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Moe ÅM, Ytterstad E, Hopstock LA, Løvsletten O, Carlsen MH, Sørbye SH. Associations and predictive power of dietary patterns on metabolic syndrome and its components. Nutr Metab Cardiovasc Dis 2024; 34:681-690. [PMID: 38161114 DOI: 10.1016/j.numecd.2023.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 10/11/2023] [Accepted: 10/23/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND AND AIMS Metabolic syndrome (MetS) defines important risk factors in the development of cardiovascular diseases and other serious health conditions. This study aims to investigate the influence of different dietary patterns on MetS and its components, examining both associations and predictive performance. METHODS AND RESULTS The study sample included 10,750 participants from the seventh survey of the cross-sectional, population-based Tromsø Study in Norway. Diet intake scores were used as covariates in logistic regression models, controlling for age, educational level and other lifestyle variables, with MetS and its components as response variables. A diet high in meat and sweets was positively associated with increased odds of MetS and elevated waist circumference, while a plant-based diet was associated with decreased odds of hypertension in women and elevated levels of triglycerides in men. The predictive power of dietary patterns derived by different dimensionality reduction techniques was investigated by randomly partitioning the study sample into training and test sets. On average, the diet score variables demonstrated the highest predictive power in predicting MetS and elevated waist circumference. The predictive power was robust to the dimensionality reduction technique used and comparable to using a data-driven prediction method on individual food variables. CONCLUSIONS The strongest associations and highest predictive power of dietary patterns were observed for MetS and its single component, elevated waist circumference.
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Affiliation(s)
- Åse Mari Moe
- Department of Mathematics and Statistics, UiT The Arctic University of Norway, Tromsø, Norway
| | - Elinor Ytterstad
- Department of Mathematics and Statistics, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Laila A Hopstock
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ola Løvsletten
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Monica H Carlsen
- Division of Nutritional Epidemiology, University of Oslo, Oslo, Norway
| | - Sigrunn H Sørbye
- Department of Mathematics and Statistics, UiT The Arctic University of Norway, Tromsø, Norway
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Hopstock LA, Kudryavtsev AV, Malyutina S, Cook S. Hazardous alcohol consumption and problem drinking in Norwegian and Russian women and men: The Tromsø Study 2015-2016 and the Know Your Heart study 2015-2018. Scand J Public Health 2023; 51:986-994. [PMID: 34965794 PMCID: PMC10599088 DOI: 10.1177/14034948211063656] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 11/16/2022]
Abstract
AIM Harmful use of alcohol is a worldwide public health concern. Cultural differences may affect responses to questions on alcohol problems, making international comparisons difficult. We aimed to compare self-reported alcohol consumption and problem drinking between Norwegian and Russian populations. METHODS We used data from women and men aged 40-69 years participating in the Tromsø Study seventh survey (Tromsø7, N=17646, participation 65%), Tromsø (2015-2016), Norway, and the Know Your Heart study (KYH, N=4099, participation 51%), Arkhangelsk and Novosibirsk (2015-2018), Russia. Alcohol consumption and problem drinking were measured by the Alcohol Use Disorders Identification Test (AUDIT) via questionnaires (Tromsø7) and interviews (KYH). We compared AUDIT scores and components between populations, by sex. RESULTS Non-drinking was more commonly reported in KYH compared with Tromsø7 (men 15.5% versus 4.9%, women 13.3% versus 7.3%). In men, hazardous consumption (41.4% versus 31.5%) and problem drinking (24.8% versus 19.6%) was higher in KYH compared with Tromsø7, but opposite for women (6.5% versus 12.0%, and 2.3% versus 5.8%). KYH men were less likely to report problem drinking behaviours than Tromsø7 men, with the exception of needing a drink first thing in the morning (13.2% versus 2.4%). KYH women consistently reported less consumption and problem drinking than Tromsø7 women. CONCLUSIONS We found between-study differences in hazardous drinking, but in men these were lower than suggested by differences in country-level statistics on alcohol consumption and alcohol-related health-harms. Study sample selection, stronger social desirability bias effects in the Russian samples, and cultural differences in responding could have affected the results.
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Affiliation(s)
| | - Alexander V. Kudryavtsev
- UiT The Arctic University of Norway, Norway
- Northern State Medical University, Russian Federation
| | - Sofia Malyutina
- Novosibirsk State Medical University, Russian Federation
- Institute of Internal and Preventive Medicine, Russian Federation
| | - Sarah Cook
- London School of Hygiene & Tropical Medicine, UK
- Imperial College London, UK
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Dalene KE, Lergenmuller S, Sund ER, Hopstock LA, Robsahm TE, Nilssen Y, Nystad W, Larsen IK, Ariansen I. Clustering and trajectories of key noncommunicable disease risk factors in Norway: the NCDNOR project. Sci Rep 2023; 13:14479. [PMID: 37660221 PMCID: PMC10475033 DOI: 10.1038/s41598-023-41660-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/29/2023] [Indexed: 09/04/2023] Open
Abstract
Noncommunicable diseases (NCDs) are a leading cause of premature death globally and have common preventable risk factors. In Norway, the NCDNOR-project aims at establishing new knowledge in the prevention of NCDs by combining information from national registries with data from population-based health studies. In the present study, we aimed to harmonize data on key NCD risk factors from the health studies, describe clustering of risk factors using intersection diagrams and latent class analysis, and identify long-term risk factor trajectories using latent class mixed models. The harmonized study sample consisted of 808,732 individuals (1,197,158 participations). Two-thirds were exposed to ≥ 1 NCD risk factor (daily smoking, physical inactivity, obesity, hypertension, hypercholesterolaemia or hypertriglyceridaemia). In individuals exposed to ≥ 2 risk factors (24%), we identified five distinct clusters, all characterized by fewer years of education and lower income compared to individuals exposed to < 2 risk factors. We identified distinct long-term trajectories of smoking intensity, leisure-time physical activity, body mass index, blood pressure, and blood lipids. Individuals in the trajectories tended to differ across sex, education, and body mass index. This provides important insights into the mechanisms by which NCD risk factors can occur and may help the development of interventions aimed at preventing NCDs.
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Affiliation(s)
- Knut Eirik Dalene
- Department of Chronic Diseases, Norwegian Institute of Public Health, PO Box 222, 0213, Oslo, Skøyen, Norway.
| | - Simon Lergenmuller
- Department of Registration, Cancer Registry of Norway, PO Box 5313, 0304, Oslo, Majorstuen, Norway
| | - Erik R Sund
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Oslo, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Laila A Hopstock
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Oslo, Norway
| | | | - Yngvar Nilssen
- Department of Registration, Cancer Registry of Norway, PO Box 5313, 0304, Oslo, Majorstuen, Norway
| | - Wenche Nystad
- Department of Chronic Diseases, Norwegian Institute of Public Health, PO Box 222, 0213, Oslo, Skøyen, Norway
| | - Inger Kristin Larsen
- Department of Registration, Cancer Registry of Norway, PO Box 5313, 0304, Oslo, Majorstuen, Norway
| | - Inger Ariansen
- Department of Chronic Diseases, Norwegian Institute of Public Health, PO Box 222, 0213, Oslo, Skøyen, Norway
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Chang M, Michelet M, Skirbekk V, Langballe EM, Hopstock LA, Sund ER, Krokstad S, Strand BH. Trends in the use of home care services among Norwegians 70+ and projections towards 2050: The HUNT study 1995-2017. Scand J Caring Sci 2023; 37:752-765. [PMID: 36967552 DOI: 10.1111/scs.13158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 01/20/2023] [Accepted: 02/13/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Life expectancy (LE) is increasing worldwide, while there is lack of information on how this affects older individuals' use of formal home care services. AIM We aimed to decompose LE into years with and without home care services and estimate projected number of users towards 2050 in Norway for people 70 years or older. METHODS This study is based on a sample of 25,536 participants aged 70 years and older in the Trøndelag Health Study (HUNT) survey 2 (1995-1997), 3 (2006-2008), or 4 (2017-2019) linked with national data on mortality. Prevalence of home care services was standardised to the Norwegian population by age and sex. The Sullivan method was used to estimate expected years with and without home help services and nursing services for the years 1995, 2006 and 2016. Data from HUNT4 and Statistics Norway were used to estimate projected use of these services between 2020 and 2050. RESULTS During 1995-2017, the use of home help services decreased from 22.6% to 6.2% (p < 0.001), and from 6.4% to 5.5% (p = 0.004) for home nursing services. Adjusted for age and sex, the use of home help services decreased significantly over time (p < 0.001), while home nursing services were stable (p = 0.69). LE at age 70 increased from 11.9 to 15.3 years in men (p < 0.05) during 1995-2017, and from 14.7 to 17.1 in women (p < 0.05). In the same period, the expected years receiving home help decreased from 2.6 to 1.1 in men (p < 0.05), and from 4.4 to 2.1 in women (p < 0.05). The expected years receiving home nursing increased from 0.6 to 0.9 in men (p < 0.05), and from 1.3 to 1.7 in women (p < 0.05). Projected numbers of people 70+ in Norway in need of either of these services were estimated to rise from 64,000 in 2020 to 160,000 in 2050. CONCLUSION While overall life expectancy increased, the expected years receiving home help have decreased and home nursing slightly increased among the Norwegian population aged 70 years and older during 1995-2017. However, the substantial increase in the projected number of older adults using home care services in the future is an alert for the current health care planners.
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Affiliation(s)
- Milan Chang
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
- Icelandic Gerontological Research Institute, Reykjavik, Iceland
| | - Mona Michelet
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tonsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Vegard Skirbekk
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Ellen M Langballe
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tonsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Laila A Hopstock
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Erik R Sund
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, NTNU Norwegian University of Science and Technology, Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
| | - Steinar Krokstad
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, NTNU Norwegian University of Science and Technology, Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Bjørn H Strand
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tonsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
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Nakandi K, Benebo FO, Hopstock LA, Stub T, Kristoffersen AE. Adherence to lifestyle recommendations among Norwegian cancer survivors and the impact of traditional and complementary medicine use: the Tromsø Study 2015-2016. BMC Complement Med Ther 2023; 23:292. [PMID: 37598174 PMCID: PMC10439550 DOI: 10.1186/s12906-023-04123-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/11/2023] [Indexed: 08/21/2023] Open
Abstract
INTRODUCTION Adherence to healthy lifestyle recommendations has positive effects on cancer outcomes yet adherence is low among cancer survivors. Differences in adherence between women and men, phase of survivorship, and other factors that might increase adherence, like the use of traditional and complementary medicine (T&CM), need to be explored. We aimed to study the adherence to national recommendations for a healthy diet (daily intake of ≥ 5 portions of fruit/vegetables), physical activity (150 min of moderate-intensity or 75 min of high-intensity/week), normal body mass index (BMI) (18.5-24.9 kg/m2), non-smoking, and low-risk alcohol consumption (women ≤ 10 g/day, men ≤ 20 g/day) among Norwegian cancer survivors and their associations with sex, the use of T&CM, and survivorship phase. METHODS We used logistic regression, independent sample t-test, and chi-square test to study self-reported (diet, physical activity, smoking, alcohol consumption) and measured (BMI) adherence in 1530 cancer survivors (40 years and above, participating in the population-based Tromsø Study conducted in 2015-2016 (65% attendance). We dichotomized all assessed lifestyle recommendations (adherence = 1 point, non-adherence = 0 points), and created a score for every recommendation (0-5 points). Adherence to individual lifestyle recommendations and the use of T&CM as well as the phase of survivorship was adjusted for sex, age, income, and living with a partner. RESULTS Adherence to recommendations was 7.5% for diet, 85.3% for physical activity, 30.5% for BMI, 89.3% for non-smoking, and 87.6% for alcohol consumption. In total 2.3% adhered to all five recommendations concurrently (mean score 2.96 [SD = 0.86]). Women adhered to more recommendations concurrently compared to men (3.03 [SD = 0.90] vs. 2.89 [SD = 0.80] points respectively, [p = .012]). In total, 31% reported the use of T&CM and there were no differences in adherence to individual lifestyle recommendations or concurrent adherence in overall T&CM use compared to non-use. Users of self-help techniques were more likely to adhere to the recommendations of diet (aOR 2.69, 95% CI 1.45-4.98) and physical activity (aOR 6.26, 95% CI 1.51-25.92). Users of traditional healers and users of more than one T&CM modality were less likely to adhere to the low-risk alcohol consumption recommendation, (aOR 0.32, 95% CI 0.13-0.77, and aOR 0.53, 95% CI 1.08-2.17, respectively) compared to T&CM non-users. Survivors with cancer previously (1162) had higher odds of adhering to the recommendation of diet (aOR 2.66, 95% CI 1.36-5.19) than survivors with cancer presently (n = 368), but not to other recommendations. CONCLUSION The health of cancer survivors can be improved through adherence to lifestyle recommendations, yet our study found partial adherence among survivors in Norway, in accordance with findings from other countries. Although overall T&CM use was not associated with higher adherence to lifestyle recommendations, differences in adherence were seen among individual modalities like the use of self-help techniques and traditional healers. Our results suggest the need for intensified follow-up of lifestyle with attention to male survivors and diet among all survivors throughout the cancer survivorship continuum.
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Affiliation(s)
- Kiwumulo Nakandi
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Faculty of Health Science, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, N-9037, Norway.
| | - Faith O Benebo
- Systems Epidemiology, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Laila A Hopstock
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Trine Stub
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Faculty of Health Science, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, N-9037, Norway
| | - Agnete E Kristoffersen
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Faculty of Health Science, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, N-9037, Norway
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Mikkelsen M, Wilsgaard T, Grimsgaard S, Hopstock LA, Hansson P. Associations between postprandial triglyceride concentrations and sex, age, and body mass index: cross-sectional analyses from the Tromsø study 2015-2016. Front Nutr 2023; 10:1158383. [PMID: 37396133 PMCID: PMC10308115 DOI: 10.3389/fnut.2023.1158383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Elevated serum triglyceride concentrations increase the risk of developing atherosclerosis, the leading cause of cardiovascular disease. Postprandial triglyceride concentrations have shown to be a stronger predictor of cardiovascular disease compared to fasting triglycerides. It is therefore clinically relevant to study patterns of postprandial triglyceride concentrations in a general adult population. Aims The aim of this cross-sectional analysis was to examine postprandial triglyceride concentrations in women and men, and the association with age, body mass index and menopausal status. Methods Non-fasting blood samples from 20,963 women and men aged 40 years and older, attending the seventh survey of the Tromsø Study (2015-2016), were analyzed for postprandial triglyceride concentrations using descriptive statistics and linear regression models. Self-reported time since last meal before blood sampling was categorized into 1-h intervals with 7+ hours considered fasting. Results Men had higher triglyceride concentrations compared to women. The pattern of postprandial triglyceride concentrations differed between the sexes. In women, the highest triglyceride concentration (19% higher compared to fasting level, p < 0.001) was found 3-4 h postprandially compared to 1-3 h in men (30% higher compared to fasting level, p < 0.001). In women, all subgroups of age and BMI had higher triglyceride concentrations than the reference group (age 40-49 years and BMI < 25 kg/m2), but no linear trend for age was observed. In men, triglyceride concentrations were inversely associated with age. Body mass index was positively associated with triglyceride concentration in both women (p < 0.001) and men (p < 0.001), although this association was somewhat modified by age in women. Postmenopausal women had significantly higher triglyceride concentrations compared to premenopausal women (p < 0.05). Conclusion Postprandial triglyceride concentrations differed in groups of sex, age, body mass index, and menopausal status.
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Affiliation(s)
- Mari Mikkelsen
- Department of Clinical Medicine, Clinical Nutrition Research Group, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sameline Grimsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Laila A. Hopstock
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Patrik Hansson
- Department of Clinical Medicine, Clinical Nutrition Research Group, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
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Ho KKN, Skarpsno ES, Nilsen KB, Ferreira PH, Pinheiro MB, Hopstock LA, Johnsen MB, Steingrímsdóttir ÓA, Nielsen CS, Stubhaug A, Simic M. A bidirectional study of the association between insomnia, high-sensitivity C-reactive protein, and comorbid low back pain and lower limb pain. Scand J Pain 2023; 23:110-125. [PMID: 35420264 DOI: 10.1515/sjpain-2021-0197] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 03/08/2022] [Indexed: 01/17/2023]
Abstract
OBJECTIVES To examine the possible bidirectional association between insomnia and comorbid chronic low back pain (LBP) and lower limb pain and to explore whether high-sensitivity C-reactive protein (hsCRP) amplifies these associations. METHODS We calculated adjusted risk ratios (RR) with 95% confidence intervals (CI) for the development of insomnia and mild-to-severe chronic LBP and lower limb pain at 11 years follow-up in participants aged ≥32 years and with hsCRP ≤10 mg/L at baseline in 2007-2008: 3,714 without chronic LBP or lower limb pain (sample 1) and 7,892 without insomnia (sample 2). RESULTS Compared to participants without chronic pain, participants with comorbid chronic LBP and lower limb pain had a RR of insomnia of 1.37 (95% CI 1.12-1.66). Compared with participants without insomnia, participants with insomnia did not have an increased risk of comorbid chronic LBP and lower limb pain (RR: 1.06, 95% CI 0.76-1.46); however, participants with insomnia had a RR of chronic LBP of 1.20 (95% CI 1.02-1.42). There was no strong amplifying effect of elevated hsCRP (3.00-10.0 mg/L) on these associations. CONCLUSIONS These findings suggest that elevated hsCRP does not amplify the associations between insomnia and mild-to-severe chronic LBP and lower limb pain. Further research using data on the temporal relation between insomnia, chronic pain, and inflammatory responses are required to fully understand the causal pathways.
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Affiliation(s)
- Kevin K N Ho
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Eivind S Skarpsno
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
| | - Kristian B Nilsen
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
- Department of Neurology, Oslo University Hospital, Division of Clinical Neuroscience, Oslo, Norway
| | - Paulo H Ferreira
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Marina B Pinheiro
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
- Institute for Musculoskeletal Health, University of Sydney and Sydney Local Health District, Sydney, NSW, Australia
| | - Laila A Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - Ólöf A Steingrímsdóttir
- Department of Chronic Diseases, Norwegian Institute of Public Heath, Oslo, Norway
- Department of Research and Development, Oslo University Hospital, Oslo, Norway
| | - Christopher S Nielsen
- Department of Chronic Diseases, Norwegian Institute of Public Heath, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Audun Stubhaug
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Milena Simic
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
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Uchai S, Andersen LF, Johansson J, Hopstock LA, Hjartåker A. Dual-Energy X-Ray Absorptiometry Derived Adiposity Measures and Pre-Frailty/Frailty among Norwegian Adults: The Tromsø Study 2007-2015. J Nutr Health Aging 2023; 27:403-410. [PMID: 37357322 DOI: 10.1007/s12603-023-1920-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/06/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVES Aging is associated with changes in body composition. Excess adiposity among older adults has been linked with metabolic syndromes and aggravated age-associated decline in physical functioning. Few longitudinal studies have explored the association between dual-energy X-ray absorptiometry (DXA)-derived total as well as central adiposity measures and frailty. We examined the association of DXA-derived total and central adiposity with pre-frailty/frailty among Norwegian adults after 8 years of follow-up. DESIGN Prospective observational study. SETTING Community-dwelling adults from Tromsø, Norway. MEASUREMENTS Adiposity was defined by fat mass index (FMI) and visceral adipose tissue (VAT) mass assessed using DXA measures. Frailty status was assessed by low grip strength, slow walking speed, exhaustion, unintentional weight loss and low physical activity level. Pre-frail and frail participants at baseline were excluded. Sex-stratified multivariable logistic regression models were used to investigate the association. RESULTS Participants comprised 234 women (mean age 68 years) and 146 men (mean age 69 years) attending the population-based Tromsø Study in 2007-2008 (Tromsø6) and 2015-2016 (Tromsø7). At the end of follow-up, 25.6% of the women and 27.4% of the men were pre-frail/frail. Compared with women in the lowest tertiles, those in the highest tertile of baseline FMI (odds ratio [OR] 4.42, 95% confidence interval [CI] 1.88-10.35) and VAT mass (OR 2.47, 95% CI 1.10-5.50), respectively had higher odds for pre-frailty/frailty at follow-up. CONCLUSION We found a higher likelihood of pre-frailty/frailty in later years among women with general and central adiposity in adulthood, highlighting the importance of preventing excess adiposity for healthy aging.
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Affiliation(s)
- S Uchai
- Shreeshti Uchai, Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Norway, Postbox: 1046, Blindern, 0317 Oslo, Norway
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Moe ÅM, Sørbye SH, Hopstock LA, Carlsen MH, Løvsletten O, Ytterstad E. Identifying dietary patterns across age, educational level and physical activity level in a cross-sectional study: the Tromsø Study 2015 - 2016. BMC Nutr 2022; 8:102. [PMID: 36109801 PMCID: PMC9476603 DOI: 10.1186/s40795-022-00599-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 09/06/2022] [Indexed: 11/21/2022] Open
Abstract
Background A healthy diet can decrease the risk of several lifestyle diseases. From studying the health effects of single foods, research now focuses on examining complete diets and dietary patterns reflecting the combined intake of different foods. The main goals of the current study were to identify dietary patterns and then investigate how these differ in terms of sex, age, educational level and physical activity level (PAL) in a general Nordic population. Methods We used data from the seventh survey of the population-based Tromsø Study in Norway, conducted in 2015-2016. The study included 21,083 participants aged \documentclass[12pt]{minimal}
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\begin{document}$$72\%$$\end{document}72% completed a comprehensive food frequency questionnaire (FFQ). After exclusion, the study sample included 10,899 participants with valid FFQ data. First, to cluster food variables, the participants were partitioned in homogeneous cohorts according to sex, age, educational level and PAL. Non-overlapping diet groups were then identified using repeated hierarchical cluster analysis on the food variables. Second, average standardized diet intake scores were calculated for all individuals for each diet group. The individual diet (intake) scores were then modelled in terms of age, education and PAL using regression models. Differences in diet scores according to education and PAL were investigated by pairwise hypothesis tests, controlling the nominal significance level using Tukey’s method. Results The cluster analysis revealed three dietary patterns, here named the Meat and Sweets diet, the Traditional diet, and the Plant-based- and Tea diet. Women had a lower intake of the Traditional diet and a higher preference for the Plant-based- and Tea diet compared to men. Preference for the Meat and Sweets diet and Traditional diet showed significant negative and positive trends as function of age, respectively. Adjusting for age, the group having high education and high PAL compared favourably with the group having low education and low PAL, having a significant lower intake of the Meat and Sweets and the Traditional diets and a significant higher intake of the Plant-based- and Tea diet. Conclusions Three dietary patterns (Meat and Sweets, Traditional, and Plant-based- and Tea) were found by repeated clustering of randomly sampled homogeneous cohorts of individuals. Diet preferences depended significantly on sex, age, education and PAL, showing a more unhealthy dietary pattern with lower age, low education and low PAL. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-022-00599-4.
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Kholmatova K, Krettek A, Leon DA, Malyutina S, Cook S, Hopstock LA, Løvsletten O, Kudryavtsev AV. Obesity Prevalence and Associated Socio-Demographic Characteristics and Health Behaviors in Russia and Norway. IJERPH 2022; 19:ijerph19159428. [PMID: 35954782 PMCID: PMC9367755 DOI: 10.3390/ijerph19159428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 01/27/2023]
Abstract
Associations between obesity and socio-demographic and behavioral characteristics vary between populations. Exploring such differences should throw light on factors related to obesity. We examined associations between general obesity (GO, defined by body mass index) and abdominal obesity (AO, defined by waist-to-hip ratio) and sex, age, socio-economic characteristics (education, financial situation, marital status), smoking and alcohol consumption in women and men aged 40–69 years from the Know Your Heart study (KYH, Russia, N = 4121, 2015–2018) and the seventh Tromsø Study (Tromsø7, Norway, N = 17,646, 2015–2016). Age-standardized prevalence of GO and AO was higher in KYH compared to Tromsø7 women (36.7 vs. 22.0% and 44.2 vs. 18.4%, respectively) and similar among men (26.0 vs. 25.7% and 74.8 vs. 72.2%, respectively). The positive association of age with GO and AO was stronger in KYH vs. Tromsø7 women and for AO it was stronger in men in Tromsø7 vs. KYH. Associations between GO and socio-economic characteristics were similar in KYH and Tromsø7, except for a stronger association with living with spouse/partner in KYH men. Smoking had a positive association with AO in men in Tromsø7 and in women in both studies. Frequent drinking was negatively associated with GO and AO in Tromsø7 participants and positively associated with GO in KYH men. We found similar obesity prevalence in Russian and Norwegian men but higher obesity prevalence in Russian compared to Norwegian women. Other results suggest that the stronger association of obesity with age in Russian women is the major driver of the higher obesity prevalence among them compared to women in Norway.
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Affiliation(s)
- Kamila Kholmatova
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037 Tromsø, Norway; (A.K.); (D.A.L.); (L.A.H.); (O.L.); (A.V.K.)
- International Research Competence Centre, Northern State Medical University, Troitsky Av., 51, 163069 Arkhangelsk, Russia
- Correspondence:
| | - Alexandra Krettek
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037 Tromsø, Norway; (A.K.); (D.A.L.); (L.A.H.); (O.L.); (A.V.K.)
- Department of Public Health, School of Health Sciences, University of Skövde, 541 28 Skövde, Sweden
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, 405 30 Gothenburg, Sweden
| | - David A. Leon
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037 Tromsø, Norway; (A.K.); (D.A.L.); (L.A.H.); (O.L.); (A.V.K.)
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK;
| | - Sofia Malyutina
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Academician M.A. Lavrentiev Av., 17, 630090 Novosibirsk, Russia;
- Department of Therapy, Hematology and Transfusiology, Novosibirsk State Medical University, Krasny Av., 52, 630090 Novosibirsk, Russia
| | - Sarah Cook
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK;
- Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London SW3 6LY, UK
| | - Laila A. Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037 Tromsø, Norway; (A.K.); (D.A.L.); (L.A.H.); (O.L.); (A.V.K.)
| | - Ola Løvsletten
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037 Tromsø, Norway; (A.K.); (D.A.L.); (L.A.H.); (O.L.); (A.V.K.)
| | - Alexander V. Kudryavtsev
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037 Tromsø, Norway; (A.K.); (D.A.L.); (L.A.H.); (O.L.); (A.V.K.)
- International Research Competence Centre, Northern State Medical University, Troitsky Av., 51, 163069 Arkhangelsk, Russia
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Hagen A, Eggen AE, Hanssen TA, Lappegard KT, Lochen ML, Njolstad I, Wilsgaard T, Hopstock LA. Time trends in cardiovascular risk factors across levels of education in a general population. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Northern Norway Health Authority
Background
Favourable changes over time in population cardiovascular disease (CVD) risk has not benefitted all socioeconomic groups equally. Social inequality in health also exists in high-income countries with an egalitarian welfare system.
Purpose
We aimed to study CVD risk factors across educational groups over time in a Norwegian general population.
Methods
We used multivariable linear regression and generalised estimating equation models with age-adjusted means and proportions to examine CVD risk (smoking, physical activity level, obesity [body mass index ≥30 kg/m2], blood pressure, total- and low-density lipoprotein [LDL] cholesterol, and total risk of CVD [estimated 10-year risk with NORRISK 2]) across four levels of education: Primary/partly secondary up to 10 years of schooling, upper secondary, tertiary <4 years, tertiary ≥4 years in women and men aged 40-79 years attending a population-based study with two consecutive surveys in 2007-2008 (N=11,941) and 2015-2016 (N=20,322).
Results
In women, the difference between the lowest and the highest education level in risk factors in 2007-2008 versus 2015-2016 was for smoking 22.0 vs 19.2 percentage points (pp), obesity 8.7 vs 8.8 pp, sedentary physical activity level 10.5 vs 11.5 pp (p=0.012), systolic blood pressure 5.5 vs 3.4 mmHg (p=0.001), total cholesterol 0.2 mmol/L vs no difference (p<0.001), LDL cholesterol 0.3 vs 0.1 mmol/L (p<0.001), and total CVD risk 0.9 vs 1.8 (p<0.001), respectively. In men, the corresponding numbers were for smoking 20.1 vs 16.8 pp, obesity 9.9 vs 12.9 pp, sedentary physical activity level 10 vs 11.5 pp (p=0.027), systolic blood pressure 1.7 vs 1.7 mmHg, total cholesterol 0.2 mmol/L vs no difference (p<0.001), LDL cholesterol 0.1 mmol/L vs no difference (p<0.001), and total CVD risk 1.2 vs 0.9, respectively. No difference across educational levels and time regarding blood pressure or total- or LDL cholesterol in users of antihypertensives and lipid-lowering drugs was found, except for an educational difference in the first but not the second time period in female antihypertensive users.
Conclusion
We found a clinically relevant educational gap in CVD risk factors, with more favourable levels with higher education. Over time, the educational gap increased in physical activity in both sexes, and in total CVD risk in women. Further, the educational gap declined in blood lipids in both sexes, and in systolic blood pressure in women. While medication use seems to contribute to weaken the educational gradient in blood pressure and lipid levels, a stronger emphasis on lifestyle interventions is needed to reduce the educational inequalities in behavioural CVD risk factors.
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Affiliation(s)
- A Hagen
- Nordland Hospital, Department of Medicine, Bodo, Norway
| | - AE Eggen
- UiT The Arctic University of Norway, Department of Community Medicine, Tromso, Norway
| | - TA Hanssen
- UiT The Arctic University of Norway, Department of Health and Care Sciences, Tromso, Norway
| | - KT Lappegard
- Nordland Hospital, Department of Medicine, Bodo, Norway
| | - ML Lochen
- UiT The Arctic University of Norway, Department of Community Medicine, Tromso, Norway
| | - I Njolstad
- UiT The Arctic University of Norway, Department of Community Medicine, Tromso, Norway
| | - T Wilsgaard
- UiT The Arctic University of Norway, Department of Community Medicine, Tromso, Norway
| | - LA Hopstock
- UiT The Arctic University of Norway, Department of Community Medicine, Tromso, Norway
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12
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Hopstock LA, Grimsgaard S, Johansen H, Kanstad K, Wilsgaard T, Eggen AE. The seventh survey of the Tromsø Study (Tromsø7) 2015-2016: study design, data collection, attendance, and prevalence of risk factors and disease in a multipurpose population-based health survey. Scand J Public Health 2022; 50:919-929. [PMID: 35509230 PMCID: PMC9578102 DOI: 10.1177/14034948221092294] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Aims: The Tromsø Study is an ongoing population-based health study in Tromsø, Norway, initiated in 1974. The purpose of the seventh survey (Tromsø7) 2015–2016 was to advance the population risk factor surveillance and to collect new types of data. We present the study design, data collection, attendance, and prevalence of risk factors and disease. Methods: All inhabitants in Tromsø municipality, Norway, aged 40 years and older (N=32,591) were invited to a health screening including extensive questionnaires, face-to-face interviews, biological sampling (blood, urine, saliva, nasal/throat swabs, faeces), measurements (anthropometry, blood pressure, pulse, pulse oximetry) and clinical examinations (pain sensitivity, echocardiography, cognitive, physical, and lung function, accelerometer measurements, eye examinations, carotid ultrasound, electrocardiography, dual-energy X-ray absorptiometry, and heart, lung and carotid auscultation). New research areas in this round were dental and oral health examinations, collection of faecal samples for studies of normal bacterial flora and antibiotic resistance, and 24-hour urine samples for examination of sodium and iodine intakes. Results: Attendance was 65% (N=21,083), and was higher in women, age group 50–79 years, previous attenders, and Norwegian-born individuals. Cardiovascular risk factor levels and prevalence of chronic obstructive lung disease decreased since the last survey, while the prevalence of obesity and diabetes increased. Conclusions: Attendance was stable from the sixth survey. Interaction with participants might be key to maintain participation. Favourable trends in risk factors continue, except for a continued increase in obesity. Both new data collection technology and traditional physical examinations will be crucial for the impact of future population studies.
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Affiliation(s)
- Laila A Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sameline Grimsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Heidi Johansen
- Northern Norway Regional Health Authority, Tromsø, Norway
| | - Kristin Kanstad
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Anne Elise Eggen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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Husberg VH, Hopstock LA, Friborg O, Rosenvinge JH, Bergvik S, Rognmo K. Epidemiology of comorbid hazardous alcohol use and insomnia in 19 185 women and men attending the population-based Tromsø Study 2015-2016. BMC Public Health 2022; 22:844. [PMID: 35477423 PMCID: PMC9047295 DOI: 10.1186/s12889-022-13250-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/19/2022] [Indexed: 11/10/2022] Open
Abstract
Background Hazardous alcohol use is known to be comorbid with insomnia problems. The present study examined the prevalence of insomnia and if the odds of insomnia differed between women and men with a hazardous alcohol use. Methods Cross-sectional data from the seventh survey of the Norwegian population-based Tromsø Study 2015–2016 (participation 65%). The sample included 19 185 women and men 40–96 years. Hazardous alcohol use was defined by the Alcohol Use Disorder Identification Test (AUDIT) and insomnia by the Bergen Insomnia Scale. Covariates included socio-demographics, shift work, somatic conditions and mental distress defined by Hopkins Symptom Check List-10 (HSCL-10). Mental distress was also included as a moderator. Results Insomnia was more prevalent among participants with a hazardous alcohol use (24.1%) than without (18.9%), and participants who had hazardous alcohol use had higher odds of insomnia (odds ratio = 1.49, 95% CI = 1.20, 1.85). The association turned non-significant after adjustment for mental distress. Adding mental distress as a moderator variable revealed a higher odds of insomnia among hazardous alcohol users having no or low-to-medium levels of mental distress, but not among participants with high levels of mental distress. Conclusion Insomnia was more prevalent among women and men reporting hazardous alcohol use. When mental distress was treated as a moderator, hazardous alcohol use did not yield higher odds for insomnia among those with high levels of mental distress. This suggests that mental distress may play an important role in the association between hazardous alcohol use and insomnia. And that the impact of alcohol on insomnia may differ depending on the severity of mental distress. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13250-5.
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Affiliation(s)
- Vendela H Husberg
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Laila A Hopstock
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Oddgeir Friborg
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Jan H Rosenvinge
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Svein Bergvik
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kamilla Rognmo
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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14
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Cook S, Solbu MD, Eggen AE, Iakunchykova O, Averina M, Hopstock LA, Kholmatova K, Kudryavtsev AV, Leon DA, Malyutina S, Ryabikov A, Williamson E, Nitsch D. Comparing prevalence of chronic kidney disease and its risk factors between population-based surveys in Russia and Norway. BMC Nephrol 2022; 23:145. [PMID: 35421937 PMCID: PMC9008943 DOI: 10.1186/s12882-022-02738-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 03/11/2022] [Indexed: 11/30/2022] Open
Abstract
Background Little data exists on the prevalence of chronic kidney disease (CKD) in the Russian population. We aimed to estimate the prevalence of CKD in a population-based study in Russia, compare with a similar study in Norway, and investigate whether differences in risk factors explained between-study differences in CKD. Methods We compared age- and sex-standardised prevalence of reduced eGFR (< 60 ml/min/1.73m2 CKD-EPI creatinine equation), albuminuria and or a composite indicator of CKD (one measure of either reduced eGFR or albuminuria) between participants aged 40–69 in the population-based Know Your Heart (KYH) study, Russia (2015–2018 N = 4607) and the seventh Tromsø Study (Tromsø7), Norway (2015–2016 N = 17,646). We assessed the contribution of established CKD risk factors (low education, diabetes, hypertension, antihypertensive use, smoking, obesity) to between-study differences using logistic regression. Results Prevalence of reduced eGFR or albuminuria was 6.5% (95% Confidence Interval (CI) 5.4, 7.7) in KYH and 4.6% (95% CI 4.0, 5.2) in Tromsø7 standardised for sex and age. Odds of both clinical outcomes were higher in KYH than Tromsø7 (reduced eGFR OR 2.06 95% CI 1.67, 2.54; albuminuria OR 1.54 95% CI 1.16, 2.03) adjusted for sex and age. Risk factor adjustment explained the observed between-study difference in albuminuria (OR 0.92 95% CI 0.68, 1.25) but only partially reduced eGFR (OR 1.42 95% CI 1.11, 1.82). The strongest explanatory factors for the between-study difference was higher use of antihypertensives (Russian sample) for reduced eGFR and mean diastolic blood pressure for albuminuria. Conclusions We found evidence of a higher burden of CKD within the sample from the population in Arkhangelsk and Novosibirsk compared to Tromsø, partly explained by between-study population differences in established risk factors. In particular hypertension defined by medication use was an important factor associated with the higher CKD prevalence in the Russian sample. Supplementary Information The online version contains supplementary material available at 10.1186/s12882-022-02738-2.
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15
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Heitmann KA, Løchen ML, Stylidis M, Hopstock LA, Schirmer H, Morseth B. Associations between physical activity, left atrial size and incident atrial fibrillation: the Tromsø Study 1994-2016. Open Heart 2022; 9:e001823. [PMID: 35074937 PMCID: PMC8788327 DOI: 10.1136/openhrt-2021-001823] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 01/09/2022] [Indexed: 11/17/2022] Open
Abstract
AIMS Left atrial (LA) enlargement is an independent risk factor for atrial fibrillation (AF). Interestingly, some athletes have increased risk of AF, which may be linked to LA enlargement; however, little is known about the relationship between LA enlargement and AF risk at moderate-level physical activity (PA). We aimed to explore the associations between PA, LA size and risk of incident AF, and if PA can attenuate the risk of AF with LA enlargement. METHODS This prospective study followed 2479 participants (52.4% female), free from known cardiac pathology, for median 20.2 years. Participants were followed up for hospital-diagnosed AF, confirmed by electrocardiography, from 1994-95 through 2016. At baseline, LA size was evaluated by anteroposterior LA diameter, and PA was self-reported by questionnaire. RESULTS We observed a U-shaped relationship between PA and AF, and moderately active had 32% lower AF risk than inactive (HRadjusted 0.68, 95% CI 0.50 to 0.93). Participants with LA enlargement had 38% higher AF risk compared with participants with normal LA size (HRadjusted 1.38, 95% CI 1.12 to 1.69). However, the increased AF risk with LA enlargement was attenuated by PA; compared with inactive participants with LA enlargement, the AF risk was 45% lower among active with LA enlargement (HRadjusted 0.55, 95% CI 0.39 to 0.79). AF risk in active participants with LA enlargement did not differ from active with normal LA size. These patterns were observed in both men and women, and in participants over/under 65 years. CONCLUSION Moderate PA was associated with reduced AF risk, and PA attenuated the increased risk of AF with LA enlargement in both men and women and all age groups.
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Affiliation(s)
- Kim Arne Heitmann
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Centre for Research and Education, University Hospital of North Norway, Tromsø, Norway
| | - Maja-Lisa Løchen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Michael Stylidis
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Laila A Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Henrik Schirmer
- Department of Cardiology, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Centre for Research and Education, University Hospital of North Norway, Tromsø, Norway
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16
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Larsen AU, Hopstock LA, Jorde R, Grimnes G. No improvement of sleep from vitamin D supplementation: insights from a randomized controlled trial. Sleep Med X 2021; 3:100040. [PMID: 34881361 PMCID: PMC8567000 DOI: 10.1016/j.sleepx.2021.100040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 11/11/2022] Open
Abstract
Background Vitamin D has been linked to sleep health in observational studies. Data from randomized controlled trials (RCTs) with vitamin D is scarce. Methods This study presents the results of a secondary analysis of 189 vitamin D insufficient participants (47.1% women) in a previously performed RCT, of which 92 were randomized to vitamin D (100,000 IU (2500 μg) as a bolus dose followed by 20,000 IU (500 μg) per week), and 97 to placebo. At baseline and after 4 months at the end of the study serum 25-hydroxyvitamin D (s-25(OH)D) was measured, and the study questionnaire assessing sleep duration, daytime sleepiness, and symptoms of insomnia, was completed. Results At baseline, mean s-25(OH)D was 35.0 ± 11.8 and 35.5 ± 13.3 nmol/L in the vitamin D and placebo groups, respectively. After four months, we found no statistically significant differences between the intervention groups in any of the assessed sleep outcomes, neither when stratified by sex, nor when performed in subgroups based on baseline or end of study s-25(OH)D level or presence of sleep complaints at baseline. Conclusions We were not able to demonstrate a significant effect of vitamin D supplementation on sleep in this vitamin D insufficient population. RCT investigating vitamin D for 4 months in participants with low vitamin D status. Vitamin D did not improve sleep duration, excessive daytime sleepiness or insomnia. The role of vitamin D in sleep health remains controversial.
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Affiliation(s)
- A U Larsen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - L A Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - R Jorde
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - G Grimnes
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
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17
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Lundblad MW, Johansson J, Jacobsen BK, Grimsgaard S, Andersen LF, Wilsgaard T, Hopstock LA. Secular and longitudinal trends in body composition: The Tromsø Study, 2001 to 2016. Obesity (Silver Spring) 2021; 29:1939-1949. [PMID: 34523258 DOI: 10.1002/oby.23267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Overweight, defined as excessive fat mass, is a long-standing worldwide public health challenge. Traditional anthropometric measures used to identify overweight and obesity do not assess body composition. The aim of this study was to examine population trends in general and abdominal fat mass during the past two decades. METHODS This study included participants from one or more consecutive surveys of the population-based Tromsø Study, including Tromsø 5 (conducted in 2001, n = 1,662, age 40-84 years), Tromsø 6 (2007-2008, n = 901, age 40-88 years), and Tromsø 7 (2015-2016, n = 3,670, age 40-87 years), with total body dual-energy x-ray absorptiometry scans. Trends in total fat and visceral adipose tissue (VAT) were analyzed by generalized estimation equation models in strata of sex and age groups. RESULTS Total fat and VAT mass increased during 2001 to 2016, with a larger increase during 2007 to 2016 than from 2001 to 2007 and among the youngest age group (40-49 years), particularly in women. Women had higher total fat mass than men, whereas men had higher VAT mass than women. CONCLUSIONS General and abdominal dual-energy x-ray absorptiometry-derived fat mass increased during the past two decades in this general population. Of particular concern is the more pronounced increase in the past decade and in the younger age groups.
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Affiliation(s)
| | - Jonas Johansson
- Department of Community Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Bjarne K Jacobsen
- Department of Community Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
- Department of Community Medicine, Centre for Sami Health Research, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Sameline Grimsgaard
- Department of Community Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
| | | | - Tom Wilsgaard
- Department of Community Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Laila A Hopstock
- Department of Community Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
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18
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Kholmatova K, Kudryavtsev AV, Malyutina S, Hopstock LA, Cook S, Krettek A, Leon DA. Obesity prevalence and associations with socio-economic and behavioral factors in population-based studies in Russia and Norway, 2015–2017. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Obesity is an epidemic of XXI century, as its prevalence doubled during the last forty years. As Russia and Norway are countries with different life expectancy there could be differences in obesity and its correlates.
Purpose
To investigate and compare prevalence and socio-economic and behavioral factors associated with obesity in Russia and Norway with data from population-based studies.
Methods
We used multivariable logistic regression to examine associations of obesity (body mass index>30 kg/m2) with socio-economic factors (age, education, marital status, and poor financial situation defined as difficulty to afford clothes) and behavioral characteristics (smoking, alcohol use) in participants aged 40–69 years from the Know Your Heart study (Russia, 2015–2017, N=4 106) and the seventh Study (Norway, 2015–16, N=17 604). All results for covariates are mutually adjusted. Between-study comparisons of the associations of obesity with the same covariates were performed through investigation of their interactions with the “study” variable.
Results
The age-standardized prevalence of obesity was higher in Russia among women (36.8 vs 22.0%, p<0.001) and did not differ among men (26.7 vs 25.7%, p=0.224). In Russian women, obesity was positively associated with age of 50–69 years relative to 40–49 years (OR=2.5, 95% CI 2.0–3.1), no university education (OR=1.5, 95% CI 1.2–1.8), and poor financial situation (OR=1.5, 95% CI 1.2–1.9). In Norwegian women, obesity was negatively associated with the age of 50–69 years (OR=0.8, 95% CI 0.8–1.0), current smoking (OR=0.8, 95% CI 0.7–1.0) and drinking alcohol ≥2 times per week (OR=0.6, 95% CI 0.5–0.6), and positively associated with no university education (OR=1.5, 95% CI 1.3–1.7), previous smoking (OR=1.3, 95% CI 1.1–1.4), and drinking ≥5 alcohol drinks per occasion (OR=1.7, 95% CI 1.3–2.2). In Russian men, obesity was positively associated with living with spouse/partner (OR=1.5, 95% CI 1.1–2.2), drinking alcohol ≥2 times per week (OR=1.4, 95% CI 1.1–1.8), and negatively associated with current smoking (OR=0.6, 95% CI 0.4–0.8). In Norwegian men, obesity was positively associated with no university education (OR=1.4, 95% CI 1.2–1.6), previous smoking (OR=1.3, 95% CI 1.2–1.5), and drinking ≥5 alcohol drinks per occasion (OR=1.7, 95% CI 1.5–1.9), and negatively associated with current smoking (OR=0.8, 95% CI 0.7–1.0) and drinking alcohol ≥2 times per week (OR=0.7, 95% CI 0.6–0.7). Interactions with the “study” variable in women were significant for age, financial situation, frequency of alcohol use; in men - for living with spouse/partner, frequency of alcohol use, number of alcohol drinks taken per occasion.
Conclusion
The prevalence of obesity was higher in Russian compared to Norwegian women, but there was no difference between Russian and Norwegian men. There were different between-country patterns of the associations of obesity with the socio-economic and behavioral characteristics.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): The Know Your Heart study was a component of International Project on Cardiovascular Disease in Russia and funded by Wellcome Trust Strategic Award [100217], UiT The Arctic University of Norway, Norwegian Institute of Public Health, and Norwegian Ministry of Health and Care Services. The Tromsø Study was funded by UiT The Arctic University of Norway, Northern Norway Regional Health Authority, Norwegian Ministry of Health and Care Services, Norwegian Research Council, and various public and charity research funds in Norway. PhD scholarship and operational funds of the first author were provided by Northern State Medical University, Arkhangelsk, Russia and by UiT The Arctic University of Norway
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Affiliation(s)
- K Kholmatova
- Northern State Medical University, Arkhangelsk, Russian Federation
| | - A V Kudryavtsev
- Northern State Medical University, Arkhangelsk, Russian Federation
| | - S Malyutina
- Research institute of internal and preventive medicine branch of Institute of Cytology and Genetics, Novosibirsk, Russian Federation
| | - L A Hopstock
- UiT The Arctic University of Norway, Tromsø, Norway
| | - S Cook
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - A Krettek
- UiT The Arctic University of Norway, Tromsø, Norway
| | - D A Leon
- London School of Hygiene and Tropical Medicine, London, United Kingdom
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19
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Lundblad MW, Jacobsen BK, Johansson J, Grimsgaard S, Andersen LF, Hopstock LA. Anthropometric measures are satisfactory substitutes for the DXA-derived visceral adipose tissue in the association with cardiometabolic risk-The Tromsø Study 2015-2016. Obes Sci Pract 2021; 7:525-534. [PMID: 34631131 PMCID: PMC8488451 DOI: 10.1002/osp4.517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Body mass index (BMI) increases while cardiometabolic risk factors decrease in individuals in high-income countries. This paradoxical observation raises the question of whether current measures of overweight and obesity properly identify cardiometabolic risk. METHODS A total of 3675 participants (59% women) aged 40-84 years with whole-body dual-energy x-ray absorptiometry scans from the seventh survey of the Tromsø Study were included to examine the association between visceral adipose tissue (VAT) in grams and BMI, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). Further, their association with single cardiometabolic risk factors (blood pressure, triglycerides, total cholesterol, high-density lipoprotein [HDL] cholesterol, glycated hemoglobin, high-sensitivity C-reactive protein), modified single components from the ATP Ⅲ criteria for metabolic syndrome (hypertension, diabetes, high triglycerides, and low HDL cholesterol), and metabolic syndrome were examined. RESULTS VAT mass was strongly correlated with BMI (r ≥ 0.77), WC (r ≥ 0.80), WHR (r ≥ 0.58), and WHtR (r ≥ 0.78). WC was the strongest predictor for VAT (area under the curve: 0.90). Compared to anthropometric measures, the associations between VAT and metabolic syndrome as well as single components of metabolic syndrome were statistically significantly stronger, but the clinical differences were likely minor. CONCLUSION Although VAT mass showed statistically stronger associations with cardiometabolic risk compared to traditional anthropometrics, the clinical importance was likely small. Simple, clinically available tools seem to satisfactory substitute for VAT to identify cardiometabolic risk.
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Affiliation(s)
- Marie W. Lundblad
- Department of Community MedicineUiT The Arctic University of NorwayTromsøNorway
| | - Bjarne K. Jacobsen
- Department of Community MedicineUiT The Arctic University of NorwayTromsøNorway
- Department of Community MedicineCentre for Sami Health ResearchUiT The Arctic University of NorwayTromsøNorway
| | - Jonas Johansson
- Department of Community MedicineUiT The Arctic University of NorwayTromsøNorway
| | - Sameline Grimsgaard
- Department of Community MedicineUiT The Arctic University of NorwayTromsøNorway
| | | | - Laila A. Hopstock
- Department of Community MedicineUiT The Arctic University of NorwayTromsøNorway
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20
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Nilsen A, Hanssen TA, Lappegård KT, Eggen AE, Løchen ML, Selmer RM, Njølstad I, Wilsgaard T, Hopstock LA. Change in cardiovascular risk assessment tool and updated Norwegian guidelines for cardiovascular disease in primary prevention increase the population proportion at risk: the Tromsø Study 2015-2016. Open Heart 2021; 8:openhrt-2021-001777. [PMID: 34462328 PMCID: PMC8407203 DOI: 10.1136/openhrt-2021-001777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 08/02/2021] [Indexed: 11/10/2022] Open
Abstract
Aims To compare the population proportion at high risk of cardiovascular disease (CVD) using the Norwegian NORRISK 1 that predicts 10-year risk of CVD mortality and the Norwegian national guidelines from 2009, with the updated NORRISK 2 that predicts 10-year risk of both fatal and non-fatal risk of CVD and the Norwegian national guidelines from 2017. Methods We included participants from the Norwegian population-based Tromsø Study (2015–2016) aged 40–69 years without a history of CVD (n=16 566). The total proportion eligible for intervention was identified by NORRISK 1 and the 2009 guidelines (serum total cholesterol ≥8 mmol/L, systolic blood pressure ≥160 mm Hg or diastolic blood pressure ≥100 mm Hg) and NORRISK 2 and the 2017 guidelines (serum total cholesterol ≥7 mmol/L, low density lipoprotein (LDL) cholesterol ≥5 mmol/L, systolic blood pressure ≥160 mm Hg or diastolic blood pressure ≥100 mm Hg). Results The total proportion at high risk as defined by a risk score was 12.0% using NORRISK 1 and 9.8% using NORRISK 2. When including single risk factors specified by the guidelines, the total proportion eligible for intervention was 15.5% using NORRISK 1 and the 2009 guidelines and 18.9% using NORRISK 2 and the 2017 guidelines. The lowered threshold for total cholesterol and specified cut-off for LDL cholesterol stand for a large proportion of the increase in population at risk. Conclusion The population proportion eligible for intervention increased by 3.4 percentage points from 2009 to 2017 using the revised NORRISK 2 score and guidelines.
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Affiliation(s)
- Amalie Nilsen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway .,Department of Medicine, Nordlands Hospital, Bodo, Norway
| | - Tove Aminda Hanssen
- Department of Cardiology, University Hospital of North Norway, Tromsø, Norway.,Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Knut Tore Lappegård
- Department of Medicine, Nordlands Hospital, Bodo, Norway.,Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Anne Elise Eggen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Maja-Lisa Løchen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,Department of Cardiology, University Hospital of North Norway, Tromsø, Norway
| | - Randi Marie Selmer
- Department of Infectious Disease Epidemiology and Modelling, Norwegian Institute of Public Health, Oslo, Norway
| | - Inger Njølstad
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Laila A Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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21
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Hopstock LA, Deraas TS, Henriksen A, Martiny-Huenger T, Grimsgaard S. Changes in adiposity, physical activity, cardiometabolic risk factors, diet, physical capacity and well-being in inactive women and men aged 57-74 years with obesity and cardiovascular risk - A 6-month complex lifestyle intervention with 6-month follow-up. PLoS One 2021; 16:e0256631. [PMID: 34432850 PMCID: PMC8386855 DOI: 10.1371/journal.pone.0256631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 08/06/2021] [Indexed: 12/16/2022] Open
Abstract
A key challenge in lifestyle interventions is long-term maintenance of favorable lifestyle changes. Middle-aged and older adults are important target groups. The purpose of this analysis was to investigate changes in adiposity, physical activity, cardiometabolic risk factors, diet, physical capacity, and well-being, in inactive middle-aged and older women and men with obesity and elevated cardiovascular disease risk, participating in an interdisciplinary single-arm complex lifestyle intervention pilot study. Participants were recruited from the population-based Tromsø Study 2015-2016 with inclusion criteria age 55-74 years, body mass index (BMI) ≥30kg/m2, sedentary lifestyle, no prior myocardial infarction and elevated cardiovascular risk. Participants (11 men and 5 women aged 57-74 years) underwent a 6-month intervention of two 1-hour group-sessions per week with instructor-led gradually intensified exercise (endurance and strength), one individual and three 2-hour group counselling sessions with nutritionist (Nordic Nutrition Recommendations) and psychologist (Implementation intention strategies). We investigated changes in adiposity (weight, BMI, body composition, waist circumference), physical activity (self-reported and via physical activity trackers), cardiometabolic risk factors (blood pressure, HbA1c, blood lipids), diet (intake of energy, nutrients, foods), physical capacity (aerobic capacity, muscle strength), and psychological well-being, measured at baseline and end-of-intervention, using mean-comparison paired t-tests. Further, we investigated self-reported healthy lifestyle maintenance six months after end-of-intervention, and monthly changes in daily step count, moderate-to-vigorous physical activity (MVPA) and total energy expenditure. From baseline to end-of-intervention, there was a mean decrease in weight, BMI, fat mass, waist circumference, intake of total- and saturated fat, and increase in lean mass, lateral pulldown and leg press. We detected no changes in mean levels of physical activity, cardiometabolic risk factors or well-being. Six months after end-of-intervention, 25% responded healthy lifestyle achievement and maintenance, while objectively measured physical activity remained unchanged. The results are useful for development of a protocol for a full-scale trial. Trial registration: The study was registered at www.ClinicalTrials.gov registry (NCT03807323).
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Affiliation(s)
- Laila A. Hopstock
- Faculty of Health Sciences, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Trygve S. Deraas
- Faculty of Health Sciences, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Andre Henriksen
- Faculty of Health Sciences, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Torsten Martiny-Huenger
- Faculty of Health Sciences, Department of Psychology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sameline Grimsgaard
- Faculty of Health Sciences, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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22
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Sagelv EH, Ekelund U, Hopstock LA, Fimland MS, Løvsletten O, Wilsgaard T, Morseth B. The bidirectional associations between leisure time physical activity change and body mass index gain. The Tromsø Study 1974-2016. Int J Obes (Lond) 2021; 45:1830-1843. [PMID: 34007009 DOI: 10.1038/s41366-021-00853-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/13/2021] [Accepted: 04/27/2021] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To examine whether leisure time physical activity changes predict subsequent body mass index (BMI) changes, and conversely, whether BMI changes predict subsequent leisure time physical activity changes. METHODS This prospective cohort study included adults attending ≥3 consecutive Tromsø Study surveys (time: T1, T2, T3) during 1974-2016 (n = 10779). If participants attended >3 surveys, we used the three most recent surveys. We computed physical activity change (assessed by the Saltin-Grimby Physical Activity Level Scale) from T1 to T2, categorized as Persistently Inactive (n = 992), Persistently Active (n = 7314), Active to Inactive (n = 1167) and Inactive to Active (n = 1306). We computed BMI change from T2 to T3, which regressed on preceding physical activity changes using analyses of covariance. The reverse association (BMI change from T1 to T2 and physical activity change from T2 to T3; n = 4385) was assessed using multinomial regression. RESULTS Average BMI increase was 0.86 kg/m2 (95% CI: 0.82-0.90) from T2 to T3. With adjustment for sex, birth year, education, smoking and BMI at T2, there was no association between physical activity change from T1 to T2 and BMI change from T2 to T3 (Persistently Inactive: 0.89 kg/m2 (95% CI: 0.77-1.00), Persistently Active: 0.85 kg/m2 (95% CI: 0.81-0.89), Active to Inactive: 0.90 kg/m2 (95% CI: 0.79-1.00), Inactive to Active 0.85 kg/m2 (95% CI: 0.75-0.95), p = 0.84). Conversely, increasing BMI was associated with Persistently Inactive (odds ratio (OR): 1.17, 95% CI: 1.08-1.27, p < 0.001) and changing from Active to Inactive (OR: 1.16, 95% CI: 1.07-1.25, p < 0.001) compared with being Persistently Active. CONCLUSIONS We found no association between leisure time physical activity changes and subsequent BMI changes, whereas BMI change predicted subsequent physical activity change. These findings indicate that BMI change predicts subsequent physical activity change at population level and not vice versa.
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Affiliation(s)
- Edvard H Sagelv
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Laila A Hopstock
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Marius Steiro Fimland
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Unicare Helsefort Rehabilitation Centre, Rissa, Norway
| | - Ola Løvsletten
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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23
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Johansson J, Morseth B, Scott D, Strand BH, Hopstock LA, Grimsgaard S. Moderate-to-vigorous physical activity modifies the relationship between sedentary time and sarcopenia: the Tromsø Study 2015-2016. J Cachexia Sarcopenia Muscle 2021; 12:955-963. [PMID: 34060236 PMCID: PMC8350215 DOI: 10.1002/jcsm.12718] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 04/14/2021] [Accepted: 04/26/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Sarcopenia is an age-related muscle disease primarily characterized by reductions in muscle strength that increases the risk of falls, fractures, cognitive impairment, and mortality. Exercise is currently preferred in prevention and treatment, but it is unknown how different habitual physical activity and sedentary behaviour patterns associate with sarcopenia status. The purpose of the present study was to compare associations of these patterns with probable sarcopenia in older adults. METHODS In 3653 community-dwelling participants (51% women) aged 60-84 years from the seventh survey of the Tromsø Study, we assessed objective physical activity and sedentary behaviour collected over 8 days (ActiGraph wGT3X-BT Accelerometer), grip strength (Jamar+ Digital Dynamometer), five-repetition chair stands, and self-reported disease. We combined tertiles of sedentary (SED) time and moderate-to-vigorous physical activity (MVPA) to create nine different activity profiles (SEDHIGH , SEDMOD , and SEDLOW combined with MVPAHIGH , MVPAMOD , or MVPALOW ). Multiple logistic regression models were used to examine how these profiles associated with probable sarcopenia, defined by low handgrip strength and/or slow chair stands time according to the revised European Working Group on Sarcopenia in Older People criteria. RESULTS Probable sarcopenia was present in 227 (6.2%) participants. Men with probable sarcopenia had on average 35.3 min more SED time and 20 min less MVPA compared with participants without sarcopenia (P < 0.01 for all), while women with probable sarcopenia only had 18 min less MVPA (P < 0.001). Compared with the SEDHIGH -MVPALOW reference activity profile (714.2 min SED/day and 10.4 min MVPA/day), the SEDHIGH -MVPAMOD profile (697.1 min SED/day and 31.5 min MVPA/day) had significantly lower odds ratio (OR) for probable sarcopenia (OR 0.17, 95% confidence interval [CI] 0.08-0.35), while the SEDLOW -MVPALOW profile (482.9 min SED/day and 11.0 min MVPA/day) did not (OR 0.72, 95% CI 0.47-1.11). These findings were not influenced by age, sex, smoking, or self-reported diseases, and higher levels of MVPA did not further decrease ORs for probable sarcopenia. CONCLUSIONS Older adults who achieve moderate amounts of MVPA have reduced odds for probable sarcopenia, even when they have high sedentary time. Those with low sedentary time did not have reduced odds for probable sarcopenia when they also had low amounts of MVPA. These findings need confirmation in longitudinal studies but suggest that interventions for preventing sarcopenia should prioritize increasing MVPA over reducing sedentary behaviour.
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Affiliation(s)
- Jonas Johansson
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - David Scott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.,Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Bjørn Heine Strand
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway.,Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Laila A Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sameline Grimsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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24
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Nilsen L, Hopstock LA, Grimsgaard S, Carlsen MH, Lundblad MW. Intake of Vegetables, Fruits and Berries and Compliance to "Five-a-Day" in a General Norwegian Population-The Tromsø Study 2015-2016. Nutrients 2021; 13:nu13072456. [PMID: 34371965 PMCID: PMC8308725 DOI: 10.3390/nu13072456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 07/13/2021] [Accepted: 07/16/2021] [Indexed: 11/26/2022] Open
Abstract
Vegetables, fruits and berries are associated with reduced disease risk, and recommended intake is “five-a-day”. We studied the intake of vegetables, fruits and berries and compliance with “five-a-day” in 11,425 adults (40–96 years) who completed a food frequency questionnaire in the seventh wave of the Tromsø Study (2015–2016). Intake and proportion above/below recommended intake (250 g/day of vegetables and 250 g/day of fruits/berries, combined and separately) were analyzed. Logistic regression was used to examine compliance with recommendations in 10-year age-groups, and level of education, body mass index (BMI) and physical activity, in strata of sex and adjusted for total energy. Median intake of vegetables was 228 and 168 g/day, and fruits/berries 292 and 268 g/day, in women and men, respectively. In total, 31% of women and 17% of men met the five-a-day recommendation, and 44% and 60% of women, and 25% and 54% of men, met the recommendation for vegetables and fruits/berries, respectively. Odds of compliance with recommendation for both vegetables and fruits/berries were positively associated with age, education and physical activity (p trend < 0.001). The intake of vegetables, fruits and berries was suboptimal, in particular for vegetables. More women than men met the recommendation, and intake varied by education, physical activity level, age and BMI.
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Affiliation(s)
- Linn Nilsen
- Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway; (L.A.H.); (S.G.); (M.W.L.)
- Correspondence: ; Tel.: +47-415-51-306
| | - Laila A. Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway; (L.A.H.); (S.G.); (M.W.L.)
| | - Sameline Grimsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway; (L.A.H.); (S.G.); (M.W.L.)
| | - Monica Hauger Carlsen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, 0372 Oslo, Norway;
| | - Marie W. Lundblad
- Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway; (L.A.H.); (S.G.); (M.W.L.)
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25
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Løvsletten O, Njølstad I, Wilsgaard T, Hopstock LA, Jacobsen BK, Bønaa KH, Eggen AE, Løchen ML. Is the ongoing obesity epidemic partly explained by concurrent decline in cigarette smoking? Insights from a longitudinal population study. The Tromsø Study 1994-2016. Prev Med 2021; 147:106533. [PMID: 33771565 DOI: 10.1016/j.ypmed.2021.106533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 02/17/2021] [Accepted: 03/21/2021] [Indexed: 12/16/2022]
Abstract
The increase of obesity coincides with a substantial decrease in cigarette smoking. We assessed post-cessation weight change and its contribution to the obesity epidemic in a general population in Norway. A total of 14,453 participants (52.6% women), aged 25-54 years in 1994, who attended at least two of four surveys in the Tromsø Study between 1994 and 2016, were included in the analysis. Hereof 77% participated in both the first and the last survey. Temporal trends in mean body mass index (BMI), prevalence of obesity (BMI ≥ 30 kg/m2) and daily smoking were estimated with generalized estimation equations. We assessed BMI change by smoking status (ex-smoker, quitter, never smoker, daily smoker), and also under a scenario where none quit smoking. In total, the prevalence of daily smoking was reduced over the 21 years between Tromsø 4 (1994-1995) and Tromsø 7 (2015-2016) by 22 percentage points. Prevalence of obesity increased from 5 - 12% in 1994-1995 to 21-26% in 2015-2016, where obesity in the youngest (age 25-44 in 1994) increased more than in the oldest (p < 0.0001). Those who quit smoking had a larger BMI gain compared to the other three smoking subgroups over the 21 years (p < 0.0001). The scenario where none quit smoking would imply a 13% reduction in BMI gain in the population, though substantial age-related differences were noted. We conclude that smoking cessation contributed to the increase in obesity in the population, but was probably not the most important factor. Public health interventions should continue to target smoking cessation, and also target obesity prevention.
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Affiliation(s)
- Ola Løvsletten
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Inger Njølstad
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Laila A Hopstock
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bjarne K Jacobsen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Centre for Sami Health Research, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kaare H Bønaa
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Technology and Science, Trondheim, Norway
| | - Anne Elise Eggen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Maja-Lisa Løchen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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26
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Cook S, Eggen AE, Hopstock LA, Malyutina S, Shapkina M, Kudryavtsev AV, Melbye H, Quint JK. Chronic Obstructive Pulmonary Disease (COPD) in Population Studies in Russia and Norway: Comparison of Prevalence, Awareness and Management. Int J Chron Obstruct Pulmon Dis 2021; 16:1353-1368. [PMID: 34025121 PMCID: PMC8132463 DOI: 10.2147/copd.s292472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/21/2021] [Indexed: 11/23/2022] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide. Despite a high prevalence of smoking and respiratory symptoms, two recent population-based studies in Russia found a relatively low prevalence of obstructive lung function. Here, we investigated the prevalence of both obstructive lung disease and respiratory symptoms in a population-based study conducted in two Russian cities and compared the findings with a similar study from Norway conducted in the same time period. Methods The study population was a sub-sample of participants aged 40–69 years participating in the Know Your Heart (KYH) study in Russia in 2015–18 (n=1883) and in the 7th survey of the Tromsø Study (n=5271) carried out in Norway in 2015–16 (Tromsø 7) who participated in spirometry examinations. The main outcome was obstructive lung function (FEV1/FVC ratio< lower limit of normal on pre-bronchodilator spirometry examination) with and without respiratory symptoms (chronic cough and breathlessness). In those with obstructive lung function, awareness (known diagnosis) and management (use of medications, smoking cessation) were compared. Results The age-standardized prevalence of obstructive lung function was similar among men in both studies (KYH 11.0% vs Tromsø 7 9.8%, p=0.21) and higher in the Norwegian (9.4%) than Russian (6.8%) women (p=0.006). In contrast, the prevalence of obstructive lung function plus respiratory symptoms was higher in Russian men (KYH 8.3% vs Tromsø 7 4.7%, p<0.001) but similar in women (KYH 5.9% vs Tromsø 7 6.4%, p=0.18). There was a much higher prevalence of respiratory symptoms in Russian than Norwegian participants of both sexes regardless of presence of obstructive lung function. Conclusion The prevalence of respiratory symptoms was strikingly high among Russian participants but this was not explained by a higher burden of obstructive lung function on spirometry testing in comparison with Norwegian participants. Further work is needed to understand the reasons and health implications of this high prevalence of cough and breathlessness.
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Affiliation(s)
- Sarah Cook
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.,National Heart and Lung Institute, Imperial College London, London, UK
| | - Anne Elise Eggen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Laila A Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sofia Malyutina
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation.,Novosibirsk State Medical University, Russian Ministry of Health, Novosibirsk, Russian Federation
| | - Marina Shapkina
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation
| | - Alexander V Kudryavtsev
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,Northern State Medical University, Arkhangelsk, Russian Federation
| | - Hasse Melbye
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Jennifer K Quint
- National Heart and Lung Institute, Imperial College London, London, UK
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Syed S, Morseth B, Hopstock LA, Horsch A. A novel algorithm to detect non-wear time from raw accelerometer data using deep convolutional neural networks. Sci Rep 2021; 11:8832. [PMID: 33893345 PMCID: PMC8065130 DOI: 10.1038/s41598-021-87757-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 04/05/2021] [Indexed: 11/09/2022] Open
Abstract
To date, non-wear detection algorithms commonly employ a 30, 60, or even 90 mins interval or window in which acceleration values need to be below a threshold value. A major drawback of such intervals is that they need to be long enough to prevent false positives (type I errors), while short enough to prevent false negatives (type II errors), which limits detecting both short and longer episodes of non-wear time. In this paper, we propose a novel non-wear detection algorithm that eliminates the need for an interval. Rather than inspecting acceleration within intervals, we explore acceleration right before and right after an episode of non-wear time. We trained a deep convolutional neural network that was able to infer non-wear time by detecting when the accelerometer was removed and when it was placed back on again. We evaluate our algorithm against several baseline and existing non-wear algorithms, and our algorithm achieves a perfect precision, a recall of 0.9962, and an F1 score of 0.9981, outperforming all evaluated algorithms. Although our algorithm was developed using patterns learned from a hip-worn accelerometer, we propose algorithmic steps that can easily be applied to a wrist-worn accelerometer and a retrained classification model.
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Affiliation(s)
- Shaheen Syed
- Department of Computer Science, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Bente Morseth
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Laila A Hopstock
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Alexander Horsch
- Department of Computer Science, UiT The Arctic University of Norway, Tromsø, Norway
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28
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Hopstock LA, Morseth B, Cook S, Eggen AE, Grimsgaard S, Lundblad MW, Løchen ML, Mathiesen E, Nilsen A, Njølstad I. Treatment target achievement after myocardial infarction and ischaemic stroke: cardiovascular risk factors, medication use, and lifestyle: the Tromsø Study 2015-16. Eur J Prev Cardiol 2021; 29:362-370. [PMID: 33778888 DOI: 10.1093/eurjpc/zwab050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/03/2021] [Accepted: 03/12/2021] [Indexed: 12/29/2022]
Abstract
AIMS To investigate European guideline treatment target achievement in cardiovascular risk factors, medication use, and lifestyle, after myocardial infarction (MI) or ischaemic stroke, in women and men living in Norway. METHODS AND RESULTS In the population-based Tromsø Study 2015-16 (attendance 65%), 904 participants had previous validated MI and/or stroke. Cross-sectionally, we investigated target achievement for blood pressure (<140/90 mmHg, <130/80 mmHg if diabetes), LDL cholesterol (<1.8 mmol/L), HbA1c (<7.0% if diabetes), overweight (body mass index (BMI) <25 kg/m2, waist circumference women <80 cm, men <94 cm), smoking (non-smoking), physical activity (self-reported >sedentary, accelerometer-measured moderate-to-vigorous ≥150 min/week), diet (intake of fruits ≥200 g/day, vegetables ≥200 g/day, fish ≥200 g/week, saturated fat <10E%, fibre ≥30 g/day, alcohol women ≤10 g/day, men ≤20 g/day), and medication use (antihypertensives, lipid-lowering drugs, antithrombotics, and antidiabetics), using regression models. Proportion of target achievement was for blood pressure 55.2%, LDL cholesterol 9.0%, HbA1c 42.5%, BMI 21.1%, waist circumference 15.7%, non-smoking 86.7%, self-reported physical activity 79%, objectively measured physical activity 11.8%, intake of fruit 64.4%, vegetables 40.7%, fish 96.7%, saturated fat 24.3%, fibre 29.9%, and alcohol 78.5%, use of antidiabetics 83.6%, lipid-lowering drugs 81.0%, antihypertensives 75.9%, and antithrombotics 74.6%. Only 0.7% achieved all cardiovascular risk factor targets combined. Largely, there was little difference between the sexes, and in characteristics, medication use, and lifestyle among target achievers compared to non-achievers. CONCLUSION Secondary prevention of cardiovascular disease was suboptimal. A negligible proportion achieved the treatment target for all risk factors. Improvement in follow-up care and treatment after MI and stroke is needed.
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Affiliation(s)
- Laila A Hopstock
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Hansine Hansens vei, 9037 Tromsø, Norway.,Pandemic Unit, Tromsø Municipality, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sarah Cook
- Faculty of Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Anne Elise Eggen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Hansine Hansens vei, 9037 Tromsø, Norway
| | - Sameline Grimsgaard
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Hansine Hansens vei, 9037 Tromsø, Norway
| | - Marie W Lundblad
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Hansine Hansens vei, 9037 Tromsø, Norway
| | - Maja-Lisa Løchen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Hansine Hansens vei, 9037 Tromsø, Norway
| | - Ellisiv Mathiesen
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Amalie Nilsen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Hansine Hansens vei, 9037 Tromsø, Norway.,Department of Medicine, Nordland Hospital, Bodø, Norway
| | - Inger Njølstad
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Hansine Hansens vei, 9037 Tromsø, Norway
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Ausland JHL, Engdahl B, Oftedal B, Steingrímsdóttir ÓA, Nielsen CS, Hopstock LA, Johnsen M, Friborg O, Rosenvinge JH, Eggen AE, Krog NH. Tinnitus and associations with chronic pain: The population-based Tromsø Study (2015-2016). PLoS One 2021; 16:e0247880. [PMID: 33651844 PMCID: PMC7924755 DOI: 10.1371/journal.pone.0247880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 02/16/2021] [Indexed: 11/18/2022] Open
Abstract
Tinnitus and pain have many similarities. Both are subjective sensations that may turn chronic, they are often accompanied by hypersensitivity in their respective sensory system, and overlapping brain changes have been observed. Since no population study has examined the empirical association between chronic pain and tinnitus, the present study aimed to explore the relationship in a general adult population. We used data from the seventh survey of the Tromsø Study (2015–2016). Participants (aged ≥40) responded to questions about pain and tinnitus. Using multiple logistic regression, we analysed the adjusted relationship between chronic pain and tinnitus in the full sample (n = 19,039), using several tinnitus definitions ranging from tinnitus >5 minutes within the past 12 months (broadest definition) to at least weekly and highly bothersome tinnitus (strictest definition). We also analysed relationships between number of body regions with pain, pain intensity and bothering, and tinnitus >5 minutes, among participants with chronic pain (n = 11,589). We found an association between chronic pain and tinnitus that was present irrespective of tinnitus definition, but was stronger with more bothersome tinnitus. With chronic pain, the odds of tinnitus >5 minutes was 64% higher, while odds of at least weekly, highly bothersome tinnitus was 144% higher than without chronic pain. Among participants with chronic pain, the number of pain regions was the pain variable most strongly associated with tinnitus >5 minutes (OR = 1.17 (95% CI: 1.14–1.20) for an increase of one region), whereas the other pain variables (intensity and bothering) showed weaker associations. All chronic pain variables had significant interactions with age, with the strongest associations for the youngest individuals (40–54 years). Our findings support the existence of an association between chronic pain and tinnitus and emphasises the importance of examining for comorbid pain in tinnitus patients to provide a more comprehensive treatment of tinnitus.
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Affiliation(s)
- Jannike H-L Ausland
- Department of Environmental Health, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
- * E-mail:
| | - Bo Engdahl
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
| | - Bente Oftedal
- Department of Environmental Health, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
| | - Ólöf A. Steingrímsdóttir
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
| | - Christopher S. Nielsen
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Nydalen, Oslo, Norway
| | - Laila A. Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Langnes, Tromsø, Norway
| | - Magnar Johnsen
- Department of Occupational and Environmental Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Oddgeir Friborg
- Department of Psychology, UiT The Arctic University of Norway, Langnes, Tromsø, Norway
| | - Jan H. Rosenvinge
- Department of Psychology, UiT The Arctic University of Norway, Langnes, Tromsø, Norway
| | - Anne E. Eggen
- Department of Community Medicine, UiT The Arctic University of Norway, Langnes, Tromsø, Norway
| | - Norun H. Krog
- Department of Environmental Health, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
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30
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Nilsen L, Hopstock LA, Skeie G, Grimsgaard S, Lundblad MW. The Educational Gradient in Intake of Energy and Macronutrients in the General Adult and Elderly Population: The Tromsø Study 2015-2016. Nutrients 2021; 13:nu13020405. [PMID: 33525333 PMCID: PMC7911135 DOI: 10.3390/nu13020405] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/21/2021] [Accepted: 01/25/2021] [Indexed: 11/16/2022] Open
Abstract
Worldwide, there are socioeconomic inequalities in health and diet. We studied the relationship between education and nutrient intake in 11,302 women and men aged 40-96 years who participated in the seventh survey of the population-based Tromsø Study (2015-2016), Norway (attendance 65%). Diet was assessed using a validated food-frequency questionnaire. We examined the association between education and intake of total energy and macronutrients by sex using linear and logistic regression models adjusted for age, body mass index, leisure time physical activity and smoking. The intake of macronutrients was compared with the Nordic Nutrition Recommendations 2012. There was a positive association between education and intake of fiber and alcohol, and a negative association between education and intake of total carbohydrates and added sugar in both women and men. Participants with long tertiary education had higher odds of being compliant with the recommended intake of fiber and protein and the maximum recommended level for added sugar and had lower odds of being compliant with the recommended intake of total carbohydrates and the maximum recommended level for alcohol, compared to participants with primary education. Overall, we found that participants with higher education were more compliant with the Nordic Nutrition Recommendations 2012.
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Lundblad MW, Jacobsen BK, Johansson J, De Lucia Rolfe E, Grimsgaard S, Hopstock LA. Reference Values for DXA-Derived Visceral Adipose Tissue in Adults 40 Years and Older from a European Population: The Tromsø Study 2015-2016. J Obes 2021; 2021:6634536. [PMID: 34055405 PMCID: PMC8147540 DOI: 10.1155/2021/6634536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 03/13/2021] [Accepted: 04/08/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Reference values for visceral adipose tissue (VAT) are needed and it has been advocated that body composition measures depend on both the technique and methods applied, as well as the population of interest. We aimed to develop reference values for VAT in absolute grams (VATg), percent (VAT%), and as a kilogram-per-meters-squared index (VATindex) for women and men, and investigate potential differences between these measures and their associations with cardiometabolic risk factors (including metabolic syndrome (MetS)). METHODS In the seventh survey of the population-based Tromsø Study, 3675 participants (aged 40-84, 59% women) attended whole-body DXA scans (Lunar Prodigy GE) from where VAT was derived. We used descriptive analysis, correlations, receiver operating characteristics (ROC), and logistic regression to propose reference values for VAT and investigated VAT's association with cardiometabolic risk factors, MetS and single MetS components. Further, Youden's index was used to suggest threshold values for VAT. RESULTS VATg and VATindex increased until age 70 and then decreased, while VAT% increased with age across all age groups. VAT (all measurement units) was moderate to highly correlated and significantly associated with all cardiometabolic risk factors, except for total cholesterol. Associations between MetS, single MetS components, and VATg and VATindex were similar, and VAT% did not contribute any further to this association. CONCLUSION These VAT reference values and thresholds, developed in a sample of adults of Norwegian origin, could be applied to other studies with similar populations using the same DXA device and protocols. The associations between VAT and cardiometabolic risk factors were similar across different measurement units of VAT.
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Affiliation(s)
- Marie W. Lundblad
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bjarne K. Jacobsen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Jonas Johansson
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Emanuella De Lucia Rolfe
- NIHR Cambridge Biomedical Research Centre—Diet, Anthropometry and Physical Activity Group, MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Sameline Grimsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Laila A. Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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32
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Heitmann KA, Løchen ML, Hopstock LA, Stylidis M, Welde B, Schirmer H, Morseth B. Cross-sectional associations between accelerometry-measured physical activity, left atrial size, and indices of left ventricular diastolic dysfunction: The Tromsø Study. Prev Med Rep 2020; 21:101290. [PMID: 33425668 PMCID: PMC7782323 DOI: 10.1016/j.pmedr.2020.101290] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/04/2020] [Accepted: 12/13/2020] [Indexed: 02/08/2023] Open
Abstract
Examination of how objectively PA and LAVi associate in a general population represents novelty. PA is associated with greater LA size in participants <70 years with normal diastolic function. LA enlargement is only associated with diastolic dysfunction in the most inactive participants. We suggest that LA enlargement in active individuals is not an expression of cardiac dysfunction.
Whereas left atrial (LA) enlargement is an independent predictor for adverse cardiovascular events and all-cause mortality, this is regarded a physiological adaption of exercise. Paradoxically, LA size in athletes may overlap the enlargement observed in patients with cardiac pathology. Current knowledge is mainly derived from studies of athletes, and little is known about cardiac adaptations to physical activity (PA) in the general population. We explored the association between objectively measured PA and LA volume index (LAVi), and between LAVi enlargement and indices of diastolic dysfunction stratified by PA-level. Our study included 1573 participants from the population-based Tromsø Study (2015–16). PA was assessed with an ActiGraph wGT3X-BT accelerometer. Echocardiography was performed according to current guidelines. The associations between PA and LAVi, and between LAVi enlargement and indices of diastolic dysfunction were estimated by univariable and multivariable linear regression analyses, adjusted for sex, age, and cardiovascular risk factors. Our multiple adjusted analyses showed significant linear associations between PA and LAVi in ages < 70 years, and between PA and LAVi in participants with normal diastolic function. No associations were seen in ages ≥ 70 years or for participants with abnormal diastolic function. In those 40–54 years, the most active participants had larger LAVi (4.45 mL/m2, p = 0.016) than the least active. LAVi enlargement was only associated with indices of diastolic dysfunction in the most inactive participants. In conclusion, higher levels of PA associate with greater LAVi in participants < 70 years with normal diastolic function. LAVi enlargement is only associated with diastolic dysfunction in the most inactive participants.
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Affiliation(s)
- Kim Arne Heitmann
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway.,Centre for Clinical Research and Education, University Hospital of North Norway, Tromsø, Norway
| | - Maja-Lisa Løchen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Laila A Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Michael Stylidis
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Boye Welde
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Henrik Schirmer
- Department of Cardiology, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Sagelv EH, Ekelund U, Hopstock LA, Aars NA, Fimland MS, Jacobsen BK, Løvsletten O, Wilsgaard T, Morseth B. Do declines in occupational physical activity contribute to population gains in body mass index? Tromsø Study 1974-2016. Occup Environ Med 2020; 78:oemed-2020-106874. [PMID: 33277383 DOI: 10.1136/oemed-2020-106874] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 11/11/2020] [Accepted: 11/16/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To examine whether occupational physical activity changes predict future body mass index (BMI) changes. METHODS This longitudinal cohort study included adult participants attending ≥3 consecutive Tromsø Study surveys (examinations 1, 2 and 3) from 1974 to 2016 (N=11 308). If a participant attended >3 surveys, the three most recent surveys were included. Occupational physical activity change (assessed by the Saltin-Grimby Physical Activity Level Scale) was computed from the first to the second examination, categorised into persistently inactive (n=3692), persistently active (n=5560), active to inactive (n=741) and inactive to active (n=1315). BMI change was calculated from the second to the third examination (height being fixed at the second examination) and regressed on preceding occupational physical activity changes using analysis of covariance adjusted for sex, birth year, smoking, education and BMI at examination 2. RESULTS Overall, BMI increased by 0.84 kg/m2 (95% CI 0.82 to 0.89). Following adjustments as described previously, we observed no differences in BMI increase between the occupational physical activity change groups (Persistently Inactive: 0.81 kg/m2, 95% CI 0.75 to 0.87; Persistently Active: 0.87 kg/m2, 95% CI 0.82 to 0.92; Active to Inactive: 0.81 kg/m2, 95% CI 0.67 to 0.94; Inactive to Active: 0.91 kg/m2, 95% CI 0.81 to 1.01; p=0.25). CONCLUSION We observed no prospective association between occupational physical activity changes and subsequent BMI changes. Our findings do not support the hypothesis that occupational physical activity declines contributed to population BMI gains over the past decades. Public health initiatives aimed at weight gain prevention may have greater success if focusing on other aspects than occupational physical activity.
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Affiliation(s)
- Edvard H Sagelv
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Troms, Norway
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Oslo, Norway
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Oslo, Norway
| | - Laila A Hopstock
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Troms, Norway
| | - Nils Abel Aars
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Troms, Norway
| | - Marius Steiro Fimland
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Trøndelag, Norway
- Unicare Helsefort Rehabilitation Centre, Rissa, Trøndelag, Norway
| | - Bjarne Koster Jacobsen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Troms, Norway
- Centre for Sami Health Research, Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Troms, Norway
| | - Ola Løvsletten
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Troms, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Troms, Norway
| | - Bente Morseth
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Troms, Norway
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Årnes AP, Nielsen CS, Stubhaug A, Fjeld MK, Hopstock LA, Horsch A, Johansen A, Morseth B, Wilsgaard T, Steingrímsdóttir ÓA. Physical activity and cold pain tolerance in the general population. Eur J Pain 2020; 25:637-650. [PMID: 33165994 DOI: 10.1002/ejp.1699] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND The relationship between habitual physical activity (PA) and experimental pain tolerance has been investigated in small samples of young, healthy and/or single-sex volunteers. We used a large, population-based sample to assess this relationship in men and women with and without chronic pain. METHODS We used data from the sixth and seventh Tromsø Study surveys (2007-2008; 2015-2016), with assessed pain tolerance of participants with the cold pressor test (CPT: dominant hand in circulating cold water at 3°C, maximum test time 106 s), and self-reported total amount of habitual PA in leisure time (n = 19,087), exercise frequency (n = 19,388), exercise intensity (n = 18,393) and exercise duration (n = 18,343). A sub-sample had PA measured by accelerometers (n = 4,922). We used Cox regression to compare CPT tolerance times between self-reported PA levels. For accelerometer-measured PA, we estimated hazard ratios for average daily activity counts, and for average daily minutes of moderate-to-vigorous PA done in bouts lasting 10 min or more. Models were tested for PA-sex, and PA-chronic pain and PA-moderate-to-severe chronic pain interactions. RESULTS Leisure-time PA, exercise intensity and exercise duration were positively associated with CPT tolerance (p < .001; p = .011; p < .001). More PA was associated with higher CPT tolerance. At high levels of leisure-time PA and exercise intensity, men had a significantly higher CPT tolerance than women. Accelerometer-measured PA was not associated with CPT tolerance. CONCLUSIONS This study is one of the first to show that higher self-reported habitual PA was connected to higher experimental pain tolerance in a population-based sample, especially for men. This was not found for accelerometer-measured PA. SIGNIFICANCE This study finds that higher level of self-reported leisure-time physical activity is associated with increased cold pressor pain tolerance in a large population-based sample. Though present in both sexes, the association is strongest among men. Despite the robust dose-response relationship between pain tolerance and self-reported activity level, no such relationship was found for accelerometer-measured activity, reflecting a possible discrepancy in the aspect of physical activity measured. Though the study design does not permit causal conclusions, the findings suggest that increasing physical activity may increase pain tolerance in the general population.
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Affiliation(s)
- Anders P Årnes
- Department of Pain, Department of Community Medicine, University Hospital of North Norway, Tromsø, Norway.,Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Christopher S Nielsen
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.,Department of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Audun Stubhaug
- Department of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Mats K Fjeld
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Laila A Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Alexander Horsch
- Department of Computer Science, UiT The Arctic University of Norway, Tromsø, Norway
| | - Aslak Johansen
- Department of Pain, Department of Community Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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Trias-Llimós S, Pennells L, Tverdal A, Kudryavtsev AV, Malyutina S, Hopstock LA, Iakunchykova O, Nikitin Y, Magnus P, Kaptoge S, Di Angelantonio E, Leon DA. Quantifying the contribution of established risk factors to cardiovascular mortality differences between Russia and Norway. Sci Rep 2020; 10:20796. [PMID: 33247203 PMCID: PMC7695740 DOI: 10.1038/s41598-020-77877-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 11/17/2020] [Indexed: 02/02/2023] Open
Abstract
Surprisingly few attempts have been made to quantify the simultaneous contribution of well-established risk factors to CVD mortality differences between countries. We aimed to develop and critically appraise an approach to doing so, applying it to the substantial CVD mortality gap between Russia and Norway using survey data in three cities and mortality risks from the Emerging Risk Factor Collaboration. We estimated the absolute and relative differences in CVD mortality at ages 40-69 years between countries attributable to the risk factors, under the counterfactual that the age- and sex-specific risk factor profile in Russia was as in Norway, and vice-versa. Under the counterfactual that Russia had the Norwegian risk factor profile, the absolute age-standardized CVD mortality gap would decline by 33.3% (95% CI 25.1-40.1) among men and 22.1% (10.4-31.3) among women. In relative terms, the mortality rate ratio (Russia/Norway) would decline from 9-10 to 7-8. Under the counterfactual that Norway had the Russian risk factor profile, the mortality gap reduced less. Well-established CVD risk factors account for a third of the male and around a quarter of the female CVD mortality gap between Russia and Norway. However, these estimates are based on widely held epidemiological assumptions that deserve further scrutiny.
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Affiliation(s)
- Sergi Trias-Llimós
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Lisa Pennells
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Aage Tverdal
- Centre for Fertility and Health, Norwegian Insitute of Public Health, Oslo, Norway
| | - Alexander V Kudryavtsev
- Central Scientific Research Laboratory, Northern State Medical University, Arkhangelsk, Russia
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sofia Malyutina
- Research Institute of Internal and Preventive Medicine-Branch of IC&G, SB RAS, Novosibirsk, Russia
- Novosibirsk State Medical University, Ministry of Health of Russia, Novosibirsk, Russia
| | - Laila A Hopstock
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Olena Iakunchykova
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Yuri Nikitin
- Research Institute of Internal and Preventive Medicine-Branch of IC&G, SB RAS, Novosibirsk, Russia
| | - Per Magnus
- Centre for Fertility and Health, Norwegian Insitute of Public Health, Oslo, Norway
| | - Stephen Kaptoge
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | | | - David A Leon
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- International Laboratory for Population and Health, National Research University, Higher School of Economics, Moscow, Russian Federation
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Cook S, Hopstock LA, Eggen AE, Bates K, Iakunchykova O, Kontsevaya A, McKee M, Schirmer H, Voevoda M, Kudryavtsev AV, Malyutina S, Leon DA. Pharmacological management of modifiable cardiovascular risk factors (blood pressure and lipids) following diagnosis of myocardial infarction, stroke and diabetes: comparison between population-based studies in Russia and Norway. BMC Cardiovasc Disord 2020; 20:234. [PMID: 32430002 PMCID: PMC7236339 DOI: 10.1186/s12872-020-01513-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 05/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) mortality is substantially higher in Russia than in neighbouring Norway. We aimed to compare blood pressure- and lipid-lowering medication use and proportion meeting treatment targets between general population samples in the two countries in those with CVD and diabetes. METHODS The study population was adults aged 40-69 years reporting a diagnosis of myocardial infarction (MI), stroke and/or diabetes participating in cross-sectional population-based studies in Russia (Know Your Heart (KYH) 2015-18 N = 626) and Norway (The Tromsø Study 2015-16 (Tromsø 7) N = 1353). Reported medications were coded according to the 2016 WHO Anatomical Therapeutic Chemical Classification system. Treatment targets were defined using the Joint European Societies guidelines for CVD prevention in clinical practice (2016). RESULTS Age- and sex-standardized prevalence of use of lipid-lowering medications was higher in Tromsø 7 for all three conditions with a disproportionately large difference in those reporting MI (+ 48% (95% CI 39, 57%)). Proportion meeting treatment targets for LDL cholesterol was poor in both studies (age- and sex-standardized prevalence of control KYH vs Tromsø 7: MI 5.1% vs 10.1%; stroke 11.6% vs 5.8%; diabetes 24.9% vs 23.3%). Use of antihypertensive medication was higher in KYH for stroke (+ 40% (95% CI 30, 50%)) and diabetes (+ 27% (95% CI 19, 34%)) groups but approximately equal for the MI group (- 1% (95% CI -1, 1%)). Proportion meeting blood pressure targets was lower in KYH vs Tromsø 7 (MI 51.8% vs 76.3%; stroke 49.5% vs 69.6%; diabetes 51.9% vs 63.9%). CONCLUSIONS We identified different patterns of medication use in people with CVD and diabetes. However despite higher use of lipid-lowering medication in the Norwegian study treatment to target for total cholesterol was poor in both Russian and Norwegian studies. In contrast we found higher levels of use of antihypertensive medications in the Russian study but also that less participants met treatment targets for blood pressure. Further work should investigate what factors are responsible for this seeming paradox and how management of modifiable risk factors for secondary prevention could be improved.
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Affiliation(s)
- Sarah Cook
- Department of Community Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway.
| | - Laila A Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - Anne Elise Eggen
- Department of Community Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - Katie Bates
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.,Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Schöpfstraße 41/1, A-6020, Innsbruck, Austria
| | - Olena Iakunchykova
- Department of Community Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - Anna Kontsevaya
- National research center for preventive medicine, Moscow, Russian Federation, 101990
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Henrik Schirmer
- Akershus University Hospital, 1478, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, 0318, Oslo, Norway
| | - Michael Voevoda
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation, 630090
| | - Alexander V Kudryavtsev
- Department of Community Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway.,Northern State Medical University, Arkhangelsk, Russian Federation, 163000
| | - Sofia Malyutina
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation, 630090.,Novosibirsk State Medical University, Russian Ministry of Health, Novosibirsk, Russian Federation, 630091
| | - David A Leon
- Department of Community Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway.,Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
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37
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Imahori Y, Frost C, Mathiesen EB, Ryabikov A, Kudryavtsev AV, Malyutina S, Kornev M, Hughes AD, Hopstock LA, Leon DA. Effect of adiposity on differences in carotid plaque burden in studies conducted in Norway and Russia: a cross-sectional analysis of two populations at very different risk of cardiovascular mortality. BMJ Open 2020; 10:e036583. [PMID: 32381537 PMCID: PMC7223302 DOI: 10.1136/bmjopen-2019-036583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Large differences exist in the burden of cardiovascular disease (CVD) between Russia and Western European countries including Norway. Obesity prevalence may contribute to the differences. We investigated whether difference in the level of adiposity, assessed using body mass index and waist-to-hip ratio(WHR), could explain intercountry differences in the burden of carotid plaque, a measure of atherosclerosis, in the populations. DESIGN Cross-sectional analysis. Logistic and linear regression models were used. SETTING We used population-based cross-sectional Know Your Heart (KYH) study in Russia and the Tromsø 7 study (Tromsø 7) in Norway. PARTICIPANTS 3262 and 1800 men and women aged 40-69 years in KYH and Tromsø 7, respectively. PRIMARY AND SECONDARY OUTCOME The presence of carotid plaques and plaque score assessed using ultrasound. RESULTS The presence of carotid plaques and plaque score were higher in KYH than Tromsø 7 regardless of age group and sex. A positive association between carotid plaque burden and adiposity was found (OR of having at least one plaque per SD in WHR 1.18 (95% CI 1.06 to 1.31) for men; 1.15 (1.06 to 1.25) for women)) adjusted for age, smoking and education in a pooled analysis of the two studies. There was little evidence of the interaction between study and adiposity. These effects did not differ between the two studies. However, neither adiposity nor CVD risk factors (smoking, systolic blood pressure, cholesterol, glycosylated haemoglobin) explained the higher carotid plaque burden in KYH compared with Tromsø 7. CONCLUSION Adiposity, especially abdominal adiposity, is a risk factor for carotid plaque in Russia and Norway, although neither adiposity nor established CVD risk factors explained the higher plaque burden in Russia. To reduce the CVD burden in Russia, beyond prevention and treatment of adiposity, further research is required to understand why Russia has a high burden of atherosclerosis.
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Affiliation(s)
- Yume Imahori
- London School of Hygiene and Tropical Medicine, London, UK
| | - Chris Frost
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Andrey Ryabikov
- Reserach Institute of Internal and Preventive Medicine, Novosibirsk, Russian Federation
- Novosibirsk State Medical University, Novosibirsk, Russian Federation
| | | | - Sofia Malyutina
- Reserach Institute of Internal and Preventive Medicine, Novosibirsk, Russian Federation
- Novosibirsk State Medical University, Novosibirsk, Russian Federation
| | - Michael Kornev
- Northern State Medical University, Arkhangelsk, Russian Federation
| | | | | | - David A Leon
- London School of Hygiene and Tropical Medicine, London, UK
- UiT The Arctic University of Norway, Tromsø, Norway
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Sharashova E, Wilsgaard T, Ball J, Morseth B, Gerdts E, Hopstock LA, Mathiesen EB, Schirmer H, Løchen ML. Long-term blood pressure trajectories and incident atrial fibrillation in women and men: the Tromsø Study. Eur Heart J 2020; 41:1554-1562. [PMID: 31050731 PMCID: PMC7174044 DOI: 10.1093/eurheartj/ehz234] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/23/2018] [Accepted: 04/08/2019] [Indexed: 12/11/2022] Open
Abstract
AIMS To explore sex-specific associations between long-term individual blood pressure (BP) patterns and risk of incident atrial fibrillation (AF) in the general population. METHODS AND RESULTS Blood pressure was measured in 8376 women and 7670 men who attended at least two of the three population-based Tromsø Study surveys conducted in 1986-87, 1994-95, and 2001. Participants were followed for incident AF throughout 2013. Latent mixed modelling was used to identify long-term trajectories of systolic BP and hypertension. Cox regression was used to estimate associations between the identified trajectories and incident AF. Elevated systolic BP throughout the exposure period (1986-2001) independently and differentially increased risk of AF in women and men. In women, having elevated systolic BP trajectories doubled AF risk compared to having persistently low levels, irrespective of whether systolic BP increased, decreased, or was persistently high over time, with hazard ratios of 1.88 (95% confidence interval 1.37-2.58), 2.32 (1.61-3.35), and 1.94 (1.28-2.94), respectively. In men, those with elevated systolic BP that continued to increase over time had a 50% increased AF risk: 1.51 (1.09-2.10). When compared to those persistently normotensive, women developing hypertension during the exposure period, and women and men with hypertension throughout the exposure period had 1.40 (1.06-1.86), 2.75 (1.99-3.80), and 1.36 (1.10-1.68) times increased risk of AF, respectively. CONCLUSION Long-term BP and hypertension trajectories were associated with increased incidence of AF in both women and men, but the associations were stronger in women.
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Affiliation(s)
- Ekaterina Sharashova
- Department of Community Medicine, UiT The Arctic University of Norway, Hansine Hansens veg 18, 9019 Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Hansine Hansens veg 18, 9019 Tromsø, Norway
| | - Jocasta Ball
- Pre-Clinical Disease and Prevention, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Bente Morseth
- Department of Community Medicine, UiT The Arctic University of Norway, Hansine Hansens veg 18, 9019 Tromsø, Norway
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Eva Gerdts
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Laila A Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Hansine Hansens veg 18, 9019 Tromsø, Norway
| | - Ellisiv B Mathiesen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Henrik Schirmer
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Akershus University Hospital, Lørenskog, Oslo, Norway
| | - Maja-Lisa Løchen
- Department of Community Medicine, UiT The Arctic University of Norway, Hansine Hansens veg 18, 9019 Tromsø, Norway
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Imahori Y, Mathiesen EB, Morgan KE, Frost C, Hughes AD, Hopstock LA, Johnsen SH, Emaus N, Leon DA. The association between anthropometric measures of adiposity and the progression of carotid atherosclerosis. BMC Cardiovasc Disord 2020; 20:138. [PMID: 32183704 PMCID: PMC7079386 DOI: 10.1186/s12872-020-01417-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 03/04/2020] [Indexed: 12/20/2022] Open
Abstract
Background Few reports are available on the contribution of general and abdominal obesity to the progression of carotid atherosclerosis in late adulthood. This study investigated the impact of four simple anthropometric measures of general and abdominal obesity on the progression of carotid atherosclerosis and the extent to which the association between adiposity and the progression of plaque burden is mediated by cardiometabolic markers. Methods Four thousand three hundred forty-five adults (median age 60) from the population-based Tromsø Study were followed over 7 years from the first carotid ultrasound screening to the next. The progression of carotid atherosclerosis was measured in three ways: incidence of plaques in previously plaque-free participants; change in the number of plaques; and total plaque area (TPA). We used generalised linear models to investigate the association between each adiposity measure – body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) – and each outcome. Models were adjusted for potential confounders (age, sex, smoking, education, physical activity). The pathways through which any associations observed might operate were investigated by further adjusting for cardiometabolic mediators (systolic blood pressure, cholesterol, and HbA1c). Results There was little evidence that adiposity was related to the formation of new plaques during follow-up. However, abdominal adiposity was associated with TPA progression. WHtR showed the largest effect size (mean change in TPA per one standard deviation (SD) increase in WHtR of 0.665 mm2, 95% confidence interval 0.198, 1.133) while BMI showed the smallest. Effect sizes were substantially reduced after the adjustment for potential mediators. Conclusions Abdominal obesity indirectly measured with WC seems more strongly associated with the progression of TPA than general obesity. These associations appear to be largely mediated by known cardiometabolic markers.
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Affiliation(s)
- Yume Imahori
- Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Ellisiv B Mathiesen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø and Department of Neurology, University Hospital of North Norway, 9037, Tromsø, Norway
| | - Katy E Morgan
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Chris Frost
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Alun D Hughes
- Department of Population Science & Experimental Medicine, & MRC Unit for Lifelong Health and Ageing, University College London, London, WC1E 6BT, UK
| | - Laila A Hopstock
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - Stein Harald Johnsen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø and Department of Neurology, University Hospital of North Norway, 9037, Tromsø, Norway
| | - Nina Emaus
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - David A Leon
- Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.,Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway
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Petersen J, Malyutina S, Ryabikov A, Kontsevaya A, Kudryavtsev AV, Eggen AE, McKee M, Cook S, Hopstock LA, Schirmer H, Leon DA. Uncontrolled and apparent treatment resistant hypertension: a cross-sectional study of Russian and Norwegian 40-69 year olds. BMC Cardiovasc Disord 2020; 20:135. [PMID: 32169049 PMCID: PMC7071707 DOI: 10.1186/s12872-020-01407-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 02/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Uncontrolled hypertension is a major cardiovascular risk factor. We examined uncontrolled hypertension and differences in treatment regimens between a high-risk country, Russia, and low-risk Norway to gain better understanding of the underlying factors. METHODS Population-based survey data on 40-69 year olds with hypertension defined as taking antihypertensives and/or having high blood pressure (140+/90+ mmHg) were obtained from Know Your Heart Study (KYH, N = 2284), Russian Federation (2015-2018) and seventh wave of The Tromsø Study (Tromsø 7, N = 5939), Norway (2015-2016). Uncontrolled hypertension was studied in the subset taking antihypertensives (KYH: N = 1584; Tromsø 7: 2792)and defined as having high blood pressure (140+/90+ mmHg). Apparent treatment resistant hypertension (aTRH) was defined as individuals with uncontrolled hypertension on 3+ OR controlled on 4+ antihypertensive classes in the same subset. RESULTS Among all those with hypertension regardless of treatment status, control of blood pressure was achieved in 22% of men (KYH and Tromsø 7), while among women it was 33% in Tromsø 7 and 43% in KYH. When the analysis was limited to those on treatment for hypertension, the percentage uncontrolled was higher in KYH (47.8%, CI 95 44.6-50.9%) than Tromsø 7 (38.2, 36.1-40.5%). The corresponding figures for aTRH were 9.8% (8.2-11.7%) and 5.7% (4.8-6.8%). Antihypertensive monotherapies were more common than combinations and used by 58% in Tromsø 7 and 44% in KYH. In both KYH and Tromsø 7, untreated hypertension was higher in men, those with no GP visit in the past year and problem drinkers. In both studies, aTRH was associated with older age, CVD history, obesity, and diabetes. In Tromsø 7, also male gender and any drinking. In KYH, also chronic kidney disease. CONCLUSION There is considerable scope for promoting combination therapies in line with European treatment guidelines in both study populations. The factors associated with untreated hypertension overlap with known correlates of treatment non-adherence and health check non-attendance. In contrast, aTRH was characterised by obesity and underlying comorbidities potentially complicating treatment.
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Affiliation(s)
- Jakob Petersen
- London School of Hygiene & Tropical Medicine, WC1E 7HT, London, UK.
| | - Sofia Malyutina
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, 630090, Russia.,Novosibirsk State Medical University, Russian Ministry of Health, Novosibirsk, 630091, Russia
| | - Andrey Ryabikov
- Novosibirsk State Medical University, Russian Ministry of Health, Novosibirsk, 630091, Russia
| | - Anna Kontsevaya
- National Research Center for Preventive Medicine, Ministry of Healthcare, Moscow, Russia
| | | | - Anne Elise Eggen
- Department of Community Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - Martin McKee
- London School of Hygiene & Tropical Medicine, WC1E 7HT, London, UK
| | - Sarah Cook
- Department of Community Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - Laila A Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| | - Henrik Schirmer
- Department of Community Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway.,University of Oslo, Institute for clinical medicine, 1171 Blindern, 0318, Oslo, Norway.,Department of Cardiology, Akershus University Hospital, 1478 Nordbyhagen, Oslo, Norway
| | - David A Leon
- London School of Hygiene & Tropical Medicine, WC1E 7HT, London, UK.,Department of Community Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway.,International Laboratory for Population and Health, National Research University, Higher School of Economics, Moscow, Russia
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Sagelv EH, Hopstock LA, Johansson J, Hansen BH, Brage S, Horsch A, Ekelund U, Morseth B. Criterion validity of two physical activity and one sedentary time questionnaire against accelerometry in a large cohort of adults and older adults. BMJ Open Sport Exerc Med 2020; 6:e000661. [PMID: 32153981 PMCID: PMC7047487 DOI: 10.1136/bmjsem-2019-000661] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2020] [Indexed: 11/17/2022] Open
Abstract
Objectives We compared the ability of physical activity and sitting time questionnaires (PAQ) for ranking individuals versus continuous volume calculations (physical activity level (PAL), metabolic equivalents of task (MET), sitting hours) against accelerometry measured physical activity as our criterion. Methods Participants in a cohort from the Tromsø Study completed three questionnaires; (1) The Saltin-Grimby Physical Activity Level Scale (SGPALS) (n=4040); (2) The Physical Activity Frequency, Intensity and Duration (PAFID) questionnaire (n=5902)) calculated as MET-hours·week-1 and (3) The International Physical Activity questionnaire (IPAQ) short-form sitting question (n=4896). We validated the questionnaires against the following accelerometry (Actigraph wGT3X-BT) estimates: vector magnitude counts per minute, steps∙day-1, time (minutes·day-1) in sedentary behaviour, light physical activity, moderate and vigorous physical activity (MVPA) non-bouted and ≥10 min bouted MVPA. Results Ranking of physical activity according to the SGPALS and quartiles (Q) of MET-hours∙week-1 from the PAFID were both positively associated with accelerometry estimates of physical activity (p<0.001) but correlations with accelerometry estimates were weak (SGPALS (PAL): r=0.11 to 0.26, p<0.001) and weak-to-moderate (PAFID: r=0.39 to 0.44, p<0.01). There was 1 hour of accelerometry measured sedentary time from Q1 to Q4 in the IPAQ sitting question (p<0.001) and also weak correlations (r=0.22, p<0.01). Conclusion Ranking of physical activity levels measured with PAQs appears to have higher validity than energy expenditure calculations. Self-reported sedentary time poorly reflects accelerometry measured sedentary time. These two PAQs can be used for ranking individuals into different physical activity categories supporting previous studies using these instruments when assessing associations with health outcomes.
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Affiliation(s)
- Edvard H Sagelv
- Faculty of Health Sciences, School of Sport Sciences, UiT Arctic University of Norway, Tromso, Troms, Norway
| | - Laila A Hopstock
- Faculty of Health Sciences, Department of Community Medicine, UiT Arctic University of Norway, Tromso, Troms, Norway
| | - Jonas Johansson
- Faculty of Health Sciences, Department of Community Medicine, UiT Arctic University of Norway, Tromso, Troms, Norway
| | - Bjørge H Hansen
- Faculty of Health and Sport Sciences, Department of Sport Science and Physical Education, University of Agder, Kristiansand, Vest-Agder, Norway
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, Cambridgeshire, UK.,Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Odense, Syddanmark, Denmark
| | - Alexander Horsch
- Faculty of Science and Technology, Department of Computer Science, UiT Arctic University of Norway, Tromso, Troms, Norway
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Oslo, Norway.,Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Oslo, Norway
| | - Bente Morseth
- Faculty of Health Sciences, School of Sport Sciences, UiT Arctic University of Norway, Tromso, Troms, Norway
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Lundblad MW, Andersen LF, Jacobsen BK, Carlsen MH, Hjartåker A, Grimsgaard S, Hopstock LA. Energy and nutrient intakes in relation to National Nutrition Recommendations in a Norwegian population-based sample: the Tromsø Study 2015-16. Food Nutr Res 2019; 63:3616. [PMID: 32082100 PMCID: PMC7007761 DOI: 10.29219/fnr.v63.3616] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 10/24/2019] [Accepted: 11/05/2019] [Indexed: 12/05/2022] Open
Abstract
Introduction According to the Global Burden of Disease project, unhealthy diet accounts for most of the disease burden in Norway. Current recommendations on nutrient intake in Norway reflect those published in the evidence-based Nordic Nutrition Recommendations from 2012 (NNR2012). Aim To study energy and nutrient intakes and compliance with the NNR2012 among women and men in a population-based study. Methods A total of 15,146 participants (aged 40–99 years) completed a validated food frequency questionnaire (261 questions on food items, meals, and beverages) in the seventh survey of the Tromsø Study in 2015–16; 11,425 participants were eligible for the current analysis. Nutrient intake was estimated by a food and nutrient calculation system at the University of Oslo, Norway. We compared energy, macronutrient, and micronutrient intakes with the NNR2012. Results In total, 85% of the women and men were not in compliance with the maximum recommended intake of saturated fat, and 40 and 77% of women and men, respectively, were not in compliance with the lowest recommended intake of fiber. More than 30% of women and 25% of men had a relatively high probability of inadequate intake of vitamin D, and more than 10% of the men had a relatively high probability of inadequate intake of vitamin B6 and vitamin C. More than 20% of women and men had a high probability of excessive intake of niacin, and almost 40% of women had a high probability of excessive intake of vitamin A. Conclusion Although most participants were in compliance with NNR2012, a large proportion of participants had higher intakes than maximum recommended for saturated fat, and lower than recommended for fiber and vitamin D.
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Affiliation(s)
- Marie W Lundblad
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Lene Frost Andersen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Bjarne K Jacobsen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.,Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Monica Hauger Carlsen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Anette Hjartåker
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Sameline Grimsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Laila A Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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43
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Sagelv EH, Ekelund U, Pedersen S, Brage S, Hansen BH, Johansson J, Grimsgaard S, Nordström A, Horsch A, Hopstock LA, Morseth B. Physical activity levels in adults and elderly from triaxial and uniaxial accelerometry. The Tromsø Study. PLoS One 2019; 14:e0225670. [PMID: 31794552 PMCID: PMC6890242 DOI: 10.1371/journal.pone.0225670] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 11/08/2019] [Indexed: 12/23/2022] Open
Abstract
Introduction Surveillance of physical activity at the population level increases the knowledge on levels and trends of physical activity, which may support public health initiatives to promote physical activity. Physical activity assessed by accelerometry is challenged by varying data processing procedures, which influences the outcome. We aimed to describe the levels and prevalence estimates of physical activity, and to examine how triaxial and uniaxial accelerometry data influences these estimates, in a large population-based cohort of Norwegian adults. Methods This cross-sectional study included 5918 women and men aged 40–84 years who participated in the seventh wave of the Tromsø Study (2015–16). The participants wore an ActiGraph wGT3X-BT accelerometer attached to the hip for 24 hours per day over seven consecutive days. Accelerometry variables were expressed as volume (counts·minute-1 and steps·day-1) and as minutes per day in sedentary, light physical activity and moderate and vigorous physical activity (MVPA). Results From triaxial accelerometry data, 22% (95% confidence interval (CI): 21–23%) of the participants fulfilled the current global recommendations for physical activity (≥150 minutes of MVPA per week in ≥10-minute bouts), while 70% (95% CI: 69–71%) accumulated ≥150 minutes of non-bouted MVPA per week. When analysing uniaxial data, 18% fulfilled the current recommendations (i.e. 20% difference compared with triaxial data), and 55% (95% CI: 53–56%) accumulated ≥150 minutes of non-bouted MVPA per week. We observed approximately 100 less minutes of sedentary time and 90 minutes more of light physical activity from triaxial data compared with uniaxial data (p<0.001). Conclusion The prevalence estimates of sufficiently active adults and elderly are more than three times higher (22% vs. 70%) when comparing triaxial bouted and non-bouted MVPA. Physical activity estimates are highly dependent on accelerometry data processing criteria and on different definitions of physical activity recommendations, which may influence prevalence estimates and tracking of physical activity patterns over time.
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Affiliation(s)
- Edvard H. Sagelv
- School of Sport Sciences, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
- * E-mail:
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- Department of Chronic Diseases and Ageing, the Norwegian Institute for Public Health, Oslo, Norway
| | - Sigurd Pedersen
- School of Sport Sciences, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Søren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, Southern Denmark University, Odense, Denmark
| | - Bjørge H. Hansen
- Department of Sport Science and Physical Education, Faculty of Health Sciences, University of Agder, Agder, Norway
| | - Jonas Johansson
- Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Sameline Grimsgaard
- Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Anna Nordström
- School of Sport Sciences, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Alexander Horsch
- Department of Computer Science, Faculty of Natural Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Laila A. Hopstock
- Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
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44
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Sagelv EH, Ekelund U, Johansson J, Welde B, Grimsgaard S, Emaus N, Nordström A, Brage S, Horsch A, Hopstock LA, Morseth B. Measures Of Adiposity And Its Association To Physical Activity In Adults: The Tromsø Study. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000561838.55831.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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45
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Hagen K, Hopstock LA, Elise Eggen A, Mathiesen EB, Nilsen KB. Does insomnia modify the association between C-reactive protein and migraine? The Tromsø Study 2015-2016. Cephalalgia 2019; 39:1022-1029. [PMID: 30862180 DOI: 10.1177/0333102418825370] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND The relationship between high sensitivity C-reactive protein and migraine is unclear. The aim of this cross-sectional population-based study was to investigate the association between high sensitivity C-reactive protein and types of headache, and to evaluate the impact of insomnia on this association. METHODS A total of 20,486 (63%) out of 32,591 invited, aged ≥40 years or older, participated in the seventh wave of the Tromsø study conducted in 2015-2016 and had valid information on headache, insomnia and high sensitivity C-reactive protein. The influence of insomnia on the association between questionnaire-based diagnoses of headache and elevated high sensitivity C-reactive protein defined as >3.0 mg/L was assessed using multiple logistic regression, estimating prevalence odds ratio with 95% confidence intervals. RESULTS A total of 6290 participants (30.7%) suffered from headache during the last year. Among these, 1736 (8.5%) fulfilled the criteria of migraine, 991 (4.8%) had migraine with aura, 746 (3.6%) migraine without aura (3.8%), and 4554 (22.2%) had non-migrainous headache. In the final multi-adjusted analysis, elevated high sensitivity C-reactive protein was associated with headache (odds ratio 1.10, 95% confidence interval 1.01-1.20), migraine (odds ratio 1.17, 95% confidence interval 1.01-1.35), and migraine with aura (odds ratio 1.23, 95% confidence interval 1.01-1.53). No association was found between elevated high sensitivity C-reactive protein and migraine without aura or non-migrainous headache. The association between high sensitivity C-reactive protein and migraine was strongly dependent on insomnia status. Among individuals with insomnia, elevated high sensitivity C-reactive protein was associated with migraine (odds ratio 1.49, 95% confidence interval 1.02-2.17), and migraine with aura (odds ratio 1.59, 95% confidence interval 1.03-2.45), whereas no such relationship was found among those without insomnia. CONCLUSIONS In this cross-sectional study, participants with migraine, in particular migraine with aura, were more likely to have elevated high sensitivity C-reactive protein, evident only among those with insomnia.
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Affiliation(s)
- Knut Hagen
- 1 Department of Neuroscience and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.,2 Norwegian Advisory Unit on Headache, St. Olavs Hospital, Trondheim, Norway
| | - Laila A Hopstock
- 3 Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Anne Elise Eggen
- 3 Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ellisiv B Mathiesen
- 4 Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.,5 Department of Neurology, University Hospital of North Norway, Tromsø, Norway
| | - Kristian Bernhard Nilsen
- 1 Department of Neuroscience and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.,6 Department of Neurology, Oslo University Hospital, Oslo, Norway
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46
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Cook S, Malyutina S, Kudryavtsev AV, Averina M, Bobrova N, Boytsov S, Brage S, Clark TG, Diez Benavente E, Eggen AE, Hopstock LA, Hughes A, Johansen H, Kholmatova K, Kichigina A, Kontsevaya A, Kornev M, Leong D, Magnus P, Mathiesen E, McKee M, Morgan K, Nilssen O, Plakhov I, Quint JK, Rapala A, Ryabikov A, Saburova L, Schirmer H, Shapkina M, Shiekh S, Shkolnikov VM, Stylidis M, Voevoda M, Westgate K, Leon DA. Know Your Heart: Rationale, design and conduct of a cross-sectional study of cardiovascular structure, function and risk factors in 4500 men and women aged 35-69 years from two Russian cities, 2015-18. Wellcome Open Res 2018; 3:67. [PMID: 30123849 PMCID: PMC6073094 DOI: 10.12688/wellcomeopenres.14619.3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2018] [Indexed: 12/03/2022] Open
Abstract
Russia has one of the highest rates of cardiovascular disease in the world. The International Project on Cardiovascular Disease in Russia (IPCDR) was set up to understand the reasons for this. A substantial component of this study was the Know Your Heart Study devoted to characterising the nature and causes of cardiovascular disease in Russia by conducting large cross-sectional surveys in two Russian cities Novosibirsk and Arkhangelsk. The study population was 4542 men and women aged 35-69 years recruited from the general population. Fieldwork took place between 2015-18. There were two study components: 1) a baseline interview to collect information on socio-demographic characteristics and cardiovascular risk factors, usually conducted at home, and 2) a comprehensive health check at a primary care clinic which included detailed examination of the cardiovascular system. In this paper we describe in detail the rationale for, design and conduct of these studies.
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Affiliation(s)
- Sarah Cook
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Sofia Malyutina
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, 630090, Russian Federation.,Novosibirsk State Medical University, Russian Ministry of Health, Novosibirsk, 630091, Russian Federation
| | | | - Maria Averina
- UiT the Arctic University of Norway, Tromsø, 9037, Norway
| | - Natalia Bobrova
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Sergey Boytsov
- Federal State budget organization, National medical research center of cardiology, Russian Ministry of Health, Moscow, 121552, Russian Federation
| | - Soren Brage
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Taane G Clark
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | | | | | | | - Alun Hughes
- UCL Institute of Cardiovascular Science, University College London, London, WC1E 6BT, UK
| | - Heidi Johansen
- UiT the Arctic University of Norway, Tromsø, 9037, Norway
| | - Kamila Kholmatova
- Northern State Medical University, Arkhangelsk, 163000, Russian Federation
| | | | - Anna Kontsevaya
- National research center for preventive medicine, Moscow, 101990, Russian Federation
| | - Michael Kornev
- Northern State Medical University, Arkhangelsk, 163000, Russian Federation
| | | | - Per Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, 0851, Norway
| | | | - Martin McKee
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Katy Morgan
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Odd Nilssen
- UiT the Arctic University of Norway, Tromsø, 9037, Norway
| | - Ilya Plakhov
- Lytech Laboratory LLC, Moscow, 107023, Russian Federation
| | - Jennifer K Quint
- Royal Brompton Campus, Imperial College London, London, SW3 6LY, UK
| | - Alicja Rapala
- UCL Institute of Cardiovascular Science, University College London, London, WC1E 6BT, UK
| | - Andrey Ryabikov
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, 630090, Russian Federation.,Novosibirsk State Medical University, Russian Ministry of Health, Novosibirsk, 630091, Russian Federation
| | - Lyudmila Saburova
- Institute of Philosophy and Law, Ural Branch of the Russian Academy of Sciences, Ekaterinburg, 620990, Russian Federation
| | | | - Marina Shapkina
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, 630090, Russian Federation.,Novosibirsk State Medical University, Russian Ministry of Health, Novosibirsk, 630091, Russian Federation
| | - Suhail Shiekh
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Vladimir M Shkolnikov
- Max Planck Institute for Demographic Research, Rostock, 18057, Germany.,Higher School for Economics, National Research University , Moscow, 101000, Russian Federation
| | | | - Michael Voevoda
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, 630090, Russian Federation
| | - Kate Westgate
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - David A Leon
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK.,UiT the Arctic University of Norway, Tromsø, 9037, Norway
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47
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Cook S, Malyutina S, Kudryavtsev AV, Averina M, Bobrova N, Boytsov S, Brage S, Clark TG, Diez Benavente E, Eggen AE, Hopstock LA, Hughes A, Johansen H, Kholmatova K, Kichigina A, Kontsevaya A, Kornev M, Leong D, Magnus P, Mathiesen E, McKee M, Morgan K, Nilssen O, Plakhov I, Quint JK, Rapala A, Ryabikov A, Saburova L, Schirmer H, Shapkina M, Shiekh S, Shkolnikov VM, Stylidis M, Voevoda M, Westgate K, Leon DA. Know Your Heart: Rationale, design and conduct of a cross-sectional study of cardiovascular structure, function and risk factors in 4500 men and women aged 35-69 years from two Russian cities, 2015-18. Wellcome Open Res 2018. [PMID: 30123849 DOI: 10.12688/wellcomeopenres.14619.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Russia has one of the highest rates of cardiovascular disease in the world. The International Project on Cardiovascular Disease in Russia (IPCDR) was set up to understand the reasons for this. A substantial component of this study was the Know Your Heart Study devoted to characterising the nature and causes of cardiovascular disease in Russia by conducting large cross-sectional surveys in two Russian cities Novosibirsk and Arkhangelsk. The study population was 4542 men and women aged 35-69 years recruited from the general population. Fieldwork took place between 2015-18. There were two study components: 1) a baseline interview to collect information on socio-demographic characteristics and cardiovascular risk factors, usually conducted at home, and 2) a comprehensive health check at a primary care clinic which included detailed examination of the cardiovascular system. In this paper we describe in detail the rationale for, design and conduct of these studies.
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Affiliation(s)
- Sarah Cook
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Sofia Malyutina
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, 630090, Russian Federation.,Novosibirsk State Medical University, Russian Ministry of Health, Novosibirsk, 630091, Russian Federation
| | | | - Maria Averina
- UiT the Arctic University of Norway, Tromsø, 9037, Norway
| | - Natalia Bobrova
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Sergey Boytsov
- Federal State budget organization, National medical research center of cardiology, Russian Ministry of Health, Moscow, 121552, Russian Federation
| | - Soren Brage
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Taane G Clark
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | | | | | | | - Alun Hughes
- UCL Institute of Cardiovascular Science, University College London, London, WC1E 6BT, UK
| | - Heidi Johansen
- UiT the Arctic University of Norway, Tromsø, 9037, Norway
| | - Kamila Kholmatova
- Northern State Medical University, Arkhangelsk, 163000, Russian Federation
| | | | - Anna Kontsevaya
- National research center for preventive medicine, Moscow, 101990, Russian Federation
| | - Michael Kornev
- Northern State Medical University, Arkhangelsk, 163000, Russian Federation
| | | | - Per Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, 0851, Norway
| | | | - Martin McKee
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Katy Morgan
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Odd Nilssen
- UiT the Arctic University of Norway, Tromsø, 9037, Norway
| | - Ilya Plakhov
- Lytech Laboratory LLC, Moscow, 107023, Russian Federation
| | - Jennifer K Quint
- Royal Brompton Campus, Imperial College London, London, SW3 6LY, UK
| | - Alicja Rapala
- UCL Institute of Cardiovascular Science, University College London, London, WC1E 6BT, UK
| | - Andrey Ryabikov
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, 630090, Russian Federation.,Novosibirsk State Medical University, Russian Ministry of Health, Novosibirsk, 630091, Russian Federation
| | - Lyudmila Saburova
- Institute of Philosophy and Law, Ural Branch of the Russian Academy of Sciences, Ekaterinburg, 620990, Russian Federation
| | | | - Marina Shapkina
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, 630090, Russian Federation.,Novosibirsk State Medical University, Russian Ministry of Health, Novosibirsk, 630091, Russian Federation
| | - Suhail Shiekh
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Vladimir M Shkolnikov
- Max Planck Institute for Demographic Research, Rostock, 18057, Germany.,Higher School for Economics, National Research University , Moscow, 101000, Russian Federation
| | | | - Michael Voevoda
- Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, 630090, Russian Federation
| | - Kate Westgate
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - David A Leon
- London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK.,UiT the Arctic University of Norway, Tromsø, 9037, Norway
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48
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Cook S, Malyutina S, Hopstock LA, Kudryavtsev AV, Wilsgaard T, Voevoda M, Schirmer H, Bobrova N, Kholmatova K, Diez Benavente E, Leon DA. Understanding East-West differences in cardiovascular disease in Europe: Early findings of the Heart to Heart comparative population-based studies in Russia and Norway, 2015-2018. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Cook
- London School of Hygiene and Tropical Medicine, London, UK
| | - S Malyutina
- Novosibirsk State Medical University, Novosibirsk, Russia
| | - LA Hopstock
- UiT The Arctic University of Norway, Tromsø, Norway
| | | | - T Wilsgaard
- UiT The Arctic University of Norway, Tromsø, Norway
| | - M Voevoda
- Research Institute of Internal and Preventive Medicine, Branch of IC&G, SB RAS, Novosibirsk, Russia
| | - H Schirmer
- Akershus University Hospital, Oslo, Norway
| | - N Bobrova
- London School of Hygiene and Tropical Medicine, London, UK
| | - K Kholmatova
- Northern State Medical University, Arkhangelsk, Russia
| | | | - DA Leon
- London School of Hygiene and Tropical Medicine, London, UK
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49
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Renninger M, Løchen ML, Ekelund U, Hopstock LA, Jørgensen L, Mathiesen EB, Njølstad I, Schirmer H, Wilsgaard T, Morseth B. The independent and joint associations of physical activity and body mass index with myocardial infarction: The Tromsø Study. Prev Med 2018; 116:94-98. [PMID: 30218724 DOI: 10.1016/j.ypmed.2018.09.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 08/07/2018] [Accepted: 09/11/2018] [Indexed: 11/30/2022]
Abstract
Physical activity and overweight are associated with myocardial infarction (MI). However, their joint association with MI remains unclear. Our objective was to examine the independent and joint association between leisure-time physical activity (LTPA), body mass index (BMI) and MI. This prospective cohort study included 16,572 men and women (47.5% women) aged 20-54 years who took part in the second Tromsø Study. At baseline in 1979-80 LTPA was assessed by questionnaire. Data on MI was collected and adjudicated through hospital and causes of death registries between 1979 and 2013. Cox proportional hazards models were used to examine the independent and joint associations between LTPA, BMI and MI. The final sample included 16,104 individuals. During a median follow up of 34 years, 1613 incident cases of MI were recorded. Physical inactivity and elevated BMI were both independently associated with MI (p for trend 0.02 and <0.001). In joint analyses, normal weight, inactive individuals had a 20% higher risk of MI compared to their active counterparts (hazard ratio (HR) 1.20 (1.02-1.41)). The highest risk of MI was seen in obese, inactive individuals when compared to normal weight, active individuals (HR 3.20 (2.30-4.44)). The risk of MI increased with increasing BMI regardless of the activity level. HRs were lower for active compared to inactive individuals within the same BMI category. The findings suggest that LTPA and BMI are independently associated with risk of MI. LTPA seems to attenuate but not eliminate the risk of MI associated with excess bodyweight.
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Affiliation(s)
- Marius Renninger
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Department of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilians-Universität München, Munich, Germany
| | - Maja-Lisa Løchen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway; Department of Cardiology, University Hospital of North Norway, Tromsø, Norway
| | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway; Norwegian Institute for Public Health, Oslo, Norway
| | - Laila A Hopstock
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Lone Jørgensen
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Department of Clinical Therapeutic Services, University Hospital of Northern Norway, Tromsø, Norway
| | - Ellisiv B Mathiesen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway; Department of Neurology, University Hospital of North Norway, Tromsø, Norway
| | - Inger Njølstad
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Henrik Schirmer
- Department of Cardiology, University Hospital of North Norway, Tromsø, Norway; Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway; Centre for Clinical Research and Education, University Hospital of North Norway Trust, Tromsø, Norway.
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50
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Sharashova E, Wilsgaard T, Njolstad I, Mathiesen EB, Hopstock LA, Ball J, Gerdts E, Morseth B, Lochen ML. 6168Long-term systolic blood pressure trajectories predict risk of incident atrial fibrillation in a general population cohort study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.6168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- E Sharashova
- UiT The Arctic University of Norway, Department of Community Medicine, Tromso, Norway
| | - T Wilsgaard
- UiT The Arctic University of Norway, Department of Community Medicine, Tromso, Norway
| | - I Njolstad
- UiT The Arctic University of Norway, Department of Community Medicine, Tromso, Norway
| | - E B Mathiesen
- UiT The Arctic University of Norway, Department of Clinical Medicine, Tromso, Norway
| | - L A Hopstock
- UiT The Arctic University of Norway, Department of Health and Care Sciences, Tromso, Norway
| | - J Ball
- Baker IDI Heart and Diabetes Institute, Pre-Clinical Disease and Prevention, Melbourne, Australia
| | - E Gerdts
- University of Bergen, Department of Clinical Science, Bergen, Norway
| | - B Morseth
- UiT The Arctic University of Norway, School of Sport Sciences, Tromso, Norway
| | - M L Lochen
- UiT The Arctic University of Norway, Department of Community Medicine, Tromso, Norway
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