A visual migraine aura locus maps to 9q21-q22.

OBJECTIVE: To identify susceptibility loci for visual migraine aura in migraine families primarily affected with scintillating scotoma type of aura. METHODS: We included Finnish migraine families with at least 2 affected family members with scintillating scotoma as defined by the International Criteria for Headache Disorders-II. A total of 36 multigenerational families containing 351 individuals were included, 185 of whom have visual aura and 159 have scintillating scotoma. Parametric and nonparametric linkage analyses were performed with 378 microsatellite markers. The most promising linkage loci found were fine-mapped with additional microsatellite markers. RESULTS: A novel locus on chromosome 9q22-q31 for migraine aura was identified (HLOD = 4.7 at 104 cM). Fine-mapping identified a shared haplotype segment of 12 cM (9.8 Mb) on 9q21-q22 among the aura affected. Four other loci showed linkage to aura: a locus on 12p13 showed significant evidence of linkage, and suggestive evidence of linkage was detected to loci on chromosomes 5q13, 6q25, and 13q14. CONCLUSIONS: A novel visual migraine aura locus has been mapped to chromosome 9q21-q22. Interestingly, this region has previously been linked to occipitotemporal lobe epilepsy with prominent visual symptoms. Our finding further supports a shared genetic background in migraine and epilepsy and suggests that susceptibility variant(s) to visual aura for both of these traits are located in the 9q21-q22 locus.

Genetic association study of endothelin-1 and its receptors EDNRA and EDNRB in migraine with aura.

The effect of endothelin-1 and its receptors EDNRA and EDNRB in migraine with aura (MA) susceptibility is not established yet. We studied the association between the MA end-diagnosis and three migraine trait components and 32 single nucleotide polymorphisms (SNPs) capturing the variation of endothelin genes in 850 Finnish migraine patients and 890 non-migrainous individuals. The SNPs showing evidence of association were further studied in 648 German migraine patients and 651 non-migrainous individuals. No significant association was detected. However, the homozygous minor genotype (5% in cases) of the EDNRA SNP rs2048894 showed nominal association with MA both in the Finnish sample (P = 0.015) and in the pooled sample [odds ratio (OR) 1.61, 95% confidence interval (CI) 1.12-2.32, P = 0.010] when adjusted for gender and sample origin. The trait age of onset < 20 years was also associated with rs2048894 (OR 1.69, 95% CI 1.13-2.54, P = 0.011) in the pooled sample. To confirm this finding studies on even larger samples are required.

The effect of flaxseed supplementation in processed foods on serum fatty acids and enterolactone.

OBJECTIVE: The purpose was to study the effects of flaxseed supplementation as a part of daily diet on serum lipids, fatty acids and plasma enterolactone. DESIGN: Eighty volunteers participated in this clinical nutrition study which was carried out in a controlled, double-blind and cross-over manner. The subjects were randomized to diet sequences AB or BA. Diet A meals contained 1.3 g/100 g ground flaxseed and 5 g/100 g flaxseed oil. Also 3-4 g/100 of inulin and wheat fiber was added. AB diet with non-supplemented foods served as control. Test subjects were on both diets for 4 weeks separated by a 4-week wash-out period. Fifteen test subjects continued an open part of the study for 4 additional months. INTERVENTIONS: The dietary intake, basic blood values, serum lipids, fatty acids and enterolactone were measured at baseline, after both intervention periods and during the open study, at baseline and after 2 and 4 months. Serum thiocyanate and blood cadmium were controlled after both intervention periods. RESULTS: The percentage of flaxseed supplemented test food out of total dietary intake was 20% of energy. The test food contained significantly higher amounts of fiber, polyunsaturated fatty acids (PUFAs) and especially alpha-linolenic acid than the control food. No significant changes were observed in the basic laboratory values or in blood lipids. There was a significant increase in serum alpha-linolenic acid, eicosapentaenoic acid and docosapentaenoic acid. Serum enterolactone concentration was doubled during flaxseed supplementation. Serum thiocyanate and blood cadmium values did not exceed reference values and there was no difference between the diets. CONCLUSIONS: In this study we were able to show that, by adding ground flaxseed and flaxseed oil to one or two daily meals, it is possible to obtain significant effects on serum levels of enterolactone and alpha-linolenic acid. SPONSORSHIP: The study was sponsored by the National Technology Agency of Finland (Tekes).

Coffee consumption and the risk of coronary heart disease and death.

OBJECTIVES: To study prospectively the relation of coffee drinking with fatal and nonfatal coronary heart disease (CHD) and all-cause mortality and to perform a cross-sectional analysis at baseline on the association between coffee drinking and CHD risk factors, diagnosed diseases, self-reported symptoms, and use of medicines. METHODS: The study cohort consisted of 20 179 randomly selected eastern Finnish men and women aged 30 to 59 years who participated in a cross-sectional risk factor survey in 1972, 1977, or 1982. Habitual coffee drinking, health behavior, major known CHD risk factors, and medical history were assessed at the baseline examination. Each subject was followed up for 10 years after the survey using the national hospital discharge and death registers. Multivariate analyses were performed by using the Cox proportional hazards model. RESULTS: In men, the risk of nonfatal myocardial infarction was not associated with coffee drinking. The age-adjusted association of coffee drinking was J shaped with CHD mortality and U shaped with all-cause mortality. The highest CHD mortality was found among those who did not drink coffee at all (multivariate adjusted). Also, in women, all-cause mortality decreased by increasing coffee drinking. The prevalence of smoking and the mean level of serum cholesterol increased with increasing coffee drinking. Non-coffee drinkers more often reported a history of various diseases and symptoms, and they also more frequently used several drugs compared with coffee drinkers. CONCLUSIONS: Coffee drinking does not increase the risk of CHD or death. In men, slightly increased mortality from CHD and all causes in heavy coffee drinkers is largely explained by the effects of smoking and a high serum cholesterol level. Arch Intern Med. 2000;160:3393-3400.

The effect of breakfast cereal on diet and serum cholesterol: a randomized trial in North Karelia, Finland.

OBJECTIVE: To test the hypothesis that a high carbohydrate breakfast with breakfast cereal leads to a meaningful reduction in dietary energy intake from fat, especially from saturated fat, and thus lower serum cholesterol levels. DESIGN: An open randomized controlled cross-over trial. The subjects were randomized into intervention breakfast cereal or usual breakfast (control) groups. SETTING: Free-living subjects aged 29-71 y in Eastern Finland SUBJECTS: 224 enrolled, 209 completed the study. The subjects were recruited from a survey of a random population sample and from other sources, and their serum cholesterol was not lower than 5.0 mmol/l. Recruited persons did not have any chronic disease or very low saturated fat intake. INTERVENTION: The cereal group consumed 80 g (men) or 60 g (women) cereal at breakfast and the control group continued their usual dietary habits for six weeks. After a wash out of six weeks, a cross-over with another six week trial period took place. Measurements (including serum samples and a 3 d food record) took place before and after the two trial periods. RESULTS: The intervention period led to 2.5 en% (energy percent units) reduction in saturated fatty acids intake. The reduction in total fat intake was 5.5 en%. This was compensated for by increased intake of carbohydrates. The reduction in saturated fatty acids intake led to modest (but in group 1 significant) 0.15 mmol/l (2.5%) reduction in total serum cholesterol level. CONCLUSIONS: The trial showed that regular cereal breakfast can lead to reduced intake of total and saturated fatty acids of the daily diet and consequently to reduction in serum cholesterol level.

Effect of extreme fish consumption on dietary and plasma antioxidant levels and fatty acid composition.

OBJECTIVE: To assess the effects of high-fish and low-fish diets on plasma concentrations of fatty acids and selected antioxidants. DESIGN AND SUBJECTS: The effects of fish consumption on dietary and plasma antioxidant levels and fatty acid composition were studied as part of a large dietary survey of Finnish adults (n = 1861). High-fish consumers were matched with low-fish consumers and 41 pairs were identified. The members of each pair were of the same sex, from the same 10 y age group, and from the same or adjacent areas. There were 21 men and 20 women in each group, with a mean age of 54.3 y. METHODS: The fish consumption of the subjects was investigated with a qualitative food questionnaire. Additionally, a 3 d food record was used to estimate the diet. Two indices were defined to describe the oxidation potential of the diets. The plasma alpha-tocopherol, gamma-tocopherol, and beta-carotene concentrations and various fatty acids were analysed. RESULTS: The mean fish intake was 103 g/d in the high-fish and 5 g/d in the low-fish group. The dietary intakes of vitamin C, protein, total n-3 polyunsaturated fatty acids (PUFA), eicosapentaenoic acid, docosahexaenoic acid, mercury, selenium, and salt and the theoretical oxidative potential were higher (P < 0.05) and the saturated fatty acid intake lower (P < 0.01) in the high-fish than in the low-fish group. The dietary vitamin E intake was similar in both groups but the ratio of dietary vitamin E/PUFA was higher (P < 0.01) in the high-fish than in the low-fish group (0.85 and 0.75, respectively). The plasma n-3 PUFAs were higher (P < 0.001) and n-6 PUFAs lower (P < 0.001) in the high-fish than in the low-fish group. There were no differences in plasma antioxidant levels between the groups. CONCLUSION: This study shows that extreme fish consumption does not affect plasma antioxidant levels.

Modern and healthy?: socioeconomic differences in the quality of diet.

OBJECTIVE: The purpose of this study was to describe how nutrient intake and food consumption varied according to education and household income in men and women. The second aim was to find out to what extent the goals of the national dietary guidelines were met in different socioeconomic groups. DESIGN: A random dietary survey using a 3 d estimated food record and a self-administered questionnaire. SETTING: Individuals from four different regions in Finland in spring 1992. SUBJECTS: 870 men and 991 women aged 25-64 y. MAIN OUTCOME MEASURES: Food group and nutrient consumption, two saturated fat indices, educational level and household income. MAIN RESULTS: Men with a higher educational level had a lower energy intake and women with a higher income a lower intake of carbohydrates. The intake of vitamin C and carotenoids increased with increasing socioeconomic status. Otherwise, no socioeconomic differences in energy intake, densities of fat and saturated fat, macronutrient or fibre were found. Higher socioeconomic groups consumed more cheese, vegetables, fruit and berries and candies and less milk, butter and bread. CONCLUSIONS: Higher socioeconomic groups did not follow current national dietary guidelines better than lower socioeconomic groups. Higher socioeconomic groups consumed more of the modern recommended foods, such as vegetables and fruit and berries, but less traditional recommended foods, such as bread and potatoes.

Lack of effect on blood pressure by polyunsaturated and monounsaturated fat diets.

We carried out a blind highly controlled study to investigate the effects of a sunflower-oil-rich diet and a rapeseed-oil-rich diet on the blood pressure of normotensive subjects. Twenty-nine men and 30 women, average age 30 years (range 18-65) were first fed a baseline diet high in saturated fatty acids (19 E% (percentage of total energy), total fat 36 E%) for 2 weeks. According to the crossover design 30 subjects then received a sunflower oil diet high in polyunsaturated fatty acids (13 E%, total fat 38 E%) followed by a low erucic acid rapeseed oil diet high in monounsaturated fatty acids (16 E%, total fat 38 E%) for 3.5 weeks each. The other 29 subjects had the same diets in reverse order. At the end of the saturated fat period systolic blood pressure was 122.6 +/- 11.5(mean +/- SD) mmHg and diastolic blood pressure 75.4 +/- 7.5 mmHg; during the sunflower oil diet the figures were 119.6 +/- 10.3 and 73.9 +/- 7.4 mmHg, and during the rapeseed oil diet 120.1 +/- 11.2 and 72.6 +/- 6.4 mmHg, respectively. There was a significant difference in diastolic blood pressure only between the two oil diets (P less than 0.01). At the end of a 4 weeks' recovery period the systolic and diastolic blood pressures of the subjects were even lower (118.6 +/- 10.6 and 72.3 +/- 8.3 mmHg, respectively) than during the study. These results suggest that the dietary changes had only minor effects - if any at all - on blood pressure in healthy normotensive subjects.