The low death rate from coronary heart disease among the Greenland Eskimos has been ascribed to their high fish consumption. We therefore decided to investigate the relation between fish consumption and coronary heart disease in a group of men in the town of Zutphen, the Netherlands. Information about the fish consumption of 852 middle-aged men without coronary heart disease was collected in 1960 by a careful dietary history obtained from the participants and their wives. During 20 years of follow-up 78 men died from coronary heart disease. An inverse dose-response relation was observed between fish consumption in 1960 and death from coronary heart disease during 20 years of follow-up. This relation persisted after multiple logistic-regression analyses. Mortality from coronary heart disease was more than 50 per cent lower among those who consumed at least 30 g of fish per day than among those who did not eat fish. We conclude that the consumption of as little as one or two fish dishes per week may be of preventive value in relation to coronary heart disease.

Objective: To study the intake of catechins in the Dutch population and to assess the relation between catechin intake and other dietary factors. Catechins, dietary components that belong to the¯avonoid family, potentially protect against chronic diseases such as cancer and cardiovascular diseases. Catechins are the major components of tea, but they are present in many other plant foods as well. Design: Data were used from a nationwide dietary survey carried out in 1998 among a representative sample of 6200 Dutch men and women aged 1 ± 97 y. Dietary data were collected using a 2 day dietary record method. Results: The average daily catechin intake was 50 mg (s.d. 56 mgaday). Catechin intake increased with age, and the intake was higher in women (60 mgaday) than in men (40 mgaday). Tea was the main catechin source in all age groups, whereas chocolate was second in children, and apples and pears were second in adults and elderly. Catechin intake was lower in smokers than in non-smokers, and increased with socio-economic status. A high intake was associated with a high intake of ®ber (r 0.20), vitamin C (r 0.17) and beta-carotene (r 0.10). Conclusions: Catechins are quantitatively important bioactive components of the daily diet, which should be taken into account when studying the relation between diet and chronic diseases. Catechin intake is only moderately associated with the intake of other nutrients, but much stronger with certain health behaviours such as smoking. Sponsorship: Commission of the European Communities Agriculture and Fisheries (FAIR) speci®c RTD Programme CT95 0653.

In a stratified, random sample of 100 men and 100 women, aged 20-59 years, residing in Zutphen, the Netherlands, the hypothesis was tested that high scores on "John Henryism," a strong behavioral predisposition to cope actively with psychosocial environmental stressors, would be associated with higher blood pressure, especially among persons of lower education. In univariate analyses higher scores on John Henryism were strongly associated with higher blood pressures in men. Among women there was only an association of John Henryism and systolic blood pressure, but this association was no longer statistically significant after adjustment for potential confounders such as age, alcohol consumption, physical activity, Quetelet Index, and education. Among men, however, the association between John Henryism and systolic blood pressure remained statistically significant after adjustment for potential confounders. The association between John Henryism and blood pressure was more pronounced for men of low educational background.

In 1965 within the Zutphen Study information on several possible determinants of body fatness (eg, energy intake, energy expenditure, alcohol intake, coffee consumption, tea consumption, and smoking) was collected. Univariate analyses showed that for 525 men aged 45-64 y and free from cardiovascular diseases, indicators of body fatness were inversely related to the difference between energy intake and expenditure, physical activity per kilogram body weight, smoking, and coffee consumption. Alcohol intake was directly related to Quetelet index, and tea consumption was not related to indicators of body fatness. Inverse associations between indicators of body fatness and the difference between energy intake and expenditure, physical activity per kilogram body weight, and smoking were confirmed in multivariate analyses. The inverse association between body fatness and the difference between energy intake and expenditure may be due to the underestimation of energy intake by obese subjects. In lean people this association may be explained by a thermogenic effect of smoking.

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