Seven Countries Study

Jansen, D. F., Nedeljkovic, S., Feskens, E. J. M., Ostojic, M. C., Grujic, M. Z., Bloemberg, B. P. M., Kromhout D., Coffee consumption, alcohol use, and cigarette smoking as determinants of serum total and HDL cholesterol in two Serbian cohorts of the Seven Countries Study. Arterioscler Thromb Vase Biol., 15, 1793, 1995... 

Puddu, P.E., Jouve, R., Mariotti, S., Giampaoli, S., Lanti, M., Reale, A. and Menotti, A. (1988) Evaluation of 10 QT prediction formulas in 881 middle-aged men from the seven countries study emphasis on the cubic root Fridericia s equation. Journal of Electrocardiology, 21, 219-229. 

An extension of the Seven Countries Study, by Ancel Keys and colleagues, indicated the particular importance of the flavonoids. During the study, which was reported in 1980, random samples of the food eaten by the participants were taken and stored for future analysis. When this was done, it was found that the average intakes of the antioxidants vitamin E, P-carotene and vitamin C were not related to the 25-year coronary heart disease mortality rates. In contrast, the intake of flavonoids was inversely related to the mortality. 

Hertog, M.G.L. et al., Flavonoid intake and long-term risk of coronary heart disease and cancer in the seven countries study. Arch. Intern. Med., 155, 381, 1995. 

The same authors [204] confirmed these results in the Seven Country Study. The contribution of flavonols and flavones in explaining the variance in coronary heart disease mortality rates across 16 cohorts from seven countries was studied. Flavonol and flavone intake was inversely correlated with mortality from coronary heart disease. These finding are in line with the results of a cohort study in Finnland [205], where a significant inverse gradient was observed between dietary intake of flavonoids and total and coronary mortality. 

The Zupthen Elderly Study found a weak inverse association between flavonoid intake from fruit and vegetables sources and cancer of the alimentary and respiratory tracts combined [209]. The same authors observed no independent association with mortality from other causes between flavonoid intake and cancer mortality in the Seven Country Study [204]. 

Pekkanen J, Nissinen A, Punsar S, Karvonen MJ. Serum cholesterol and risk of accidental or violent death in a 25-year follow-up The Finnish cohorts of the Seven Countries Study. Arch Int Med 1989 149 1589-1591. 

Abbreviations ATBC, a- locopherol /t-Carotene Cancer prevention Caerphilly, Welsh country study- Europe FD, Flavonoids and Dementia FMC, Finnish Mobile Clinical examination HPFS, Health Professional Follow-up Study IWHS, Iowa Women s Health Study Rotterdam, Nederland-Europe WHS, Women s Health Study—female health professional, postmenopausal, or not intending to become pregnant Zuphten, was part of the Seven Country Study on the relationship between food and chronic diseases. 

A number of studies, including several large prospective studies, such as the Framingham Study (Anderson et al, 1987), the Multiple Risk Intervention Trial (Stamler et al, 1986) and the Lipid Research Clinics Program (Pekkanen et al., 1990), as well as the Seven Countries Study (Verschuren et al, 1995) showed a positive correlation between levels of plasma cholesterol and mortality from CHD. However, epidemiological associations cannot prove causality and elevated cholesterol levels could be either a cause, a correlate or a consequence of CHD. 

Verschuren, W.M.M., Jacobs, D.R., Bloemberg, B.P.M., Kromhout, D., Menotti, A., Aravanis, C., Blackburn, H., Buzina, R., Dontas, A.S., Fidanza, F., Karvonen, M.J., Nedeljkovic, S., Nissinen, A., Toshima, H. 1995. Serum total cholesterol and long-term coronary heart disease mortality in different cultures. Twenty-five-year follow-up of the Seven Countries Study. /. Am. Med. Assoc. 274, 131-136. 

Menotti A, Keys A, Blackburn H, et al. Comparison of multivariate predictive power of major risk factors for coronary heart diseases in different countries Results from eight nations of the Seven Countries Study, 25-year follow-up. J Cardiovasc Risk 1996 3 69-75. 

Kromhout, D. A. Menotti B. Bloemherg C. Aravanis H. Blackburn R. Buzina A.S. Dontas E Fidanza S. Giaipaoli A. Jansen, et al. Dietary saturated and transfatty acids and cholesterol and 25-year mortality from coronary heart disease The seven countries study. Prev. Med. 1995, 24, 308-315. 

Further support for the cardioprotective effect of flavonoids has been obtained from a reexamination of food records from 16 cohorts within the Seven Countries Study [10]. During a 25-year follow-up period, an inverse association was observed between CHD mortality and flavonoid intake this explained a small but significant portion (8%) of the variance in CHD deaths, independently of intakes of alcohol and antioxidant vitamins. CHD mortality was observed to be lowest in Japan with an estimated average flavonoid intake of 61 mg/d, mainly derived from green tea. 

Verschuren WM, Jacobs DR, Bloemberg BP, et al.. Serum total cholesterol and longterm coronary heart disease mortality in different cultures. Twenty-five-year followup of the seven countries study, JAMA, Jul 12 1995 274(2) 131-136. 

The Seven Countries Study,a longitudinal study which started in 1958 in the former Yugoslavia and went on to recruit a total of 12,763 men, 40—59 years of age, in seven countries, the United States, Japan and countries from Northern and Southern Europe. The follow-up period was extended up to 50 years while one of the first findings was that Cretan men had exceptionally low death rates from heart disease, despite moderate to high intake of fat. This ecological indication was firstly attributed to the traditional dietary pattern of this population. 

Keys A, Menotti A, Karvonen MJ, et al. The diet and 15-year death rate in the seven countries study. Am f Epidemiol. 1986 124(6) 903 —915. Willcox BJ, Willcox DC, Todoriki H, et al. Caloric restriction, the traditional Okinawan diet, and healthy aging the diet of the world s longest-lived people and its potential impact on morbidity and life span. Ann N Y Acad Sci. 2007 1114 434-455. 

Kromhout D, Keys A, Aravanis C, et al. Food consumption patterns in the 1960s in seven countries. Am J Clin Nutr. 1989 49(5) 889-894. Menotti A, Conti S, Corradini P, Giampaoli S, Rumi A, Signoretti P. Incidence and prediction of coronary heart disease in the Italian cohorts of the Seven Countries Study. 10 year experience (author s transl). G Ital Cardiol. 1980 10(7) 792-806. 

Fidanza F, Alberti A, Lanti M, Menotti A. Mediterranean Adequacy Index correlation with 25-year mortality from coronary heart disease in the Seven Countries Study. Nutr Metab Cardiovasc Dis. 2004 14(5) 254—258. 

The Mediterranean diet has been associated with longevity and low incidence of chronic and degenerative diseases as shown in the Seven Countries Study [1-4] and several others studies, which attribute to the virgin olive oil (VOO) many of the healthy advantages of this diet [5-7]. 

Keys A et al (1986) The diet and 15-year death rate in the seven countries study. Am J Epidemiol 124 903-915... 

Epidemiological studies including the Seven Country Study indicate a reduced risk of lung and colorectal cancer in older men ingesting high doses of vitamin Bg... 

M.C. Jansen, H.B Beuno-de-Mesquita, R. Buzina, F. Fidanza, A. Minotti, H. Blackburn, A.M. Nissenen, F.J. Kok, and D. Kromhout. Dietary fiber and plant foods in relation to colorectal cancer mortality The seven countries study. Int. J. Cancer, 81 174-179 (1999). 

It is a fallacy to believe that individuals with risk factors for cardiovascular events like smoking, hypertension, or hyperlipidemia can neutralize or minimize their adverse effects by exercise. In the Seven Countries Study (23,24), Finland had the highest overall prevalence of coronary heart disease. The Finnish population consumes large amounts of animal fat. Fiimish lumberjacks are an example of physically active people in whom the risk for coronary heart disease remains high (25). The approach to prevent coronary heart disease should be multifaceted... 

The Mediterranean diet, rich in fresh fruits and vegetables, was shown to be inversely related to the incidence of eardiovaseular disease, as shown in the Seven Countries Studies [59,169-171]. OUve oil, the dietary fat of choice in the Mediterranean area, in eomparison to other vegetable oils has a peculiar fatty acid composition. The monounsaturated oleic acid (C-18 l, n = 9) is the most abundant fatty acid in oUve oil (56-84%), whereas the polyunsaturated Unoleic acid (C-18 2, n = 6) ranges only from 3% to 21%. In addition, oUve oil eontains a variety of minor components, including polyphenols (up to 800 mg/kg), whieh provide the typical taste and aroma of extra virgin olive oil and eonfer on this oil its stability to oxidation [172]. 

---