Summary
The Finnish and Russian Karelia are adjacent areas in northern Europe, socio‐economically distinct but geoclimatically similar. The Karelia Allergy Study was commenced in 1998 to characterize ...the allergy profiles in the two areas. Allergy prevalence had increased in Finland since the early 1960s, but the situation in Russia was unknown. The key finding was that allergic symptoms and diseases were systematically more common in Finnish children and adults than in their Russian counterparts. For example, in the early 2000s, hay fever in school children was almost non‐existent in Russian Karelia, and only 2% were sensitized to birch pollen compared with 27% in Finnish Karelia. Adult birth cohorts showed that among those born in the 1940s, the sensitization to pollens and pets was at the same low level in both countries, but among younger generation born in the late 1970s, the difference was already manifold. Seropositivity to some pathogens, microbial content in house dust and drinking water seemed to confer allergy protection in Russia. In subsequent studies, it became apparent that on the Finnish side, healthy children had a more biodiverse living environment as well as greater diversity of certain bacterial classes on their skin than atopic children. Abundance of skin commensals, especially Acinetobacter (gammaproteobacteria), associated with anti‐inflammatory gene expression in blood leucocytes. In vivo experiments with the mouse model demonstrated that intradermally applied Acinetobacter protected against atopic sensitization and lung inflammation. These observations support the notion that the epidemic of allergy and asthma results from reduced exposure to natural environments with rich microbiota, changed diet and sedentary lifestyle. Genetic studies have confirmed strong influence of lifestyle and environment. With our results from the Karelia study, a 10‐year National Allergy Programme was started in 2008 to combat the epidemic in Finland.
Finland has experienced remarkable changes in population levels of coronary heart disease risk factors and mortality over the past decades. The National FINRISK studies have monitored risk factors in ...major non-communicable diseases from 1972 to 2012. The 40-year changes in those risk factors are presented.
Study population included participants aged 30-59 years in the series on independent random population samples. Data were collected in 5-year intervals in 1972-2012. FINRISK studies so far comprised 53 589 men and women who participated in a health examination, gave a venous blood sample and filled in questionnaires. Serum total cholesterol, systolic and diastolic blood pressure, and body mass index (BMI) were measured using standardized protocol, and smoking status was recorded.
Total serum cholesterol decreased remarkably until 2007, but after that has increased. Systolic blood pressure has continued to decline over time since 1972, while decrease in diastolic blood pressure has levelled off during the last 10 years. Smoking prevalence has markedly decreased. BMI has increased in the population, but most significantly in the earlier survey years, not the past 10 years.
After three decades of favourable development, the population risk factor levels showed some increase in total cholesterol and diastolic blood pressure. This emphasizes the need for continued efforts towards national disease prevention and health promotion.
The aim of this study was to examine population trends from 1982 to 2012 in Finland for leisure time physical activity (LTPA), commuting physical activity (CPA), occupational physical activity (OPA), ...and total physical activity. Furthermore, time trends in physical activity by educational levels and body mass index (BMI) categories were explored. Data were collected in independent cross‐sectional population surveys, implemented every 5 years from 1982 to 2012. The data comprised 21 903 men and 24 311 women. Participants underwent a health examination and filled in questionnaires. Information on LTPA, CPA, and OPA was used both separately and combined to create an index of total physical activity. Between 1982 and 2012, high LTPA has increased in men (from 21% to 33%) and women (from 12% to 27%). High CPA and high OPA have decreased in men (from 17% to 12% and from 48% to 36%, respectively) and women (from 30% to 20% and from 26% to 21%, respectively). Total physical activity has remained fairly stable. Differences by education and BMI have increased, particularly for LTPA. Marked changes in physical activity have taken place over time. Differences in LTPA and OPA have grown wider across educational groups and BMI categories.
Study objective: The validity of self reported smoking in population surveys remains an important question. An associated question is what would be the value of measuring serum cotinine ...concentrations in such surveys to obtain validated smoking data. Design: Cross sectional analysis of data on self reported smoking and serum cotinine among a random population sample of 5846 persons aged 25 to 64 years, who participated in the FINRISK-92 survey. Main results: Among self reported regular smokers, 97.2% of men and 94.9% of women had a cotinine concentration of 10 ng/ml or higher in serum. Of those participants who reported to have smoked at any time during their life but not during the previous month, 6.3% of men and 5.2% of women had a serum cotinine concentration of at least 10 ng/ml. Among never smokers 2.5% of men and 2.7% of women had detectable level of cotinine in their serum. The validity of self reporting was similar among subjects from different areas, ages, and socioeconomic groups. Conclusions: In a sample of the general population in Finland the validity of self reported smoking is high, and most of the few self reported non-smokers who had cotinine in their serum had only low or moderate levels.
Summary
Background
Atopic allergy has been more common among schoolchildren in Finland, as compared to Russian Karelia. These adjacent regions show one of the most contrasting socio‐economical ...differences in the world.
Objective
We explored changes in allergy from school age to young adulthood from 2003 to 2010/2012 in these two areas. The skin and nasal microbiota were also compared.
Methods
Randomly selected children from Finnish (n = 98) and Russian Karelia (n = 82) were examined in 2003, when the children were 7–11 years of age, and again in 2010 (Finnish Karelia) and 2012 (Russian Karelia). We analysed self‐reported allergy symptoms and sensitization to common allergens by serum sIgE values. The skin (volar forearm) and nasal mucosa microbiota, collected in 2012 (aged 15–20 years), identified from DNA samples, were compared with multivariate methods.
Results
Asthma, hay fever, atopic eczema, self‐reported rhinitis, as well as atopic sensitization, were threefold to 10‐fold more common in Finland, as compared to Russian Karelia. Hay fever and peanut sensitization were almost non‐existent in Russia. These patterns remained throughout the 10‐year follow‐up. Skin microbiota, as well as bacterial and fungal communities in nasal mucosa, was contrastingly different between the populations, best characterized by the diversity and abundance of genus Acinetobacter; more abundant and diverse in Russia. Overall, diversity was significantly higher among Russian subjects (Pskin < 0.0001, Pnasal‐bacteria < 0.0001 and Pnasal‐fungi < 0.01). Allergic diseases were not associated with microbial diversity in Finnish subjects.
Conclusions and Clinical Relevance
Differences in allergic phenotype, developed in early life, remain between populations. A parallel difference in the composition of skin and nasal microbiota suggests a potential underlying mechanism. Our results also suggest that high abundance and diversity of Acinetobacter might contribute to the low allergy prevalence in Russia. Implications of early‐life exposure to Acinetobacter should be further investigated.
The mutual influence of smoking behavior and friendships in adolescence is studied. It is attempted to disentangle influence and selection processes in reciprocal and non-reciprocal friendships. An ...actor-based model is described for the co-evolution of friendship networks and smoking behavior. This model considers alternative selection and influence mechanisms, and models continuous-time changes in network and behavior. The data consists of a longitudinal sample of 1326 Finnish adolescents in 11 high schools. Findings suggest that selection as well as influence processes play an important role in adolescent smoking behavior. Selection had a relatively stronger role than influence, in particular when selecting non-reciprocal friends. The strength of both influence and selection processes decreased over time.
Abstract Background Metabolic syndrome (MetS) is associated with a substantially increased risk for cardiovascular disease and diabetes. We examined the contribution of length of residence, ...socioeconomic position and lifestyle-related factors to the differences in the prevalence of MetS among migrants compared with Finns. Methods Cross-sectional data from randomly sampled 30–64 year-old health examination participants (318 Russian, 212 Somali, and 321 Kurdish origin migrants) of the Migrant Health and Wellbeing Survey (2010 − 2012) were used. Health 2011 Survey participants ( n = 786) were the reference group. Results Compared with Finns, prevalence of MetS was significantly higher among all migrants except for Somali men. Among men, age-adjusted prevalence ratio (PR) of MetS compared with Finns was 1.71, 95% confidence interval (CI) 1.19–2.46 for Russians, PR 0.95 (95% CI 0.54–1.67) for Somali, and PR 2.10 (95% CI 1.51–2.93) for Kurds. Among women, respective PRs were 1.45 (95% CI 1.08–1.97) for Russians, PR 2.34 (95% CI 1.75–3.14) for Somali and PR 2.22 (95% CI 1.67–2.97) for Kurds. Adjustment for sociodemographic and lifestyle-related factors attenuated the differences in MetS among women but not men. Conclusions Further studies should aim at identifying factors related to elevated risk for MetS among Russian and Kurdish men. Interventions aiming at improving lifestyle-related factors are needed for reducing inequalities in the prevalence of MetS among migrant women. Effectiveness of interventions focusing on reducing overweight and obesity among Somali and Kurdish women should be evaluated.
Background: Declining response rates pose a serious threat to the validity of estimates derived from epidemiological studies. If respondents and non-respondents differ systematically from each other, ...there can be a bias in the results of the study. A population-based cohort study was conducted to investigate disparities in socioeconomic structure between respondents and non-respondents and the contribution of these disparities to socioeconomic differences in total and cardiovascular mortality. Design: Data comprised 32 354 male and female participants and 4890 non-participants aged 35–74 years who belonged to the sample in one of the five FINRISK surveys in 1972, 1977, 1982, 1987 or 1992 in Finland. They were followed up for 9 years and 6 months. Results: It was found that the lower socioeconomic groups were over-represented among non-respondents both in men and women. When comparing the relative risk of death using the highest socioeconomic group of the participants as the reference group, it was found that although the socioeconomic gradient was similar for participants and non-participants—that is, lower groups had a higher risk of death—the risk was at a higher level among non-respondents. Conclusions: Basing analysis on participants does not distort the relative risk of death associated with socioeconomic position. However, it does underestimate the absolute risk.
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