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"Coronary Heart Disease Mortality and Blood Cholesterol In the Seven Countries study, there were great differences in coronary heart disease (CHD) mortality at similar blood cholesterol levels. In this study Dr. Keys pointed to a correlation between deaths from coronary heart disease and serum cholesterol in 15 populations in seven countries. Dr Ravnskov plotted his original data which was not available in the research summaries. Particularly interesting were differences between two localities within the same country or nearby islands in each of 4 of the seven countries. West Finland had about 45 CHD (coronary heart disease) deaths at a median cholesterol level of 250 mg/dl. However North Karelia, also in Finland, had over 200 CHD deaths at about 260 mg/dl. The island of Crete had only 20 CHD deaths at cholesterol levels of about 200. The nearby island of Corfu had about 85 CHD deaths at a cholesterol level of about 190 mg/dl."

Calcium:magnesium ratio in local groundwater and incidence of acute myocardial infarction among males in rural Finland. Kousa A, Havulinna AS, Moltchanova E, Taskinen O, Nikkarinen M, Eriksson J, Karvonen M. Environ Health Perspect. 2006 May;114(5):730-4. doi:10.1289/ehp.8438 PMID: 16675428 Results of this study with specific Bayesian statistical analysis support earlier findings of a protective role of Mg and low Ca:Mg ratio against coronary heart disease but do not support the earlier hypothesis of a protective role of Ca

Serum 25-hydroxyvitamin D and the risk of ovarian cancer. Toriola AT, Surcel HM, Agborsangaya C, Grankvist K, Tuohimaa P, Toniolo P, Lukanova A, Pukkala E, Lehtinen M. Eur J Cancer. 2009 Aug 25. [Epub ahead of print] PMID: 19713101 doi:10.1016/j.ejca.2009.08.002 Conclusion Overall, we did not observe a significant association between serum 25-OHD concentrations and the risk of ovarian cancer. However, we found evidence suggestive of an increased risk among women with low to insufficient serum 25-OHD concentrations.

Lack of association between serum levels of 25-hydroxyvitamin D and the subsequent risk of prostate cancer in Finnish men. Faupel-Badger JM, Diaw L, Albanes D, Virtamo J, Woodson K, Tangrea JA. Cancer Epidemiol Biomarkers Prev. 2007 Dec;16(12):2784-6. PMID: 18086789 doi: 10.1158/1055-9965.EPI-07-0672

Fish oil-derived fatty acids, docosahexaenoic acid and docosapentaenoic acid, and the risk of acute coronary events: the Kuopio ischaemic heart disease risk factor study. Rissanen T, Voutilainen S, Nyyssönen K, Lakka TA, Salonen JT. Circulation. 2000 Nov 28;102(22):2677-9. PMID: 11094031 Methods and Results-We studied this association in the Kuopio Ischaemic Heart Disease Risk Factor Study, a prospective population study in Eastern Finland. Subjects were randomly selected and included 1871 men aged 42 to 60 years who had no clinical coronary heart disease at baseline examination. A total of 194 men had a fatal or nonfatal acute coronary event during follow-up. In a Cox proportional hazards' model adjusting for other risk factors, men in the highest fifth of the proportion of serum DHA+DPA in all fatty acids had a 44% reduced risk (P=0.014) of acute coronary events compared with men in the lowest fifth. Men in the highest fifth of DHA+DPA who had a low hair content of mercury (2.0 µg/g). There was no association between proportion of eicosapentaenoic acid and the risk of acute coronary events. Conclusions-Our data provide further confirmation for the concept that fish oil-derived fatty acids reduce the risk of acute coronary events. However, a high mercury content in fish could attenuate this protective effect.

Antioxidant Supplementation in Atherosclerosis Prevention (ASAP) study: a randomized trial of the effect of vitamins E and C on 3-year progression of carotid atherosclerosis. Salonen JT, Nyyssönen K, Salonen R, Lakka HM, Kaikkonen J, Porkkala-Sarataho E, Voutilainen S, Lakka TA, Rissanen T, Leskinen L, Tuomainen TP, Valkonen VP, Ristonmaa U, Poulsen HE. J Intern Med. 2000 Nov;248(5):377-86. PMID: 11123502 DOI: 10.1046/j.1365-2796.2000.00752.x Conclusions. Our study shows that a combined supplementation with reasonable doses of both vitamin E and slow-release vitamin C can retard the progression of common carotid atherosclerosis in men. This may imply benefits with regard to other atherosclerosis-based events.

Six-year effect of combined vitamin C and E supplementation on atherosclerotic progression: the Antioxidant Supplementation in Atherosclerosis Prevention (ASAP) Study. Salonen RM, Nyyssönen K, Kaikkonen J, Porkkala-Sarataho E, Voutilainen S, Rissanen TH, Tuomainen TP, Valkonen VP, Ristonmaa U, Lakka HM, Vanharanta M, Salonen JT, Poulsen HE; Antioxidant Supplementation in Atherosclerosis Prevention Study. Circulation. 2003 Feb 25;107(7):947-53. PMID: 12600905 doi: 10.1161/01.CIR.0000050626.25057.51 Conclusions- These data replicate our 3-year findings confirming that the supplementation with combination of vitamin E and slow-release vitamin C slows down atherosclerotic progression in hypercholesterolemic persons.

Mercury, fish oils, and risk of acute coronary events and cardiovascular disease, coronary heart disease, and all-cause mortality in men in eastern Finland. Virtanen JK, Voutilainen S, Rissanen TH, Mursu J, Tuomainen TP, Korhonen MJ, Valkonen VP, Seppänen K, Laukkanen JA, Salonen JT. Arterioscler Thromb Vasc Biol. 2005 Jan;25(1):228-33. Epub 2004 Nov 11. PMID: 15539625 doi: 10.1161/01.ATV.0000150040.20950.61 Conclusions- High content of mercury in hair may be a risk factor for acute coronary events and CVD, CHD, and all-cause mortality in middle-aged eastern Finnish men. Mercury may also attenuate the protective effects of fish on cardiovascular health. Mercury may increase the risk of cardiovascular diseases. In this study, high mercury content in hair increased the risk of cardiovascular morbidity and mortality in middle-aged Finnish men and attenuated the beneficial effects of fish oils on cardiovascular health. Regular consumption of fish with high mercury content should be avoided.

Glycemic index, glycemic load, and the risk of acute myocardial infarction in Finnish men: The Kuopio Ischaemic Heart Disease Risk Factor Study. Mursu J, Virtanen JK, Rissanen TH, Tuomainen TP, Nykänen I, Laukkanen JA, Kortelainen R, Voutilainen S. Nutr Metab Cardiovasc Dis. 2009 Oct 14. [Epub ahead of print] PMID: 19836217 doi:10.1016/j.numecd.2009.08.001 Conclusions Our results suggest that both high dietary GI and GL are associated with increased risk of AMI among overweight and GL possibly among less physically active men.

High dietary methionine intake increases the risk of acute coronary events in middle-aged men. Virtanen JK, Voutilainen S, Rissanen TH, Happonen P, Mursu J, Laukkanen JA, Poulsen H, Lakka TA, Salonen JT. Nutr Metab Cardiovasc Dis. 2006 Mar;16(2):113-20. Epub 2005 Nov 2. PMID: 16487911 doi:10.1016/j.numecd.2005.05.005 Conclusions The main finding of this study is that long-term, moderately high dietary methionine intake may increase the risk of acute coronary events in middle-aged Finnish men free of prior CHD. More prospective research is needed to confirm the role of dietary methionine in the development of CVD, and whether its effects are independent of homocysteine.

Serum Long-Chain n-3 Polyunsaturated Fatty Acids and Risk of Hospital Diagnosis of Atrial Fibrillation in Men. Virtanen JK, Mursu J, Voutilainen S, Tuomainen TP. Circulation. 2009 Dec 8;120(23):2315-21. Epub 2009 Nov 23. PMID: 19933935 doi: 10.1161/CIRCULATIONAHA.109.852657 Conclusions- An increased concentration of long-chain n-3 PUFAs in serum, a marker of fish or fish oil consumption, may protect against AF. Serum docosahexaenoic acid concentration had the greatest impact

Vitamin D supplementation during the first year of life and risk of schizophrenia: a Finnish birth cohort study. McGrath J, Saari K, Hakko H, Jokelainen J, Jones P, Järvelin MR, Chant D, Isohanni M. Schizophr Res. 2004 Apr 1;67(2-3):237-45. PMID: 14984883 Conclusion: Vitamin D supplementation during the first year of life is associated with a reduced risk of schizophrenia in males. Preventing hypovitaminosis D during early life may reduce the incidence of schizophrenia.

Fish consumption and depressive symptoms in the general population in Finland. Tanskanen A, Hibbeln JR, Tuomilehto J, Uutela A, Haukkala A, Viinamäki H, Lehtonen J, Vartiainen E. Psychiatr Serv. 2001 Apr;52(4):529-31. PMID: 11274502 After the analysis adjusted for potential confounders, the likelihood of having depressive symptoms was significantly higher among infrequent fish consumers than among frequent consumers.

"NEW YORK (Reuters Health) - Low vitamin D levels in the body may be deadly, according to a new study hinting that adults with lower, versus higher, blood levels of vitamin D may be more likely to die from heart disease or stroke. Vitamin D is an essential vitamin mostly obtained from direct sunlight exposure, but also found in foods and multivitamins. Dr. Annamari Kilkkinen, at the National Institute for Health and Welfare in Helsinki, Finland, and colleagues compared blood levels of vitamin D and deaths from heart disease or stroke over time in 2,817 men and 3,402 women in Finland."

Defining Adequate Vitamin D Intake : Cross-sectional and Intervention Studies Viljakainen, Heli Tuulikki University of Helsinki 2008-05-23 Doctoral dissertation (article-based) Vitamin D is required for normal bone growth and maintenance of the skeleton throughout life. In Finland, like in many other Western countries, the population suffers from inadequate or deficient vitamin D status, especially during winter, which is thought to increase the risk of osteoporosis. New strategies to prevent osteoporosis are actively being sought. The main objective of this thesis was to determine whether vitamin D is feasible in the primary prevention of osteoporosis; does it affect bone mineral accrual during the growth period? A second goal was to ascertain whether seasonal variation in calcitropic hormones affects bone remodelling, and to elucidate the vitamin D intake needed to overcome this variation in different age groups. In summary, vitamin D intake remains inadequate among the target groups of this thesis, as reflected by seasonal variation in calcitropic hormones and bone metabolism. Dietary intake of vitamin D should be increased to achieve at least an adequate vitamin D status (S-25-OHD>50 nmol/l) and possibly an optimal vitamin D status (S-25-OHD>80 nmol/l) throughout the year. This could be accomplished by introducing new vitamin D-fortified foods to the market."

Association between serum 25(OH)D concentrations and bone stress fractures in Finnish young men. Ruohola JP, Laaksi I, Ylikomi T, Haataja R, Mattila VM, Sahi T, Tuohimaa P, Pihlajamäki H. J Bone Miner Res. 2006 Sep;21(9):1483-8. doi: 10.1359/jbmr.060607 Conclusions: A lower level of serum 25(OH)D concentration may be a generally predisposing element for bone stress fractures. Considering the obvious need of additional vitamin D in prevention of stress fractures, the effects of vitamin D fortification of foods and supplementation will be subjects of interest for future research PMID: 16939407

Teenage girls and elderly women living in northern Europe have low winter vitamin D status. Andersen R, Mølgaard C, Skovgaard LT, Brot C, Cashman KD, Chabros E, Charzewska J, Flynn A, Jakobsen J, Kärkkäinen M, Kiely M, Lamberg-Allardt C, Moreiras O, Natri AM, O'brien M, Rogalska-Niedzwiedz M, Ovesen L. Eur J Clin Nutr. 2005 Apr;59(4):533-41. PMID: 15714215 doi:10.1038/sj.ejcn.1602108 CONCLUSION: Vitamin D status is low in northern Europe during winter. More than one-third of the adolescent girls have vitamin D status below 25 nmol/l and almost all are below 50 nmol/l. Two-thirds of the elderly community-dwelling women have vitamin D status below 50 nmol/l. Use of vitamin D supplements is a significant positive determinant for S-25OHD for both girls and women (P = 0.001). SPONSORSHIP: The European Fifth Framework Programme (Contract No. QLK1-CT-2000-00623)

Association of low 25-hydroxyvitamin D concentrations with elevated parathyroid hormone concentrations and low cortical bone density in early pubertal and prepubertal Finnish girls. Cheng S, Tylavsky F, Kröger H, Kärkkäinen M, Lyytikäinen A, Koistinen A, Mahonen A, Alen M, Halleen J, Väänänen K, Lamberg-Allardt C. Am J Clin Nutr. 2003 Sep;78(3):485-92. Erratum in: Am J Clin Nutr. 2006 Jan;83(1):174. PMID: 12936933 CONCLUSIONS: Vitamin D-deficient girls have low cortical BMD and high iPTH concentrations, which are consistent with secondary hyperparathyroidism. A low vitamin D concentration accompanied by high bone resorption (TRAP 5b) may limit the accretion of bone mass in young girls.

Differences in vitamin D status between countries in young adults and the elderly. McKenna MJ. Am J Med. 1992 Jul;93(1):69-77. PMID: 1385673 PURPOSE: To compare vitamin D status between countries in young adults and in the elderly. MATERIALS AND METHODS: Reports on vitamin D status (as assessed by serum 25-hydroxyvitamin D) from 1971 to 1990 were reviewed. Studies were grouped according to geographic regions: North America (including Canada and the United States); Scandinavia (including Denmark, Finland, Norway, and Sweden); and Central and Western Europe (including Belgium, France, Germany, Ireland, The Netherlands, Switzerland, and the United Kingdom). RESULTS: Vitamin D status varies with the season in young adults and in the elderly, and is lower during the winter in Europe than in both North America and Scandinavia. Oral vitamin D intake is lower in Europe than in both North America and Scandinavia. Hypovitaminosis D and related abnormalities in bone chemistry are most common in elderly residents in Europe but are reported in all elderly populations. CONCLUSIONS: The vitamin D status in young adults and the elderly varies widely with the country of residence. Adequate exposure to summer sunlight is the essential means to ample supply, but oral intake augmented by both fortification and supplementation is necessary to maintain baseline stores. All countries should adopt a fortification policy. It seems likely that the elderly would benefit additionally from a daily supplement of 10 micrograms of vitamin D.

Low serum 25-hydroxyvitamin D concentrations and secondary hyperparathyroidism in middle-aged white strict vegetarians. Lamberg-Allardt C, Kärkkäinen M, Seppänen R, Biström H. Am J Clin Nutr. 1993 Nov;58(5):684-9. PMID: 8237875 In conclusion, white strict vegetarians are at risk of vitamin D deficiency, at least in the winter, primarily because of a low dietary vitamin D intake, despite a normal sunlight exposure in summer. Low serum 25(OH)D concentrations are accompanied by high S-iPTH concentrations, which also are affected by a low calcium intake. The effect of these changes on bone health remains to be evaluated.