W.Z. CO Dramatic changes in structure of fat consumption and CVD What can we learn from CVD trends in CEE: case of Poland Dubai, January 7, 2006 Witold Zatoński, M.D., POLAND Supported by European Commission grant no

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3 History After 1945 two simultaneous phenomenon:   Infection diseases, infant mortality, maternal mortality decline   Non-communicable diseases + injury increase

W.Z. CO Mortality rates from all causes Poland and UK Males 0-14 Males 15-59

W.Z. CO PROBABILITY OF DYING BY REGION, 1990 (data adapted from Murray and Lopez, 1994) EME - Established Market Economies POL - Poland CHN - China LAC - Latin America and the Caribbean OAI - Other Asia and Islands MEC - Middle Eastern Crescent IND - India SSA - Sub-Saharan Africa

W.Z. CO Male deaths at age Lung cancer Injuries Cardiovascular diseases

W.Z. CO Mortality rates from cardiovascular diseases, Poland and Finland Males, age 45-64Females, age 45-64

W.Z. CO Economical and political transformation in central Europe. A health miracle. Democracy is healthier

W.Z. CO Premature mortality, Poland age group MalesFemales

W.Z. CO Premature mortality in selected countries Males, age 45-64

W.Z. CO Premature mortality in selected countries Females, age 45-64

W.Z. CO Mortality trends in Poland Males, age Females, age 45-64

W.Z. CO Unexpected phenomenon of transition period in CEE countries is rapid decrease in premature mortality due to CVD

W.Z. CO Standardized incidence rates from myocardial infarction population of Warsaw at age ( Pol-Monica Warsaw) Source: Stefan Rywik „Czy zmienia się zagrożenie chorobami układu krążenia w Polsce? na przykładzie populacji Warszawy w średnim wieku”

W.Z. CO Cardiovascular diseases mortality, Poland Males, age 20-44Males, age 45-64Males, age 65+ Females, age 20-44Females, age Females, age 65+

W.Z. CO Changes in standardized mortality rates from cardiovascular diseases, Poland (expressed as a percentage, 1991=100%) age age 45-64age 65 and over malesfemales

W.Z. CO Standardizet mortality rates from cardiovascular diseases by place of living, all age,Poland femalesmales

W.Z. CO CVD mortality by education in Poland 1994 to 2002* femalesmales *age 45-64

W.Z. CO Cardiovascular diseases mortality, Poland and Finland Males, age 20-44Males, age 45-64Males, age 65+ Females, age Females, age Females, age 65+

W.Z. CO Mortality trands from cardiovascular diseases, selected countries Males, age Females, age 45-64

W.Z. CO „Natural” experiment in Poland

W.Z. CO Polyunsaturated / saturated fatty acids ratio in Poland,

W.Z. CO Consumption of vegetable oils in Poland in (kg/capita/year) Source: National Food and Nutrition Institute, Poland

W.Z. CO Consumption of vegetable oils and butter in Poland in (kg/capita/year) Source: National Food and Nutrition Institute, Poland

W.Z. CO Structure of vegetable oils consumption in Poland in 2002

W.Z. CO Risk of ischaemic heart diseases* according to polyunsaturated / saturated fatty acids ratio (in NHS**) Poland 1990 Poland 1992 Poland 1994 Poland Predicted RR for Poland **W.Willett at al., Nurses Health Study - Personal Comunication *IHS + atherosclerosis and arterial diseases at age

W.Z. CO Consumption of exotic fruit in Poland, (kg/capita/quarter)

W.Z. CO Fruits consumption in Poland in Annual increase since 1990: 4%

W.Z. CO Vegetable consumption in Poland in Stable trend since 1990

W.Z. CO Smoking prevalence. Adults (>15) in Poland in Males: annual decline since 1989: 1.9% Females: stable trend since 1982

W.Z. CO Prevalence of tobacco smoking by age groups, males, Poland,

W.Z. CO Prevalence of tobacco smoking by age groups, females, Poland,

W.Z. CO Medical service

W.Z. CO Premature mortality time trends, Russia, Poland and Lithuania in Males aged 15-59

W.Z. CO Life Expectancy at Birth in selected countries