3RD CONFERENCE ON HEALTH TRANSFORMATION IN CENTRAL EUROPE AFTER 1990: A THIRD LOOK Is the dramatic decline in cardiovascular diseases in Central Europe (Czech Republic, Slovakia, Poland) mainly due to dietary changes? Warsaw, October 29-30, 2001. Provadia rural district.
3RD CONFERENCE ON HEALTH TRANSFORMATION IN CENTRAL EUROPE AFTER 1990: A THIRD LOOK
Is the dramatic decline in cardiovascular diseases in Central Europe (Czech Republic, Slovakia, Poland) mainly due to dietary changes? Warsaw, October 29-30, 2001
Provadia rural district
Dolen Chiflik rural district
Could seasonal deficits in protective foods be contributing to high stroke incidence in Bulgaria?The Varna Diet and Stroke Study.
Powles J 1, Kirov P 2*, Feschieva N 3, Stanoev M 3, Dokova K 3, O’Connell M 4, Sanz A 5 (*presenter)
Varna Diet and Stroke Study, c/- Department of Social Medicine, Marin Drinov 52, 9002 Varna, Bulgaria. http://www.medinfo.cam.ac.uk/com_med/varna/stroke/index.htm
East / west gradients for deaths attributed to stroke tend to be greater than those for coronary heart disease and high rates in the east are inadequately explained by published data on blood pressure distributions and smoking prevalence. Fresh fruit and vegetable consumption in winter/spring has been very low in the East, even in countries such as Bulgaria and Hungary which have had high consumption levels in summer/autumn.
Methods: Stroke incidence study.
A ‘hot pursuit’ stroke registry was established in Primorski district of the city of Varna and in 2 rural districts (Dolen Chiflik and Provadia). The study registrar maintained close personal and telephone contact with dense networks of notifiers – especially in primary care in the ambulance service. Suspected eligible strokes were assessed by study neurologists within a median (interquartile range) of 8 (4-31) days. First in lifetime strokes at ages 45 to 84 in year beginning 1/5/2000, form the basis of this report.
Methods: Diet study
Volunteers aged 45 to 74 were quota sampled from the patients of general practitioners (n = 37, 38, 44 and 40 for rural and urban males and females respectively). Volunteers kept diet diaries for one week in winter and one week in the following summer and gave 2 24 hr urine collections (PABA validated for completeness) and blood in each season. Plasma vitamin C is used as a biomarker for fresh fruit and vegetables.
RM, UM, RF and UF = rural males, urban males, rural females and urban females
Scatterplots of plasma vitamin C concentrations in winter versus summer