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American Journal of Epidemiology Vol. 124, No. 6: 903-915
Copyright © 1986 by The Johns Hopkins University School of Hygiene and Public Health


research-article

THE DIET AND 15-YEAR DEATH RATE IN THE SEVEN COUNTRIES STUDY

ANCEL KEYS1, ALESSANDRO MIENOTTI2, MARITI J. KARVONEN3, CHRIST ARAVANIS4, HENRY BLACKBURN1, RATKO BUZINA5, B. S. DJORDJEVIC6, A. S. DONTAS7, FLAMINIO FIDANZA8, MARGARET H. KEYS1, DAAN KROMHOUT9, SRECKO NEDELJKOVIC10, SVEN PUNSAR11, FULVIA SECCARECCIA2 and HIRONORI TOSHIMA12

1Division of Epidemiology, School of Public Health, University of Minnesota Minneapolis, MN 55455
2Laboratory of Epidemiology and Biostatistics Istituto Superiore di Sanitá Rome, Italy
384060 Pioppi (SA) Italy
447 Vasilissis Sophias, Athens, Greece
5Department of Nutrition, Institute of Public Health of Croatia Zagreb, Yugoslavia
6University of Belgrade School of Medicine Belgrade, Yugoslavia
71 Stesichorou Street, 106 74 Athens, Greece
8Institute of Food Sciences and Nutrition, University of Perugia Perugia, Italy
9Department of Social Medicine, University of Leiden Leiden, The Netherlands
10Interna Klinika, University of Belgrade Medical School Belgrade, Yugoslavia
11Department of Public Health Science, University of Helsinki Helsinki, Finland
12Kurume University School of Medicine, The Third Department of Internal Medicine Kurume, Japan

Keys, A. (84060 Pioppi (SA), Italy), A. Menotti, M. J. Karvonen, C. Aravanis, H. Blackburn, R. Buzina, B. S. Djordjevlc, A. S. Dontas, F. Fldanza, M. H. Keys, D. Kromhout, S. Nedeljkovic, S. Punsar, F. Seccareccia, and H. Toshima. The diet and 15-year death rate In the Seven Countries Study. Am J Epidemiol 1986; 124:903–15

In 15 cohorts of the Seven Countries Study, comprising 11,579 men aged 40-years and "healthy" at entry, 2,288 died In 15 years. Death rates differed among cohorts. Differences In mean age, blood pressure, serum cholesterol, and smoking habits "explained" 46% of variance in death rate from all causes, 80% from coronary heart dIsease, 35% from cancer, and 45% from stroke. Death rate differences were unrelated to cohort differences in mean relative body weIght. fatness, and physical activity. The cohorts differed in average dIets. Death rates were related positively to average percentage of dIetary energy from saturated fatty acids, negatively to dietary energy percentage from monounsaturated fatty acids, and were unrelated to dietary energy percentage from polyunsaturated fatty acids, proteins, carbohydrates, and alcohol. All death rates were negatively related to the ratio of monounsaturated to saturated fatty acids. Inclusion of that ratio with age, blood pressure, serum cholesterol, and smokIng habits as inde pendent variables accounted for 85% of variance In rates of deaths from all causes, 96% coronary heart dIsease, 55% cancer, and 66% stroke. Oleic acid accounted for almost all dIfferences In monounsaturates among cohorts. All- cause and coronary heart disease death rates were low In cohorts with olive oil the main fat Causal relationshIps are not claimed but consideration of characteristics of populations as well as of Individuals withIn populations is urged evaluating risks.

coronary disease; death rate; diet; neoplasms; olelc acid; populations


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