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ABSTRACT: OBJECTIVE:To investigate the associations of anxiety and depression symptoms with weight change and incident obesity in men and women.DESIGN:We conducted a prospective cohort study using the Norwegian Nord-Trøndelag Health Study (HUNT).SUBJECTS:The study cohort included 25 180 men and women, 19-55 years of age from the second survey of the HUNT (1995-1997).MEASUREMENTS:Anxiety and depression symptoms were measured using the Hospital Anxiety and Depression Scale. Weight change was determined for the study period of an average 11 years. Incident obesity was new-onset obesity classified as having a body mass index of 30.0 kg m(2) at follow-up. The associations of anxiety or depression with weight change in kilograms (kg) was estimated using linear regression models. Risk ratios (RRs) for incident obesity associated with anxiety or depression were estimated using log-binomial regression.RESULTS:In men, any anxiety or depression was associated with an average 0.81 kg (95% confidence interval (CI) 0.27-1.34) larger weight change after 11 years compared with those without such symptoms (mean weight change: 5.04 versus 4.24 kg). Women with any anxiety or depression had an average 0.98 kg (95% confidence interval (CI) 0.49-1.47) larger weight change compared with those without such symptoms (mean weight change: 5.02 versus 4.04 kg). Participants with any anxiety or depression had a significantly elevated cumulative incidence of obesity (men: RR 1.37, 95% CI 1.13-1.65; women: RR 1.18, 95% CI 1.00-1.40).CONCLUSION:We found that symptoms of anxiety and depression were associated with larger weight change and an increased cumulative incidence of obesity in both men and women.International Journal of Obesity advance online publication, 11 December 2012; doi:10.1038/ijo.2012.204.
International journal of obesity (2005) 12/2012; · 4.34 Impact Factor
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ABSTRACT: The HUNT Study includes large total population-based cohorts from the 1980ies, covering 125 000 Norwegian participants; HUNT1 (1984-86), HUNT2 (1995-97) and HUNT3 (2006-08). The study was primarily set up to address arterial hypertension, diabetes, screening of tuberculosis, and quality of life. However, the scope has expanded over time. In the latest survey a state of the art biobank was established, with availability of biomaterial for decades ahead. The three population based surveys now contribute to important knowledge regarding health related lifestyle, prevalence and incidence of somatic and mental illness and disease, health determinants, and associations between disease phenotypes and genotypes. Every citizen of Nord-Trøndelag County in Norway being 20 years or older, have been invited to all the surveys for adults. Participants may be linked in families and followed up longitudinally between the surveys and in several national health- and other registers covering the total population. The HUNT Study includes data from questionnaires, interviews, clinical measurements and biological samples (blood and urine). The questionnaires included questions on socioeconomic conditions, health related behaviours, symptoms, illnesses and diseases. Data from the HUNT Study are available for researchers who satisfy some basic requirements (www.ntnu.edu/hunt), whether affiliated in Norway or abroad.
International Journal of Epidemiology 08/2012; · 6.41 Impact Factor
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ABSTRACT: We wanted to study mortality after hip fractures among elderly women in Norway. We found that excess mortality was highest short time after hip fracture, but persisted for several years after the fracture. The excess mortality was not explained by pre-fracture medical conditions.
The purpose of the present study was to investigate short and long term mortality after hip fracture, and to evaluate how comorbidity, bone mineral density, and lifestyle factors affect the survival after hip fractures.
The study cohort emerges from a population-based health survey in the county of Nord-Trøndelag, Norway. Women aged 65 or more at participation at the health survey who sustained a hip fracture after attending the health survey are cases in this study (n = 781). A comparison cohort was constructed based on participants at HUNT 2 with no history of hip fractures (n = 3, 142). Kaplan-Meier survival curves were used to evaluate crude survival, and Cox regression analyses were used to study age-adjusted hazard ratios for mortality and for multivariable analyses involving relevant covariates.
Mean length of follow-up after fracture was 2.8 years. Within the first 3 months of follow-up, 78 (10.0%) of the hip fracture patients died, compared to only 39 (1.7%) in the control group. HR for mortality 3 months after hip fracture was 6.5 (95% CI 4.2-9.6). For the entire follow-up period women who sustained a hip fracture had an HR for mortality of 1.9 (95% CI 1.6-2.3), compared with women without a hip fracture.
We found that elderly women who sustained a hip fracture had increased mortality risk. The excess mortality was highest short time after the fracture, but persisted for several years after the fracture, and was not explained by pre-fracture medical conditions.
Osteoporosis International 11/2011; 23(6):1807-11. · 4.58 Impact Factor
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ABSTRACT: Weight loss is a risk factor for hip fractures, but few studies have evaluated the effect of weight loss on distal forearm fracture risk. In this longitudinal study including 7,871 postmenopausal women, weight loss of 5% or more was associated with an increased risk of distal forearm fractures.
Weight loss is an established risk factor for hip fractures, but little is known about weight loss and distal forearm fractures risk.
The study included 7,871 women aged 65 years or more in the Nord-Trøndelag health study (HUNT) in 1994-1995 (HUNT II) who also had their height and weight measured in 1984-1986 (HUNT I). Forearm bone mineral density (BMD) by single energy x-ray absorptiometry was available for 5,688 women (HUNT II). Fractures sustained after HUNT II were registered during an average of 5.8 years.
A total of 536 women sustained a distal forearm fracture. After adjustments for age and body mass index (BMI) at HUNT I, women who lost > or =5% of their weight between HUNT I and HUNT II had a relative risk of fractures of 1.33 (95% confidence interval: 1.09, 1.62) compared with the rest of the women. The higher risk of forearm fracture among women with weight loss was at least partially explained by their lower forearm BMD.
Weight loss of 5% or more was associated with a 33% increased risk of distal forearm fractures.
Osteoporosis International 03/2009; 20(12):2009-16. · 4.58 Impact Factor
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ABSTRACT: Summary Weight loss is a risk factor for hip fractures, but few studies have evaluated the effect of weight loss on distal forearm
fracture risk. In this longitudinal study including 7,871 postmenopausal women, weight loss of 5% or more was associated with
an increased risk of distal forearm fractures.
Introduction Weight loss is an established risk factor for hip fractures, but little is known about weight loss and distal forearm fractures
risk.
Methods The study included 7,871 women aged 65 years or more in the Nord-Trøndelag health study (HUNT) in 1994–1995 (HUNT II) who
also had their height and weight measured in 1984–1986 (HUNT I). Forearm bone mineral density (BMD) by single energy x-ray
absorptiometry was available for 5,688 women (HUNT II). Fractures sustained after HUNT II were registered during an average
of 5.8 years.
Results A total of 536 women sustained a distal forearm fracture. After adjustments for age and body mass index (BMI) at HUNT I, women
who lost ≥5% of their weight between HUNT I and HUNT II had a relative risk of fractures of 1.33 (95% confidence interval:
1.09, 1.62) compared with the rest of the women. The higher risk of forearm fracture among women with weight loss was at least
partially explained by their lower forearm BMD.
Conclusion Weight loss of 5% or more was associated with a 33% increased risk of distal forearm fractures.
Osteoporosis International - OSTEOPOROSIS INT. 01/2009; 20(12):2009-2016.
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ABSTRACT: In a population-based cohort of 1,421 women 45-60 years old followed for 15.5 years, 71% of the women had lost height. Height loss was associated with low forearm bone density and increased bone loss, but high body weight and oestrogen therapy were protective factors. Increased height loss indicates a generalized state of bone loss.
The degree of height loss and its association to forearm bone mineral density (BMD) and bone loss was investigated in a population-based cohort of middle-aged women followed for more than 15 years.
Among 8,856 women aged 45-60 years attending the first HUNT Study, Norway (1984-86), a 35% random sample was invited to forearm densitometry 11.3 years later (HUNT 2, 1995-97), and 2,188 attended (78.3%). In 2001, 15.5 years since baseline, all were invited to follow-up densitometry and height measurement.
A total of 71.2% and 17.4% of the 1,421 women attending had lost >1 cm and >3 cm of height since baseline, respectively. Women aged >or= 64 years at HUNT 2 had a relative risk (RR) for height loss >3 cm of 3.1 (95% CI 2.2, 4.3) compared to women <64 years. A strong and negative association was found between height loss and forearm BMD, adjusted for time since menopause. A high rate of height loss was associated to increased forearm bone loss. High body weight, oestrogen treatment and good self-rated health were protective against height loss.
Height loss is frequent in middle-aged women, and increased height loss indicates a generalized state of bone loss.
Osteoporosis International 10/2007; 18(9):1261-9. · 4.58 Impact Factor
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ABSTRACT: To estimate the association between level of physical activity in 1984-1986 and 1995-1997 and lung function in 1995-1997 among Norwegian men and women aged 28-80 years.
In 1984-1986 and 1995-1997, all residents of Nord-Trøndelag County, Norway, aged > or =20 years were invited to participate in the Nord-Trøndelag Health Studies. These analyses included a sample that took part in both studies and underwent spirometry (n = 8047). We used linear regression models adjusting for potential confounders stratified by sex and age groups (28-49 years, 50-69 years and > or =70 years) to estimate the association between forced expiratory volume in 1 second (FEV1) and physical activity.
Men and women who were physically active in 1985 and 1995 had the highest lung function in both sexes and in all age groups. The reduction in FEV1 ranged from 20 ml to 170 ml, similar to 1-7% of predicted values dependent on physical activity level. Lung function was also associated with body mass index (BMI), height, smoking and subjective health.
The findings show that a high level of physical activity corresponds to about 3-5 years of normal decline in FEV1 (30 ml/year), and may therefore overcome the disadvantages of a decline in FEV1 from increasing age.
The international journal of tuberculosis and lung disease: the official journal of the International Union against Tuberculosis and Lung Disease 01/2007; 10(12):1399-405. · 2.73 Impact Factor
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ABSTRACT: The neuroendocrine (NE) system may play an important role in smoking-induced airway diseases. The aim of the present study was to examine the relationship between serum levels of the general NE marker chromogranin A (CgA) and smoking habits, respiratory symptoms and lung function. The study population consisted of never-smokers with normal lung function, smokers with normal lung function and smokers with airway obstruction who were randomly selected from the lung study of the Nord-Trøndelag Health Study (HUNT). Serum CgA was determined in 151, 138 and 116 subjects, respectively. All subjects were seronegative for Helicobacter pylori. Male smokers with airway obstruction had significantly higher serum CgA levels (median 3.70 nmol x L(-1) (interquartile range 3.10-5.15)) than both smokers with normal lung function (3.00 nmol x L(-1) (2.50-3.67)) and never-smokers with normal lung function (2.90 nmol x L(-1) (2.57-3.30)). The elevated levels of CgA correlated with the degree of airway obstruction. Moreover, the presence of respiratory symptoms and chronic bronchitis among male smokers were associated with increased serum CgA levels. Females had CgA levels similar to male smokers independent of smoking status and lung function. Elevated serum chromogranin A levels in subjects with airway obstruction and respiratory symptoms may represent neuroendocrine activation in inflammatory or remodelling processes in the lung.
European Respiratory Journal 10/2006; 28(3):542-8. · 5.89 Impact Factor
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ABSTRACT: Norway has a very high incidence of osteoporotic fractures, with substantial regional differences in fracture incidence. The present study evaluated whether there are differences in bone mineral density (BMD) between regions in Norway with differences in fracture incidence. The authors used data collected in four large, population-based, multipurpose studies performed in four regions of Norway during 1994-2001. Distal forearm BMD was measured by single energy x-ray absorptiometry in 10,667 participants aged 40-75 years. Cross-calibration was performed by using the European Forearm Phantom. Mean distal forearm BMD was lower in the urban populations of Tromso, Oslo, and Bergen compared with the rural county of Nord-Trondelag, whereas there was no difference between the rural part of Tromso and Nord-Trondelag. For women, body mass index explained some of these differences. The prevalence of low BMD (z score < or = -1) in Oslo, Bergen, and urban Tromso, compared with Nord-Trondelag, was 1.6-1.7 times higher in men and 1.5-2.0 times higher in women, whereas no significant difference was found between rural Tromso and Nord-Trondelag. In this study, higher BMD was found in rural compared with urban areas of Norway, which might help explain the differences in fracture incidence. There was no apparent north-south gradient in BMD.
American Journal of Epidemiology 12/2004; 160(11):1039-46. · 5.22 Impact Factor
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ABSTRACT: Studies have indicated that females are more vulnerable to the deleterious effect of tobacco smoking than males. The current study aimed to investigate the associations between tobacco smoking and reported respiratory symptoms, self-rated health, and lung function by sex. In 1995-1997 65,225 subjects aged > or = 20 yrs (71% of invited) attended for screening within the Nord-Trøndelag Health Study. Among these, 10,941 subjects selected randomly or because they reported having asthma or asthma-related symptoms, participated in the Bronchial Obstruction in Nord-Trøndelag study consisting of spirometry and a personal interview. Tobacco smoking was associated with increased prevalence of respiratory symptoms, reduced lung function, and lower score on global self-rated health (SRH). Adjusted for smoking burden and lung function, females had a higher risk for reporting respiratory symptoms and lower SRH compared with males. Further, smoking burden was associated with a larger relative reduction in expiratory lung function in females than in males. Females reported more symptoms and lower self-rated health compared with males with similar smoking burden. Even if smoking in females was associated with a larger reduction in per cent predicted lung function compared with males, this does not fully explain the higher symptom prevalence in females.
European Respiratory Journal 06/2003; 21(6):1017-23. · 5.89 Impact Factor
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ABSTRACT: Girls take up smoking at least as frequently as boys. Few studies have focused on gender differences in the impact of adolescent smoking. We evaluated the sex-specific effect of adolescent smoking on respiratory symptoms and lung function. All students in junior high and high schools in Nord-Trøndelag County Norway, 1995-97, were invited to participate in a cross-sectional study. Information on smoking habits and respiratory symptoms was obtained by self-administered questionnaires. Spirometry was performed in accordance with ATS standards. Eight-thousand-three-hundred and five students (83%) completed both questionnaire and spirometry. Among 6811 students aged 13-18 years (50.3% girls) with no history of asthma, 2993 (43.9%) reported never smoking, 665 (98%) reported occasional smoking, and 667 (9.9%) reported daily smoking (mean initiation age: 13.9 years). More boys than girls were heavy smokers. In all smoking categories, smokers reported a higher prevalence of respiratory symptoms than nonsmokers; symptoms increased with smoke burden. Girls reported more symptoms compared to boys with comparable smoke burden. A dose-response relation between smoking and reduced lung function was found only in girls. Girls were more vulnerable than boys to the impact of smoking on respiratory symptoms and lung function.
Respiratory Medicine 11/2002; 96(10):796-804. · 2.47 Impact Factor
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ABSTRACT: The purpose of this study was to develop new prediction equations for flow/volume spirometry parameters in asymptomatic, never-smoking adults in Norway, and to assess any differences of these parameters when applying the new and most commonly used equation sets. Flow/volume spirometry was measured according to the American Thoracic Society criteria in 2,792 subjects aged > or = 20 yrs, randomly selected from participants in the Nord-Trøndelag Health Study. Ever-smokers and subjects with respiratory symptoms and/or diseases reported in this questionnaire were excluded. A total of 546 females and 362 males met the inclusion criteria and were included in the analyses. Most lung function variables were nonlinear by age and had to be transformed. After a plateau in younger adults, the variables declined by age. The reference values for forced expiratory volume in one second and forced vital capacity from the present study, were higher than those given by prediction equations from the European Community for Coal and Steel, but in closer agreement with later studies from Europe, Australia and the USA. Healthcare providers should be encouraged to reconsider their choice of prediction equations of spirometry in order to improve management of obstructive lung diseases.
European Respiratory Journal 11/2001; 18(5):770-9. · 5.89 Impact Factor
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ABSTRACT: In a population-based health survey, densitometry was performed at the distal and ultradistal radius with single-energy X-ray absorptiometry. Bone mineral density (BMD) data and self-reported reproductive and lifestyle data from 1652 randomly selected peri- and postmenopausal women aged 50-59 years were analyzed. A total of 893 (54.1%) postmenopausal women reported no prior use of hormone replacement therapy (HRT) and constituted the principal group of study. These women were more frequently smokers, consumed less alcohol, more coffee and had made less use of oral contraceptives (OC) than women in the HRT group. The strongest association with both distal and ultradistal radius bone densities was found for age, weight, time since menopause and a history of bilateral oophorectomy. Among reproductive factors, nulliparous women had lower BMD than parous women; however, no linear relationship was found between parity and bone density. A weak, positive relationship was found for OC and BMD in bivariate, but not in multivariate analyses. A history of hysterectomy was positively associated with BMD, stronger at the ultradistal than distal radius. A positive relationship between alcohol consumption and BMD was found at the ultradistal radius. Present or prior smokers had lower BMD than never smokers. In the multivariate model, interaction between pack-years of smoking and daily coffee intake was observed at the distal radius, and both factors had a stronger negative influence on distal than ultradistal radius bone density. In perimenopausal women, most reproductive and lifestyle risk factors found to be associated with BMD of the radius may be explained by different levels of estrogen.
Osteoporosis International 02/2001; 12(3):222-9. · 4.58 Impact Factor
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ABSTRACT: Studies have indicated that women are more vulnerable to the effect of tobacco smoking compared with men. The aim of this study was to explore the prevalence of reported respiratory symptoms and diseases according to smoking burden, age and sex.
Questionnaire in a cross sectional population based study.
The BONT (Bronchial obstruction in Nord-Trondelag) study is part of a comprehensive health survey of all inhabitants aged above 19 years in the county of Nord-Trondelag, Norway, which was carried out from 1995 to 1997.
A total of 65 717 subjects, 71.3% of the total population aged 20-100, answered the main questionnaire.
In all, 12.7% men and 12.1% women reported episodes of wheezing or breathlessness during the past 12 months, 8.8% men and 8.4% women reported that they had or had had asthma, 7.5% men and 8.2% women had ever used asthma medication, and 4.0% men and 3.0% women reported chronic bronchitis. Thirty per cent of men and 31% of women were smokers, and average pack years of smoking were 15.9 and 10.3, respectively. Among previous and current smokers, significant more women reported episodes of wheezing or breathlessness, current asthma and persistent coughing compared with men with the same smoke burden (pack years) and daily number of cigarettes.
The prevalence of reported asthma and use of asthma medication was higher than reported in previous Scandinavian studies. Respiratory symptoms increased by smoking burden. Comparing the prevalence of symptoms and current asthma among women and men with the same smoke burden or daily cigarette consumption, women seemed to be more susceptible to the effect of tobacco smoking than men.
Journal of Epidemiology & Community Health 01/2001; 54(12):917-22. · 3.19 Impact Factor
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ABSTRACT: Children with bronchial asthma are the largest group of children with chronic disease in general practice. The aim of this study was to obtain information on morbidity, examination, and treatment in children with bronchial asthma. 102 children with current asthma, aged 7-15 years, participated in this study, which used a questionnaire, flow volume spirometry with beta2-agonist reversibility test, and two weeks of registrations of peak flow and symptom score. Most children had mild to moderate asthma; 60% had acceptable asthma control defined by a morbidity index. 64 children used either inhaled steroids or dinatriumcromoglycate prophylactic. 76 children had been examined by a paediatrician. Lung function measurements had been performed in 57 of 69 children with follow-up in general practice during the last 12 months. Allergy tests had been taken of 87 children. With respect to allergen exposure at home, only 30 children reported having an optimal home environment. Despite the extensive follow-up of children with asthma, our study indicates that the asthma control is not up to the standard set by current guidelines. By use of written treatment plans, and increasing knowledge of the disease, triggers and of the treatment of children and their parents, we probably would exploit the potential better. The recommendations and goals of the guidelines should, however, also be evaluated.
Tidsskrift for Den norske legeforening 03/2000; 120(4):449-53.
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ABSTRACT: Exhaled nitric oxide is a potential marker of lower airway inflammation. Allergic rhinitis is associated with asthma and bronchial hyperresponsiveness. To determine whether or not nasal and exhaled NO concentrations are increased in allergic rhinitis and to assess the relation between hyperresponsiveness and exhaled NO, 46 rhinitic and 12 control subjects, all nonasthmatic nonsmokers without upper respiratory tract infection, were randomly selected from a large-scale epidemiological survey in Central Norway. All were investigated with flow-volume spirometry, methacholine provocation test, allergy testing and measurement of nasal and exhaled NO concentration in the nonpollen season. Eighteen rhinitic subjects completed an identical follow-up investigation during the following pollen season. Exhaled NO was significantly elevated in allergic rhinitis in the nonpollen season, especially in perennially sensitized subjects, as compared with controls (p=0.01), and increased further in the pollen season (p=0.04), mainly due to a two-fold increase in those with seasonal sensitization. Nasal NO was not significantly different from controls in the nonpollen season and did not increase significantly in the pollen season. Exhaled NO was increased in hyperresponsive subjects, and decreased significantly after methacholine-induced bronchoconstriction, suggesting that NO production occurs in the peripheral airways. In allergic rhinitis, an increase in exhaled nitric oxide on allergen exposure, particularly in hyperresponsive subjects, may be suggestive of airway inflammation and an increased risk for developing asthma.
European Respiratory Journal 03/1999; 13(2):301-6. · 5.89 Impact Factor
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ABSTRACT: A group of chest physicians, general practitioners, clinical pharmacologist and pharmacists appointed by the Institute of Pharmacotherapy, University of Oslo has evaluated the present knowledge about treatment of chronic obstructive lung disease. The group discusses today's medical treatment of this rather numerous group of patients. It is stated that, to a high degree, the treatment of these patients lacks proper documentation, and that treatment needs to be tested out on an individual basis. The group proposes a flow chart for this purpose.
Tidsskrift for Den norske legeforening 03/1995; 115(6):710-3.
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T. K. Omsland,
L. A. Ahmed,
A. Gronskag,
B. Schei,
N. Emaus, A. Langhammer,
R. M. Joakimsen,
L. Jorgensen,
A. J. Sogaard,
C. G. Gjesdal,
H. E. Meyer
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ABSTRACT: Higher rates of hip fracture and all fractures combined have been observed in urban compared with rural areas, but whether there are urban-rural differences in distal forearm fracture rates is less studied. The aim of this longitudinal study was to compare the incidence of forearm fracture in postmenopausal women in urban and rural areas in Norway and to investigate risk factors that could explain potential fracture differences. The study included data from 11,209 women aged 65 years or more who participated in two large health studies, the Tromso Health Study in 1994-1995 and the Nord-Trondelag Health Study in 1995-1997. Forearm bone mineral density (BMD) was measured by single-energy X-ray absorptiometry in a subsample of women (n = 7333) at baseline. All women were followed with respect to hospital-verified forearm fractures (median follow-up 6.3 years). A total of 9249 and 1960 women lived in areas classified as rural and urban, respectively. Urban women had an increased forearm fracture risk [relative risk (RR) = 1.29, 95% confidence interval (CI) 1.09-1.52] compared with women in rural areas. Rural women had higher body mass index (BMI) than urban women, and the RR was moderately reduced to 1.21 (95% CI 1.02-1.43) after BMI adjustments. Rural women had the highest BMD. In the subgroup with measured BMD, adjustments for BMD changed the urban versus rural RR from 1.21 (95% CI 0.96-1.52) to 1.05 (95% CI 0.83-1.32), suggesting that BMD is an important explanatory factor. In conclusion, higher rates of forearm fractures was found in urban compared with rural women.
J Bone Miner Res. 26(4):850-6.
