title: [The 4 Provinces Study: its principal objectives and design. The Researchers of the 4 Provinces Study].
abstract: OBJECTIVE
  Spain shows an important variation in the geographical distribution of ischaemic heart disease and cerebrovascular disease mortality. In this article, the primary objectives and design of the Four Provinces study are described. In this study we analyzed the contribution of environmental factors (diet, lipid profile and plasma antioxidants), acting in childhood, to explain differences in cardiovascular mortality rates between different provinces in Spain.
  
  
  METHODS
  An ecological design was projected in which the units to study were four Spanish provinces with a wide variation in cardiovascular mortality in adulthood. The design compares diet, anthropometric variables and biological markers (particularly plasma lipids and antioxidant levels) in 6-7-year-old children, between the two provinces with the highest cardiovascular mortality rates and the two provinces with the lowest. The information for each province is collected in a cross-sectional manner in a representative sample of children from each province.
  
  
  CONCLUSIONS
  Evidence from the literature concerning Northern European countries suggest the contribution of environmental factors during early age in the development of cardiovascular disease in adulthood. The "Four Provinces" study will provide, for the first time, information about the influence of factors in early childhood of cardiovascular risk in a Mediterranean country. The study will also offer interesting data about food intake during school age in four provinces and it will allow us to estimate values of population of the variables of interest in those provinces.
authors.affiliation: Departamento de Medicina Preventiva y Salud Pública, Universidad País Vasco, Vitoria.
authors.forename: F
authors.initials: F
authors.lastname: Rodríguez Artalejo
authors.forename: C
authors.initials: C
authors.lastname: Garcés
authors.forename: A
authors.initials: A
authors.lastname: Gil
authors.forename: M A
authors.initials: MA
authors.lastname: Lasunción
authors.forename: J M
authors.initials: JM
authors.lastname: Martín Moreno
authors.forename: L
authors.initials: L
authors.lastname: Gorgojo
authors.forename: M
authors.initials: M
authors.lastname: de Oya
mesh_terms: D000975:Antioxidants / Q000032:analysis; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology* / Q000401:mortality; D002648:Child; D003430:Cross-Sectional Studies; D003625:Data Collection / Q000379:methods; D004032:Diet; D004463:Ecology; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D012107:Research Design; D013030:Spain / Q000453:epidemiology
chemical_list: D000975:Antioxidants; D008055:Lipids
vernacular_title: Estudio Cuatro Provincias: principales objectivos y diseño. Investigadores del Estudio Cuatro Provincias.