Effect of a single oat bran cereal breakfast on serum cholesterol, lipoproteins, and apolipoproteins in patients with hyperlipoproteinemia type IIa.

Serum cholesterol-lowering effects of oat bran-enriched diets have been indicated in several studies in which oat bran was given several times a day. Concomitant changes in the daily diet, ie, a diminished energy intake or changes in the composition of fats in the diet, also have been reported and used to explain the hypocholesterolemic effect of oats. The present study was designed to replace only the conventional continental breakfast by a single oat bran cereal muesli containing 60 g of oat bran and to measure the effects of this dietetic modification on serum lipids in 13 patients with hypercholesterolemia type IIa. Compared with a 3-week baseline period, total serum cholesterol (7.38 +/- 0.35 mmol/L, mean +/- SEM) was reduced by 10.9, 8.4, and 9.7% in the first, second, and third week of oat bran ingestion (p < .01). High-density lipoprotein and low-density lipoprotein cholesterol as well as apolipoprotein A1 decreased to the same extent (8 to 11%; p < .05) during the oat bran period, whereas a pronounced reduction of 25.8% was seen for apolipoprotein B100 (p < .01), which is a major component of low-density lipoprotein. Dietary data obtained by 3-day food records at baseline, oat bran, and follow-up period did not show any differences between the study periods except for dietary fiber, which was increased from 21.9 g/day to 42.4 g/day (p < .002) during the test period because of the daily oat bran intake.(ABSTRACT TRUNCATED AT 250 WORDS)     

Comparing smoking and smoking cessation process in the Republic of Karelia, Russia and North Karelia, Finland

STUDY OBJECTIVE: The aims of this study were to assess and validate self reported smoking prevalence and to assess smoking cessation related process variables in the Republic of Karelia, Russia and in North Karelia, Finland. DESIGN: Comparative population surveys of random population samples from both areas in spring 1992. The study included a self administered questionnaire, physical measurements and laboratory tests. The validity of self reported smoking prevalence was assessed by serum cotinine analyses. SETTING: The district of Pitkaranta in the Republic of Karelia, Russia and province of North Karelia, Finland. PARTICIPANTS: The study population was a 25 to 64 year old population in both areas. A stratified random sample of 1000 people in Pitkaranta and 2000 people in North Karelia was drawn from the population registers. In Pitkaranta 380 men and 455 women, and in North Karelia 673 men and 803 women, participated in the survey. RESULTS: The self reported prevalence rates of daily smoking in Pitkaranta were 65% among men and 10% among women. In North Karelia the respective rates were 29% and 13%. Women in Pitkaranta greatly underreported their smoking status, which was assessed by comparing the self reported data to the serum cotinine measurements. The smoking prevalence among women in Pitkaranta would rise from 10% to 21% if all participants with high cotinine values would be regarded as smokers. Compared with smokers in North Karelia, a higher percentage of smokers in Pitkaranta expressed their wish to quit and believed that they would succeed. However, on average they had fewer previous smoking cessation attempts than smokers in North Karelia. In addition, the health personnel in North Karelia were more active in advising smokers to quit. CONCLUSIONS: High smoking prevalence among men in Pitkaranta obviously contributes much to the high premature death rate in the Republic of Karelia. There is considerable underreporting of smoking in Pitkaranta, especially among women, which is probably attributable to the cultural unacceptability of female smoking in Russia. The common wish to quit, few previous cessation attempts and much lower rates of ex smokers, together with less smoking cessation counselling from health personnel, need to be considered in tailoring antismoking interventions in the area.       

Implementation of a hypertension control program in the County of North Karelia,Finland

A hypertension control program was established as part of the more comprehensive North Karelia Project. This project was started in 1972 in response to a petition from the population of North Karelia, a county in Finland, asking for national assistance to reduce the exceptionally high cardiovascular disease mortality and morbidity in the area. The North Karelia Project was carried out from 1972 to 1977.The hypertension control program was implemented mainly in local health centers by physicians and public health nurses, who followed guidelines issued by the project staff and worked under its supervision.Although the target population for the North Karelia Project was the entire population of North Karelia, the project focused on middle-aged men. The hypertension subprogram was introduced in steps. Its objectives included the training of health personnel, establishment of an information system in the county to educate people about hypertension, and organization of the detection, treatment, and followup of hypertensives. A hypertension dispensary was established in each of the 12 health centers in the county. Continuous training of the local public health nurses and physicians faciliated integration of the hypertension program into the operations of the health centers.A central hypertension register and the hypertension control clinics at the health centers were the essential tools in the systematic followup of hypertensives. Some 17,000 hypertensives were on the register by the end of the 5-year project.The main aim in providing health education about hypertension, as well as in treating hypertension itself, was to prevent severe cardiovascular diseases as a whole. Therefore the hypertension control program was integrated into the comprehensive cardiovascular disease control program, and hypertensives received advice concerning smoking and dietary changes as well as about high blood pressure.A survey of health care personnel in North Karelia and in a reference area showed that the care of hypertensives was more systematic in North Karelia and that its health care personnel were more satisfied with the cardiovascular disease care that was provided.     

The role of breakfast in the treatment of obesity: a randomized clinical trial.

Fifty-two moderately obese adult women were stratified according to their baseline breakfast-eating habits and randomly assigned a weight-loss program. The no-breakfast group ate two meals per day and the breakfast group ate three meals per day. The energy content of the two weight-loss programs was identical. After the 12-wk treatment, baseline breakfast eaters lost 8.9 kg in the no-breakfast treatment and 6.2 kg in the breakfast treatment. Baseline breakfast skippers lost 7.7 kg in the breakfast treatment and 6.0 kg in the no-breakfast treatment. This treatment-by-strata-by-time interaction effect (P less than 0.06) suggests that those who had to make the most substantial changes in eating habits to comply with the program achieved better results. Analyses of behavioral data suggested that eating breakfast helped reduce dietary fat and minimize impulsive snacking and therefore may be an important part of a weight-reduction program.     

Effects of fructo-oligosaccharide-supplemented infant cereal: a double-blind, randomized trial

Fructo-oligosaccharides (FOS) may have potential benefits, since they exhibit many soluble dietary fibre-like properties. Foods currently available for weaning infants are generally low in fibre content and lack these potential benefits. Data documenting tolerance of FOS in weaning foods are greatly lacking. Our present objective was to evaluate the tolerance and gastrointestinal effects of FOS-supplemented infant cereal used as a daily addition to the diet of healthy infants. Healthy infants were randomly assigned to receive either 0.75 g FOS per serving of cereal or placebo for 28 d. The primary outcome of interest was gastrointestinal tolerance, which was assessed by daily parental reporting of functional variables for 28 d, including stool patterns and signs and symptoms of gastrointestinal tolerance. Secondary outcomes were also measured including: cereal intake (g cereal and g FOS/d), stool pH, changes in anthropometric measurements and adverse events. The study population included a total of fifty-six infants, age range 16.2-46.2 weeks with a mean age of 32.5 (sd 8.9) weeks; twenty-nine infants were randomized to the control group (age 31.8 (sd 9.0) weeks) and twenty-seven to the FOS-supplemented group (34.7 (sd 8.9) weeks). Average daily total intake per infant and average intake per serving were similar in both groups. Average FOS consumption was 0.74 (sd 0.39) g/d and as high as 3.00 g/d. Stool consistency was less likely to be described as 'hard', and more likely to be described as 'soft' or 'loose', in the FOS v. control group. The mean number of stools per infant was 1.99 (sd 0.62) per d in the FOS-supplemented group compared with 1.58 (sd 0.66) in the control group (P=0.02). There were no differences between the groups in reporting for crying, spitting-up or colic. No differences were found for stool pH. FOS-supplements added to cereal were well tolerated in doses of up to 3.00 g/d. FOS consumption led to more regular and softer stools, without diarrhoea, as well as less-reported frequency of symptoms associated with constipation such as hard stools or skipped days without stool. The present study is one of few studies documenting tolerance to increased fibre intake in the form of FOS as part of a weaning food.     

Olive-oil-enriched diet: effect on serum lipoprotein levels and biliary cholesterol saturation

The effect of diet enriched with a monounsaturated fatty acid (olive oil) on serum lipoproteins, biliary cholesterol saturation index, and gallbladder motility compared with a standard low-fat diet was evaluated in 11 young volunteers admitted to a metabolic ward. A significant decrease of mean total cholesterol (-9.5%), total apo B (-7.4%), LDL cholesterol (-12.2%), and total triglycerides (-25.5%) was observed after the olive-oil-enriched diet. Total HDL- and HDL-subfractions-cholesterol levels as well as serum apo A-I mean levels remained unchanged. Cholesterol saturation index of the bile and fasting and after-meal gallbladder volumes were unaffected by the enriched diet as compared with the low-fat diet. Olive oil may be a natural fat that can be used for the control of plasma and LDL cholesterol as a valid alternative to polyunsaturated fatty acids.     

The effect of ready-to-eat cereal consumption on energy intake, body weight and anthropometric measurements: results from a randomized, controlled intervention trial

The objective of this work was to determine the effect of consumption of ready-to-eat cereal (RTEC) in the evening in place of a normal evening snack on body weight, anthropometric measurements and energy intake in overweight individuals. Seventy overweight participants who were self-reported habitual evening snackers were assigned to either the control or treatment group. For 6 weeks the treatment group consumed RTEC instead of their normal evening snack. Body weight, anthropometric and food intake measurements were taken at 2-week intervals. There were no significant differences between groups in any anthropometric measurements; however, within the treatment group, body weight (p?=?0.030) and waist circumference (p?=?0.0003) were reduced after 6 weeks compared with baseline. Evening energy intake was lower in the treatment group compared with the control group (p?=?0.007). These data indicate that replacing evening snacks with RTEC in overweight habitual evening snackers significantly reduces post dinner energy intake and may assist with weight management.     

The effect of ready-to-eat cereal consumption on energy intake,body weight and anthropometric measurements: results from a randomized,controlled intervention trial

The objective of this work was to determine the effect of consumption of ready-to-eat cereal (RTEC) in the evening in place of a normal evening snack on body weight, anthropometric measurements and energy intake in overweight individuals. Seventy overweight participants who were self-reported habitual evening snackers were assigned to either the control or treatment group. For 6 weeks the treatment group consumed RTEC instead of their normal evening snack. Body weight, anthropometric and food intake measurements were taken at 2-week intervals. There were no significant differences between groups in any anthropometric measurements; however, within the treatment group, body weight (p = 0.030) and waist circumference (p = 0.0003) were reduced after 6 weeks compared with baseline. Evening energy intake was lower in the treatment group compared with the control group (p = 0.007). These data indicate that replacing evening snacks with RTEC in overweight habitual evening snackers significantly reduces post dinner energy intake and may assist with weight management.     

The effect of intensified diet counseling on the diet of hypertensive subjects in primary health care: a 2-year open randomized controlled trial of lifestyle intervention against hypertension in eastern Finland

BACKGROUND: Diet is an essential part of the nonpharmacological management of hypertension. The aim of this study was to investigate in a primary health care setting the effect of intensified diet counseling on the diet of hypertensive subjects. METHODS: A total of 715 free-living subjects, ages 25-74 years, with systolic blood pressure 140-179 mm Hg and/or diastolic blood pressure 90-109 mm Hg and/or drug treatment for hypertension participated in an open randomized trial with a 2-year follow-up at health centers in eastern Finland. The intervention group (n = 360) was advised to reduce their total fat, saturated fat, and salt intake and to increase monounsaturated and polyunsaturated fat intake as well as to reduce weight and to use alcohol in moderation if at all. The usual care group (n = 355) continued with their usual primary health care. The subjects filled out a 4-day food record, and 24-h urine samples were collected at baseline and at 1- and 2-year examinations. RESULTS: The 2-year net changes (change in intervention minus change occurring in usual care group) in total fat intake [-2.7 E% (95% CI -4.0, -1.6; P < 0.0005)], in saturated fatty acid intake [-1.7 E% (95% CI -2.3, -1.1; P < 0.0005)], and in body weight [-1.4 kg (95% CI -2.0, -0.8; P < 0.0005)] were significant. Furthermore, the 2-year net change in daily sodium intake was significant, -9 mmol (95% CI -17, -2; P = 0.021), but the 24-h urinary sodium excretion showed no difference between the study groups. CONCLUSION: The intensified diet counseling in primary health care resulted in dietary changes interpreted as being of benefit in the long-term treatment of hypertension and prevention of atherosclerotic vascular diseases.     

Alcohol and high-density-lipoprotein cholesterol: a randomized controlled trial

1. A randomized controlled trial of cross-over design was set up to examine the effect of alcohol on blood lipids and certain haematological variates relevant to ischaemic heart disease. 2. One hundred subjects drank some alcohol for 4 weeks (mean intake 18.4 g/d) and abstained totally for 4 weeks, the order of these periods being randomized. 3. Alcohol appeared to produce a rise of 7% in serum high-density-lipoprotein (HDL) cholesterol, probably due to a rise in the HDL2 subfraction. 4. No significant change was detected in plasma fibrinogen or the other haematological indices. 5. These results are consistent with the hypothesis that a moderate intake of alcohol confers some protection against heart disease.     

The long-term effect of dietary advice on the diet of men with angina: the diet and angina randomized trial

Introduction The long‐term effects on diet of dietary advice to eat fruit and vegetables or fatty fish are not well described. Materials and methods From 1990 to 1996 3114 men aged 37–70 with treated angina were recruited from general practices in South Wales. A dietitian randomly allocated the eligible men to receive advice to eat more fruit and vegetables, or advice to eat more fatty fish, or both these types of advice or neither. In 2000, a brief self‐completion questionnaire was sent to a sample of 1191 of the men known to be alive at the end of March 1999. Results The questionnaire was returned by 944 of the 1036 men alive at the time the questionnaire was sent. Those given fish advice were consuming more fatty fish but the difference was modest 21.9 g day^?1 vs. 14.0 g day^?1 (P < 0.01). The differences in fruit and vegetables intake between those given fruit advice and those not given fruit advice were small 373.2 g day^?1 vs. 351.7 g day^?1 (P = 0.05). Discussion Men of this age group may be particularly resistant to fruit and vegetables advice; population‐based interventions or interventions targeted at women might be more effective.     

Whole-grain wheat breakfast cereal has a prebiotic effect on the human gut microbiota: a double-blind, placebo-controlled, crossover study

Epidemiological studies have shown an inverse association between dietary intake of whole grains and the risk of chronic disease. This may be related to the ability to mediate a prebiotic modulation of gut microbiota. However, no studies have been conducted on the microbiota modulatory capability of whole-grain (WG) cereals. In the present study, the impact of WG wheat on the human intestinal microbiota compared to wheat bran (WB) was determined. A double-blind, randomised, crossover study was carried out in thirty-one volunteers who were randomised into two groups and consumed daily 48 g breakfast cereals, either WG or WB, in two 3-week study periods, separated by a 2-week washout period. Numbers of faecal bifidobacteria and lactobacilli (the target genera for prebiotic intake), were significantly higher upon WG ingestion compared with WB. Ingestion of both breakfast cereals resulted in a significant increase in ferulic acid concentrations in blood but no discernible difference in faeces or urine. No significant differences in faecal SCFA, fasting blood glucose, insulin, total cholesterol (TC), TAG or HDL-cholesterol were observed upon ingestion of WG compared with WB. However, a significant reduction in TC was observed in volunteers in the top quartile of TC concentrations upon ingestion of either cereal. No adverse intestinal symptoms were reported and WB ingestion increased stool frequency. Daily consumption of WG wheat exerted a pronounced prebiotic effect on the human gut microbiota composition. This prebiotic activity may contribute towards the beneficial physiological effects of WG wheat.     

Blood pressure,smoking, and the incidence of lung cancer in hypertensive men in North Karelia,Finland

Few studies have suggested that elevated blood pressure might be associated with increased risk of lung cancer and that this association might vary according to smoking status. The aim of this study was to assess the effect of blood pressure and its possible interaction with smoking on lung cancer incidence in hypertensive patients. Lung cancer incidence was determined for 7,908 men enrolled in the hypertension register of the North Karelia Project between 1972 and 1988 by record linkage to the nationwide Finnish Cancer Registry. In a Cox regression model, both systolic and diastolic blood pressures were significant predictors of lung cancer, with a 10% increase in risk per 10-mmHg increment in blood pressure. In smokers, the age-adjusted hazard ratio associated with a 10-mmHg increment in diastolic blood pressure was 1.17 (95% confidence interval: 1.05, 1.29), and in nonsmokers it was 0.98 (95% confidence interval: 0.80, 1.16). For systolic blood pressure, these hazard ratios were 1.11 (95% confidence interval: 1.05, 1.17) for smokers and 1.04 (95% confidence interval: 0.95, 1.14) for nonsmokers. These findings suggest that high blood pressure levels are associated with increased risk of lung cancer in smoking, hypertensive men.     

Chitosan decreases total cholesterol in women: a randomized,double-blind,placebo-controlled trial

BACKGROUND: Hypercholesterolemia is an important risk factor for cardiovascular disease. Orally administered chitosan binds lipids in the small intestine and reduces their absorption. Chitosan has been shown to decrease serum cholesterol in animal and human studies. This study investigated the effectiveness of chitosan in reducing serum cholesterol without concomitant diet therapy. METHODS: Ninety female volunteers (age 34-70 y) with confirmed mild to moderate hypercholesterolemia were enrolled into the study. They were randomly assigned to receive chitosan (1.2 g per day) or placebo in a double-blind manner. Serum lipids, body weight and adverse events were assessed at baseline and after 28 and 56 days of treatment. Subjects maintained their usual diet and documented the type and gross amount of food consumed. RESULTS: Eighty-four subjects (41 chitosan, 43 placebo) were included in the analysis. Chitosan significantly (F=3.19, P=0.04) reduced total cholesterol compared to placebo. In a subgroup of subjects with over 60 y of age, chitosan group significantly reduced total and LDL cholesterol (F=4.21, P=0.02, and F=3.46, P=0.04, respectively) compared with placebo. Adverse effects were few; no serious events were reported. CONCLUSION: Our results demonstrate that chitosan is safe and effective for lowering cholesterol. However, the effect of chitosan for decreasing cholesterol is mild.     

Self-reported health in the Republic of Karelia, Russia and in north Karelia, Finland in 1992

BACKGROUND: Major differences in mortality, cardiovascular disease risk factors and health behaviour are known to exist between the populations of eastern Finland and the Republic of Karelia, Russia. Little is known, however, whether similar differences exist in subjective health. METHODS: In spring 1992 a population survey was conducted in North Karelia, Finland and in the area of Pitk?ranta, Republic of Karelia, Russia. Random population samples (n = 2,000 in North Karelia and n = 1,000 in Pitk?ranta) stratified for age and sex were taken from the population registers. The subjects completed questionnaires and were examined at local health centres. RESULTS: In North Karelia 50% of men reported their health as being quite good or very good, compared to 34% in Pitk?ranta (p < 0.0001 for area difference). Among women the corresponding percentages were 58% in North Karelia and 22% in Pitk?ranta (p < 0.0001). High household income and education were associated with good self-rated health among both sexes in North Karelia and among women but not men in Pitk?ranta. Self-reported physical condition was better in North Karelia than in Pitk?ranta (p < 0.0001). Psychosomatic symptoms (p = 0.0002 among men and p < 0.0001 among women) and many somatic symptoms were more prevalent in Pitk?ranta than in North Karelia. CONCLUSION: In general, people in North Karelia, Finland feel healthier than people in the neighbouring Republic of Karelia, Russia. Socioeconomic differences in subjective health are less prominent in the Republic of Karelia.     

Self-reported alcohol consumption and association to carbohydrate-deficient transferrin and gamma-glutamyltransferase in a random sample of the general population in the Republic of Karelia,Russia and in North Karelia,Finland

In the present study, alcohol consumption was estimated in a population survey in Pitk?ranta in the Republic of Karelia, Russia (RUS) and in the neighbouring province of North Karelia in Finland (FIN) in the spring of 1997 in connection with the National FINRISK Study. Alcohol consumption was evaluated by self-report and by the biological markers carbohydrate-deficient transferrin (CDT) and gamma-glutamyltransferase (GGT). In RUS, elevated CDT values were observed in 36.6% of the men and 17.6% of the women. In FIN, the respective rates were 9.6% and 9.4%, which are similar to average European rates. The prevalence of elevated CDT values seen in RUS is the highest prevalence ever reported in general population surveys. However, the self-reported alcohol consumption was similar in the two regions. These results suggest that alcohol consumption especially in Russia may not be reliably estimated by self-reporting, and that alcohol consumption is relatively high, especially among men, in RUS.     

Increasing consumption of breakfast cereal improves thiamine status in overweight/obese women following a hypocaloric diet

The aim of this study was to analyse the thiamine status in a group of young, overweight/obese women and to analyse the changes in this status produced by two weight-control programmes based on approximating the diet to the theoretical ideal, increasing the relative consumption of vegetables (V) or cereals (C) (especially breakfast cereals). The study subjects were 57 Spanish women with a body mass index (BMI) of 24-35 kg/m(2), all of whom were randomly assigned to one of two slightly hypocaloric diets. Dietetic, anthropometric and biochemical data were collected at the beginning of the study and at 2 and 6 weeks. C and V subjects showed a reduction in their energy intake, body weight and BMI, both at 2 and 6 weeks. Thiamine intake and blood thiamine levels only increased with diet C (both at 2 and 6 weeks). 21.8% cf the women, 21.8% had blood thiamine levels <150 nmol/L at the beginning of the study, but at 6 weeks of intervention only 3.7% of the women in diet C, as compared with 30.8% of the women in diet V, showed blood thiamine levels <150 nmol/L. Although both diet C and diet V induced weight loss and a reduction in BMI, diet C would appear to be more useful in the maintenance of an adequate thiamine status.     

The effect of a high cholesterol and saturated fat diet on serum high-density lipoprotein-cholesterol, apoprotein A-I, and apoprotein E levels in normolipidemic humans

The effects of a high cholesterol, high saturated fat diet on serum high density lipoprotein cholesterol, apo A-I, and apo E levels were studied in six normolipidemic subjects. The study was done on an outpatient basis and mixed natural foods normally consumed by humans were used. When compared with a low cholesterol (98 mg/day) high polyunsaturated fat (P/S ratio 1.6) diet, the high cholesterol (1021 mg/day), high saturated fat (P/S ratio 0.4) diet increased serum cholesterol (23%) by raising the cholesterol concentration in very low-density lipoproteins (59%), low-density lipoproteins (15%), and high-density lipoproteins (30%). The low-density lipoprotein-cholesterol/high-density lipoprotein-cholesterol ratio fell significantly from 1.78 to 1.58. The increased high-density lipoprotein-cholesterol was associated with an elevation of serum apo A-I but not apo E. Serum triglycerides did not change significantly.     

Digestive and physiologic effects of a wheat bran extract, arabino-xylan-oligosaccharide, in breakfast cereal

ObjectiveWe assessed whether a wheat bran extract containing arabino-xylan-oligosaccharide (AXOS) elicited a prebiotic effect and influenced other physiologic parameters when consumed in ready-to-eat cereal at two dose levels.MethodsThis double-blind, randomized, controlled, crossover trial evaluated the effects of consuming AXOS at 0 (control), 2.2, or 4.8 g/d as part of ready-to-eat cereal for 3 wk in 55 healthy men and women. Fecal microbial levels, postprandial serum ferulic acid concentrations, and other physiologic parameters were assessed at the beginning and end of each condition.ResultsThe median bifidobacteria content of stool samples (log₁₀/grams of dry weight [DW]) was found to be higher in the subjects consuming the 4.8-g/d dose (10.03) than in those consuming 2.2 g/d (9.93) and control (9.84, P < 0.001). No significant changes in the populations of other fecal microbes were observed, indicating a selective increase in fecal bifidobacteria. Postprandial ferulic acid was measured at 120 min at the start and end of each 3-wk treatment period in subjects at least 50 y old (n = 37) and increased in a dose-dependent manner (end-of-treatment values 0.007, 0.050, and 0.069 μg/mL for the control, AXOS 2.2 g/d, and AXOS 4.8 g/d conditions, respectively, P for trend < 0.001).ConclusionThese results indicate that AXOS has prebiotic properties, selectively increasing fecal bifidobacteria, and increases postprandial ferulic acid concentrations in a dose-dependent manner in healthy men and women.