Lækkun áhættuþátta hjarta- og æðasjúkdóma meðal verksmiðjufólks : árangur tveggja ára íhlutandi heilsuverndar í Járnblendiverksmiðjunni á Grundartanga

Abstract

Primary prevention of coronary risk factors among factory workers - a cohort study of two years dietary intervention. High cholesterol is considered to be a major risk factor for coronary heart diseases (CHD). Although new drugs may be effective in lowering serum cholesterol, diet with low fat content and rich in fibres is still the cornerstone for therapy of hyperlipidemia. Dietary intervention studies have mostly been carried out by using dietary advise, group sessions and informative brochures for those persons who are considered at »high risk«. However it seems difficult for most people to change their life style and the result of these efforts has often been disappointing. The aim of this study was to assess the effect of workplace oriented dietary intervention on CHD risk factors especially cholesterol, in ferroalloy factory workers in Grundartangi, in western Iceland. The two hundred workers have at least one hot meal per day while working, provided by the factory kitchen.The GP's at Akranes Health Center are responsible for the health care of the workers. A nutritionist held three meetings with the study subjects including one where spouses were invited. In cooperation with the workers and the cook, the nutritionist changed the ingredients of the kitchen menu by lowering the total amount of calories, minimizing fat, especially saturated. 155 workers (thereof 20 women) were then followed-up for two years with regard to serum lipids, smoking, weight, dietary habits and exercise. The study subjects were divided into four groups according to initial cholesterol value. The two groups with highest levels, >7.0 mmol/1 (35% of all) got more interventive attention than the others. The mean serum cholesterol levels in the whole group decreased from 6.6 mmol/1 to 6.1 or 7.6% (p<0.001) after two years. Favourable changes also occured in high density lipoprotein (HDL) which increased significantly and the ratio of LDL/HDL and cholesterol/HDL decreased significantly during the follow-up period. No statistical changes occurred in body mass index (BMI), exercise or smoking habits. It is concluded that this relatively simple workplace oriented dietary intervention for two years was found to significantly alter blood lipids in a favourable manner and if continued should decrease the future risk of CHD amongst the employees.

Á árunum 1989-1991 tóku 155 starfsmenn í Járnblendiverksmiðjunni á Grundartanga þátt í íhlutandi heilsuvernd með það að markmiði að lækka áhættuþætti hjarta- og æðasjúkdóma, einkum blóðfitur. Breytt var fæðuvali í mötuneyti verksmiðjunnar og fræðsla um mataræði og heilbrigði aukin. Kólesteról lækkaði að meðaltali um 7,6% (p<0,001) á þessu tímabili. Háþéttnifituprótín (HDL) hækkuðu (p<0,001) og hlutfall lágþéttni- og háþéttnifituprótína (LDL/HDL) og kólesteról/HDL lækkaði marktækt. Lítil breyting varð á reykingum, hreyfingu og þyngdarstuðli (BMI) við íhlutunina.