Consistency of use of plant stanol ester margarine in Finland

Abstract Objective: The aims of this study were to investigate the consistency of use of plant stanol ester margarine and to characterise consistent and inconsistent users. Design: A cohort of plant stanol ester margarine users was established based on 14 national surveys conducted by the National Public Health Institute in Finland between 1996 and 1999. A follow-up study questionnaire was developed and sent to 1294 users in 2000. Setting: Subjects who reported using plant stanol ester margarine in both the original survey and the follow-up study were classified as consistent users, and the rest as inconsistent users. Subjects: The study population consisted of 1094 subjects aged 18-87 years, 590 men and 504 women. Results: There were 357 (33%) consistent and 737 (67%) inconsistent users of plant stanol ester margarine in the study population. Consistent users were more likely to be men and to have a higher household income than inconsistent users. Both consistent and inconsistent users were predominantly middle-aged persons with a healthy lifestyle and diet as well as a history of cardiovascular disease. Healthfulness was the main factor affecting bread spread choice among 94% of the consistent users and 59% of the inconsistent users. Conclusions: The use of plant stanol ester margarine is more often inconsistent than consistent. There is nevertheless a relatively large subgroup of long-term users of plant stanol ester margarine. It is important to examine the health effects especially among these regular user

The Partial Substitution of Processed Meat with Plant-Based Foods and the Risk of Cardiovascular Disease

Background and objectives: Cardiovascular diseases (CVD) are the leading cause of death globally. A shift from animal-based diets to more plant-based diets is likely to reduce the risk of CVD. This modelling study aimed to assess the impacts of the partial substitution of processed meat with plant-based foods on CVD risk. Methods: We used pooled data from five Finnish cohorts (n = 42868, 78% men, aged ≥25 years at baseline, 7.9 years median follow-up time with 4421 incident CVD cases). Diet was assessed using a validated food frequency questionnaire at baseline and CVD cases were ascertained from national health registers. In the substitution models, 50 g/week of processed meat were substituted with similar amounts of plant-based foods (legumes, vegetables, fruits, cereals, or a combination of these). Cohort-specific hazard ratios (HRs) were calculated using a Cox proportional hazards multivariate model adjusted for relevant confounding factors. Pooled HRs were estimated from the cohort-specific HRs using a random-effects model. Results: There was a small yet statistically significant reduction in CVD risk when processed meat was partially substituted with legumes (men: HR 0.96, 95% CI 0.93–1.00, p = 0.03), vegetables (men: HR 0.99, 95% CI 0.99–1.00, p < 0.001, women: HR 0.98, 95% CI 0.96–0.99, p < 0.01), fruits (women: HR 0.98, 95% CI 0.96–0.99, p < 0.01), cereals (women: HR 0.96, 95% CI 0.94–0.98, p < 0.01), or a combination of plant-based foods (women: HR 0.98, 95% CI 0.96–0.99, p < 0.01). Discussion: The modelled partial substitution of processed meat with several plant-based foods was associated with lower CVD risk. Our findings suggest that even a small change towards a more plant-based diet may contribute to cardiovascular health at the population level and, moreover, environmental sustainability

Response to letter regarding ‘The impacts of partial replacement of red and processed meat with legumes or cereals on protein and amino acid intakes : a modelling study in the Finnish adult population’

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The impacts of partial replacement of red and processed meat with legumes or cereals on protein and amino acid intakes : a modelling study in the Finnish adult population

Background: A shift towards more plant-based diets is considered healthy and environmentally sustainable but may cause a concern regarding protein and amino acid intakes. This modelling study aimed to assess the impacts of partial replacement of red and processed meat with legumes or cereals on the protein and indispensable amino acid intakes in the Finnish adult population. Materials and methods: We used the cross-sectional data of the National FinDiet 2017 Survey (two non-consecutive 24-h recalls, n = 1655, 47% men, aged 18–74 years). Six replacement scenarios were created in which the amount of red and processed meat exceeding 70 g/day (Finnish nutrition recommendation), or 30 g/day (EAT-Lancet recommendation) was replaced with the same amounts of legumes, cereals or their combination. Differences to the reference diet were evaluated based on non-overlapping 95% confidence intervals. Population shares (%) below estimated average requirements (EAR) were calculated using the usual intake modelling methodology (SPADE). Results: The replacement scenarios decreased the protein and indispensable amino acid intakes depending on gender and age. At the 70-g level, decreases were observed only in men aged 18–64 years. At the 30-g level, decreases were observed in other gender and age groups except women aged 65–74 years. In the scenarios, the mean daily protein intake was 15–18% of total energy intake (E%) (reference 17–18 E%), and the proportions below the EAR were 7–10% in men and 8–10% in women aged 18–64 years (reference 5–7%) and 20–25% in men and 16–20% in women aged 65–74 years (reference 14–17%). For total indispensable amino acids, the proportions below the EAR were <5% in the reference diet and the scenarios. Conclusions: The mean daily protein intake remained sufficient when red and processed meat was partially replaced with legumes or cereals in the Finnish adult population. However, protein adequacy in the elderly population warrants attention and more research.Peer reviewe