From margarine to butter: predictors of changing bread spread in an 11-year population follow-up

Abstract

Objective: Finland is known for a sharp decrease in the intake of saturated fat and cardiovascular mortality. Since 2000, however, the consumption of butter-containing spreads -an important source of saturated fats -has increased. We examined social and health-related predictors of the increase among Finnish men and women. Design: An 11-year population follow-up. Setting: A representative random sample of adult Finns, invited to a health survey in 2000. Subjects: Altogether 5414 persons aged 30-64 years at baseline in 2000 were re-invited in 2011. Of men 1529 (59 %) and of women 1853 (66 %) answered the questions on bread spreads at both time points. Respondents reported the use of bread spreads by choosing one of the following alternatives: no fat, soft margarine, butter-vegetable oil mixture and butter, which were later categorized into margarine/no spread and butter/butter-vegetable oil mixture ( = butter). The predictors included gender, age, marital status, education, employment status, place of residence, health behaviours, BMI and health. Multinomial regression models were fitted. Results: Of the 2582 baseline margarine/no spread users, 24.6% shifted to butter. Only a few of the baseline sociodemographic or health-related determinants predicted the change. Finnish women were more likely to change to butter than men. Living with a spouse predicted the change among men. Finland is known for its successful health policies to reduce CVD. Since the late 1960s cardiovascular mortality and serum cholesterol levels have decreased remarkably (1,2) . The decrease in serum cholesterol can mainly be explained by changes in dietary fats. The proportion of saturated fat in the total energy intake has decreased (3,4) and the consumption of bread spreads has changed accordingly. In the late 1970s over 60 % of Finns used butter on bread (5) . In 2000 only 6 % used butter while butter-vegetable oil mixture was used by 17 % (6) . The changes have been interpreted as examples of successful food and nutrition policies and dietary interventions (7,8) . Based on the Finnish Food Balance Sheets, butter consumption began to increase in 2005 after a steady decrease previously (9) . The changing trend in consumption of butter-containing fats was also revealed by cross-sectional surveys (10) . The percentage contribution to total energy intake (E%) from fat increased between 2007 and 2012, from 33 to 36 E% among men and from 31 to 36 E% among women. The intake of saturated fat increased from 14 to 15 E% among men and from 13 to 15 E% among women. Serum cholesterol levels increased congruently: among men from 5·25 to 5·34 mmol/l and among women from 5·15 to 5·31 mmol/l (11) . In 2012, more than 40 % of saturated fat was obtained from dairy products. Among Finnish men aged 25-64 years, the most important sources of saturated fat were dishes prepared with meat or meat products (15 %), butter and butter-containing bread spreads (14 %) and