Abstract
PurposeCardiovascular disease (CVD) and cancer mortality rates in Eastern Europe are among the highest in the world. Although diet is an important risk factor, traditional eating habits in this region have not yet been explored. This analysis assessed the relationship between traditional dietary pattern and mortality from all-causes, CVD and cancer in Eastern European cohorts.MethodsData from the Health, Alcohol and Psychosocial factors in Eastern Europe prospective cohort were used, including participants from Russia, Poland and the Czech Republic. Based on food frequency questionnaire data, we constructed an Eastern European diet score (EEDS) from nine food groups which can be considered as traditional in this region. The relationship between categorical (low, moderate, high) and continuous (range 0–18) EEDS and mortality was estimated with Cox-regression.ResultsFrom 18,852 eligible participants, 2234 died during follow-up. In multivariable adjusted models, participants with high adherence to the traditional Eastern European diet had significantly higher risk of all-cause (HR 1.23; 95% CI 1.08–1.42) and CVD (1.34; 1.08–1.66) deaths compared to those with low adherence. The association with cancer mortality was only significant in Poland (high vs. low EEDS: 1.41; 1.00–1.98). From the specific EEDS components, high consumption of lard was significantly positively related to all three mortality outcomes, while preserved fruit and vegetable consumption showed consistent inverse associations.ConclusionOur results suggest that traditional eating habits may contribute to the poor health status, particularly the high CVD mortality rates, of populations in Eastern Europe. Adequate public health nutritional interventions in this region are essential.
Highlights
Thirty years after the fall of the Iron Curtain, a large health gap persists between Eastern and Western Europe
After multivariable adjustment, participants who scored high in the European diet score (EEDS) had significantly higher risk of all-cause mortality compared to low-scorers in the pooled sample (HR 1.23; 95% CI 1.08–1.42)
Regarding cause-specific mortality, we found a significant positive association for cardiovascular disease (CVD) in the pooled categorical analysis (HR in high vs. low EEDS 1.34; 95% CI 1.08–1.66), and for cancer when the risk by 2-point increase was estimated (HR 1.08; 95% CI 1.02–1.15)
Summary
Thirty years after the fall of the Iron Curtain, a large health gap persists between Eastern and Western Europe. In 2015, male and female life expectancy at birth in Eastern European countries was on average 8.4 and 4.8 years lower compared. Extended author information available on the last page of the article to the West, respectively; a difference which has only been marginally reduced over the last two decades [1]. In terms of cause-specific mortality, the East–West divide is striking for cardiovascular disease (CVD), with Russia and some other former Soviet Union countries experiencing mortality rates over three times higher than the Western European average [1]. Previous research have explored the potential explanations for the East–West health gap and important social and lifestyle risk factors are identified [4, 5].
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