DIETARY PATTERN AND 20 YEAR MORTALITY IN ELDERLY MEN IN FINLAND, ITALY, AND THE NETHERLANDS - LONGITUDINAL COHORT STUDY

Objective: To investigate the association of dietary pattern and morta lity in international data. Design: Cohort study with 20 years' follow up of mortality. Setting: Five cohorts in Finland, the Netherlands, a nd Italy. Subjects: Population based random sample of 3045 men aged 50 -70 years in 1970.Main outcome measures: Food intake was estimated usi ng a cross check dietary history. In this dietary survey method, the u sual food consumption pattern in the 6-12 months is estimated. A healt hy diet indicator was calculated for the dietary pattern, using the Wo rld Health Organisation's guidelines for the prevention of chronic dis eases. Vital status was verified after 20 years of follow up, and deat h rates were calculated. Results: Dietary intake varied greatly in 197 0 between the three countries. In Finland and the Netherlands the inta ke of saturated fatty acids and cholesterol was high and the intake of alcohol was low; in Italy the opposite was observed. In total 1796 me n (59%) died during 20 years of follow up. The healthy diet indicator was inversely associated with mortality (P for trend < 0.05). After ad justment for age, smoking, and alcohol consumption, the relative risk in the group with the healthiest diet indicator compared with the grou p with the least healthy was 0.87 (95% confidence interval 0.77 to 0.9 8). Estimated relative risks were essentially similar within each coun try. Conclusions: Dietary intake of men aged 50-70 is associated with a 20 year, all cause mortality in different cultures. The healthy diet indicator is useful in evaluating the relation of mortality to dietar y patterns.