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Rangul V, Holmen TL, Langhammer A, Ingul JM, Pape K, Fenstad JS, Kvaløy K. Cohort Profile Update: The Young-HUNT Study, Norway. Int J Epidemiol 2024; 53:dyae013. [PMID: 38302751 PMCID: PMC10834360 DOI: 10.1093/ije/dyae013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 01/17/2024] [Indexed: 02/03/2024] Open
Affiliation(s)
- Vegar Rangul
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Turid Lingaas Holmen
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Arnulf Langhammer
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Jo Magne Ingul
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kristine Pape
- Department of Public Health and Nursing, Faculty and Medicine and Health Sciences, Norwegian University of Science and Technology, NTNU, Trondheim, Norway
| | - Jørn Søberg Fenstad
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Kirsti Kvaløy
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
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2
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Wang G, Hallberg J, Charalampopoulos D, Sanahuja MC, Breyer-Kohansal R, Langhammer A, Granell R, Vonk JM, Mian A, Olvera N, Laustsen LM, Rönmark E, Abellan A, Agusti A, Arshad SH, Bergström A, Boezen HM, Breyer MK, Burghuber O, Bolund AC, Custovic A, Devereux G, Donaldson GC, Duijts L, Esplugues A, Faner R, Ballester F, Garcia-Aymerich J, Gehring U, Haider S, Hartl S, Backman H, Holloway JW, Koppelman GH, Lertxundi A, Holmen TL, Lowe L, Mensink-Bout SM, Murray CS, Roberts G, Hedman L, Schlünssen V, Sigsgaard T, Simpson A, Sunyer J, Torrent M, Turner S, Van den Berge M, Vermeulen RCH, Vikjord SAA, Wedzicha JA, Maitland van der Zee AH, Melén E. Spirometric phenotypes from early childhood to young adulthood: a Chronic Airway Disease Early Stratification study. ERJ Open Res 2021; 7:00457-2021. [PMID: 34881328 PMCID: PMC8646001 DOI: 10.1183/23120541.00457-2021] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 07/28/2021] [Accepted: 08/25/2021] [Indexed: 02/05/2023] Open
Abstract
Background The prevalences of obstructive and restrictive spirometric phenotypes, and their relation to early-life risk factors from childhood to young adulthood remain poorly understood. The aim was to explore these phenotypes and associations with well-known respiratory risk factors across ages and populations in European cohorts. Methods We studied 49 334 participants from 14 population-based cohorts in different age groups (≤10, >10–15, >15–20, >20–25 years, and overall, 5–25 years). The obstructive phenotype was defined as forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) z-score less than the lower limit of normal (LLN), whereas the restrictive phenotype was defined as FEV1/FVC z-score ≥LLN, and FVC z-score <LLN. Results The prevalence of obstructive and restrictive phenotypes varied from 3.2–10.9% and 1.8–7.7%, respectively, without clear age trends. A diagnosis of asthma (adjusted odds ratio (aOR=2.55, 95% CI 2.14–3.04), preterm birth (aOR=1.84, 1.27–2.66), maternal smoking during pregnancy (aOR=1.16, 95% CI 1.01–1.35) and family history of asthma (aOR=1.44, 95% CI 1.25–1.66) were associated with a higher prevalence of obstructive, but not restrictive, phenotype across ages (5–25 years). A higher current body mass index (BMI was more often observed in those with the obstructive phenotype but less in those with the restrictive phenotype (aOR=1.05, 95% CI 1.03–1.06 and aOR=0.81, 95% CI 0.78–0.85, per kg·m−2 increase in BMI, respectively). Current smoking was associated with the obstructive phenotype in participants older than 10 years (aOR=1.24, 95% CI 1.05–1.46). Conclusion Obstructive and restrictive phenotypes were found to be relatively prevalent during childhood, which supports the early origins concept. Several well-known respiratory risk factors were associated with the obstructive phenotype, whereas only low BMI was associated with the restrictive phenotype, suggesting different underlying pathobiology of these two phenotypes. Obstructive and restrictive phenotypes are present from childhood to adulthood but without age trends. Established risk factors for airway disease are associated with the obstructive phenotype, whereas low BMI is associated with the restrictive.https://bit.ly/3BMoMtI
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Affiliation(s)
- Gang Wang
- Dept of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Sichuan, China.,Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Shared first authors
| | - Jenny Hallberg
- Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.,Shared first authors
| | - Dimitrios Charalampopoulos
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Maribel Casas Sanahuja
- ISGlobal, Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Robab Breyer-Kohansal
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria.,Dept of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria
| | - Arnulf Langhammer
- Dept of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, Norwegian University of Science and Technology (NTNU), Levanger, Norway
| | - Raquel Granell
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Judith M Vonk
- Dept of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, University of Groningen, Groningen, The Netherlands
| | - Annemiek Mian
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Division of Respiratory Medicine and Allergology, and Neonatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Núria Olvera
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Institut d'investigacions biomediques August Pi I Sunyer, Barcelona, Spain
| | - Lisbeth Mølgaard Laustsen
- Dept of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Eva Rönmark
- Dept of Public Health and Clinical Medicine, Section for Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
| | - Alicia Abellan
- ISGlobal, Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, Barcelona, Spain
| | - Alvar Agusti
- Institut d'investigacions biomediques August Pi I Sunyer, Barcelona, Spain.,Respiratory Institute, Hospital Clinic, Univ. Barcelona, Barcelona, Spain.,CIBERESP (ISCiii), Barcelona, Spain
| | - Syed Hasan Arshad
- David Hide Asthma and Allergy Research Centre, Newport, UK.,NIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, UK.,Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - H Marike Boezen
- Dept of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Marie-Kathrin Breyer
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria.,Dept of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria
| | - Otto Burghuber
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria.,Faculty of Medicine, Sigmund Freud University, Vienna, Austria
| | - Anneli Clea Bolund
- Dept of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Adnan Custovic
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | - Gavin C Donaldson
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Liesbeth Duijts
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Division of Respiratory Medicine and Allergology, and Neonatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Division of Neonatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ana Esplugues
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Nursing Department, Faculty of Nursing and Chiropody, Universitat de València, Valencia, Spain.,Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Rosa Faner
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Ferran Ballester
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Nursing Department, Faculty of Nursing and Chiropody, Universitat de València, Valencia, Spain.,Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Sadia Haider
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Sylvia Hartl
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria.,Dept of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria.,Faculty of Medicine, Sigmund Freud University, Vienna, Austria
| | - Helena Backman
- Dept of Public Health and Clinical Medicine, Section for Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
| | - John W Holloway
- NIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, UK.,Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Gerard H Koppelman
- University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, University of Groningen, Groningen, The Netherlands.,Dept of Pediatric Pulmonology and Pediatric Allergology, University Medical Center Groningen, Beatrix Children's Hospital, University of Groningen, Groningen, The Netherlands
| | - Aitana Lertxundi
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Dept of Preventive Medicine and Public Health, Faculty of Medicine, University of the Basque Country (UPV/EHU), Leioa, Spain.,BIODONOSTIA Health Research Institute, Donostia-San Sebastian, Spain
| | - Turid Lingaas Holmen
- Dept of Public Health and General Practice, HUNT Research Center, NTNU, Levanger, Norway
| | - Lesley Lowe
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester Academic Health Science Centre, NIHR, Manchester, UK.,Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Sara M Mensink-Bout
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Clare S Murray
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester Academic Health Science Centre, NIHR, Manchester, UK.,Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Graham Roberts
- David Hide Asthma and Allergy Research Centre, Newport, UK.,NIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, UK.,Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Linnea Hedman
- Dept of Public Health and Clinical Medicine, Section for Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
| | - Vivi Schlünssen
- Dept of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Torben Sigsgaard
- Dept of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Angela Simpson
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester Academic Health Science Centre, NIHR, Manchester, UK.,Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Jordi Sunyer
- ISGlobal, Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain.,IMIM-Parc Salut Mar, Barcelona, Spain
| | | | - Stephen Turner
- Royal Aberdeen Children's Hospital NHS Grampian, Aberdeen, UK
| | - Maarten Van den Berge
- University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, University of Groningen, Groningen, The Netherlands.,Dept of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Roel C H Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Sigrid Anna Aalberg Vikjord
- Dept of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, Norwegian University of Science and Technology (NTNU), Levanger, Norway.,Dept of Medicine and Rehabilitation, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | | | - Anke H Maitland van der Zee
- Dept of Respiratory Medicine, Amsterdam University Medical Centers (UMC), University of Amsterdam.,Pediatric Respiratory Medicine, Emma Children's Hospital, Amsterdam UMC, Amsterdam, The Netherlands.,Shared last authors
| | - Erik Melén
- Dept of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.,Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.,Shared last authors
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3
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Naess M, Sund ER, Vie GÅ, Bjørngaard JH, Åsvold BO, Holmen TL, Kvaløy K. Intergenerational polygenic obesity risk throughout adolescence in a cross-sectional study design: The HUNT study, Norway. Obesity (Silver Spring) 2021; 29:1916-1924. [PMID: 34651441 DOI: 10.1002/oby.23284] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 07/08/2021] [Accepted: 08/06/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This study examined the relationship between parental obesity polygenic risk and children's BMI throughout adolescence. Additionally, from a smaller subsample, the objective was to assess whether parental polygenic risk score (PRS) may act as a proxy for offspring PRS in studies lacking offspring genetic data. METHODS A total of 8,561 parent-offspring (age 13-19 years) trios from the Trøndelag Health Study (the HUNT Study) were included, of which, 1,286 adolescents had available genetic data. Weighted parental PRSs from 900 single-nucleotide polymorphisms robustly associated with adult BMI were constructed and applied in linear mixed-effects models. RESULTS A positive association between parental PRS and offspring sex- and age-adjusted BMI (iso-BMI) throughout adolescence was identified. The estimated marginal effects per standard deviation increase in parental PRS were 0.26 (95% CI: 0.18-0.33), 0.36 (95% CI: 0.29-0.43), and 0.62 kg/m2 (95% CI: 0.51-0.72) for maternal, paternal, and combined parental PRS, respectively. In subsample analyses, the magnitude of association of the parental PRS versus offspring PRS with iso-BMI in adolescents was similar. CONCLUSIONS Parental PRS was consistently associated with offspring iso-BMI throughout adolescence. Results from subsample analyses support the use of parental PRS of obesity as a proxy for adolescent PRS in the absence of offspring genetic data.
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Affiliation(s)
- Marit Naess
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Nord-Trøndelag Hospital Trust, Levanger Hospital, Levanger, Norway
| | - Erik R Sund
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Nord-Trøndelag Hospital Trust, Levanger Hospital, Levanger, Norway
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
| | - Gunnhild Å Vie
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Johan H Bjørngaard
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bjørn Olav Åsvold
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Endocrinology, St. Olav's University Hospital, Trondheim University Hospital, Trondheim, Norway
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Turid Lingaas Holmen
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kirsti Kvaløy
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Nord-Trøndelag Hospital Trust, Levanger Hospital, Levanger, Norway
- Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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Grøtvedt L, Forsén L, Ariansen I, Graff-Iversen S, Lingaas Holmen T. Impact of snus use in teenage boys on tobacco use in young adulthood; a cohort from the HUNT Study Norway. BMC Public Health 2019; 19:1265. [PMID: 31519157 PMCID: PMC6743150 DOI: 10.1186/s12889-019-7584-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 12/19/2018] [Accepted: 09/02/2019] [Indexed: 01/05/2023] Open
Abstract
Background As smoking rates decreased, the use of Swedish snus (smokeless tobacco) concordantly increased in Norway. The role of snus as possible contributor to the reduction of smoking has been widely discussed. Our aim was to quantitate transitions in snus use, smoking and dual use of snus and cigarettes in a young male population. Methods This prospective cohort study includes 1346 boys participating in the Nord-Trøndelag Health Study in Young-HUNT1 1995–97, age 13–19 and in HUNT3 2006–08, age 23–30. Participants reported on tobacco use at both points of time. Models with binominal regression were applied to examine relative risks (RRs), of adolescent ever snus users, dual users or smokers (reference: never tobacco use), to be current snus only users, smokers (including dual users), or tobacco free in adulthood. Results Current tobacco use in this male cohort increased from 27% in adolescence to 49% in adulthood, increasing more for snus only use and dual use than for smoking only. The adjusted RR (95% CI) of becoming a smoker as young adult, was 2.2 (CI 1.7–2.7) for adolescent snus users, 3.6 (CI 3.0–4.3) for adolescent dual users, and 2.7 (CI 2.2–3.3) for adolescent smokers. RR to become snus only users as adults was 3.1 (2.5–3.9) for adolescent dual users, 2.8 (2.2–3.4) for adolescent snus users and 1.5 (1.0–2.2) for adolescent smokers. The adjusted RR for the transition from adolescent tobacco use to no tobacco use in adulthood was similar for snus users and smokers with RR 0.5 (CI 0.4–0.7), but considerably lower for dual users with RR 0.2 (CI 0.2–0.3). Conclusions The use of snus, with or without concurrent smoking, carried a high risk of adult smoking as well as adult snus only use. Dual use seemed to promote the opportunity to become snus only users in adulthood, but made it also more difficult to quit. The benefit of snus use for harm reduction is not evident in our cohort, as the combination of smoking and dual use resulted in high smoking rates among the young adults.
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Affiliation(s)
- Liv Grøtvedt
- Department of Health and Inequality, Norwegian Institute of Public Health, PO Box 222, Skøyen, N-0213, Oslo, Norway.
| | - Lisa Forsén
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway.,Norwegian National Advisory Unit on Women's Health, Oslo University Hospital, Oslo, Norway
| | - Inger Ariansen
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Sidsel Graff-Iversen
- Norwegian National Advisory Unit on Women's Health, Oslo University Hospital, Oslo, Norway
| | - Turid Lingaas Holmen
- Department of Public Health and General Practice, HUNT Research Center, Norwegian University of Science and Technology, Levanger, Norway
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Saeedzadeh Sardahaee F, Holmen TL, Micali N, Sund ER, Bjerkeset O, Kvaløy K. Suicidal ideation in relation to disordered eating, body size and weight perception: a cross-sectional study of a Norwegian adolescent population: the HUNT Study. BMJ Open 2019; 9:e029809. [PMID: 31352423 PMCID: PMC6661666 DOI: 10.1136/bmjopen-2019-029809] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE We conducted a population-based study on a sample of more than 7000 adolescents where we examined the associations between suicidal ideation (SI) and disordered eating (DE) and its related traits. DESIGN Cross-sectional. SETTINGS Data were derived from two Norwegian population-based cohorts, the Young-HUNT1 (1995-1997) and Young-HUNT3 (2006-2008) from the county of Nord-Trøndelag, Norway. PARTICIPANTS A total of 7268 adolescents (15-19 years) who had completed self-reported questionnaires including items on SI, DE, body size and weight perception were included. PRIMARY OUTCOME MEASURES ORs for SI given DE, body size or weight perception. Analyses were performed in multivariate logistic regression models. RESULTS The prevalence of SI was 23.1% in total population. Both girls and boys who reported DE, evaluated their body size as not 'about the same as others' or were 'unhappy about their weight' had between twofold to fivefold increase in odds for SI; these incremental risks were observed independent of sex, age, body mass index and socioeconomic status. We observed higher odds for SI among boys. CONCLUSIONS Our findings suggest a clear association between SI and DE and its associated traits, in both genders but especially in males. Special attention should be paid on early detection of DE traits among adolescents.
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Affiliation(s)
- Farzaneh Saeedzadeh Sardahaee
- Institute for Public Health, Medical Faculty, Norwegian University of Science and Technology NTNU, Trondheim, Trøndelag, Norway
- Brøset Department, Regional Higher Security Psychiatry Department, Trondheim, Trøndelag, Norway
| | - Turid Lingaas Holmen
- HUNT Research Center, Department of Public Health and General Practice, Norwegian University of Science and Technology, Levanger, Nord-Trøndelag, Norway
| | - Nadia Micali
- Child and Adolescent Psychiatry, Faculty of Medicine, Universite de Geneve, Geneva, Switzerland
- Behavioral and Brain Science Unit, University College London, London, UK
| | - Erik R Sund
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Levanger, Norway
| | - Ottar Bjerkeset
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norges teknisk-naturvitenskapelige universitet, Trondheim, Norway
| | - Kirsti Kvaløy
- Department of Public Health and General Practice, Medical Faculty, Norges Teknisk Naturvitenskapelige Universitet Institutt for Samfunnsmedisin, Trondheim, Norway
- Centre for Sami Health Research, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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6
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Naess M, Sund ER, Holmen TL, Kvaløy K. Implications of parental lifestyle changes and education level on adolescent offspring weight: a population based cohort study - The HUNT Study, Norway. BMJ Open 2018; 8:e023406. [PMID: 30166309 PMCID: PMC6119406 DOI: 10.1136/bmjopen-2018-023406] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 12/21/2022] Open
Abstract
OBJECTIVE Obesity tends to cluster in families reflecting both common genetics and shared lifestyle patterns within the family environment. The aim of this study was to examine whether parental lifestyle changes over time, exemplified by changes in weight and physical activity, could affect offspring weight in adolescents and if parental education level influenced the relationship. DESIGN, SETTING AND PARTICIPANTS The population-based cohort study included 4424 parent-offspring participants from the Nord-Trøndelag Health Study, Norway. Exposition was parental change in weight and physical activity over 11 years, and outcome was offspring weight measured in z-scores of body mass index (BMI) in mixed linear models. RESULTS Maternal weight reduction by 2-6 kg was significantly associated with lower offspring BMI z-scores: -0.132 (95% CI -0.259 to -0.004) in the model adjusted for education. Parental weight change displayed similar effect patterns on offspring weight regardless of parents' education level. Further, BMI was consistently lower in families of high education compared with low education in the fully adjusted models. In mothers, reduced physical activity level over time was associated with higher BMI z-scores in offspring: 0.159 (95% CI 0.030 to 0.288). Associations between physical activity change and adolescent BMI was not moderated by parental education levels. CONCLUSION Lifestyle changes in mothers were associated with offspring BMI; reduced weight with lower-and reduced physical activity with higher BMI. Father's lifestyle changes, however, did not significantly affect adolescent offspring's weight. Overall, patterns of association between parental changes and offspring's BMI were independent of parental education levels, though adolescents with parents with high education had lower weight in general.
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Affiliation(s)
- Marit Naess
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- Department of Research and Development, Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, 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
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
| | - Turid Lingaas Holmen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
| | - Kirsti Kvaløy
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- Department of Research and Development, Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, Norway
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Vie TL, Hufthammer KO, Holmen TL, Meland E, Breidablik HJ. Is self-rated health in adolescence a predictor of prescribed medication in adulthood? Findings from the Nord Trøndelag Health Study and the Norwegian Prescription Database. SSM Popul Health 2017; 4:144-152. [PMID: 29349283 PMCID: PMC5769112 DOI: 10.1016/j.ssmph.2017.11.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 04/03/2017] [Revised: 11/16/2017] [Accepted: 11/18/2017] [Indexed: 01/10/2023] Open
Abstract
Self-rated health (SRH) is a commonly used health indicator predicting morbidity and mortality in a range of populations. However, the relationship between SRH and medication is not well established. The aim of this study was to examine adolescent SRH as a predictor for prescribed medication later in young adulthood. Eighteen years' prospective data from the Nord-Trøndelag Health Study (HUNT) and the Norwegian Prescription Database (NorPD) were analyzed. Baseline data, gathered from 8982 adolescents (mean age 16.0 years) in the Young-HUNT I survey (1995-1997), were linked to individual data from NorPD, including information on all medications prescribed in 2013-2014. Gender-stratified negative binomial regression models were used to investigate the association between SRH and medication, also adjusted for age, baseline self-reported medicine use, physical and mental disability, smoking, and physical activity. Based on the Anatomical Therapeutic Chemical (ATC) Classification System, total consumption and consumption related to various ATC groups were examined. The adjusted analyses showed a dose-response relationship for females, with poorer SRH predicting higher average medication for both total consumption and for the ATC groups "Musculoskeletal system" (M), "Nervous system" (N; Analgesics (N02), Opioids (N02A)) and "Respiratiory system" (R). The predictive power of SRH, as well as the role of the adjustment factors, varies by gender and drug groups. This knowledge is important in order to identify risks for later disease and to capture pathological changes before and beyond the disease diagnosis, potentially preventing morbidity in the adult population.
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Affiliation(s)
- Tina Lokke Vie
- Helse Førde HF/Førde Health Trust, postboks 1000, 6807 Førde, Norway
| | | | - Turid Lingaas Holmen
- HUNT Research Centre, Department of Public health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Norway
| | - Eivind Meland
- Department of Global Public Health and Primary Care, University of Bergen, Norway
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8
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Grunseit AC, Chau JY, Rangul V, Holmen TL, Bauman A. Patterns of sitting and mortality in the Nord-Trøndelag health study (HUNT). Int J Behav Nutr Phys Act 2017; 14:8. [PMID: 28122625 PMCID: PMC5267382 DOI: 10.1186/s12966-016-0457-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 06/27/2016] [Accepted: 12/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Current evidence concerning sedentary behaviour and mortality risk has used single time point assessments of sitting. Little is known about how changes in sitting levels over time affect subsequent mortality risk. AIM To examine the associations between patterns of sitting time assessed at two time points 11 years apart and risk of all-cause and cardio-metabolic disease mortality. METHODS Participants were 25,651 adults aged > =20 years old from the Nord-Trøndelag Health Study with self-reported total sitting time in 1995-1997 (HUNT2) and 2006-2008 (HUNT3). Four categories characterised patterns of sitting: (1) low at HUNT2/ low at HUNT3, 'consistently low sitting'; (2) low at HUNT2/high at HUNT3, 'increased sitting'; (3) high at HUNT2/low at HUNT3, 'reduced sitting'; and (4) high at HUNT2 /high at HUNT3, 'consistently high sitting'. Associations of sitting pattern with all-cause and cardio-metabolic disease mortality were analysed using Cox regression adjusted for confounders. RESULTS Mean follow-up was 6.2 years (158880 person-years); 1212 participants died. Compared to 'consistently low sitting', adjusted hazard ratios for all-cause mortality were 1.51 (95% CI: 1.28-2.78), 1.03 (95% CI: 0.88-1.20), and 1.26 (95% CI: 1.06-1.51) for 'increased sitting', 'reduced sitting' and 'consistently high sitting' respectively. CONCLUSIONS Examining patterns of sitting over time augments single time-point analyses of risk exposures associated with high sitting time. Whilst sitting habits can be stable over a long period, life events (e.g., changing jobs, retiring or illness) may influence sitting trajectories and therefore sitting-attributable risk. Reducing sitting may yield mortality risks comparable to a stable low-sitting pattern.
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Affiliation(s)
- Anne C Grunseit
- Prevention Research Collaboration, School of Public Health, Charles Perkins Centre (D17), University of Sydney, New South Wales, 2006, Australia.
| | - Josephine Y Chau
- Prevention Research Collaboration, School of Public Health, Charles Perkins Centre (D17), University of Sydney, New South Wales, 2006, Australia
| | - Vegar Rangul
- Department of Public health and General practice, HUNT Research Centre, Faculty of Medicine, NTNU - Norwegian University of Science and Technology, Levanger, Norway
| | - Turid Lingaas Holmen
- Department of Public health and General practice, HUNT Research Centre, Faculty of Medicine, NTNU - Norwegian University of Science and Technology, Levanger, Norway
| | - Adrian Bauman
- Prevention Research Collaboration, School of Public Health, Charles Perkins Centre (D17), University of Sydney, New South Wales, 2006, Australia.,Department of Public health and General practice, HUNT Research Centre, Faculty of Medicine, NTNU - Norwegian University of Science and Technology, Levanger, Norway
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9
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Krokstad S, Ding D, Grunseit AC, Sund ER, Holmen TL, Rangul V, Bauman A. Multiple lifestyle behaviours and mortality, findings from a large population-based Norwegian cohort study - The HUNT Study. BMC Public Health 2017; 17:58. [PMID: 28068991 PMCID: PMC5223537 DOI: 10.1186/s12889-016-3993-x] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [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: 04/18/2016] [Accepted: 12/23/2016] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Lifestyle risk behaviours are responsible for a large proportion of disease burden and premature mortality worldwide. Risk behaviours tend to cluster in populations. We developed a new lifestyle risk index by including emerging risk factors (sleep, sitting time, and social participation) and examine unique risk combinations and their associations with all-cause and cardio-metabolic mortality. METHODS Data are from a large population-based cohort study in a Norway, the Nord-Trøndelag Health Study (HUNT), with an average follow-up time of 14.1 years. Baseline data from 1995-97 were linked to the Norwegian Causes of Death Registry. The analytic sample comprised 36 911 adults aged 20-69 years. Cox regression models were first fitted for seven risk factors (poor diet, excessive alcohol consumption, current smoking, physical inactivity, excessive sitting, too much/too little sleep, and poor social participation) separately and then adjusted for socio-demographic covariates. Based on these results, a lifestyle risk index was developed. Finally, we explored common combinations of the risk factors in relation to all-cause and cardio-metabolic mortality outcomes. RESULTS All single risk factors, except for diet, were significantly associated with both mortality outcomes, and were therefore selected to form a lifestyle risk index. Risk of mortality increased as the index score increased. The hazard ratio for all-cause mortality increased from 1.37 (1.15-1.62) to 6.15 (3.56-10.63) as the number of index risk factors increased from one to six respectively. Among the most common risk factor combinations the association with mortality was particularly strong when smoking and/or social participation were included. CONCLUSIONS This study adds to previous research on multiple risk behaviours by incorporating emerging risk factors. Findings regarding social participation and prolonged sitting suggest new components of healthy lifestyles and potential new directions for population health interventions.
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Affiliation(s)
- Steinar Krokstad
- HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Forskningsveien 2, 7600 Levanger, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Ding Ding
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, NSW Australia
- Centre for Chronic Disease Prevention, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, QLD Australia
| | - Anne C. Grunseit
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, NSW Australia
| | - Erik R. Sund
- HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Forskningsveien 2, 7600 Levanger, Norway
| | - Turid Lingaas Holmen
- HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Forskningsveien 2, 7600 Levanger, Norway
| | - Vegar Rangul
- HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Forskningsveien 2, 7600 Levanger, Norway
| | - Adrian Bauman
- HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Forskningsveien 2, 7600 Levanger, Norway
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, NSW Australia
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10
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Næss M, Holmen TL, Langaas M, Bjørngaard JH, Kvaløy K. Intergenerational Transmission of Overweight and Obesity from Parents to Their Adolescent Offspring - The HUNT Study. PLoS One 2016; 11:e0166585. [PMID: 27851798 PMCID: PMC5112991 DOI: 10.1371/journal.pone.0166585] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 10/31/2016] [Indexed: 01/12/2023] Open
Abstract
Purpose The main aim of this study was to examine weight associations between parents and offspring at two time points: 1995–97 and 2006–08, taking into account body mass index (BMI) and waist circumference. Methods The study included 8425 parent-offspring trios who participated in the population based Health Study of Nord Trøndelag (the HUNT Study), Norway, at either the HUNT2 (1995–97) or the HUNT3 (2006–08) survey. We used linear mixed effects models with siblings clustered within mothers to analyze the associations between 1) parental grouped BMI and offspring BMI z-scores and 2) parental grouped waist circumference and offspring waist circumference z-scores. Results Adolescent and adult overweight and obesity were higher in 2006–08 than in 1995–97, with the greatest increase observed in waist circumference. Both mother’s and father’s BMI and waist circumference were strongly associated with corresponding measures in offspring. Compared with both parents being normal weight (BMI <25 kg/m2), having two overweight or obese parents (BMI ≥25 kg/m2) was associated with a higher offspring BMI z-score of 0.76 (95% CI; 0.65, 0.87) and 0.64 (95% CI; 0.48, 0.80) in daughters, and 0.76 (95% CI; 0.65, 0.87) and 0.69 (95% CI; 0.53, 0.80) in sons, in 1995–97 and 2006–08 respectively. Offspring with one parent being overweight/obese had BMI z-scores of approximately half of offspring with two parents categorized as overweight/obese. The results of the waist circumference based analyses did not differ substantially from the BMI based analyses. Conclusions Parental overweight was strongly positively associated with offspring weight both in 1995–97 and 2006–08 where both parents being overweight/obese gave the largest effect. This seemingly stable association, strongly address the importance of public health initiatives towards preventing obesity in parents of both sexes to decrease further obesity expansion in offspring.
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Affiliation(s)
- Marit Næss
- HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, NTNU—Norwegian University of Science and Technology, Trondheim, Norway
- Department of Research and Development, Levanger Hospital, Nord-Trøndelag Health trust, Levanger, Norway
- * E-mail:
| | - Turid Lingaas Holmen
- HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, NTNU—Norwegian University of Science and Technology, Trondheim, Norway
| | - Mette Langaas
- Department of Mathematical Sciences, NTNU—Norwegian University of Science and Technology, Trondheim, Norway
| | - Johan Håkon Bjørngaard
- Department of Public Health and General Practice, Faculty of Medicine, NTNU—Norwegian University of Science and Technology, Trondheim, Norway
- Forensic Department and Research Centre Brøset, St.Olavs University Hospital Trondheim, Trondheim, Norway
| | - Kirsti Kvaløy
- HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, NTNU—Norwegian University of Science and Technology, Trondheim, Norway
- Department of Research and Development, Levanger Hospital, Nord-Trøndelag Health trust, Levanger, Norway
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11
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Zwart JA, Dyb G, Holmen TL, Stovner LJ, Sand T. The Prevalence of Migraine and Tension-Type Headaches Among Adolescents in Norway. The Nord-Trøndelag Health Study (Head-Hunt-Youth), A Large Population-Based Epidemiological Study. Cephalalgia 2016; 24:373-9. [PMID: 15096226 DOI: 10.1111/j.1468-2982.2004.00680.x] [Citation(s) in RCA: 154] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of this study was to examine the prevalence of headache and primary headache disorders like migraine and tension-type headaches among adolescents, and to explore the differences in headache prevalence and frequency by gender and age. This cross-sectional study was conducted in Nord-Trøndelag county, Norway, during the years 1995-97. In total, 8984 (88%) out of 10 202 invited adolescents aged 12-19 years participated in the youth part of the Nord-Trøndelag Health Study [Helseundersøkelsen i Nord-Trøndelag (HUNT)]. The total study population in this study consisted of 8255 individuals after exclusion of invalid questionnaires and students outside the target range of 13-18 years of age. The students completed a comprehensive questionnaire, and one of the questions was whether the students had experienced any headaches during the last 12 months. In addition, 5847 of these students were also subject to an interview in which they were asked whether they had experienced recurring headaches during the last year and, if so, were they classified as migraine (MI), tension-type headache (TTH) or non-classifiable headache. In the total questionnaire-based population, 76.8% reported having had headaches during the last 12 months (69.4% boys and 84.2% girls). Among those who also were interviewed, 29.1% reported having recurrent headaches (21.0% boys and 36.5% girls). The overall 1-year prevalence of migraine was 7%, of tension-type headache 18%, and of non-classifiable headache 4.8%. Higher prevalence rates were found for girls in all age groups and for all headache categories. The overall frequency of recurrent headaches did not vary significantly with age, but girls had significantly more frequent headaches than boys. We concluded that headache in general, and recurrent primary headache disorders like migraine and tension-type headaches, are common somatic complaints among Norwegian adolescents, especially among girls.
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Affiliation(s)
- J-A Zwart
- Department of Clinical Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
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12
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Holmen J, Holmen TL, Tverdal A, Holmen OL, Sund ER, Midthjell K. Blood pressure changes during 22-year of follow-up in large general population - the HUNT Study, Norway. BMC Cardiovasc Disord 2016; 16:94. [PMID: 27176717 PMCID: PMC4866289 DOI: 10.1186/s12872-016-0257-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [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: 07/20/2015] [Accepted: 04/29/2016] [Indexed: 11/10/2022] Open
Abstract
Background While hypertension still is a major health problem worldwide, some studies have indicated that the blood pressure level has decreased in some populations. This population based cohort study aims at analysing blood pressure changes in a large Norwegian population over a 22 year period. Methods Data is acquired from three comprehensive health surveys of the HUNT Study conducted from 1984–86 to 2006–08. All citizens of Nord-Trøndelag County, Norway, >20 years were invited: 74,549 individuals participated in 1984–86; 64,523 in 1995–97; and 43,905 in 2006–08. Results Both systolic and diastolic blood pressure levels decreased substantially from mid 1980s to mid 2000s, with the most pronounced decrease from 1995–97 to 2006–08 (from 136.0/78.9 to 128.3/70.9 mmHg in women and from 140.1/82.1 to 133.7/76.5 mmHg in men). Although the use of blood pressure lowering medication increased, there was a considerable decrease even in those who reported never use of medication (mean decrease 6.8/7.2 mmHg in women and 6.3/5.3 mmHg in men), and the decrease was most pronounced in the elderly (mean decrease 16.1/12.4 mmHg in women and 14.7/10.4 mmHg in men aged 80+). Mean heart rate, total cholesterol and daily smoking decreased, self-reported hard physical activity increased, while body weight and the prevalence of diabetes increased during the same period. Conclusions The BP decrease might seem paradoxically, as body weight and prevalence of diabetes increased during the same period. Salt consumption might have decreased, but no salt data is available. The parallel decrease in mean heart rate might indicate reduction in the white-coat phenomenon, or increased use of beta blockers or calcium channel blockers for other diagnosis than hypertension. Additionally, the data could support the “healthy obese” hypothesis, i.e., that subgroups in the population can sustain obesity without serious health consequences. Electronic supplementary material The online version of this article (doi:10.1186/s12872-016-0257-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jostein Holmen
- HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Forskningsvegen 2, 7600, Levanger, Norway.
| | - Turid Lingaas Holmen
- HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Forskningsvegen 2, 7600, Levanger, Norway
| | - Aage Tverdal
- Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Oddgeir Lingaas Holmen
- HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Forskningsvegen 2, 7600, Levanger, Norway
| | - Erik R Sund
- HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Forskningsvegen 2, 7600, Levanger, Norway
| | - Kristian Midthjell
- HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Forskningsvegen 2, 7600, Levanger, Norway
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13
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Kvaløy K, Holmen J, Hveem K, Holmen TL. Genetic Effects on Longitudinal Changes from Healthy to Adverse Weight and Metabolic Status – The HUNT Study. PLoS One 2015; 10:e0139632. [PMID: 26445370 PMCID: PMC4596824 DOI: 10.1371/journal.pone.0139632] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 09/14/2015] [Indexed: 01/11/2023] Open
Abstract
Introduction The complexity of obesity and onset and susceptibility of cardio-metabolic disorders are still poorly understood and is addressed here through studies of genetic influence on weight gain and increased metabolic risk longitudinally. Subjects/Methods Twenty seven previously identified obesity, eating disorder or metabolic risk susceptibility SNPs were tested for association with weight or metabolically related traits longitudinally in 3999 adults participating both in the HUNT2 (1995–97) and HUNT3 (2006–08) surveys. Regression analyses were performed with changes from normal weight to overweight/obesity or from metabolically healthy to adverse developments with regards to blood pressure, glucose, HDL cholesterol, triglycerides or metabolic syndrome as outcomes. Additionally, a sub-sample of 1380 adolescents was included for testing association of nine SNPs with longitudinal weight gain into young adulthood. Results The most substantial effect on BMI-based weight gain from normal to overweight/obesity in adults was observed for the DRD2 variant (rs6277)(OR: 0.79, 95% CI: 0.69–0.90, P = 3.9x10-4, adj. P = 0.015). DRD2 was not associated with BMI on a cross-sectional level. In the adolescent sample, FTO (rs1121980) was associated with change to overweight at adulthood in the combined male-female sample (OR: 1.27, 95% CI: 1.09–1.49, P = 3.0x10-3, adj. P = 0.019) and in females (OR: 1.53, 95% CI: 1.23–1.91, P = 1.8x10-4, adj. P = 0.003). When testing for association to longitudinal adverse developments with regard to blood pressure, blood lipids and glucose, only rs964184 (ZNF259/APOA5) was significantly associated to unfavourable triglyceride changes (OR: 1.66, 95% CI: 1.36–2.03, P = 5.7x10-7, adj. P = 0.001). Pleiotropic effects on metabolic traits, however, were observed for several genetic loci cross-sectionally, ZNF259/APOA5, LPL and GRB14 being the most important. Conclusions DRD2 exhibits effects on weight gain from normal weight to overweight/obesity in adults, while, FTO is associated to weight gain from adolescence to young adulthood. Unhealthy longitudinal triglyceride development is strongly affected by ZNF259/APOA. Our main finding, linking the DRD2 variant directly to the longitudinal weight gain observed, has not previously been identified. It suggests a genetic pre-disposition involving the dopaminergic signalling pathways known to play a role in food reward and satiety linked mechanisms.
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Affiliation(s)
- Kirsti Kvaløy
- HUNT Research Center, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- * E-mail:
| | - Jostein Holmen
- HUNT Research Center, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kristian Hveem
- HUNT Research Center, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Turid Lingaas Holmen
- HUNT Research Center, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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14
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Egan KB, Ettinger AS, DeWan AT, Holford TR, Holmen TL, Bracken MB. Longitudinal associations between asthma and general and abdominal weight status among Norwegian adolescents and young adults: the HUNT Study. Pediatr Obes 2015; 10:345-52. [PMID: 25405952 DOI: 10.1111/ijpo.271] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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: 06/06/2014] [Revised: 09/07/2014] [Accepted: 10/02/2014] [Indexed: 01/04/2023]
Abstract
BACKGROUND In adolescents the temporal directionality to the asthma and adiposity association remains unclear. Asthma may be a consequence of obesity; however, asthma may increase adiposity. OBJECTIVES This study aimed to assess the associations between (i) baseline weight status and subsequent asthma and (ii) baseline asthma and subsequent weight status after 4 and 11 years of follow-up (N = 1543 and N = 1596, respectively) using data from three, sequentially enrolled population-based surveys of Norwegians aged 12-30 years from 1995 to 2008. METHODS Weight status was defined as general (body mass index) or abdominal (waist circumference) underweight, normal weight, overweight or obesity. Self-report physician-diagnosed asthma defined asthma status. RESULTS Over the longitudinal 11-year follow-up, baseline generally overweight or abdominally obese adolescents had increased risk of asthma. Likewise, baseline asthmatics had increased risk of general overweight or abdominal obesity. After sex stratification, these associations were stronger in males. Generally (odds ratio [OR] 1.90; 95% confidence interval [CI] 1.32, 2.73) or abdominally (OR 1.66; 95% CI 1.13, 2.44) overweight males were at increased risk of asthma. Baseline asthmatic males were also at increased risk of general (OR 2.14; 95% CI 1.54, 2.98) and abdominal (OR 1.77; 95% CI 1.27, 2.47) overweight. CONCLUSIONS Among Norwegian adolescents, a bidirectional association of asthma and adiposity was observed in males. Each baseline condition increased the risk of the other condition over time. No association was observed in females.
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Affiliation(s)
- K B Egan
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.,Center for Perinatal, Pediatric and Environmental Epidemiology, Yale University, New Haven, CT, USA.,Yale Graduate School of Arts and Sciences, New Haven, CT, USA
| | - A S Ettinger
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.,Center for Perinatal, Pediatric and Environmental Epidemiology, Yale University, New Haven, CT, USA.,Yale Graduate School of Arts and Sciences, New Haven, CT, USA
| | - A T DeWan
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.,Center for Perinatal, Pediatric and Environmental Epidemiology, Yale University, New Haven, CT, USA.,Yale Graduate School of Arts and Sciences, New Haven, CT, USA
| | - T R Holford
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.,Center for Perinatal, Pediatric and Environmental Epidemiology, Yale University, New Haven, CT, USA.,Yale Graduate School of Arts and Sciences, New Haven, CT, USA
| | - T L Holmen
- HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Norway
| | - M B Bracken
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.,Center for Perinatal, Pediatric and Environmental Epidemiology, Yale University, New Haven, CT, USA.,Yale Graduate School of Arts and Sciences, New Haven, CT, USA.,Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA
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15
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Hansen E, Sund E, Skjei Knudtsen M, Krokstad S, Holmen TL. Cultural activity participation and associations with self-perceived health, life-satisfaction and mental health: the Young HUNT Study, Norway. BMC Public Health 2015; 15:544. [PMID: 26055410 PMCID: PMC4460785 DOI: 10.1186/s12889-015-1873-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 05/26/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Leisure time activities and culture participation may have health effects and be important in pulic health promotion. More knowledge on how cultural activity participation may influence self-perceived health, life-satisfaction, self-esteem and mental health is needed. METHODS This article use data from the general population-based Norwegian HUNT Study, using the cross-sectional Young-HUNT3 (2006-08) Survey including 8200 adolescents. Data on cultural activity participation, self-perceived health, life-satisfaction, self-esteem, anxiety and depression were collected by self-reported questionnaires. RESULTS Both attending meetings or training in an organisation or club, and attending sports events were positively associated with each of the health parameters good self-percieved health, good life-satisfaction, good self-esteem, and low anxiety and depression symptoms. We found differences according to gender and age (13-15 years versus 16-19 years old) for several culture activities, where girls aged 16-19 years seemed to benefit most from being culturally active. The extent of participation seemed to matter. Those who had frequent participation in cultural activities reported better health outcomes compared to inactive adolecents. CONCLUSIONS The results from this study indicate that participation in cultural activities may be positively associated with health, life-satisfaction and self-esteem in adolescents and thus important in public health promotion. Possible sex and age differences should be taken into account.
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Affiliation(s)
- Elisabeth Hansen
- HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Forskningsveien 2, 7600, Levanger, Norway. .,Department of Health Promotion, Nord-Trøndelag County Council, Seilmakersgata 2, Steinkjer, 7735, Norway. .,Department of Health Sciences, Mid Sweden University, Kunnskapens väg 8, 83125, Östersund, Sweden.
| | - Erik Sund
- HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Forskningsveien 2, 7600, Levanger, Norway.
| | - Margunn Skjei Knudtsen
- Department of Health Promotion, Nord-Trøndelag County Council, Seilmakersgata 2, Steinkjer, 7735, Norway.
| | - Steinar Krokstad
- HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Forskningsveien 2, 7600, Levanger, Norway. .,Psychiatric Department, Levanger Hospital, North-Trøndelag Health Trust, Kirkegata 2, Levanger, 7600, Norway.
| | - Turid Lingaas Holmen
- HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Forskningsveien 2, 7600, Levanger, Norway.
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16
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Abstract
BACKGROUND Alcohol use among adolescents has been found to be associated with parental alcohol abuse, but it's relation to more prevalent forms of hazardous drinking patterns among parents has been less explored. Few studies have included area factors when investigating alcohol use across generations. OBJECTIVES The aims of this study were to investigate whether adolescent intoxication was associated with parental heavy episodic drinking (HED) and intoxication, area-level socioeconomic status (SES), and rates of area-level HED. METHODS General Estimation Equations (GEE) was applied to analyze data from the Nord-Trøndelag Health Study (2006-08) including 2,306 adolescents. Adolescent alcohol use was defined by self-reported frequency of intoxication. Parental alcohol use was defined by parental self-reports of drinking five glasses of alcohol at one occasion (HED), whether they had been strongly intoxicated, and adolescent reports of seeing parents intoxicated. Area-level SES and HED were based on data from HUNT3 and Statistics Norway. RESULTS Parental and offspring alcohol use were associated, although this varied to some extent with gender and exposures. The strongest associations were found between offspring intoxication and offspring reports of seeing their parent intoxicated (girls: OR 3.3, 95% CI 2.3-4.7; boys: OR 3.4, 95% CI 2.4-4.7). Intoxication was more common among girls, who lived in areas with a higher level of adult HED. Living in areas with higher SES was associated with less intoxication among adolescents. CONCLUSION Intoxication in adolescence was associated with factors at both family and area level, which emphasize the need of both population and high risk preventive approaches.
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Affiliation(s)
| | - Turid Lingaas Holmen
- b HUNT Research Center , Norwegian University of Science and Technology , Levanger , Norway
| | - Steinar Krokstad
- b HUNT Research Center , Norwegian University of Science and Technology , Levanger , Norway
| | - Erik R Sund
- b HUNT Research Center , Norwegian University of Science and Technology , Levanger , Norway
| | - Grete H Bratberg
- b HUNT Research Center , Norwegian University of Science and Technology , Levanger , Norway
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Egan KB, Ettinger AS, DeWan AT, Holford TR, Holmen TL, Bracken MB. General, but not abdominal, overweight increases odds of asthma among Norwegian adolescents: the Young-HUNT study. Acta Paediatr 2014; 103:1270-6. [PMID: 25131148 DOI: 10.1111/apa.12775] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [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: 01/28/2014] [Revised: 06/26/2014] [Accepted: 08/12/2014] [Indexed: 12/21/2022]
Abstract
AIM The aim of this analysis was to examine the association between asthma and general and abdominal weight status, defined by age- and sex-specific cut-offs for body mass index (BMI) and waist circumference (WC) in adolescents. METHODS Participants aged 12-19 years in the Young-HUNT (YH) Study (YH1 1995-1997: n = 8222; YH3 2006-2008: n = 7403) completed self-administered questionnaires in school as part of a series of cross-sectional, population-based studies conducted in Nord-Trøndelag, Norway. Weight, height and WC were measured. Adjusted odds ratios (ORs) and 95% Confidence Intervals (CI) for asthma, defined by self-reported physician diagnosis, were calculated. Potential effect modifiers evaluated included sex and pubertal development status (PDS). RESULTS Asthma was reported by 11.8% of the adolescents in YH1 and 17.0% in YH3. Asthma odds significantly increased for adolescents with general (OR = 1.33; 95%CI: 1.13, 1.56), but not abdominal, overweight and increased for adolescents with general (OR = 1.34; 95%CI: 1.02, 1.75) or abdominal obesity (OR = 1.36; 95%CI: 1.16, 1.60). Underweight had no association with asthma regardless of weight assessment type, and PDS did not meaningfully influence the associations between asthma and weight. CONCLUSION Overweight and obesity both increased the odds of asthma in 12-19 year-old Norwegians. WC did not add further information to that already provided by BMI to improve our understanding of the association between asthma and weight.
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Affiliation(s)
- Kathryn B. Egan
- Department of Chronic Disease Epidemiology; Yale School of Public Health; New Haven CT USA
- Yale Graduate School of Arts and Sciences; New Haven CT USA
- Center for Perinatal, Pediatric and Environmental Epidemiology; Yale University; New Haven CT USA
| | - Adrienne S. Ettinger
- Department of Chronic Disease Epidemiology; Yale School of Public Health; New Haven CT USA
- Yale Graduate School of Arts and Sciences; New Haven CT USA
- Center for Perinatal, Pediatric and Environmental Epidemiology; Yale University; New Haven CT USA
| | - Andrew T. DeWan
- Department of Chronic Disease Epidemiology; Yale School of Public Health; New Haven CT USA
- Yale Graduate School of Arts and Sciences; New Haven CT USA
- Center for Perinatal, Pediatric and Environmental Epidemiology; Yale University; New Haven CT USA
| | - Theodore R. Holford
- Department of Chronic Disease Epidemiology; Yale School of Public Health; New Haven CT USA
- Yale Graduate School of Arts and Sciences; New Haven CT USA
- Center for Perinatal, Pediatric and Environmental Epidemiology; Yale University; New Haven CT USA
| | - Turid Lingaas Holmen
- HUNT Research Centre; Department of Public Health and General Practice; Faculty of Medicine; Norwegian University of Science and Technology; Verdal Norway
| | - Michael B. Bracken
- Department of Chronic Disease Epidemiology; Yale School of Public Health; New Haven CT USA
- Yale Graduate School of Arts and Sciences; New Haven CT USA
- Center for Perinatal, Pediatric and Environmental Epidemiology; Yale University; New Haven CT USA
- Department of Obstetrics; Gynecology and Reproductive Sciences; Yale School of Medicine; New Haven CT USA
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Abstract
OBJECTIVES Examining the associations between health and lifestyle factors recorded in the participants' early teens and development of suicidal thoughts recorded 4 years later. DESIGN Population-based prospective cohort study. SETTINGS All students in the two relevant year classes in Nord-Trøndelag County were invited, 80% attended both waves of data collection. PARTICIPANTS 2399 secondary school students who participated in the Young-HUNT1 study in 1995-1997 (13-15 years old) were included in a follow-up study 4 years later (17-19 years old). PRIMARY OUTCOME MEASURE Suicidal thoughts reported at age 17-19 years. RESULTS 408 (17%, 95% CI 15.5% to 18.5%) of the adolescents reported suicidal thoughts at follow-up, 158 (14.2%, CI 13.6% to 16.4%) boys and 250 (19.5%, CI 18.8% to 22.0%) girls. Baseline anxiety and depressive symptoms (adjusted OR (aOR) 1.9, CI 1.4 to 2.6), conduct problems (aOR 1.8, CI 1.3 to 2.6), overweight (aOR 1.9 CI 1.4 to 2.4), and muscular pain and tension (aOR 1.8, CI 1.4 to 2.4), were all associated with reporting suicidal thoughts at follow-up. CONCLUSIONS One in six young adults experienced suicidal thoughts, girls predominating. Suicidal thoughts were most strongly associated with symptoms of anxiety/depression, conduct problems, pain/tension and overweight reported when participants were 13-15 years old. Specific preventive efforts in these groups might be indicated. Future research should investigate whether similar associations are seen with suicide/suicidal attempts as endpoints.
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Affiliation(s)
- Arve Strandheim
- Department of Child and Adolescent Psychiatry, Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, Norway
- Department of Public Health and General Practice, Faculty of Medicine (ISM), HUNT Research Centre, Norwegian University of Science and Technology (NTNU), Levanger, Norway
| | - Ottar Bjerkeset
- Faculty of Health Sciences, Nord-Trøndelag University College (HiNT), Levanger, Norway
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - David Gunnell
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Sigrid Bjørnelv
- Faculty of Health Sciences, Nord-Trøndelag University College (HiNT), Levanger, Norway
- Department of Psychiatry, Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, Norway
| | - Turid Lingaas Holmen
- Department of Public Health and General Practice, Faculty of Medicine (ISM), HUNT Research Centre, Norwegian University of Science and Technology (NTNU), Levanger, Norway
| | - Niels Bentzen
- Department of Public Health and General Practice, Faculty of Medicine (ISM), HUNT Research Centre, Norwegian University of Science and Technology (NTNU), Levanger, Norway
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Vie TL, Hufthammer KO, Holmen TL, Meland E, Breidablik HJ. Is self-rated health a stable and predictive factor for allostatic load in early adulthood? Findings from the Nord Trøndelag Health Study (HUNT). Soc Sci Med 2014; 117:1-9. [PMID: 25016460 DOI: 10.1016/j.socscimed.2014.07.019] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [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: 02/02/2014] [Revised: 07/04/2014] [Accepted: 07/07/2014] [Indexed: 12/13/2022]
Abstract
Self-rated health (SRH) is a widely used health indicator predicting morbidity and mortality in a wide range of populations. However, little is known about the stability and biological basis of SRH. The aim of this study was to map the stability of SRH from adolescence to early adulthood, and to examine the relationships between SRH and biological dysregulation, in terms of allostatic load (AL). The AL score comprises the eleven biomarkers systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), cholesterol, high-density lipoprotein cholesterol (HDL), triglycerides, waist-hip ratio (WHR), diabetes risk profile, glucose, C-reactive protein (CRP) and body mass index (BMI). Eleven years prospective data from the Nord-Trøndelag Health Study (HUNT), Norway, were utilised. Baseline data were gathered from 9141 adolescents (mean age 15.9 years) in the Young-HUNT I survey (1995-1997) and follow-up data were gathered from the adult HUNT3 survey (2006-2008). Altogether, 1906 respondents completed both questionnaires and clinical measurements in both studies. Cross-tables for SRH at baseline and follow-up showed that SRH remained unchanged in 57% of the respondents. Only 3% of the respondents changed their ratings by two steps or more on a four-level scale. Further, linear regression analyses adjusted for age and gender revealed that SRH in adolescence predicted AL in young adulthood. Similar patterns were found for most of the individual biomarkers. The consistency found in SRH from adolescence to young adulthood, and its association with AL across time, indicate that routines for dealing with SRH early in life may be a central strategy to prevent morbidity in the adult population.
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Affiliation(s)
- Tina Løkke Vie
- Helse Førde HF/Førde Health Trust, Postboks 1000, 6807 Førde, Norway.
| | | | - Turid Lingaas Holmen
- HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Norway.
| | - Eivind Meland
- Department of Global Public Health and Primary Care, University of Bergen, Norway.
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20
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van Vliet-Ostaptchouk JV, Nuotio ML, Slagter SN, Doiron D, Fischer K, Foco L, Gaye A, Gögele M, Heier M, Hiekkalinna T, Joensuu A, Newby C, Pang C, Partinen E, Reischl E, Schwienbacher C, Tammesoo ML, Swertz MA, Burton P, Ferretti V, Fortier I, Giepmans L, Harris JR, Hillege HL, Holmen J, Jula A, Kootstra-Ros JE, Kvaløy K, Holmen TL, Männistö S, Metspalu A, Midthjell K, Murtagh MJ, Peters A, Pramstaller PP, Saaristo T, Salomaa V, Stolk RP, Uusitupa M, van der Harst P, van der Klauw MM, Waldenberger M, Perola M, Wolffenbuttel BHR. The prevalence of metabolic syndrome and metabolically healthy obesity in Europe: a collaborative analysis of ten large cohort studies. BMC Endocr Disord 2014; 14:9. [PMID: 24484869 PMCID: PMC3923238 DOI: 10.1186/1472-6823-14-9] [Citation(s) in RCA: 364] [Impact Index Per Article: 36.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Accepted: 01/27/2014] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Not all obese subjects have an adverse metabolic profile predisposing them to developing type 2 diabetes or cardiovascular disease. The BioSHaRE-EU Healthy Obese Project aims to gain insights into the consequences of (healthy) obesity using data on risk factors and phenotypes across several large-scale cohort studies. Aim of this study was to describe the prevalence of obesity, metabolic syndrome (MetS) and metabolically healthy obesity (MHO) in ten participating studies. METHODS Ten different cohorts in seven countries were combined, using data transformed into a harmonized format. All participants were of European origin, with age 18-80 years. They had participated in a clinical examination for anthropometric and blood pressure measurements. Blood samples had been drawn for analysis of lipids and glucose. Presence of MetS was assessed in those with obesity (BMI ≥ 30 kg/m2) based on the 2001 NCEP ATP III criteria, as well as an adapted set of less strict criteria. MHO was defined as obesity, having none of the MetS components, and no previous diagnosis of cardiovascular disease. RESULTS Data for 163,517 individuals were available; 17% were obese (11,465 men and 16,612 women). The prevalence of obesity varied from 11.6% in the Italian CHRIS cohort to 26.3% in the German KORA cohort. The age-standardized percentage of obese subjects with MetS ranged in women from 24% in CHRIS to 65% in the Finnish Health2000 cohort, and in men from 43% in CHRIS to 78% in the Finnish DILGOM cohort, with elevated blood pressure the most frequently occurring factor contributing to the prevalence of the metabolic syndrome. The age-standardized prevalence of MHO varied in women from 7% in Health2000 to 28% in NCDS, and in men from 2% in DILGOM to 19% in CHRIS. MHO was more prevalent in women than in men, and decreased with age in both sexes. CONCLUSIONS Through a rigorous harmonization process, the BioSHaRE-EU consortium was able to compare key characteristics defining the metabolically healthy obese phenotype across ten cohort studies. There is considerable variability in the prevalence of healthy obesity across the different European populations studied, even when unified criteria were used to classify this phenotype.
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Affiliation(s)
- Jana V van Vliet-Ostaptchouk
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, HPC AA31, P.O. Box 30001, Groningen RB 9700, The Netherlands
| | - Marja-Liisa Nuotio
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Unit of Public Health Genomics, National Institute for Health and Welfare, Helsinki, Finland
| | - Sandra N Slagter
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, HPC AA31, P.O. Box 30001, Groningen RB 9700, The Netherlands
| | - Dany Doiron
- Research Institute of the McGill University of Health Centre, Montreal, Canada
| | - Krista Fischer
- University of Tartu, Estonian Genome Center, Tartu, Estonia
| | - Luisa Foco
- Center for Biomedicine, European Academy of Bolzano/Bozen (EURAC), Bolzano, Italy
| | - Amadou Gaye
- Data to Knowledge Research Group, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Martin Gögele
- Center for Biomedicine, European Academy of Bolzano/Bozen (EURAC), Bolzano, Italy
| | - Margit Heier
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Tero Hiekkalinna
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Unit of Public Health Genomics, National Institute for Health and Welfare, Helsinki, Finland
| | - Anni Joensuu
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Unit of Public Health Genomics, National Institute for Health and Welfare, Helsinki, Finland
| | - Christopher Newby
- Data to Knowledge Research Group, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Chao Pang
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Genomics Coordination Center, University of Groningen, Groningen Bioinformatics Center, and University Medical Center Groningen, Groningen, The Netherlands
| | - Eemil Partinen
- University of Tartu, Estonian Genome Center, Tartu, Estonia
| | - Eva Reischl
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | | | | | - Morris A Swertz
- Genomics Coordination Center, University of Groningen, Groningen Bioinformatics Center, and University Medical Center Groningen, Groningen, The Netherlands
| | - Paul Burton
- Data to Knowledge Research Group, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | | | - Isabel Fortier
- Research Institute of the McGill University of Health Centre, Montreal, Canada
| | - Lisette Giepmans
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jennifer R Harris
- Department of Genes and Environment, Division of Epidemiology, The Norwegian Institute of Public Health, Oslo, Norway
| | - Hans L Hillege
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jostein Holmen
- HUNT Research Center, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Antti Jula
- THL-National Institute for Health and Welfare, Helsinki, Finland
| | - Jenny E Kootstra-Ros
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Kirsti Kvaløy
- HUNT Research Center, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Turid Lingaas Holmen
- HUNT Research Center, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Satu Männistö
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | | | - Kristian Midthjell
- HUNT Research Center, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Madeleine J Murtagh
- Data to Knowledge Research Group, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Annette Peters
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Peter P Pramstaller
- Center for Biomedicine, European Academy of Bolzano/Bozen (EURAC), Bolzano, Italy
- Department of Neurology, Central Hospital, Bolzano, Italy
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Timo Saaristo
- Pirkanmaa hospital district and Finnish Diabetes Association, Tampere, Finland
| | - Veikko Salomaa
- THL-National Institute for Health and Welfare, Helsinki, Finland
| | - Ronald P Stolk
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, LifeLines Cohort Study, Groningen, The Netherlands
| | - Matti Uusitupa
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, and Research Unit, Kuopio University Hospital, Kuopio, Finland
| | - Pim van der Harst
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Melanie M van der Klauw
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, HPC AA31, P.O. Box 30001, Groningen RB 9700, The Netherlands
- University of Groningen, University Medical Center Groningen, LifeLines Cohort Study, Groningen, The Netherlands
| | - Melanie Waldenberger
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Markus Perola
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Unit of Public Health Genomics, National Institute for Health and Welfare, Helsinki, Finland
- University of Tartu, Estonian Genome Center, Tartu, Estonia
| | - Bruce HR Wolffenbuttel
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, HPC AA31, P.O. Box 30001, Groningen RB 9700, The Netherlands
- University of Groningen, University Medical Center Groningen, LifeLines Cohort Study, Groningen, The Netherlands
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Magnusson M, Sørensen TIA, Olafsdottir S, Lehtinen-Jacks S, Holmen TL, Heitmann BL, Lissner L. Social Inequalities in Obesity Persist in the Nordic Region Despite Its Relative Affluence and Equity. Curr Obes Rep 2014; 3:1-15. [PMID: 24533235 PMCID: PMC3920028 DOI: 10.1007/s13679-013-0087-2] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [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] [Indexed: 12/16/2022]
Abstract
Social inequalities in overweight and obesity (OWOB) have persisted in the affluent and reputedly egalitarian Nordic countries. In this review we examine associations between socioeconomic position (SEP) and OWOB, and secular trends in such associations. Determinants and possible causes of the relations are discussed together with opportunities to cope with OWOB as a public health problem. The findings show a persisting inverse social gradient. An interaction between SEP and gender is noted for adults in Denmark, Finland and Iceland and for children in Sweden. There are overall tendencies for increased inequality, however no consistent trend for an increased social gradient in OWOB. Reasons that increased inequality does not unequivocally mirror in a steepened social gradient in obesity may include methodological questions as well as societal efforts to counteract obesity. Multi-level efforts are needed to prevent OWOB.
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Affiliation(s)
- Maria Magnusson
- />Department of Public Health and Community Medicine, University of Gothenburg, Box 454, 405 30 Gothenburg, Sweden
| | - Thorkild I. A. Sørensen
- />Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital – Part of the Copenhagen University Hospital, Copenhagen, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark
- />Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Steingerdur Olafsdottir
- />Department of Food and Nutrition, and Sport Science, University of Gothenburg, Laroverksgatan 5, Box 320, 405 30 Gothenburg, Sweden
| | - Susanna Lehtinen-Jacks
- />School of Health Sciences (HES) Medisiinarinkatu 3, University of Tampere, 33014 Tampere, Finland
- />Nutrition Unit, National Institute for Health and Welfare, Mannerheimintie 166, 00280 Helsinki, Finland
| | - Turid Lingaas Holmen
- />HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Forskningsveien 2, 7600 Levanger, Norway
| | - Berit Lilienthal Heitmann
- />Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital – Part of the Copenhagen University Hospital, Copenhagen, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark
- />National Institute of Public Health, University of Southern Denmark, Odense M, Denmark
| | - Lauren Lissner
- />Department of Public Health and Community Medicine, University of Gothenburg, Box 454, 405 30 Gothenburg, Sweden
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Holmen J, Langballe EM, Midthjell K, Holmen TL, Fikseaunet A, Saltvedt I, Tambs K. Gender differences in subjective memory impairment in a general population: the HUNT study, Norway. BMC Psychol 2013. [DOI: 10.1186/2050-7283-1-19] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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De Ridder KAA, Pape K, Cuypers K, Johnsen R, Holmen TL, Westin S, Bjørngaard JH. High school dropout and long-term sickness and disability in young adulthood: a prospective propensity score stratified cohort study (the Young-HUNT study). BMC Public Health 2013; 13:941. [PMID: 24103558 PMCID: PMC4124891 DOI: 10.1186/1471-2458-13-941] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [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: 04/30/2013] [Accepted: 10/04/2013] [Indexed: 11/17/2022] Open
Abstract
Background High school dropout and long-term sickness absence/disability pension in young adulthood are strongly associated. We investigated whether common risk factors in adolescence may confound this association. Methods Data from 6612 school-attending adolescents (13–20 years old) participating in the Norwegian Young-HUNT1 Survey (1995–1997) was linked to long-term sickness absence or disability pension from age 24–29 years old, recorded in the Norwegian Labour and Welfare Organisation registers (1998–2008). We used logistic regression to estimate risk differences of sickness or disability for school dropouts versus completers, adjusting for health, health-related behaviours, psychosocial factors, school problems, and parental socioeconomic position. In addition, we stratified the regression models of sickness and disability following dropout across the quintiles of the propensity score for high school dropout. Results The crude absolute risk difference for long-term sickness or disability for a school dropout compared to a completer was 0.21% or 21% points (95% confidence interval (CI), 17 to 24). The adjusted risk difference was reduced to 15% points (95% CI, 12 to 19). Overall, high school dropout increased the risk for sickness or disability regardless of the risk factor level present for high school dropout. Conclusion High school dropouts have a strongly increased risk for sickness and disability in young adulthood across all quintiles of the propensity score for dropout, i.e. independent of own health, family and socioeconomic factors in adolescence. These findings reveal the importance of early prevention of dropout where possible, combined with increased attention to labour market integration and targeted support for those who fail to complete school.
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Affiliation(s)
- Karin A A De Ridder
- Department of Public Health and General Practice, Norwegian University of Science and Technology, 7491 Trondheim, Norway.
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24
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De Ridder KAA, Pape K, Johnsen R, Holmen TL, Westin S, Bjørngaard JH. Adolescent health and high school dropout: a prospective cohort study of 9000 Norwegian adolescents (the Young-HUNT). PLoS One 2013; 8:e74954. [PMID: 24086408 PMCID: PMC3781164 DOI: 10.1371/journal.pone.0074954] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 08/06/2013] [Indexed: 12/16/2022] Open
Abstract
Background High school dropout is of major concern in the western world. Our aims were to estimate the risk of school dropout in adolescents following chronic somatic disease, somatic symptoms, psychological distress, concentration difficulties, insomnia or overweight and to assess to which extent the family contributes to the association between health and school dropout. Methods A population of 8950 school-attending adolescents (13–21 years) rated their health in the Young-HUNT 1 Study (90% response rate) in 1995–1997. High school dropout or completion, was defined with the Norwegian National Education Database in the calendar year the participant turned 24 years old. Parental socioeconomic status was defined by using linkages to the National Education Database, the National Insurance Administration and the HUNT2 Survey. We used logistic regression to estimate odds ratios and risk differences of high school dropout, both in the whole population and among siblings within families differentially exposed to health problems. Results All explored health dimensions were strongly associated with high school dropout. In models adjusted for parental socioeconomic status, the risk differences of school dropout according to health exposures varied between 3.6% (95% CI 1.7 to 5.5) for having ≥1 somatic disease versus none and 11.7% (6.3 to 17.0) for being obese versus normal weight. The results from the analyses comparing differentially exposed siblings, confirmed these results with the exception of weaker associations for somatic diseases and psychological distress. School dropout was strongly clustered within families (family level conditional intraclass correlation 0.42). Conclusions Adolescent health problems are markers for high school dropout, independent of parental socioeconomic status. Although school dropout it strongly related to family-level factors, also siblings with poor health have reduced opportunity to complete high school compared to healthy siblings. Public health policy should focus on ensuring young people with poor health the best attainable education.
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Affiliation(s)
- Karin A. A. De Ridder
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Physical Medicine and Rehabilitation, Levanger Hospital, Nord-Trøndelag Health Trust, Levanger, Norway
- * E-mail:
| | - Kristine Pape
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
| | - Roar Johnsen
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
| | - Turid Lingaas Holmen
- HUNT Research Center, Department of Public Health and General Practice, Norwegian University of Science and Technology, Levanger, Norway
| | - Steinar Westin
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
| | - Johan Håkon Bjørngaard
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
- Forensic Department and Research Centre Bröset, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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Chau JY, Grunseit A, Midthjell K, Holmen J, Holmen TL, Bauman AE, Van der Ploeg HP. Sedentary behaviour and risk of mortality from all-causes and cardiometabolic diseases in adults: evidence from the HUNT3 population cohort. Br J Sports Med 2013; 49:737-42. [PMID: 23666019 DOI: 10.1136/bjsports-2012-091974] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2013] [Indexed: 11/04/2022]
Abstract
BACKGROUND Sedentary behaviour is a potential risk factor for chronic-ill health and mortality, that is, independent of health-enhancing physical activity. Few studies have investigated the risk of mortality associated with multiple contexts of sedentary behaviour. OBJECTIVE To examine the prospective associations of total sitting time, TV-viewing time and occupational sitting with mortality from all causes and cardiometabolic diseases. METHODS Data from 50,817 adults aged ≥20 years from the Nord-Trøndelag Health Study 3 (HUNT3) in 2006-2008 were linked to the Norwegian Cause of Death Registry up to 31 December 2010. Cox proportional hazards models examined all-cause and cardiometabolic disease-related mortality associated with total sitting time, TV-viewing and occupational sitting, adjusting for multiple potential confounders including physical activity. RESULTS After mean follow-up of 3.3 years (137,315.8 person-years), 1068 deaths were recorded of which 388 were related to cardiometabolic diseases. HRs for all-cause mortality associated with total sitting time were 1.12 (95% CI 0.89 to 1.42), 1.18 (95% CI 0.90 to 1.57) and 1.65 (95% CI 1.24 to 2.21) for total sitting time 4-<7, 7-<10 and ≥10 h/day, respectively, relative to <4 h/day after adjusting for confounders (p-trend=0.001). A similar pattern of associations was observed between total sitting time and mortality from cardiometabolic diseases, but TV-viewing time and occupational sitting showed no or borderline significant associations with all-cause or cardiometabolic disease-related mortality over the same follow-up period. CONCLUSIONS Total sitting time is associated with all-cause and cardiometabolic disease-related mortality in the short term. However, prolonged sitting in specific contexts (ie, watching TV, at work) do not adversely impact health in the same timeframe. These findings suggest that adults should be encouraged to sit less throughout the day to reduce their daily total sitting time.
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Affiliation(s)
- Josephine Y Chau
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Anne Grunseit
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Kristian Midthjell
- HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Levanger, Norway
| | - Jostein Holmen
- HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Levanger, Norway
| | - Turid Lingaas Holmen
- HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Levanger, Norway
| | - Adrian E Bauman
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Hidde P Van der Ploeg
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, Australia Department of Public and Occupational Health, VU University Medical Center, Amsterdam, The Netherlands
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Pape K, Bjørngaard JH, De Ridder KAA, Westin S, Holmen TL, Krokstad S. Medical benefits in young Norwegians and their parents, and the contribution of family health and socioeconomic status. The HUNT Study, Norway. Scand J Public Health 2013; 41:455-62. [PMID: 23508948 DOI: 10.1177/1403494813481645] [Citation(s) in RCA: 7] [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: 11/17/2022]
Abstract
AIMS Family and intergenerational perspectives might contribute to a better understanding of why young people in many European countries experience work impairment and end up being dependent on public benefits for life sustenance. The aim of this cohort study was to explore the relationship between the receipt of medical benefits in parents and their young adult offspring and the contributions of family health and family socioeconomic status. METHODS Baseline information on the health of 7597 adolescents and their parents who participated in the HUNT Study 1995-1997 was linked to national registers to identify long-term receipt of medical benefits for parents (1992-1997) and adolescents as they entered adulthood (1998-2008). We used logistic regression to explore the association between parent and offspring receipt of medical benefits, adjusting for family health and socioeconomic status. RESULTS Among adolescents, 13% received medical benefits from age 20-29. Adolescents whose parents had received medical benefits (26%) were more likely to receive such benefits themselves from age 20-29 compared with adolescents without benefit-receiving parents (age- and sex-adjusted odds ratio (OR) 2.16, 95 % confidence interval (CI) 1.86-2.49). Adjustment for family health reduced this estimate considerably (to OR 1.66, 95% CI 1.38-1.99), whereas adjustment for family socioeconomic status had less impact. CONCLUSIONS Adolescents whose parents receive medical benefits enter adult working life with an elevated risk of health-related work exclusion. Family health vulnerability appears to be a key to understanding this association, suggesting that more attention to intergenerational continuities of health could be a way to prevent welfare dependence in future generations.
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Affiliation(s)
- Kristine Pape
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.
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Holmen TL, Bratberg G, Krokstad S, Langhammer A, Hveem K, Midthjell K, Heggland J, Holmen J. Cohort profile of the Young-HUNT Study, Norway: a population-based study of adolescents. Int J Epidemiol 2013; 43:536-44. [PMID: 23382364 DOI: 10.1093/ije/dys232] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Young-HUNT Study is the adolescent part (13-19 years) of HUNT, the Nord-Trøndelag Health Study, Norway. Three cross-sectional surveys have been conducted: Young-HUNT1 (1995-97), Young-HUNT2 (2000-01) and Young-HUNT3 (2006-08). Major public health issues, including somatic and mental health, quality of life and health behaviours are covered. Young-HUNT was performed in schools visited by trained nurses. Data collection included self-reported questionnaires, structured interviews, clinical measurements and, in Young-HUNT3, buccal smears. The total response rates varied from 90% to 83% and the Young-HUNT database includes 17 820 teenagers. Some Young-HUNT1 participants constitute the baseline for two follow-up studies: a 4-year follow-up through adolescence to Young-HUNT2 and an 11-year follow-up into young adulthood to the adult HUNT3. Longitudinal data are also obtained by linkage of data from Young-HUNT to different national health registers. Linkage to family registers allows the possibility of studying genetic and environmental interactions through generations. Presently 20 PhD students are working with the data, 11 Young-HUNT based PhD theses have been completed and more than 50 scientific papers published.
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Affiliation(s)
- Turid Lingaas Holmen
- HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Forskningsveien 2, 7600 Levanger, Norway and Levanger Hospital, Nord-Trøndelag Hospital Trust, Central Norway Regional Health Authority, 7600 Levanger, Norway
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Midthjell K, Lee CMY, Langhammer A, Krokstad S, Holmen TL, Hveem K, Colagiuri S, Holmen J. Trends in overweight and obesity over 22 years in a large adult population: the HUNT Study, Norway. Clin Obes 2013; 3:12-20. [PMID: 23935708 PMCID: PMC3734732 DOI: 10.1111/cob.12009] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 01/24/2013] [Accepted: 02/10/2013] [Indexed: 01/06/2023]
Abstract
Some reports indicate that the obesity epidemic may be slowing down or halting. We followed body mass index (BMI) and waist circumference (WC) in a large adult population in Norway (n = 90 000) from 1984-1986 (HUNT1) through 1995-1997 (HUNT2) to 2006-2008 (HUNT3) to study whether this is occurring in Norway. Height and weight were measured with standardized and identical methods in all three surveys; WC was also measured in HUNT2 and HUNT3. In the three surveys, mean BMI increased from 25.3 to 26.5 and 27.5 kg m-2 in men and from 25.1 to 26.2 and 26.9 kg m-2 in women. Increase in prevalence of obesity (BMI ≥ 30 kg m-2) was greater in men (from 7.7 to 14.4 and 22.1%) compared with women (from 13.3 to 18.3 and 23.1%). In contrast, women had a greater increase in abdominal obesity (WC ≥ 102 cm for men and WC ≥ 88 cm for women). There was a continuous shift in the distribution curve of BMI and WC to the right, demonstrating that the increase in body weight was occurring in all weight groups, but the increase of obesity was greatest in the youngest age groups. Our data showed no signs of a halt in the increase of obesity in this representative Norwegian population.
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Affiliation(s)
- K Midthjell
- Department of Community Medicine and General Practice, HUNT Research Centre, Norwegian University of Science and TechnologyLevanger, Norway
| | - C M Y Lee
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, University of SydneySydney, Australia
| | - A Langhammer
- Department of Community Medicine and General Practice, HUNT Research Centre, Norwegian University of Science and TechnologyLevanger, Norway
| | - S Krokstad
- Department of Community Medicine and General Practice, HUNT Research Centre, Norwegian University of Science and TechnologyLevanger, Norway
| | - T L Holmen
- Department of Community Medicine and General Practice, HUNT Research Centre, Norwegian University of Science and TechnologyLevanger, Norway
| | - K Hveem
- Department of Community Medicine and General Practice, HUNT Research Centre, Norwegian University of Science and TechnologyLevanger, Norway
| | - S Colagiuri
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, University of SydneySydney, Australia
| | - J Holmen
- Department of Community Medicine and General Practice, HUNT Research Centre, Norwegian University of Science and TechnologyLevanger, Norway
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Rangul V, Bauman A, Holmen TL, Midthjell K. Is physical activity maintenance from adolescence to young adulthood associated with reduced CVD risk factors, improved mental health and satisfaction with life: the HUNT Study, Norway. Int J Behav Nutr Phys Act 2012; 9:144. [PMID: 23241306 PMCID: PMC3541207 DOI: 10.1186/1479-5868-9-144] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Accepted: 12/11/2012] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Little is known about the effect maintaining physical activity throughout adolescence has on cardiovascular risk factors and health status in early adulthood. This ten-year prospective longitudinal study investigated whether differences in physical activity patterns from adolescence to young-adulthood showed different associations with subsequent cardio-metabolic risk factors and mental health in young-adulthood. METHODS Based on the second and third Norwegian Nord-Trøndelag Health Surveys (HUNT2 and 3), we included 1869 individuals (838 males) participating in Young-HUNT (1995-97), aged 13-19 years and followed-up at HUNT3 (2006-08), aged 23-31. Self-reported physical activity (PA), mental health and perceived health were recorded, along with measurements of body mass index (BMI), waist circumference (WC), total cholesterol (TC), HDL cholesterol, glucose, triglycerides, resting heart rate (HR) and blood pressure. We used separate linear regressions models to investigate associations between physical activity and each CVD risk factor, and logistic regression analysis to examine PA patterns and subsequent mental health. Physically active maintainers were compared to inactive maintainers. Adopters (inactive as adolescents and physically active as young adults) were compared to inactive maintainers and to those who discontinued activity (relapsers). RESULTS Active maintainers had significantly lower HR, compared to all other PA patterns. Active maintaining men had significantly lower WC than relapsers and inactive maintainers. When adjusted for age and gender, WC, BMI, HR, diastolic blood pressure and HDL-C showed significant differences comparing active maintaining to other PA patterns. Comparing inactive maintainers against adopters, only HR was significantly lower. Male adopters did not differ significantly in CVD risk compared to inactive maintainers and relapsers. Among females adopting was associated with lower HR and TC compared to inactive maintainers. Active maintainers showed better mental health than inactive maintainers. Active maintaining males had an increased likelihood of good mental health compared to adopters. Active maintaining females reported greater satisfaction with life compared to adopters. CONCLUSIONS Those who maintained their physical activity from adolescence to young adulthood demonstrated a significantly lower CVD risk and better mental health, compared to inactive maintainers. Compared to inactivity maintainers and relapsers, adopting physical activity was not significantly associated with lowered CVD risk. Adopting physical activity between adolescence and young adulthood may not necessarily protect against mental distress.
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Affiliation(s)
- Vegar Rangul
- Faculty of Health Science, Nord-Trøndelag University College, Levanger, Norway
- HUNT Research Centre, Faculty of Medicine, Department of Public Health and General Practice, Norwegian University of Science and Technology, Levanger, Norway
| | - Adrian Bauman
- Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, Australia
| | - Turid Lingaas Holmen
- HUNT Research Centre, Faculty of Medicine, Department of Public Health and General Practice, Norwegian University of Science and Technology, Levanger, Norway
| | - Kristian Midthjell
- HUNT Research Centre, Faculty of Medicine, Department of Public Health and General Practice, Norwegian University of Science and Technology, Levanger, Norway
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Cuypers KF, Loos RJF, Kvaløy K, Kulle B, Romundstad P, Holmen TL. Obesity-susceptibility loci and their influence on adiposity-related traits in transition from adolescence to adulthood--the HUNT study. PLoS One 2012; 7:e46912. [PMID: 23094032 PMCID: PMC3477114 DOI: 10.1371/journal.pone.0046912] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [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: 05/29/2012] [Accepted: 09/06/2012] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Obesity-susceptibility loci have been related to adiposity traits in adults and may affect body fat estimates in adolescence. There are indications that different sets of obesity-susceptibility loci influence level of and change in obesity-related traits from adolescence to adulthood. OBJECTIVES To investigate whether previously reported obesity-susceptible loci in adults influence adiposity traits in adolescence and change in BMI and waist circumference (WC) from adolescence into young adulthood. We also examined whether physical activity modifies the effects of these genetic loci on adiposity-related traits. METHODS Nine obesity-susceptibility variants were genotyped in 1 643 adolescents (13-19 years old) from the HUNT study, Norway, who were followed-up into young adulthood. Lifestyle was assessed using questionnaires and anthropometric measurements were taken. The effects of genetic variants individually and combined in a genetic predisposition score (GPS) on obesity-related traits were studied cross-sectionally and longitudinally. A modifying effect of physical activity was tested. RESULTS The GPS was significantly associated to BMI (B: 0.046 SD/allele [0.020, 0.073], p = 0.001) in adolescence and in young adulthood (B: 0.041 SD/allele [0.015, 0.067], p = 0.002) as it was to waist circumference (WC). The GPS was not associated to change in BMI (p = 0.762) or WC (p = 0.726). We found no significant interaction effect between the GPS and physical activity. CONCLUSIONS Our observations suggest that obesity-susceptibility loci established in adults affect BMI and WC already in adolescence. However, an association with change in adiposity-related traits from adolescence to adulthood could not be verified for these loci. Neither could an attenuating effect of physical activity on the association between the obesity-susceptibility genes and body fat estimates be revealed.
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Affiliation(s)
- Koenraad Frans Cuypers
- HUNT Research Center, Levanger, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
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Cuypers K, De Ridder K, Kvaløy K, Knudtsen MS, Krokstad S, Holmen J, Holmen TL. Leisure time activities in adolescence in the presence of susceptibility genes for obesity: risk or resilience against overweight in adulthood? The HUNT study. BMC Public Health 2012; 12:820. [PMID: 22998931 PMCID: PMC3491037 DOI: 10.1186/1471-2458-12-820] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [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: 03/27/2012] [Accepted: 09/10/2012] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Environment, health behavior, and genetic background are important in the development of obesity. Adolescents spend substantial part of daily leisure time on cultural and social activities, but knowledge about the effects of participation in such activities on weight is limited. METHODS A number of 1450 adolescents from the Norwegian HUNT study (1995-97) were followed-up in 2006-08 as young adults. Phenotypic data on lifestyle and anthropometric measures were assessed using questionnaires and standardized clinical examinations. Genotypic information on 12 established obesity-susceptibility loci were available for analyses. Generalized estimating equations were used to examine the associations between cultural and social activities in adolescence and adiposity measures in young adulthood. In addition, interaction effects of a genetic predisposition score by leisure time activities were tested. RESULTS In girls, participation in cultural activities was negatively associated with waist circumference (WC) (B = -0.04, 95%CI: -0.08 to -0.00) and with waist-hip ratio (WHR) (B = -0.058, 95%CI: -0.11 to -0.01). However, participation in social activities was positively associated with WC (B = 0.040, CI: 0.00 to 0.08) in girls and with BMI (B = 0.027, CI: 0.00 to 0.05) in boys. The effect of the obesity-susceptibility genetic variants on anthropometric measures was lower in adolescents with high participation in cultural activities compared to adolescents with low participation. CONCLUSION This study suggests that the effects of cultural activities on body fat are different from the effects of participation in social activities. The protective influence of cultural activities in female adolescents against overweight in adulthood and their moderating effect on obesity-susceptibility genes suggest that even cultural activities may be useful in public health strategies against obesity.
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Affiliation(s)
- Koenraad Cuypers
- HUNT Research Center, Department of Public Health and General Practice, Faculty of Medicine, Norwegian, University of Science and Technology, Forskningsveien 2, 7600, Levanger, Norway.
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Geulayov G, Gunnell DJ, Holmen TL, Metcalfe C. OP89 The Association of Parental Fatal and Non-Fatal Suicidal Behaviour with Offspring Suicidalbehaviourand Depression: A Systematic Review and Meta-Analysis. J Epidemiol Community Health 2012. [DOI: 10.1136/jech-2012-201753.089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Krokstad S, Langhammer A, Hveem K, Holmen TL, Midthjell K, Stene TR, Bratberg G, Heggland J, Holmen J. Cohort Profile: the HUNT Study, Norway. Int J Epidemiol 2012; 42:968-77. [PMID: 22879362 DOI: 10.1093/ije/dys095] [Citation(s) in RCA: 785] [Impact Index Per Article: 65.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The HUNT Study includes large total population-based cohorts from the 1980ies, covering 125 000 Norwegian participants; HUNT1 (1984-86), HUNT2 (1995-97) and HUNT3 (2006-08). The study was primarily set up to address arterial hypertension, diabetes, screening of tuberculosis, and quality of life. However, the scope has expanded over time. In the latest survey a state of the art biobank was established, with availability of biomaterial for decades ahead. The three population based surveys now contribute to important knowledge regarding health related lifestyle, prevalence and incidence of somatic and mental illness and disease, health determinants, and associations between disease phenotypes and genotypes. Every citizen of Nord-Trøndelag County in Norway being 20 years or older, have been invited to all the surveys for adults. Participants may be linked in families and followed up longitudinally between the surveys and in several national health- and other registers covering the total population. The HUNT Study includes data from questionnaires, interviews, clinical measurements and biological samples (blood and urine). The questionnaires included questions on socioeconomic conditions, health related behaviours, symptoms, illnesses and diseases. Data from the HUNT Study are available for researchers who satisfy some basic requirements (www.ntnu.edu/hunt), whether affiliated in Norway or abroad.
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Affiliation(s)
- S Krokstad
- HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Levanger Hospital, Nord-Trøndelag Health Authority, Norway
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Geulayov G, Gunnell D, Holmen TL, Metcalfe C. The association of parental fatal and non-fatal suicidal behaviour with offspring suicidal behaviour and depression: a systematic review and meta-analysis. Psychol Med 2012; 42:1567-1580. [PMID: 22129460 DOI: 10.1017/s0033291711002753] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Children whose parents die by, or attempt, suicide are believed to be at greater risk of suicidal behaviours and affective disorders. We systematically reviewed the literature on these associations and, using meta-analysis, estimated the strength of associations as well as investigated potential effect modifiers (parental and offspring gender, offspring age). METHOD We comprehensively searched the literature (Medline, PsycINFO, EMBASE, Web of Science), finding 28 articles that met our inclusion criteria, 14 of which contributed to the meta-analysis. Crude odds ratio and adjusted odds ratio (aOR) were pooled using fixed-effects models. RESULTS Controlling for relevant confounders, offspring whose parents died by suicide were more likely than offspring of two living parents to die by suicide [aOR 1.94, 95% confidence interval (CI) 1.54-2.45] but there were heterogeneous findings in the two studies investigating the impact on offspring suicide attempt (aOR 1.31, 95% CI 0.73-2.35). Children whose parents attempted suicide were at increased risk of attempted suicide (aOR 1.95, 95% CI 1.48-2.57). Limited evidence indicated that exposure to parental death by suicide is associated with subsequent risk of affective disorders. Maternal suicidal behaviour and younger age at exposure were associated with larger effect estimates but there was no evidence that the association differed in sons versus daughters. CONCLUSIONS Parental suicidal behaviour is associated with increased risk of offspring suicidal behaviour. Findings suggest that maternal suicidal behaviour is a more potent risk factor than paternal, and that children are more vulnerable than adolescents and adults. However, there is no evidence of a stronger association in either male or female offspring.
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Affiliation(s)
- G Geulayov
- School of Social and Community Medicine, University of Bristol, Bristol, UK.
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De Ridder KAA, Pape K, Johnsen R, Westin S, Holmen TL, Bjørngaard JH. School dropout: a major public health challenge: a 10-year prospective study on medical and non-medical social insurance benefits in young adulthood, the Young-HUNT 1 Study (Norway). J Epidemiol Community Health 2012; 66:995-1000. [PMID: 22315238 DOI: 10.1136/jech-2011-200047] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND School and work participation in adolescence and young adulthood are important for future health and socioeconomic status. The authors studied the association between self-rated health in adolescents, high school dropout and long-term receipt of medical and non-medical social insurance benefits in young adulthood. METHODS Self-rated health in adolescence was assessed in 8795 adolescents participating in the Norwegian Young-HUNT Study (1995-1997). Linkages to the National Education Database and the National Insurance Administration allowed identification of school dropout and receipt of long-term medical and non-medical benefits during a 10-year follow-up (1998-2007). The data were explored by descriptive statistics and by multinomial logistic regression. RESULTS A total of 17% was registered as being high school dropouts at age 24. The predicted 5-year risk of receiving benefits between ages 24-28 was 21% (95% CI 20% to 23%). High school dropouts had a 5-year risk of receiving benefits of 44% (95% CI 41 to 48) compared with 16% (95% CI 15 to 17) in those who completed high school (adjusted for self-rated health, parental education and sex). There was a 27% school dropout rate in adolescents who reported poor health compared with 16% in those who reported good health. The predicted 5-year risk of receiving any long-term social insurance benefits in adolescents who reported poor health was 33% (95% CI 30 to 37) compared with 20% (95% CI 19 to 21) in those who reported good health. CONCLUSION The strong association between poor self-rated health in adolescence, high school dropout and reduced work integration needs attention and suggests preventive measures on an individual as well as on a societal level.
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Affiliation(s)
- Karin A A De Ridder
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.
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Pape K, Bjørngaard JH, Holmen TL, Krokstad S. The welfare burden of adolescent anxiety and depression: a prospective study of 7500 young Norwegians and their families: the HUNT study. BMJ Open 2012; 2:bmjopen-2012-001942. [PMID: 23144262 PMCID: PMC3533058 DOI: 10.1136/bmjopen-2012-001942] [Citation(s) in RCA: 28] [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] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To examine the association between anxiety and depression symptoms in adolescents and their families and later medical benefit receipt in young adulthood. DESIGN Prospective cohort study. Norwegian population study linked to national registers. PARTICIPANTS Data from the Nord-Trøndelag Health Study 1995-1997 (HUNT) gave information on anxiety and depression symptoms as self-reported by 7497 school-attending adolescents (Hopkins Symptoms Checklist-SCL-5 score) and their parents (Hospital Anxiety and Depression Scale score). There were 2711 adolescents with one or more siblings in the cohort. OUTCOME MEASURES Adolescents were followed for 10 years in national social security registers, identifying long-term receipt of medical benefits (main outcome) and unemployment benefits for comparison from ages 20-29. METHODS We used logistic regression to estimate OR of benefit receipt for groups according to adolescent and parental anxiety and depression symptom load (high vs low symptom loads) and for a one point increase in the continuous SCL-5 score (range 1-4). We adjusted for family-level confounders by comparing siblings differentially exposed to anxiety and depression symptoms. RESULTS Comparing siblings, a one point increase in the mean SCL-5 score was associated with a 65% increase in the odds of medical benefit receipt from age 20-29 (adjusted OR, 1.65, 95% CI 1.10 to 2.48). Parental anxiety and depression symptom load was an indicator of their adolescent's future risk of medical benefit receipt, and adolescents with both parents reporting high symptom loads seemed to be at a particularly high risk. The anxiety and depression symptom load was only weakly associated with unemployment benefits. CONCLUSIONS Adolescents in families hampered by anxiety and depression symptoms are at a substantially higher risk of medical welfare dependence in young adulthood. The prevention and treatment of anxiety and depression in adolescence should be family-oriented and aimed at ensuring work-life integration.
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Affiliation(s)
- Kristine Pape
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
| | - Johan Håkon Bjørngaard
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
- Forensic Department and Research Centre Bröset, St Olav's University Hospital Trondheim, Trondheim, Norway
| | - Turid Lingaas Holmen
- Department of Public Health and General Practice, HUNT Research Center, Norwegian University of Science and Technology, Levanger, Norway
| | - Steinar Krokstad
- Department of Public Health and General Practice, HUNT Research Center, Norwegian University of Science and Technology, Levanger, Norway
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Cuypers K, Kvaløy K, Bratberg G, Midthjell K, Holmen J, Holmen TL. Being Normal Weight but Feeling Overweight in Adolescence May Affect Weight Development into Young Adulthood-An 11-Year Followup: The HUNT Study, Norway. J Obes 2012; 2012:601872. [PMID: 22666556 PMCID: PMC3362140 DOI: 10.1155/2012/601872] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Revised: 02/09/2012] [Accepted: 03/15/2012] [Indexed: 12/03/2022] Open
Abstract
Objectives. To explore if self-perceived overweight in normal weight adolescents influence their weight development into young adulthood and if so, whether physical activity moderates this association. Methods. A longitudinal study of 1196 normal weight adolescents (13-19 yrs) who were followed up as young adults (24-30 yrs) in the HUNT study. Lifestyle and health issues were assessed employing questionnaires, and standardized anthropometric measurements were taken. Chi square calculations and regression analyses were performed to investigate the associations between self-perceived overweight and change in BMI or waist circumference (WC) adjusted for age, age squared, sex, and other relevant cofactors. Results. Adolescents, defined as being normal weight, but who perceived themselves as overweight had a larger weight gain into young adulthood than adolescents who perceived themselves as normal weight (difference in BMI: 0.66 units [CI95%: 0.1, 1.2] and in WC: 3.46 cm [CI95%: 1.8, 5.1]). Level of physical activity was not found to moderate this association. Conclusions. This study reveals that self-perceived overweight during adolescence may affect development of weight from adolescence into young adulthood. This highlights the importance of also focusing on body image in public health interventions against obesity, favouring a "healthy" body weight taking into account natural differences in body shapes.
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Affiliation(s)
- Koenraad Cuypers
- HUNT Research Center, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Forskningsveien 2, 7600 Levanger, Norway
- *Koenraad Cuypers:
| | - Kirsti Kvaløy
- HUNT Research Center, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Forskningsveien 2, 7600 Levanger, Norway
| | - Grete Bratberg
- HUNT Research Center, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Forskningsveien 2, 7600 Levanger, Norway
- Research Department, Levanger Hospital, Nord-Trøndelag Health Trust, Nord-Trøndelag, Norway
| | - Kristian Midthjell
- HUNT Research Center, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Forskningsveien 2, 7600 Levanger, Norway
| | - Jostein Holmen
- HUNT Research Center, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Forskningsveien 2, 7600 Levanger, Norway
| | - Turid Lingaas Holmen
- HUNT Research Center, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Forskningsveien 2, 7600 Levanger, Norway
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Fasting MH, Nilsen TIL, Holmen TL, Vik T. Changes in parental weight and smoking habits and offspring adiposity: Data from the HUNT-study. ACTA ACUST UNITED AC 2011; 6:e399-407. [DOI: 10.3109/17477166.2010.518238] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Rangul V, Holmen TL, Bauman A, Bratberg GH, Kurtze N, Midthjell K. Factors predicting changes in physical activity through adolescence: the Young-HUNT Study, Norway. J Adolesc Health 2011; 48:616-24. [PMID: 21575823 DOI: 10.1016/j.jadohealth.2010.09.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [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: 04/19/2010] [Revised: 09/16/2010] [Accepted: 09/17/2010] [Indexed: 10/18/2022]
Abstract
PURPOSE The purpose of this prospective population-based study was to analyze predictors of changes in physical activity (PA) levels from early to late adolescence. METHODS Data presented are from 2,348 adolescents and their parents who participated in the Nord-Trøndelag Health study (HUNT 2, 1995-1997) and at follow-up in Young-HUNT 2, 2000-2001 Participants completed a self-reported questionnaire and participated in a clinical examination that included measurements of height and weight. RESULTS Four patterns of PA emerged in the study: active or inactive at both time points (active maintainers, 13%; inactive maintainers, 59%), inactive and became active (adopters, 12%), active and became inactive (relapsers, 16%). Being overweight, dissatisfied with life, and not actively participating in sports at baseline were significant predictors of change regarding PA among boys at follow-up. For girls, smoking, drinking, low maternal education, and physical inactivity predicted relapsers and inactive maintainers. Higher levels of education and more physically active parents at baseline seemed to protect against decreased PA during follow-up for both genders. CONCLUSION Predictors of change in, or maintaining PA status during adolescence differed by gender. These results suggest that PA-promoting interventions should be tailored by gender and focus on encouraging activity for inactive adolescents and maintenance of PA in those already active.
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Affiliation(s)
- Vegar Rangul
- Faculty of Health Science, Nord-Trøndelag University College, Levanger, Norway.
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Cuypers K, Krokstad S, Lingaas Holmen T, Skjei Knudtsen M, Bygren LO, Holmen J. Patterns of receptive and creative cultural activities and their association with perceived health, anxiety, depression and satisfaction with life among adults: the HUNT study, Norway. J Epidemiol Community Health 2011; 66:698-703. [DOI: 10.1136/jech.2010.113571] [Citation(s) in RCA: 135] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bjornelv S, Nordahl HM, Holmen TL. Psychological factors and weight problems in adolescents. The role of eating problems, emotional problems, and personality traits: the Young-HUNT study. Soc Psychiatry Psychiatr Epidemiol 2011; 46:353-62. [PMID: 20238097 DOI: 10.1007/s00127-010-0197-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [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: 12/17/2008] [Accepted: 02/18/2010] [Indexed: 11/30/2022]
Abstract
BACKGROUND The associations between psychological factors and weight problems in adolescents are not conclusive. We studied associations between psychological factors, including personality and weight problems, in an adolescent population. In addition, we examined the same psychological factors as predictors for change in weight categories during adolescence. METHOD From 1995 to 1997, 8,090 adolescents, aged 13-18 years, participated in the Young-HUNT-I study; of those, 1,619 also participated in a follow-up study in 2000-2001. They completed a questionnaire monitoring eating problems, self-esteem, personality, anxiety, and depression, and had their height and weight measured. Weight problems were defined using the international age-and sex-specific BMI-cut-offs defining underweight, overweight, and obesity. Psychological factors at baseline were studied both in relation to weight categories at baseline, and as predictors for weight change between baseline and the follow-up. RESULTS Significant sex differences in mean values were found in all psychological factors, with higher scores in girls compared with boys. In the cross-sectional design, eating problems were associated with weight problems, and the two factors of oral control (EAT-A) and food preoccupation (EAT-B) showed an inverse association. Oral control was associated with underweight, while food preoccupation was associated with overweight and obesity in both sexes. Low self-esteem was associated with overweight and obesity in both sexes, but no association was found between emotional problems or personality traits, and weight problems. During the follow-up, oral control was a clear predictor of weight change during adolescence in both sexes. Oral control protected against unhealthy weight gain but also predicted unhealthy weight reduction in both sexes. CONCLUSIONS Girls scored higher on all psychological factors compared with boys, but no sex differences were found with regard to the association between psychological factors and weight problems. Eating problems showed the strongest association with weight problems at baseline and were also the strongest predictor of weight change during adolescence.
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Affiliation(s)
- Sigrid Bjornelv
- HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Forskningsveien 2, 7600, Levanger, Norway.
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Abstract
<em>Background:</em> The aim of this study was to describe the trends of smoking and snuff consumption in adolescents in Nord-Trøndelag, Norway, in the period from 1995/97 to 2006/08, with special emphasize on regional and gender differences.<br /><em>Method:</em> We used data from all three waves of the Young-HUNT study, the youth part (ages 13-19 yrs) of the HUNT study, Nord- Trøndelag County, Norway. Young-HUNT 1 was conducted in 1995-97 (N=9131, 90% response rate), Young-HUNT 2 in 1999-2000 (N=2808, 80% response rate) and Young-HUNT 3 in 2006-08 (N=8601).<br /><em>Results:</em> Fewer adolescents had tried smoking in Young-HUNT 3 (40.6%) compared to Young-HUNT 1 (56.5%), while the prevalence of adolescents who had tried snuff increased in the same period from 17.4% to 23.5%. The prevalence of adolescents who smoked daily or occasionally decreased between Young- HUNT 1 (girls 23.8%, boys 19.8%) and Young-HUNT 3 (girls: 14.6%, boys: 12.1%), while the prevalence of daily or occasionally snuffing increased (girls: 3.4% to 13.0% and boys: 20.2% to 23.1%). This constitutes a fourfold increase of the number of young female snuff users in little more than a decade. Occasional snuff use increased most in girls while daily snuff use increased most in boys. The same tendency was seen inn all regions, but the prevalence of tobacco use varied.<br /><em>Conclusion:</em> The results demonstrate a shift from cigarette smoking to snuff use in the adolescent population between 1995 and 2008. Although a decrease in cigarette smoking occurred, the increasing snuff use makes the total tobacco consumption nearly constant
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Breidablik HJ, Meland E, Holmen TL, Lydersen S. Role of parents in adolescent self-rated health: Norwegian Nord-Trøndelag Health Study. Adolesc Health Med Ther 2010; 1:97-104. [PMID: 24600265 PMCID: PMC3915975 DOI: 10.2147/ahmt.s12877] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Self-rated health (SRH) is a known important predictor of later mortality, morbidity, and health service attendance. From adolescence onwards, this multifactorial composite seems to be relatively stable. Therefore, it is important to study how SRH is also shaped and influenced by parental factors. Methods Analyses were based on data from the Nord-Trøndelag Health studies in Norway during 1995–1997 among adolescent children aged 13–19 years and their parents. Cross-table analyses were made for parental and adolescent SRH. Proportional odds logistic regression analyses with parental SRH and a broad spectrum of other parental covariates were conducted, with adolescent SRH as the dependent variable, both unadjusted and adjusted. Results Lower level of education, living alone, smoking, low general well being, and low life satisfaction were the most important parental factors associated with lower SRH in adolescents. However, the associations between parental SRH and adolescent SRH were rather weak, and in adjusted multivariable analyses lost significance for both genders. The net effect of genetics and early vertical family influence on adolescents’ SRH thus seems to be moderate. Notably, the association between more specific health-related and lifestyle variables in parent and adolescent SRH was rather weak. Conclusion SRH in adolescents seems to be shaped only partly by parental influence, and is less “deterministic” than might be expected from some genetic studies. SRH may therefore be modifiable by health-promoting efforts in early life.
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Affiliation(s)
- Hans-Johan Breidablik
- Department of Public Health and Primary Health Care, Section for General Practice, University of Bergen, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Eivind Meland
- Department of Public Health and Primary Health Care, Section for General Practice, University of Bergen, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Turid Lingaas Holmen
- HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Stian Lydersen
- Unit for Applied Clinical Research, Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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Robberstad L, Dyb G, Hagen K, Stovner LJ, Holmen TL, Zwart JA. An unfavorable lifestyle and recurrent headaches among adolescents: the HUNT study. Neurology 2010; 75:712-7. [PMID: 20720191 DOI: 10.1212/wnl.0b013e3181eee244] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To examine the relationship between recurrent headache disorders (i.e., migraine and tension-type headache) and lifestyle factors (overweight, low physical activity, and smoking) in an unselected population study among adolescents. METHODS In this cross-sectional study from Norway, a total of 5,847 students were interviewed about headache complaints and completed a comprehensive questionnaire including items concerning physical activity and smoking. In addition, they underwent a clinical examination with height and weight measurements. Adolescents with high physical activity who were not current smokers and not overweight were classified as having a good lifestyle status. These students were compared to those with 1 or more of the negative lifestyle factors present in regard to headache diagnosis and headache frequency. RESULTS In adjusted multivariate analyses, recurrent headache was associated with overweight (odds ratio [OR] = 1.4, 95% confidence interval [CI] 1.2-1.6, p < 0.0001), low physical activity (OR = 1.2, 95% CI 1.1-1.4, p = 0.002), and smoking (OR = 1.5, 95% CI 1.3-1.7, p < 0.0001). The prevalence of OR increased with more than 1 negative lifestyle factor present, evident for headache diagnoses and frequency. CONCLUSION The results from the present study show that overweight, smoking, or low physical activity are independently and in combination associated with recurrent headache among adolescents. The associations observed and the additive effect of these negative lifestyle factors on the prevalence of recurrent headache indicates possible targets for preventive measures.
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Smidesang I, Saunes M, Storrø O, Oien T, Holmen TL, Johnsen R, Henriksen AH. Allergy related disorders among 2-yrs olds in a general population. The PACT Study. Pediatr Allergy Immunol 2010; 21:315-20. [PMID: 20003067 DOI: 10.1111/j.1399-3038.2009.00954.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [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: 11/27/2022]
Abstract
Allergic disorders represent a major health problem in most developed countries, but few population-based studies have focused on these disorders in early childhood. The aims of the present study were to investigate the prevalence, gender differences and distribution of allergy related disorders and their association to sensitization among unselected children, 2 yrs of age, in a general population. A population-based study with parental self reported questionnaire data involving allergy related symptoms and results from allergy tests from 4783 two-yr-old children was conducted, and skin prick tests (SPT) of a randomly selected sample comprising 390 children were performed. In the total population the prevalence of reported wheeze was 26%, doctor diagnosed asthma (DDAsthma) 7.0%, atopic dermatitis (AD) 17% and allergic rhinoconjunctivitis (ARC) 3%. Of the 1008 (21%) allergy tested children 59% reported a positive test, but of the randomly selected children only 8% had a positive SPT. Children with AD were most frequently sensitized and children with ARC were most likely to have other allergy related disorders (70%). More boys than girls had an allergy related disorder or a positive allergy test. In conclusion, two in five had an allergy related disorder, but less than 10% had a positive SPT. Having one allergic disorder, especially ARC, increased substantially the risk of having another, and having AD was most strongly associated to a positive allergy test. Moreover, boys were more likely than girls to have an allergy related disorder or a positive SPT indicating a gender difference in the natural history of allergy related disorders.
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Affiliation(s)
- Ingeborg Smidesang
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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Strandheim A, Holmen TL, Coombes L, Bentzen N. Alcohol use and physical health in adolescence: a general population survey of 8,983 young people in North-Trøndelag, Norway (the Young-HUNT study). Subst Use Misuse 2010; 45:253-65. [PMID: 20025452 DOI: 10.3109/10826080903080680] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [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: 12/26/2022]
Abstract
AIMS To investigate the relationship between adolescents' alcohol use and physical health. DESIGN A total population, cross-sectional survey of adolescents, aged 13-19 years, attending secondary or high school in Nord-Trøndelag County, Norway. 8,983 youths (91%) answered the Young-Hunt questionnaire in the 1995-1997 HUNT-survey. METHOD Self-reported data mainly analyzed by logistic regression models. Findings 80% of the respondents had tried alcohol, and 29% reported more than 10 intoxications. Ill health perception was associated with frequent alcohol intoxications. Tension symptoms had the closest relationship to frequency of intoxications in both genders. Girls that frequently used health services had frequent alcohol intoxications. FUNDING Central Norway Regional Health and the County Council of Nord-Trøndelag. CONCLUSIONS There is a close association of physical health complaints and alcohol intoxication frequency in Norwegian teenagers. The study's limitations were noted.
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Affiliation(s)
- Arve Strandheim
- Department of Public Health and General Practice, The Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
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Nilsen SM, Krokstad S, Holmen TL, Westin S. Adolescents’ health-related dietary patterns by parental socio-economic position, The Nord-Trøndelag Health Study (HUNT). Eur J Public Health 2009; 20:299-305. [DOI: 10.1093/eurpub/ckp137] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bjornelv S, Lydersen S, Holmen J, Lund Nilsen TI, Holmen TL. Sex differences in time trends for overweight and obesity in adolescents: the Young-HUNT study. Scand J Public Health 2009; 37:881-9. [PMID: 19736250 DOI: 10.1177/1403494809347022] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS To investigate sex differences in the prevalence and extent of overweight and obesity in adolescents aged 14-18 years. METHODS Standardized measurements of height and weight were collected from surveys of adolescents in the same geographical area in 1966-69 (n = 8378) and in 1995-97 (n = 6673). The prevalence rates of overweight and obesity were calculated using criteria approved by the International Obesity Task Force. The extents of overweight and obesity were assessed by computing age- and sex-specific body mass index (BMI) percentiles. RESULTS In 1995-97, 17.2% met the criteria for either overweight or obesity, as compared with 10.7% in 1966-69. The prevalence of overweight and obesity combined was higher in girls (13.0%) than in boys (8.5%) in 1966-69 (difference 4.5%, 95% confidence interval (CI) 3.1-5.9), while no sex difference was found in 1995-97 (girls 16.9%, boys 17.5%, difference -0.6, 95% CI -2.3-1.1). The increase in overweight was greater in boys (6.2PP, 95% CI 4.7-7.6) than in girls (1.9PP, 95% CI 0.4-3.5), while the sex difference in increased obesity was smaller (boys 2.8PP, 95% CI 2.1-3.4, girls 2.0PP, 95% CI 1.3-2.6). The increase in extent of overweight and obesity was highest in boys. The values of the 85th percentile and the 95th percentile in boys increased by 1.3 and 3.0 BMI units, respectively. The corresponding increases in girls were 0.7 and 1.7 BMI units. CONCLUSIONS A marked sex difference in time trends for both the prevalence and extent of overweight and obesity, with a more pronounced increase in boys than in girls, was demonstrated. This might have implications for preventive strategies.
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Affiliation(s)
- Sigrid Bjornelv
- HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Verdal, Norway.
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Strandheim A, Holmen TL, Coombes L, Bentzen N. Alcohol intoxication and mental health among adolescents--a population review of 8983 young people, 13-19 years in North-Trøndelag, Norway: the Young-HUNT Study. Child Adolesc Psychiatry Ment Health 2009; 3:18. [PMID: 19549305 PMCID: PMC2708131 DOI: 10.1186/1753-2000-3-18] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2009] [Accepted: 06/23/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aims of this study were to describe alcohol use among Norwegian teenagers and investigate the associations between mental health problems and alcohol intoxications with focus on age and gender. METHODS Population based, cross-sectional survey addressing all adolescents aged 13-19 years, attending secondary or high school in North - Trøndelag County, Norway. 8983 youths (91%) answered the Young-HUNT questionnaire in the 1995-1997 survey. Logistic regression models were used to study associations. RESULTS 80% of the respondents reported that they had tried drinking alcohol, and 57% had been intoxicated at least once. The proportion of the students, which had tried alcohol, was equal in both genders and increased with age. Attention problems and conduct problems were strongly associated with frequent alcohol intoxications in both genders. Anxiety and depressive symptoms among girls were also related to high numbers of intoxications CONCLUSION Gender differences in number of alcohol intoxications were small. There was a close association between both conduct and attention problems and high alcohol consumption in both genders. Girls with symptoms of anxiety and depression reported more frequent alcohol intoxications.
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Affiliation(s)
- Arve Strandheim
- Norwegian University of Science and Technology, the Faculty of Medicine, Department of Public Health and General Practice, Trondheim, Norway.
| | - Turid Lingaas Holmen
- Norwegian University of Science and Technology, the Faculty of Medicine, Department of Public Health and General Practice, Trondheim, Norway,Norwegian University of Science and Technology, the Faculty of Medicine, Department of Public Health and General Practice, HUNT research centre, Verdal, Norway
| | - Lindsey Coombes
- Oxford Brookes University, the School of Health and Social Care, Oxford, UK
| | - Niels Bentzen
- Norwegian University of Science and Technology, the Faculty of Medicine, Department of Public Health and General Practice, Trondheim, Norway
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Rangul V, Holmen TL, Midthjell K. Factors Predicting Changes In Physical Activity Through Adolescence; The Young-hunt Study, Norway. Med Sci Sports Exerc 2009. [DOI: 10.1249/01.mss.0000354195.51439.57] [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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