HAPIEE Study

Pilot study

As the first phase of this research, we conducted a 2-year study, funded by the Wellcome Trust, to test the feasibility of a multi-centre cohort study, and to validate measurements of dietary factors, alcohol consumption and psychosocial factors in population samples in 3 countries of the region. The study was conducted 1999-2000 in random samples of men and women aged 45-64 selected from population registers in Russia (city of Novosibirsk), Poland (2 districts of Krakow) and the Czech Republic (2 cities).

All participants completed a questionnaire during an interview, including food fr3equency questionnaire and several measures of alcohol consumption. A subsample of subjects provided blood samples and completed a 24-hour diet recall; this will allow us to validate nutrient intakes against biomarkers. To assess the seasonality in intakes of selected nutrients and repeatability of alcohol and psychosocial measures, the questionnaire, 24-hour recall and blood samples was be repeated in about 100 subjects in each country at a different season. Blood samples were analysed centrally. Validity of data on mortality from CVD was assessed by reviewing death certificates and hospital records. In Russia, we have also collected data on incident cases of cardiac events; this forms a case-control study, with healthy subjects in the population sample as controls.

The pilot study demonstrated that the cohort study was feasible. All centres have good facilities and access to population registers and other relevant institutions, and all are able to conduct a large study. Study procedures were acceptable to study participants. Response rates were between 65% and 71%. Although not set up to have the power to provide new information, results from the pilot studies have shown:

• Large differences between countries a marked seasonality in dietary intakes of fresh fruits and vegetables; in Russia, the intake in autumn was 7 times higher than in winter and spring. This is consistent with the hypothesis that poor availability of these foods over a large part of the year may play a role in high mortality in the region.
• Much higher depression score in Russia than in Poland and in the Czech Republic. Within each country, depression was strongly associated with education, material deprivation and general and job stress.
• Drinking pattern of Russian men differs markedly from the other two countries. Russians drink less often but large amounts per drinking occasions. They have high rates of problem drinking and negative consequences of drinking. An extra litre of alcohol consumption per capita in Russia is associated with much larger increase in harm than in other countries.
• Unfavourable distribution of all psychosocial measures in Russia, compared to the other two countries; most of these measures were also related to self-rated health, depression score and to health behaviours.
• Linkage of survey data with national death registers are feasible, and the necessary collaborations in relevant institutions have been established. The existing registers of myocardial infarction and stroke in Novosibirsk (Russia) [and in Kaunas (Lithuania), not part of the pilot], confirming with the MONICA protocol, provide further information on non-fatal outcomes.

This page last modified 22 January, 2008 by [Content Provider]