bmj.com -- Press Releases

Press Releases Saturday 29 May 1999
No 7196 Volume 318

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(1) THE REASON THE FRENCH HAVE LOW LEVELS OF HEART
DISEASE

(2) CHILDREN MORE LIKELY TO HAVE ABDOMINAL PAIN
DURING TERMTIME THAN SCHOOL HOLIDAYS

(3) CANCER RATES IN CHILDREN OF NUCLEAR INDUSTRY
EMPLOYEES NO HIGHER THAN GENERAL POPULATION IN
ENGLAND AND WALES

(1) THE REASON THE FRENCH HAVE LOW LEVELS OF HEART
DISEASE

(Why heart disease mortality is low in France: the time lag explanation)
http://www.bmj.com/cgi/content/full/318/7196/1471

(Commentary: Alcohol and other dietary factors may be important)
http://www.bmj.com/cgi/content/full/318/7196/1471#resp1

(Commentary: Intrauterine nutrition may be important)
http://www.bmj.com/cgi/content/full/318/7196/1471#resp2

(Commentary: Heterogeneity of populations should be taken into account)
http://www.bmj.com/cgi/content/full/318/7196/1471#resp3

Low levels of ischaemic heart disease in France is not down to drinking
red wine, suggest researchers in this week's BMJ. In their paper Dr
Malcolm Law and Professor Nicholas Wald from the Wolfson Institute
of Preventive Medicine in London present a new hypothesis to explain
why the French population has experienced such a low incidence of
heart disease and provide supporting evidence. The crux of their
hypothesis is that animal fat consumption and serum cholesterol are
relatively new phenomena in France and that there is a time-lag in the
effect they have on health.

Animal fat consumption and serum cholesterol concentration have only
been similar in French and British populations for the last 15 years, say
the authors. For decades up to 1970 France had lower animal fat
consumption and serum cholesterol and only between 1970 and 1980
did French levels increase to those in Britain.

Law and Wald explain that French mortality from ischaemic heart
disease is nevertheless still only about a quarter of that in Britain
because of a "time lag" effect. They estimate that the time lag between
an increase in fat consumption and its effect on heart disease is
somewhere between 25 to 35 years and explain that the time lag is
similar to that which is seen in relation to lung cancer risk and smoking.

The authors examine previous explanations of the "French paradox"
including the under certification of heart disease deaths by French
doctors (which they say could account for about 20 per cent of the
difference in mortality rates); smoking; alcohol intake (especially red
wine); the consumption of garlic and onions and the moderately warmer
climate in France. They conclude that apart from smoking in women,
these factors explain little of the difference and that the most important
explanation lies in the time-lag hypothesis.

Law and Wald emphasise that the consumption of animal fat leads to a
slow increase in the risk of mortality from heart disease, but, as with
smoking and lung cancer, these risks decrease rapidly on cessation.

Also see accompanying commentaries to this paper.

Contact:

Dr Malcolm Law, Reader, Wolfson Institute of Preventive Medicine, St
Bartholomew's and The Royal London School of Medicine and
Dentistry, London or Professor Nicholas Wald
Email: M.R.Law{at}mds.qmw.ac.uk

Professor Meir Stampfer, Channing Laboratory, Department of
Medicine, Brigham and Women's Hospital and Harvard Medical
School, Boston
Email: meir.stampfer{at}channing.harvard.edu

Professor David Barker, Director, MRC Environmental Epidemiology
Unit, University of Southampton, Southampton General Hospital,
Southampton
email: david.barker{at}mrc.soton.ac.uk

Professor Johan Mackenbach, Department of Public Health, Erasmus
University Rotterdam, Netherlands
Email: mackenbach{at}mgz.fgg.eur.nl

(2) CHILDREN MORE LIKELY TO HAVE ABDOMINAL PAIN
DURING TERMTIME THAN SCHOOL HOLIDAYS

(Incidence of non-specific abdominal pain in children during school
term: population survey based on discharge diagnoses)
http://www.bmj.com/cgi/content/full/318/7196/1455

Children are much more likely to have abdominal pain during the school
term than during the school holiday, report Nigel Williams from
Leicester Royal Infirmary and colleagues from Leicester in this week's
BMJ. Based on a study of children aged five to 16 years in
Leicestershire, the authors found that the rate of admissions for
abdominal pain at the Leicester Royal Infirmary was 1.4 times greater
than during the school holidays. Williams et al conclude that
psychological and behavioural factors may be involved in the genesis
and presentation of the condition.

Contact:

Mr Nigel Williams, Senior Registrar in Surgery, Department of Surgery,
Leicester General Hospital, Leicester
Email: willnma{at}dircon.co.uk

(3) CANCER RATES IN CHILDREN OF NUCLEAR INDUSTRY
EMPLOYEES NO HIGHER THAN GENERAL POPULATION IN
ENGLAND AND WALES

(Cancer in children of nuclear industry employees: report on children
aged under 25 years from nuclear industry family study)
http://www.bmj.com/cgi/content/full/318/7196/1433

The incidence of cancer and leukaemia among children of nuclear
industry employees is similar to that of the general population in England
and Wales, find researchers in a study published in this week's BMJ. Dr
Eve Roman from the Leukaemia Research Fund based at the University
of Leeds, along with colleagues from the London School of Hygiene
and Tropical Medicine and the Imperial Cancer Research Fund studied
46,107 children of male and female employees at nuclear establishments
operated by the Atomic Energy Authority, Atomic Weapons
Establishment and British Nuclear Fuels.

The researchers set up the nuclear industry family study to investigate
possible links between child health and parents' occupational exposure
to ionising radiation. They found that a total of 111 of the 46,107
children were reported to have developed a malignancy before their
25th birthday. Among children born in 1965 or later (two thirds of all
children in the study) it was possible to make comparisons with cancer
rates in the general population of England and Wales. No unusual
cancer patterns were evident.

Roman et al also found that the leukaemia rate in children whose fathers
had accumulated a relatively high dose of ionising radiation (more than
100 millisieverts) before their child's conception was higher than in
children conceived before their father's employment in the nuclear
industry. However, because this finding was based on only three cases -
two of which had been reported on before - the authors caution that
firm conclusions cannot be drawn. Further, the authors say that in the
industries studied, high preconceptual doses were found to be rare and,
even if there were an association, it could only account for three at the
most of the 22 leukaemias diagnosed in almost 40,000 children born to
male workers.