Talk:Seven Countries Study

Findings of the Seven Countries Study

The findings of the Seven Countries Study were applied in North Karelia a region in Finland that had the worldwide highest rate of cardiovascular disease and a particularly low life expectancy for the male population. From 1972 to 1977, the North Karelia Project for Population-Based Lifestyle Interventions was started. The core was the replacement of saturated fats (mainly butter) with unsaturated fats (mainly rapeseed oil), higher vegetable consumption, less salt and less tobacco consumption. Because of its great success, the project was expanded to the whole of Finland in 1977. The average serum cholesterol level was reduced by 20%. The rate of deaths from cardiovascular disease in middle-aged men (between 35 and 64 years of age) was reduced by more than 80% (from 690 per 100,000 annually to 100 per 100,000 annually). The life expectancy of the entire population increased by 10 years and surveys also showed an improvement in subjective health perceptions. Pass3456 (talk) 21:46, 17 August 2024 (UTC)

References

No wp:synth. Just adding Information about a topic from more than one source. As good authers shouöd do. Pass3456 (talk) 21:49, 17 August 2024 (UTC)

The first source (which is not WP:MEDRS, and appears to misrepresent the MEDRS it cites, PMID:27242088) mentions that some SCS-related "findings" were applied in Karelia. The second (a review in a non-MEDLINE journal) describes a multi-pronged heath programme in Karelia without mentioning SCS. You seem to be combining those two things to convey something that can't be WP:Verified. By implying the health programme's success was entirely down to SCS (it also included smoking reduction and other lifestyle changes) you are also straying from the source, even if WP:SYNTH were allowed. As a reminder, "good editors" must not "combine material from multiple sources to state or imply a conclusion not explicitly stated by any of the sources". So far as I can see no source is tying the results of the Karelia programme to SCS in the way your text does, and although it may be reasonable to infer a link oneself, Wikipedia doesn't do that.

Still, there is probably something to be said on this topic. PMID:33734841 for example describes how the SCS findings prompted public pressure for something to be done about chronic health problems. I wonder if we might need a substantial "Influence on public health programs" section? Bon courage (talk) 05:50, 18 August 2024 (UTC)

I agree on the need for the "Influence on public health programs".

Still fail to see why we should not give info on the results. As a reader I am particularly interested in the results. If the results were good I probably would like do dig deeper, if not it is a waste of time. --Pass3456 (talk) 15:00, 18 August 2024 (UTC)

Because the results don't derive from the SCS. Bon courage (talk) 15:01, 18 August 2024 (UTC)

The SCS identified the now classical risk factors of blood pressure and blood cholesterol level and cigarette smoking. These risk factors were adressed with the population based intervention. And it worked. Si it is an approval. The different outome would have been that it did not work - in that case it would have been a strong case against the SCS and Ancel keys. --Pass3456 (talk) 16:34, 18 August 2024 (UTC)

SCS was one of many epidemiological studies influencing the Karelia programme, alongside the British Doctors Study and Framingham Heart Study, as PMID:27242088 explains. After the first 5 years the programme was found to have no effect on mortality. It increasingly included other interventions and, increasingly, drugs, and eventually showed some success. It's not possible to tease out the effect of the SCS in this complicated mix – or, if it is, we'd need the strong WP:MEDRS doing that. Bon courage (talk) 16:45, 18 August 2024 (UTC)

• "Large epidemiological studies, such as the British Medical Doctors Study, the Framingham Heart Study, and the Seven Countries Study, identified a few behavioral and biological factors associated with the CHD risk, particularly tobacco smoking, high serum cholesterol, and high blood pressure."
• "he North Karelia Project, the first community-based CVD prevention project in the world, was launched in 1972. The main aim of the project was to reduce the extremely high CHD mortality among workingage men by reducing the levels of the 3 main CVD risk factors."
• "During the 40-year period, from 1972 to 2012, the levels of all 3 risk factors declined markedly, except smoking among women (Table 1). From the baseline level in the early 1970s to 2012, CHD mortality decreased from 643 to 118 per 100,000 among working-age (ages 35 to 64 years) men and from 114 to 17 per 100,000 among working-age women (Fig. 1). The decrease was 82% in men and 84% in women (Table 2). During the first 10 years, changes in smoking prevalence and serum cholesterol and systolic blood pressure levels explained nearly all of the observed mortality reduction. Between 1982 and 2002, the observed CHD mortality decline was faster than predicted. In the last 10 years, trends in observed and predicted mortality have been quite similar."

The statistics say that in the second and third decade there was an "excessive" decline of mortality. 1/3 of the decline (the "excess") was not attributable to the three risk factors. I agree that this was most probably due to the advance of statins and the decline of Trans fat. But the fact remains that the reduction of the three risk factors had in reality exactly the impact that was calculated by the Seven Countries Study, the British Medical Doctors Study and the Framingham Heart Study. I think thats impressive.

Pass3456 (talk) 17:39, 18 August 2024 (UTC)

There is coverage of this in some lipidology textbooks, "Keys' findings prompted the Finnish Government to promote a healthier diet in North Karelia, and by the mid 1990s CVD mortality had been reduced by more than half. This improvement was achieved by substantial decreases in sodium intake, saturated fat intake, and smoking and an increase in vegetable and plant sterol consumption". The source is Paul Durrington (2007). Hyperlipidaemia: Diagnosis and Management, 3rd edition. CRC Press p. 214. I will have a look for anything more recent. Psychologist Guy (talk) 23:24, 18 August 2024 (UTC)

Based on what I have found Pekka Puska is the major author who has written about the North Karelia data. These are review articles he has written [1], [2] and older general articles [3], [4]. In regard to the review articles they were both published in the Global Heart Journal. This is the official journal of the World Heart Federation. This is all pretty much solid science. I wouldn't oppose citing Pekka Puska. I think we do need to note on the article that dietary changes (reducing saturated fat intake) contributed to cardiovascular disease decline in Finland but that is not the only factor, the reduction on smoking should also be cited. It should be noted that our Wikipedia article on North Karelia cites the National Institute for Health and Welfare (Finland), a source we can use here if need be. Psychologist Guy (talk) 23:47, 18 August 2024 (UTC)

Pekka Puska met Ancel Keys and was influenced by him. Keys himself was interested in studying the health of the Finnish population. There is mention of Keys and Puska in the book Historical Explorations of Modern Epidemiology Patterns, Populations and Pathologies (Springer, 2023). I don't have the book, I may come back to this at another date if I read it. Psychologist Guy (talk) 23:59, 18 August 2024 (UTC)

Thank you in advance :-) Pass3456 (talk) 17:19, 19 August 2024 (UTC)