Category Archive for: ‘Smoking’

Four lifestyle factors combined and cardiovascular disease

A healthful diet and lifestyle is related to low CVD risk

A Mediterranean style diet, a high level of physical activity, not smoking and moderate alcohol consumption were all associated with low 10-year risk of CHD and CVD in the European HALE project. A very low risk of these diseases was observed in elderly men who had four compared to those who had none or one healthful diet and lifestyle factor. We estimate that among elderly men who did not adhere to a low-risk lifestyle pattern, 64% of deaths due to CHD and 61% due to CVD might have been prevented based on the observed risk differences.


Among elderly men, the more healthful factors of diet and lifestyle the lower the CVD mortality observed. More than 60% of CVD mortality was associated with lack of adherence to the low-risk pattern. This finding implies that even at advanced ages those who follow a Mediterranean style diet and maintain a healthful lifestyle are less likely to die from CVD.


Coffee, alcohol, smoking and cognitive decline

Coffee may promote cognitive function in contrast to alcohol and smoking

In elderly men of the FINE study, moderate coffee drinking was associated with less cognitive decline, while alcohol consumption and tobacco-smoking were not related to cognition.

Coffee associated with less cognitive decline


Coffee and cognitive decline

The least cognitive decline was observed for elderly men who consumed 3 cups of coffee/day. It was 4 times less than the decline among non-consumers. The association between coffee consumption and cognitive decline over a 10-year period was investigated in the FINE study. In Finland, 90% of the elderly men drank coffee, while 95% did so in The Netherlands and 50% in Italy.

Alcohol and smoking not related to cognitive decline

Alcohol consumption was not related to cognitive decline in men without CVD or diabetes at entry. About 80% of the elderly men in Zutphen used alcohol while only 5% drank as many as 3 drinks per day. There was also no association between cigarette smoking and cognitive decline in men without CVD or diabetes at entry. In Zutphen, only 23% of men aged 70-89 smoked cigarettes.


Cardiovascular risk factors and dementia

Cardiovascular risk factors also associated with dementia

The risk factors – smoking, serum cholesterol, blood pressure, lung function and the presence of CVD at baseline – were associated with death from dementia. The risk was 58% greater for heavy compared to non-smokers, 55% greater for hypertensives compared to those with normal blood pressure, 73% greater for those with a high level of serum cholesterol, 46% lower for those with a high compared  to a low lung function and 94% greater for those with a history of CVD at baseline compared to those with no such history. Men with a combination of two of the risk factors had a 2 times greater risk of death from dementia. These results suggest that that cardiovascular risk factors measured in midlife predict the risk of death with dementia.

Cardiovascular risk factors measured in the Seven Countries Study

Cardiovascular risk factors were measured at baseline and 160 out of 10,211 middle-aged men died from dementia during 40 years of follow-up. The results of the SCS suggest that cardiovascular risk factors affect the neurodegenerative process leading to dementia.


Smoking, all-cause mortality and long-term survival

Strong relationship of smoking with all-cause mortality

Smoking was associated with all-cause mortality after 10-years of follow-up in all cohorts of the Seven Countries Study except the Japanese, apparently due to the small number of events in Japan in the early follow-up. The strength of this association was stronger in the cohorts from the US and northern Europe than in the eastern and southern European cohorts. After 25 years of follow-up, in contrast, smoking was associated with a higher all-cause mortality in all 16 cohorts. For example, the 40-year follow-up data from the Zutphen Study showed that smokers had a 60% higher all-cause mortality compared to non-smokers. In the elderly men of Finland, the Netherlands and Italy, the 10-year all-cause mortality was 67% higher in smokers than in non-smokers.

Apparent large health gain from stopping smoking
Cigarette smoking and life expectancy

Men who stopped smoking at age 40 had 4.6 year greater life expectancy, while men who stopped smoking at age 70 had an addes 2.5 years. Life expectancy at age 40 was 6.8 years shorter for cigarette smokers compared to non-smokers and 8.8 years for men who smoked more than 30 cigarettes per day. Exclusively cigar or pipe smokers had a 4.7 year lower life expectancy.


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Studies in the elderly

The Zutphen Elderly, HALE and FINE studies researched the indicators of healthy ageing.

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Average flavonol intake and coronary heart disease rates in the 16 cohorts

High cohort flavonol intake related to low CHD mortality rates.


Average flavonol intake and CHD mortality rates
[/glossary_exclude]The average flavonol intake varied in the 16 cohorts of the Seven Countries Study between <10 mg/day in the rural Finnish  and >60 mg/day in the rural Japanese cohorts. After 25 years of follow-up the CHD mortality rate was 6 times higher among farmers from Eastern Finland compared to those in Japan. The average cohort flavonol intake was significantly inversely associated with 25-year CHD mortality rates.

The intake of flavonols

Information on the average food intake of the 16 cohorts was obtained in the 1960s, and the average flavonol intake was determined chemically in representative food composites. The most common flavonol measured was quercetin. Flavonols are a subclass of the flavodnoids, an extended class of chemically related compounds ubiquitously present in plant foods. In a range of experimental models, these compounds have demonstrated biological effects, which may partially explain the beneficial health effects of a diet high in vegetables and fruits. Flavonols are present in tea, apples, onions and red wine. High intakes were observed in Japan due to a high consumption of tea, in Slavonia (Croatia) due to a high intake of onions and in Dalmatia (Croatia) because of a high intake of red wine.


Smoking and cardiovascular disease

Smoking increases CHD risk

When the Seven Countries Study started in 1958 the prevalence of smokers was very high and ranged from 44% in Belgrade professors in Serbia to 78% in fisherman from Ushibuka in Japan. The 10-year follow-up data showed that smoking was associated with a higher risk of CHD mortality in countries where there were enough events for analysis and the strongest associations were observed in northern Europe where CHD was highest. An analysis using the 25-year CHD mortality data showed similar results.  

Smoking a long-term predictor of CVD

The Finnish cohorts showed that the relative risk of CHD mortality among cigarette smokers compared to non-smokers decreased the longer the follow-up, but the excess CHD risk remained significant after 35 years of follow-up.

The 40-year data from the Zutphen Study showed that cigarette smokers at entry had a 59% higher CHD and a 66% higher CVD mortality risk compared to non-smokers. The duration as well as intensity of smoking was also independently predictive of CVD mortality.