Original Article
European Journal of Clinical Nutrition (2006) 60, 378–385. doi:10.1038/sj.ejcn.1602327; published online 23 November 2005
Follow-up of diet and cardiovascular risk factors 20 years after cessation of intervention in the Oslo Diet and Antismoking Study
Guarantor: S Tonstad.
Contributors: IE: study design, data collection, statistics, writing the manuscript; IS: study design, data collection, data analysis, statistics; EMH: study design, data collection; HA: study design, data analysis, statistics; IH study design; ST: study design, data analysis, writing the manuscript, supervising IE.
I Ellingsen1, E M Hjerkinn2, H Arnesen2, I Seljeflot2, I Hjermann1 and S Tonstad1
- 1Department of Preventive Medicine, Ullevål University Hospital, Oslo, Norway
- 2Centre of Clinical Research, Ullevål University Hospital, Oslo, Norway
Correspondence: Dr I Ellingsen, Department of Preventive Cardiology, Ullevål University Hospital, N-0407 Oslo, Norway. E-mail: ingrid.ellingsen@uus.no
Received 26 July 2004; Revised 30 August 2005; Accepted 16 September 2005; Published online 23 November 2005.
Abstract
Objective:
The Oslo Diet and Antismoking study was a 5-year randomised trial initiated in 1972–1973, which studied the effect of dietary change and smoking cessation for the prevention of coronary heart disease among high-risk middle-aged men. To test the long-term maintenance of lifestyle change, we examined diet and cardiovascular risk factors in subjects initially randomised to the control and intervention groups 20 years after cessation of the intervention.
Subjects and design:
Of the original cohort that included 1232 participants, 910 survivors were identified in 1997 and cardiovascular risk factors were measured in 563 (62%) in 1997–1999. Of these, 558 (99%) also completed questionnaires about their food intake and attitudes to health and diet.
Results:
Cigarette smoking was nearly halved between baseline and 20-year follow-up in each of the intervention and control groups (P<0.001 within groups), but did not differ between the intervention group (39%) versus the control group (34%); P=0.07. Body mass index increased by 1.4
2.6 and 1.62.6 kg/m2 between baseline and 20-year follow-up in the intervention and control groups, respectively (P<0.001 within groups; NS between groups). Serum total cholesterol and triglyceride concentrations decreased substantially in subjects treated or untreated with statins (P<0.001 within the intervention and control groups) but did not differ between the groups (total cholesterol change of -1.41.3 and -1.31.2 mmol/l, respectively, and triglyceride change of -0.51.0 mmol/l in both groups). Men in the intervention group reported a less atherogenic fat quality score and lower intakes of fat, saturated fat and cholesterol, higher intakes of long chain polyunsaturated fatty acids, protein and beta-carotene and greater attention to lifestyle and change of diet than the control group (all P<0.05). The fatty acid concentrations did not differ, however, between the intervention and control groups (P>0.05).
Conclusions:
No long-term differences in smoking rates or lipid concentrations between the intervention and control groups were observed in the surviving attendees two decades after the end of the trial. Lifestyle intervention still influenced the dietary intake, though modestly.
Keywords:
dietary intervention, dietary intake, BMI, lipids, serum fatty acids
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