Fat and heart disease: yes we can make a change--the case of North Karelia (Finland).
METHODS
The exceptionally high mortality from cardiovascular disease (CVD) in the Finnish population in the 1970s ensued the initiation of preventive health interventions, which were first started in the Province of North Karelia and later on extended to all other regions of Finland. Their aim was to change population diets, especially with respect to the quality of fat: to reduce saturated and increase unsaturated fat intake. In addition, emphasis was placed on increased vegetable intake and salt reduction. The aim of this paper was to illustrate the effect of combined efforts of several stakeholders on CVD. This comprehensive action in Finland has involved health education programs, preventive measures in health services, actions at schools, broad collaboration with non-governmental and private sector organizations, government policies, population-based monitoring and evaluation, and international collaboration.


RESULTS
The combined efforts of all stakeholders have greatly helped people to reduce the intake of saturated fat and to replace this with unsaturated fat. This has been associated with an improved quality of the dietary fat (e.g. in 1972, over 90% of the population used butter on their bread compared to <5% at present) and a remarkable reduction in blood cholesterol levels. It has led to a 80% reduction in annual CVD mortality rates among the working aged population, to a major increase in life expectancy and to major improvements in functional capacity and health. Studies have shown that the reduction in blood cholesterol levels, explained by the target dietary changes, have had the greatest impact on these very favorable health changes.


CONCLUSIONS
The Finnish experience shows both the feasibility and great potential of CVD prevention and heart health promotion through general dietary changes in the population.
Puska
Pekka
P
National Institute for Health and Welfare, Helsinki, Finland. pekka.puska@thl.fi
D002318:Cardiovascular Diseases / Q000401:mortality / Q000517:prevention & control*; D004032:Diet / Q000639:trends; D004041:Dietary Fats / Q000008:administration & dosage* / Q000592:standards; D005247:Feeding Behavior; D005387:Finland; D006266:Health Education; D006293:Health Promotion; D006801:Humans; D012307:Risk Factors
D004041:Dietary Fats