International Journal of Epidemiology 2000;29:260-265
© International Epidemiological Association 2000
Saturated fat, vitamin C and smoking predict long-term population all-cause mortality rates in the Seven Countries Study
a Division of Public Health Research, National Institute of Public Health and the Environment, Bilthoven, The Netherlands.
b Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
c Department of Public Health and General Practice, University of Kuopio, Finland.
Reprint requests to: Prof. Daan Kromhout, National Institute of Public Health and the Environment, Division of Public Health Research, PO Box 1, 3720 BA Bilthoven, The Netherlands. E-mail: daan.kromhout{at}RIVM.nl
Background The Seven Countries Study has shown that population mortality rates for various chronic diseases are related to diet and smoking. This paper addresses the associations between diet, smoking and 25-year all-cause mortality.
Methods Baseline surveys were carried out between 1958 and 1964 on 12 763 middle-aged men constituting 16 cohorts in seven countries. In 1987/88 equivalent food composites representing the average food intake of each cohort at baseline were collected and chemically analysed in one central laboratory. During 25 years of follow-up 5973 men died and age-adjusted population mortality rates were calculated for each cohort.
Results Multivariate linear regression analyses showed that the population intake of saturated fat and the prevalence of smoking were positively associated with population all-cause mortality rates. Population vitamin C intake was inversely associated with all-cause mortality. It was calculated that a reduction in saturated fat intake of 5% of energy, a 20 mg/d increase in vitamin C and a 10% decrease in the prevalence of smokers may decrease the 25-year all-cause population mortality rate by 12.4% (95% CI : 5.6, 19.4%) at an average population all-cause mortality rate of 45%.
Conclusion At the population level saturated fat, vitamin C and cigarette smoking are important determinants of all-cause mortality.
Keywords Saturated fat, vitamin C, smoking, all-cause mortality, ecologic analysis, Seven Countries Study
Accepted 23 August 1999
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