk and vegetable margarines, than among those cared for at home. The day-care group had higher intake of protein, dietary fibre, thiamine, potassium and magnesium, and lower intake of sucrose compared with the group cared for at home. Adjustment for sociodemographic factors did not change the results. In all children, food consumption was more varied on weekdays compared with weekends. On weekdays, children had higher intake of dietary fibre and protein and lower intake of sucrose compared to weekends.
The type of day care was associated with food consumption and nutrient intake among pre-school children and hence might have an impact on their nutrition and health. The diet of the children attending day care outside the home was more balanced and closer to the national recommendations.
Public Health Nutrition 06/2010; 13(6A):957-64. · 2.17 Impact Factor
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ABSTRACT: To evaluate food and nutrient intake and especially eating during the school day among Finnish secondary-school pupils.
Cross-sectional study. Data were collected using a structured questionnaire mailed to home and by 48 h dietary recall interviews performed at schools in 2007.
Twelve schools in three cities in Finland.
The seventh grade pupils (a total of 1469 at the mean age of 13.8 years). Questionnaire data were available from 726 pupils and dietary data from a subgroup of 40 % (n 306).
According to the questionnaire data, 40 % of the girls and 28 % of the boys reported eating fresh vegetables daily and the respective figures for fruit were 32 % and 23 %. Altogether, 71 % of the adolescents reported having school lunch every day. The average intake of sucrose was higher and the average intakes of fibre, iron, folate and vitamin D were lower than recommended. School lunch provided around 20 % of daily energy intake, while the recommended daily energy intake level is one-third. However, the school lunch as consumed was nutritionally superior to the other daily meals. Snacks provided 41 % of the daily energy. The most common sources of sucrose were sugary drinks.
Low consumption of fruit and vegetables and abundant consumption of sucrose-rich drinks and snacks are the main problems in the diet of Finnish adolescents. The nutritional quality of the school lunch is good, but the supply of healthy snacks must be improved in schools. Schools can promote healthy eating habits by making healthy choices easy during the school day.
Public Health Nutrition 06/2010; 13(6A):965-72. · 2.17 Impact Factor
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ABSTRACT: To decrease the intake of sucrose, increase the intake of fibre and the consumption of fruit and vegetables among secondary-school pupils.
Intervention study among eighth grade pupils during one school year. Data were collected by questionnaires and from a subgroup of pupils by 48 h dietary recall at baseline in spring 2007 and after the intervention in 2008.
Twelve secondary schools were randomly allocated to intervention (IS) and control schools (CS) within three cities. Intervention included nutrition education and improvement of the food environment focusing particularly on the quality of snacks at school.
A total of 659 pupils completed the questionnaires and the dietary recall was obtained from 287 pupils both at baseline and follow-up.
The frequency of consumption of rye bread increased (P = 0.03) and that of sweets decreased (P = 0.006) among girls in the IS. The intake of sucrose fell among IS pupils, from 12.8 % to 10.5 % of the total energy intake (P = 0.01). Intake of fruit (g/MJ) remained the same in IS, whereas it decreased in CS (P = 0.04).
Sugar intake can be lowered by improving the quality of snacks, but it is more difficult to increase fibre intake and fruit and vegetable consumption unless the content of school lunches can be modified. It is the responsibility of the adults working in schools to create a healthy environment and to make healthy choices easy for pupils.
Public Health Nutrition 06/2010; 13(6A):973-9. · 2.17 Impact Factor
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ABSTRACT: This study presents data on the contribution of eating occasions to the daily intakes of energy and nutrients. The 48-h dietary data of Finnish adults were gathered from two independent, population-based health surveys undertaken in 2002 and 2007. Snack-dominated and main-meal dominated eating patterns were defined as the habit of obtaining the majority of daily energy from snacks or from main meals. The snack-dominated eating pattern increased in adults from 2002 to 2007, significantly in men. Mostly, similar changes in daily nutrient intakes were observed between study years within eating patterns. Higher alcohol intake in men and higher sucrose intake and lower fibre intake in women were associated with the snack-dominated eating pattern. Due to instability in the snack-dominated eating pattern we conclude that main meals and snacks seem to be parallel ways of composing daily diet with only a few dietary differences.
Appetite 03/2010; 54(3):623-6. · 2.59 Impact Factor
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ABSTRACT: 80% of Finnish men fill their civic duty and complete military service. Conscripts' dietary habits have been studied limitedly.
The aim was to determine conscripts' nutrient intake and food use in garrison, on leave, and in encampment conditions.
This study examined volunteer conscripts in: (1) garrison and leave conditions (n=47) and (2) encampment conditions (n=31). Data were collected using food diaries.
The proportion of energy derived from fat was 32.9% at garrison and 36.5% at encampment and on leave. Saturated fat constituted 12.5 energy % at garrison, 15.0 energy % at encampment, and 15.3 energy % on leave. Sucrose intake was high at encampment (17.7 energy %) and on leave (13.0 energy %). Salt, vitamin, and mineral intakes exceeded national recommendations in all conditions. Fiber intakes did not reach recommendations.
At garrison and encampment, nutrient intakes reached recommendations. In free time, conscripts favored energy-rich nutrient-poor foods, which warrants intervening and dietary education.
Military medicine 08/2009; 174(7):678-84. · 0.92 Impact Factor
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ABSTRACT: The aim was to identify the important sources of added sucrose and determinants of high intake, and to evaluate what impact a high proportion of energy from added sucrose has on the intake of foods and nutrients. The subjects consisted of children invited to the nutrition study within the Type 1 Diabetes Prediction and Prevention birth cohort and born in 2001 (n 846). Of these, 471 returned 3 d food records at 3 years of age. The average daily intake of added sucrose was 35 (sd 17) g (11.3 % of energy intake) and that of total sucrose was 41 (sd 18) g (13.3 % of energy intake). Sucrose added by manufacturers accounted for 82 %, naturally occurring sucrose for 15 % and sucrose added by consumers for 3 % of the total sucrose. Juice drinks, yoghurt/cultured milks, and chocolate and confectionery were the main contributors to added sucrose intake. Consumption of rye bread, porridge, fresh vegetables, cooked potatoes, skimmed milk, hard cheeses, margarine and fat spread as well as intake of most nutrients decreased across the quartiles of added sucrose (P < 0.05). Being cared for at home, having a father with a vocational school degree, having at least two siblings and a milk-restricted diet increased the risk for a high-sucrose diet. The study implied that a high proportion of added sucrose in the diet had mainly an unfavourable impact on the intake of recommended foods and key nutrients in Finnish children. The rationale for the recommendation to reduce the intake of refined sugars to ensure adequate intakes of nutrients seems reasonable.
The British journal of nutrition 09/2008; 101(8):1209-17. · 3.45 Impact Factor
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ABSTRACT: The aim of the study was to assess whether perinatal factors are associated with the risk of asthma in childhood in a register-based, nested case-control study in Finland. All children born between January 1, 1996, and April 30, 2004, who were entitled to a special reimbursement for antiasthmatic drugs (i.e., had diagnosed asthma by 2006 and had purchased inhaled corticosteroids or montelukast at least once), were identified (n = 21,038). For each case, one matched control child was selected. The associations between perinatal factors, derived from the Finnish Medical Birth Register, and the risk of asthma were analyzed by conditional logistic regression. In the final multivariate model, maternal asthma, young age, smoking, previous miscarriages, and a high number of previous deliveries, as well as cesarean section, low gestational age, and low ponderal index, were associated with an increased risk of asthma in children diagnosed before the age of 3 years. Among children diagnosed at the age of 3 years or later, maternal asthma, low gestational age, and low ponderal index were associated with an increased risk, and a high number of previous deliveries was associated with a decreased risk of asthma. In conclusion, perinatal factors play a role in the development of asthma in childhood, but the etiology may differ in early and late-onset asthma.
American journal of epidemiology 08/2008; 168(2):170-8. · 5.59 Impact Factor
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ABSTRACT: To examine the efficacy and safety of foods fortified with calcium in the adult population in Finland.
A simulation study based on the FINDIET 2002 Survey, which estimated habitual food consumption, dietary supplement use and nutrient intakes using 48-hour recall and two 3-day food records, and an Internet survey of the consumption of fortified foods and dietary supplements.
Participants of FINDIET 2002 were 25-64 years old from five areas (n = 2007). Participants of the Internet-based survey (n = 1537) were over 15 years of age from all over the country.
If all potentially fortifiable foods were to be fortified with calcium, the proportion of participants with calcium intake below the recommended level (< 800 mg day(-1)) would decrease from 20.3% to 3.0% in men and from 27.8% to 5.6% in women compared with the situation where no foods were fortified. At the same time, the proportion of participants with calcium intake above the tolerable upper intake level (UL, > 2500 mg day(-1)) would increase from 0.6% to 12.7% in men and from 0.1% to 3.8% in women. However, in a probability-based model (11% of all fortifiable foods to be fortified with calcium) the proportion of participants with calcium intake below the recommended level would be 15.7% in men and 23.2% in women. The proportion with intake above the UL in this model would be 1.2% in men and 0.7% in women.
Food fortification would be a relatively effective and safe way to increase the calcium intake of the Finnish adult population.
Public Health Nutrition 09/2006; 9(6):792-7. · 2.17 Impact Factor
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ABSTRACT: Objective To examine the efficacy and safety of foods fortified with calcium in the adult population in Finland.Design A simulation study based on the FINDIET 2002 Survey, which estimated habitual food consumption, dietary supplement use and nutrient intakes using 48-hour recall and two 3-day food records, and an Internet survey of the consumption of fortified foods and dietary supplements.Setting/participants Participants of FINDIET 2002 were 25–64 years old from five areas (n = 2007). Participants of the Internet-based survey (n = 1537) were over 15 years of age from all over the country.Results If all potentially fortifiable foods were to be fortified with calcium, the proportion of participants with calcium intake below the recommended level (<800 mg day−1) would decrease from 20.3% to 3.0% in men and from 27.8% to 5.6% in women compared with the situation where no foods were fortified. At the same time, the proportion of participants with calcium intake above the tolerable upper intake level (UL, >2500 mg day−1) would increase from 0.6% to 12.7% in men and from 0.1% to 3.8% in women. However, in a probability-based model (11% of all fortifiable foods to be fortified with calcium) the proportion of participants with calcium intake below the recommended level would be 15.7% in men and 23.2% in women. The proportion with intake above the UL in this model would be 1.2% in men and 0.7% in women.Conclusions Food fortification would be a relatively effective and safe way to increase the calcium intake of the Finnish adult population.
Public Health Nutrition 08/2006; 9(06):792 - 797. · 2.17 Impact Factor
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ABSTRACT: 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.
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.
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.
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.
Preventive Medicine 12/2004; 39(5):849-55. · 3.22 Impact Factor
