“If It Isn’t Fun.” – The Fit Finns
The East Finn survey participants make long travels by boat, bus, truck, car, and often by bicycle to come to our examinations at the border guard station. One of the remarkable things about them is that they are quite fit, yet their arteries are heavily involved with the fatty lesions of atherosclerosis. Finally, the disease becomes manifest by angina or cardiac infarction. These men have a lifetime high level of fitness as a result of their vigorous occupations. It seems incongruous, but is highly significant, that a population with one of the highest rates of vascular disease recorded should have, perhaps, the highest level of fitness and also live in rural calm and order. This teaches us much.
The Finnish men we examine have lined, open faces. Though not as gregarious as our Mediterranean subjects, they move through the survey stations with good humor, quick to smile and to respond to greetings. The Finnish language is distinctive, with a staccato sound, clear and bell-like, full of vowels. It is pleasing off the tongue of the young women technicians, is clipped and semi-swallowed by our medical colleagues, and is a deep, bearish growl from the mouths of our hardy participants. These voices together create a soothing harmony throughout the busy survey station.
I suspect that there are different degrees of culturally determined motivation and competitiveness under stress. The Finnish men, for example, appear genuinely challenged by our exercise tolerance test, giving it their “all.” Alan Barry’s scale of perceived exertion is graded consistently lower here than in other Seven Countries study areas. On a scale of one to 15, the same level of activity might be perceived as an eight by the Finns and a 13 by the Italians, though these comparisons have not yet been made systematically. Similarly, with pulmonary function tests, the Finn technicians are vigorous and the participants highly responsive, making all-out expiratory efforts. It is also likely, as our London colleague, Geoffrey Rose, has found, and as we confirm with his chest pain questionnaire, that there are sizable cultural, as well as biologic differences in responses among men of our Seven Countries regions. Comparative population studies have greatly expanded our understanding but do not resolve all the fundamental issues about “nature versus nurture.”