International Journal of Epidemiology, Vol 18, S203-S209, Copyright © 1989 by International Epidemiological Association
FH Epstein
Three components of lifestyle--nutrition, smoking and alcohol drinking
patterns--have been related to rates of decline or increase of coronary
heart disease (CHD) mortality in 27 countries during the past 10 to 25
years. In almost all of the countries with major falls or rises in CHD
mortality, there are, respectively, corresponding decreases or increases in
animal fat consumption, with reciprocal changes in the consumption of
vegetable fats. Countries with moderate or small mortality declines show
variable patterns of fat consumption. The prevalence of smoking is
declining among men and remains unchanged or is increasing slightly among
women in most countries, suggesting that differences in the rate of decline
between countries or between the sexes are not related to an appreciable
degree to differences in the change of smoking habits; however, the
mortality changes in any individual country are most probably influenced by
smoking. The consumption of alcoholic beverages increases almost everywhere
and cannot be related quantitatively to the secular CHD mortality trends.
These findings support in general the presently recommended courses of
action for the prevention of premature CHD.
ARTICLES
The relationship of lifestyle to international trends in CHD
Social and Preventive Medicine, University of Zurich, Switzerland.
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