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Background: Physical activity (PA) is associated with reduced mortality. However, whether there is an added benefit of long‐term endurance training is unclear. Thus, we aimed to examine 10‐year mortality in older male endurance athletes compared with an older male general population. Method: Male athletes (n = 503) participating in an annual long‐distance ski race (median years of participation: 14, range: 1–53) from the Norwegian Birkebeiner Aging study (BiAS), and non‐athletic men (n = 1867) attending the sixth Tromsø Study (Tromsø6) aged ≥65 years were included. Associations with endurance sport practice and joint exposures of endurance sport practice and self‐reported leisure‐time PA with all‐cause mortality were examined. We analyzed the data with Cox proportional hazard models and regression standardization. Results: After 10 years (median: 10.4, range: 0.5–11.1) the mortality rate was lower in athletes (hazard ratio (HR) 0.34, 95% confidence interval (CI): 0.24–0.49) compared with non‐athletes, corresponding to a 15% (95% CI: 12–19%) absolute risk reduction associated with endurance sport practice. In joint analyses categorized according to PA and endurance sport practice, we observed an inverse dose–response relationship with mortality (p < 0.001). Compared to inactive non‐athletes, PA was associated with lower mortality in both active non‐athletes and athletes. However, the observed benefit among participants reporting moderate‐to‐vigorous PA was larger in athletes (HR: 0.21, 95% CI: 0.14–0.32) than non‐athletes (HR: 0.43, 95% CI: 0.31–0.59) (p < 0.01). Conclusion: Endurance sport practice was associated with reduced 10‐year mortality, beyond the effect of PA in older men. This study suggests that long‐term endurance sport practice maintained into older adulthood promotes longevity. [ABSTRACT FROM AUTHOR]

This study explores the risk for cancer by level of antibodies to the anaerobe oral bacteria of periodontitis Tannerella forsythia (TF), Porphyromonas gingivalis (PG), and Treponema denticola (TD) all three collectively termed the red complex, and the facultative anaerobe bacterium Aggregatibacter actinomycetemcomitans (AA). The prospective cohort, the Oslo II-study from 2000, the second screening of the Oslo study of 1972/73, has been followed for 17 ½ years with regard to cancer incidence and mortality. A random sample of 697 elderly men comprised the study cohort. The antibody results measured by enzyme linked immunosorbent assay (ELISA) were used in the Cox proportional hazards analyses, and quartile risk on cancer incidence in a 17 ½ years follow-up. Among the 621 participants with no prior cancer diagnoses, 221 men developed cancer. The incidence trend was inverse, and the results are shown as 1st quartile of highest value and 4th as lowest of antibody levels. The results of the Cox proportional regression analyses showed that TF inversely predicts bladder cancer (n = 22) by Hazard Ratio (HR) = 1.71 (95% CI: 1.12, 2.61). TD inversely predicts colon cancer (n = 26) by HR = 1.52 (95% CI: 1.06, 2.19) and bladder cancer (n = 22) by HR = 1.60 (95% CI: 1.05, 2.43). Antibodies to two oral bacteria, TF and TD, showed an inverse risk relationship with incidence of specific cancers: TF bladder cancer, TD bladder and colon cancer. Lowered immunological response to the oral infection, periodontitis, is shown to be a risk factor in terms of cancer aetiology. [ABSTRACT FROM AUTHOR]

Background: Stroke mortality comprises different specific diagnoses as cerebral infarction, different haemorrhagic conditions and unspecified stroke. This study seeks to explore the prediction of oral health indicators versus known cardiovascular disease risk factors for stroke mortality. Methods: Altogether, 12,764 men aged 58 to 77 years were invited to the health screening Oslo II in the year 2000. It included general medical measurements and questionnaire information. Mortality data were supplied by Statistics Norway for the 6530 attending men. Cox proportional hazards regression analyses were used to establish prediction models for mortality. Results: Oral health by number of tooth extractions >10 was found to be an independent predictor for cerebral infarction hazard ratio = 2.92, 95% confidence interval (1.24–6.89). This was independent of HDL-Cholesterol (inversely) hazard ratio = 0.21, 95% confidence interval (0.06–0.76), frequent alcohol consumption (drinking 4–7 times per week) hazard ratio = 3.58, 95% confidence interval (1.40–9.13) and diabetes hazard ratio = 4.28, 95% confidence interval (1.68–10.89). Predictors for cerebral haemorrhage were age, hs-C-reactive protein and body mass index (inversely). Age and total cholesterol (inversely) were predictors for unspecified stroke. Conclusions: Oral health measured by number of tooth extractions >10 was an independent predictor for cerebral infarction in addition to age, HDL-C, hs-C-reactive protein and diabetes. The pattern of risk factors varied between the specific stroke diagnoses. [ABSTRACT FROM AUTHOR]

Aims The objective was to examine the association of physical activity and resting heart rate (RHR) with hospital-diagnosed atrial fibrillation (AF) in a Norwegian cohort. Methods and results This prospective study included 20 484 adults (50.3% men) who participated in the third Tromsø Study survey in 1986-87. At baseline, physical activity was assessed by a validated questionnaire, and RHR was objectively measured. Participants were followed from baseline through 2010 with respect to incident cases of hospital-diagnosed AF documented on an electrocardiogram. During a mean follow-up period of 20 years (409 045 person-years), 750 participants (70.5% men) were diagnosed with AF. Compared with the low physical activity group, moderately active individuals had a 19% lower risk of any AF [adjusted hazard ratio (HR) 0.81, 95% confidence interval (CI) 0.68-0.97], whereas highly active had similar risk of AF. Vigorously active individuals showed a non-significantly higher risk of AF (adjusted HR 1.37, 95% CI 0.77-2.43). Risk of AF increased with decreasing RHR (adjusted HR 0.92, 95% CI 0.86-0.98 for each 10 b.p.m. increase in RHR), and RHR < 50 b.p.m. was a risk factor for AF (P < 0.05). Conclusion In this prospective cohort study, leisure time physical activity was associated with AF in a J-shaped pattern. Moderate physical activity was associated with a reduced risk of AF, whereas higher activity levels attenuated the benefits of moderate activity. Low RHR was a risk factor for AF. Our results support the hypothesis that moderate and vigorous physical activity may affect AF risk via different pathophysiological mechanisms. [ABSTRACT FROM AUTHOR]

Objective: To study the impact of resting heart rate and leisure time physical activity at middle age on long term risk of drug treated lone atrial fibrillation (AF). Design: Longitudinal cohort study of 309 540 Norwegian men and women aged 40-45 years examined during 1985-1999 followed from 2005 through 2009. Setting: Data from a national health screening programme were linked to the Norwegian Prescription Database (NorPD). Patients: The cohort comprised 162 078 women and 147 462 men; 575 (0.4%) men and 288 women (0.2%) received flecainide and 568 men and 256 women sotalol and were defined as patients with AF. Interventions: No interventions. Main outcome measures: The outcome was lone fibrillation defined by having at least one prescription of flecainide or sotalol registered in NorPD between 2005 and 2009. Cox proportional hazard regression models were used to assess time to first prescription. Results: The risk for being prescribed these drugs increased with decreasing baseline resting heart. Adjusted hazard ratio (HR) per 10 beats/min decrease in resting heart rate for flecainide prescription was 1.26 in men (95% CI 1.17 to 1.35) and 1.15 (95% CI 1.05 to 1.27) in women. Similar effects were seen for sotalol in men, but not in women. Men who reported intensive physical activity were more often prescribed flecainide than those in the sedentary group (adjusted HR=3.14, 95% CI 2.17 to 4.54). Conclusions: This population based study supports the hypothesis that the risk of drug treated lone AF increases with declining resting heart rate in both sexes, and with increasing levels of self-reported physical activity in men. [ABSTRACT FROM AUTHOR]

Background Physical activity (PA) is inversely associated with mortality in the general population. We wanted to quantify the association of self-reported PA with mortality from all causes, ischaemic heart disease (IHD) and stroke, and compare it with other known risk factors in different age segments.Methods The Bergen Clinical Blood Pressure Survey examined a sample of 6811 Norwegian men and women in 1965–71 with follow-up until 2005–07. Cox proportional hazard regression ratio (HR) and population attributable fraction (PAF) were calculated for the old (>65), middle-aged (45–64) and young adults (22–44), respectively. We minimized confounding and bias by progressive comprehensive adjustments and subgroup-analyses (excluding early follow-up deaths, participants with self-reported disease and participants with changes in their PA-level prior baseline due to disease).Results The HR [95% confidence interval (CI)] associated with a high PA-level was 0.63(0.56–0.71), 0.66(0.52–0.83) and 0.66(0.47–0.93) for mortality from all causes, IHD and stroke, respectively (reference: no participation in any of the listed activities, adjusted for age and gender). PAF (95% CI) of no/low activity (reference: any activity) was consistent across all age groups, varying from 7.3% (3.4–11.4) in the young adults to 9.1% (3.6–15.3) in the old. PAF of smoking and high s-cholesterol declined with increasing age [smoking from 19.9% (15.3–24.7) to 1.5% (−1.3 to 6.2) and s-cholesterol from 11.5% (5.6–17.5) to −9.5% (−18.1 to −0.7)], whereas PAF of hypertension increased from 5.3% (2.1–9.1) to 18.9% (8.3–28.4).Conclusion The relative importance of traditional risk factors varies between the age groups, but physical activity is a major health promoting factor across all age segments and should be encouraged particularly in an ageing population. [ABSTRACT FROM AUTHOR]

Background: The individual physical activity level is an independent risk factor for cardiovascular disease and death, as well as a possible target for improving health outcome. However, today´s widely adopted risk score charts, typically do not include the level of physical activity. There is a need for a simple risk assessment tool, which includes a reliable assessment of the level of physical activity. The aim of this study was therefore, to analyse the association between the self-reported levels of physical activity, according to the Saltin-Grimby Physical Activity Level Scale (SGPALS) question, and cardiovascular risk factors, specifically focusing on the group of individuals with the lowest level of self-reported PA. Methods: We used cross sectional data from the Intergene study, a random sample of inhabitants from the western part of Sweden, totalling 3588 (1685 men and 1903 women, mean age 52 and 51). Metabolic measurements, including serum-cholesterol, serum-triglycerides, fasting plasma-glucose, waist circumference, blood pressure and resting heart rate, as well as smoking and self-reported stress were related to the self-reported physical activity level, according to the modernized version of the SGPALS 4-level scale. Results: There was a strong negative association between the self-reported physical activity level, and smoking, weight, waist circumference, resting heart rate, as well as to the levels of fasting plasma-glucose, serum-triglycerides, low-density lipoproteins (LDL), and self-reported stress and a positive association with the levels of high-density lipoproteins (HDL). The individuals reporting the lowest level of PA (SGPALS, level 1) had the highest odds-ratios (OR) for having pre-defined levels of abnormal risk factors, such as being overweight (men OR 2.19, 95% CI: 1.51-3.19; women OR 2.57, 95 % CI: 1.78-3.73), having an increased waist circumference (men OR 3.76, 95 % CI: 2.61-5.43; women OR 2.91, 95% CI: 1.94-4.35) and for reporting stress (men OR 3.59, 95 % CI: 2.34-5.49; women OR 1.25, 95% CI: 0.79-1.98), compared to the most active individuals, but also showed increased OR for most other risk factors analyzed above. Conclusion: The self-reported PA-level according to the modernized Saltin-Grimby Physical Activity Level Scale, SGPALS, is associated with the presence of many cardiovascular risk factors, with the most inactive individuals having the highest risk factor profile, including self-reported stress. We propose that the present SGPALS may be used as an additional, simple tool in a routine risk assessment in e.g. primary care, to identify inactive individuals, with a higher risk profile. [ABSTRACT FROM AUTHOR]

Background: Several studies have demonstrated an association between obesity and asthma. However, it is uncertain if fraction of exhaled nitric oxide (Feno), which is used as a marker of airway inflammation, and atopy are associated with BMI. The aim of this study was to examine if obese subjects with asthma symptoms have a different phenotype of asthma than nonobese subjects as indicated by Feno.Methods: The subjects (N = 2,187) consisted of women and men, aged 25 to 74, living in Gothenburg, Sweden, who participated in the randomly selected INTERGENE study cohort. Measurements included anthropometric measures, bioelectric impedance, Feno, pulmonary function, and blood samples for IgE; questionnaires included items on respiratory symptoms. Obesity was defined as BMI ≥ 30 kg/m(2). In this cross-sectional analysis, general linear models were used to analyze how Feno was associated with anthropometry, body composition, wheezing, and atopy.Results: In nonobese subjects, wheezing was associated with raised Feno and atopy, whereas in contrast, obese subjects who reported wheezing had lower Feno than obese subjects without wheezing (16.1 vs 19.1 parts per billion, P < .01). The prevalence of atopy was similar in both of those subgroups (25.0% vs 20.7%, P = .4). Similarly, in 395 subjects (19%) who reported wheezing, Feno was negatively associated with BMI, waist-to-hip ratio, and percentage of body fat, whereas no significant relationships were observed in those without respiratory symptoms.Conclusions: Wheezing was significantly associated with reduced Feno in obese subjects, whereas there was a positive association between wheezing and Feno among the nonobese subjects, indicating a possible difference in asthma phenotype, based on body weight. [ABSTRACT FROM AUTHOR]

The article investigates whether obese asthmatic patients have a different phenotype of asthma compared with non-obese patients as indicated by fraction of exhaled nitric oxide (FENO). The authors report that among non-obese subjects, wheezing was found to be associated with higher FENO and atopy, while obese subjects who suffered from wheezing have lower FENO compared with obese subjects who did not wheeze. They conclude that there exists an association between wheezing and reduced FENO among obese people.

The gastric-derived orexigenic peptide ghrelin affects brain circuits involved in energy balance as well as in reward. Indeed, ghrelin activates an important reward circuit involved in natural- as well as drug-induced reward, the cholinergicdopaminergic reward link. It has been hypothesized that there is a common reward mechanism for alcohol and sweet substances in both animals and humans. Alcohol dependent individuals have higher craving for sweets than do healthy controls and the hedonic response to sweet taste may, at least in part, depend on genetic factors. Rat selectively bred for high sucrose intake have higher alcohol consumption than non-sucrose preferring rats and vice versa. In the present study a group of alcohol-consuming individuals selected from a population cohort was investigated for genetic variants of the ghrelin signalling system in relation to both their alcohol and sucrose consumption. Moreover, the effects of GHS-R1A antagonism on voluntary sucrose- intake and operant self-administration, as well as saccharin intake were investigated in preclinical studies using rodents. The effects of peripheral grelin administration on sucrose intake were also examined. Here we found associations with the ghrelin gene haplotypes and increased sucrose consumption, and a trend for the same association was seen in the high alcohol consumers. The preclinical data show that a GHS-R1A antagonist reduces the intake and self-administration of sucrose in rats as well as saccharin intake in mice. Further, ghrelin increases the intake of sucrose in rats. Collectively, our data provide a clear indication that the GHS-R1A antagonists reduces and ghrelin increases the intake of rewarding substances and hence, the central ghrelin signalling system provides a novel target for the development of drug strategies to treat addictive behaviours. [ABSTRACT FROM AUTHOR]

Introduction: Central ghrelin signaling is required for the rewarding effects of alcohol in mice. Because ghrelin is implied in other addictive behaviors such as eating disorders and smoking, and because there is co-morbidity between these disorders and alcohol dependence, the ghrelin signaling system could be involved in mediating reward in general. Furthermore, in humans, single nucleotide polymorphisms (SNPs) and haplotypes of the pro-ghrelin gene (GHRL) and the ghrelin receptor gene ( GHSR) have previously been associated with increased alcohol consumption and increased body weight. Known gender differences in plasma ghrelin levels prompted us to investigate genetic variation of the ghrelin signaling system in females with severe alcohol dependence ( n = 113) and in a selected control sample of female low-consumers of alcohol from a large cohort study in southwest Sweden ( n = 212). Methods: Six tag SNPs in the GHRL (rs696217, rs3491141, rs4684677, rs35680, rs42451, and rs26802) and four tag SNPs in the GHSR (rs495225, rs2232165, rs572169, and rs2948694) were genotyped in all individuals. Results: We found that one GHRL haplotype was associated with reports of paternal alcohol dependence as well as with reports of withdrawal symptoms in the female alcohol-dependent group. Associations with 2 GHSR haplotypes and smoking were also shown. One of these haplotypes was also negatively associated with BMI in controls, while another haplotype was associated with having the early-onset, more heredity-driven, type 2 form of alcohol dependence in the patient group. Conclusion: Taken together, the genes encoding the ghrelin signaling system cannot be regarded as major susceptibility genes for female alcohol dependence, but is, however, involved in paternal heritability and may affect other reward- and energy-related factors such as smoking and BMI. [ABSTRACT FROM AUTHOR]

Background. Cardiovascular (CVD) mortality decreased abruptly in Norway during WW II but increased faster than in other European countries from the 1950's. Mean life expectancy for middle-aged men declined during 1960's. Objectives. To give a short overview of CVD epidemiology, especially changes in coronary heart disease (CHD) mortality, total serum cholesterol and diet during the latter half of the 20th century. Methods. Review of mortality statistics, reports from the previous National Health Screening Service and papers concerning risk factor and dietary changes. Data on CHD morbidity are not available. Discussion and conclusions. CHD mortality reached its peak during 1966-1970. It declined during the next 30 years bringing Norwegian mortality rates to levels comparable to some Mediterranean countries. The main causes for the decline during the first twenty years of this time period are reduced total cholesterol levels from the 1970's to the 1990's, as well as a declined prevalence of smoking in the male population. Improved medical and interventional treatment are likely to explain the changes occurring during the last decade of the 20th century. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To examine whether total serum homocysteine (tHcy) in a population-based sample of middle-aged women is an independent risk factor for presence of lacunar infarcts (LIs) 24 years later. DESIGN: Prospective population study, follow-up time 24 years. SETTING: Gothenburg, an urban area in western Sweden. PARTICIPANTS: Five hundred twenty-six women, 89.6% of the original study sample of the Population Study of Women in Gothenburg, aged 46 to 60 at baseline in 1968/69 and re-examined at age 70 to 84. MEASUREMENTS: After 24 years of follow-up, all subjects underwent a psychiatric examination, and 277 computerized tomography (CT) scans of the brain were performed. Two radiologists assessed LIs and white matter lesions (WMLs). Baseline serum tHcy was analyzed from frozen stored serum samples. Logistic regression analyses were performed controlling for potential confounders such as age and selected cardiovascular risk factors. RESULTS: Thirty-four subjects had LIs in 1992 (12.3%). In the full multivariate-adjusted stepwise model, LIs were associated with elevated tHcy (odds ratio (OR)=1.09, 95% confidence interval (CI)=1.01–1.17 per μmol/L of tHcy increment). Women with tHcy values in the highest tertile were almost three times as likely to have LIs (OR=2.82, 95% CI=1.34–5.93) as were those in the lowest tertile. tHcy was not related to WMLs. Subjects who did not undergo a CT scan did not differ from those who did regarding tHcy or any of the covariates studied. CONCLUSION: tHcy in middle-aged women is an independent risk factor for LIs, but not WMLs, as observed using CT later in life. [ABSTRACT FROM AUTHOR]

The role of dairy fat in the aetiology of myocardial infarction (MI) is controversial. The aim of this study was to evaluate the association between intake of dairy fat and dairy products, and risk of a first acute MI. A total of 111 MI patients with a first acute MI and 107 population controls (men and women, age 45-75 years) were studied. Diet was assessed using a 180-item food frequency questionnaire. The MI cases had higher intake of total fat, but lower intake of saturated fat and dairy fat than the control persons. No effect of dairy fat or saturated fat on the odds ratio for MI was observed, however. A significant inverse trend in odds of MI for intake of cheese was observed, but the trend was no longer significant after adjustment for smoking. The results suggest that intake of fat from dairy products may not be associated with increased risk of having a first MI. The healthy control persons had a diet that differed from the diet of the MI patients in many aspects, and dairy products were a part of this diet. This may have protected them from having a first MI. [ABSTRACT FROM AUTHOR]

Certain dietary patterns may be related to the risk of CVD. We hypothesised that a plant-centred dietary pattern would be associated with a reduced risk of first myocardial infarction (MI). A case???control study of Norwegian men and postmenopausal women (age 45???75 years) was performed. A FFQ was administered, generally within 3??d after incident MI (n 106 cases). Controls (n 105) were frequency matched on sex, age and geographic location. On the FFQ, 190 items were categorised into thirty-five food groups and an a priori healthy diet pattern score was created. We estimated OR using logistic regression with adjustment for energy intake, family history of heart disease, marital status, current smoking, education and age. Among food groups, the risk of MI was significantly higher per sd of butter and margarine (OR 1??66 (95??% CI 1??12, 2??46)), and lower per sd of tomatoes (OR 0??53 (95??% CI 0??35, 0??79)), high-fat fish (OR 0??57 (95??% CI 0??38, 0??86)), wine (OR 0??58 (95??% CI 0??41, 0??83)), salad (OR 0??59 (95??% CI 0??40, 0??87)), wholegrain breakfast cereals (OR 0??64 (95??% CI 0??45, 0??90)), cruciferous vegetables (OR 0??66 (95??% CI 0??47, 0??93)) and non-hydrogenated vegetable oil (OR 0??68 (95??% CI 0??49, 0??95)). An abundance of cases were found to have a low a priori healthy diet pattern score. A dietary pattern emphasising nutrient-rich plant foods and high-fat fish and low in trans fatty acids was associated with decreased risk of MI among Norwegians. [ABSTRACT FROM PUBLISHER]

The article discusses the study on the association of height, age and atopy with fraction of exhaled nitric oxide in a large adult general population sample. The study involves a random adult general population sample with a total of 2,200 subjects. Examination of the subjects includes the fraction of exhaled nitric oxide (FENO), pulmonary function and anthropometric variables. The study has found out that height, but not gender, was associated with FENO.

Aims: The aim was to evaluate total and cardiovascular disease (CVD) mortality in relation to use of oral contraceptives (OC) in a cohort of women with a relatively high prevalence of smoking and high serum lipid levels. Methods: In all 29,053 women aged 20–49 years were invited to a health survey in 1985–88. Of the total 82% attended and 20,282 women free of known CVD were included in this analysis. The relative risk (RR) of mortality during 14 years of follow-up was compared between OC users and non-users by means of proportional hazards regression. Results: About 50% of 827 OC users were daily cigarette smokers, and the mean total cholesterol level in the cohort was 5.9 mmol/l. There were 518 deaths, of which 10 occurred among the women taking OC at baseline. Of three deaths from CVD among OC users, two occurred in the first year of follow-up. Among non-smokers using OC three women died during the follow-up; none of the deaths was due to CVD. Women using OC of any type had no different adjusted total mortality (RR 0.87; 95% CI 0.46–1.65) or CVD mortality (RR 1.41; 95% CI 0.44–4.56) compared with non-users. Conclusions: The results were consistent with previous evidence which does not indicate that mortality from all causes or CVD is elevated in women using OC. [ABSTRACT FROM AUTHOR]

Objective: A study was undertaken to examine the relative ability of occupational class, education, household income, and housing conditions to discriminate all cause and cause-specific mortality-risk in Oslo, and to see if this relative ability is consistent across the 12 most common causes of death. Design and setting: Census records of inhabitants in Oslo 1990 aged 45 to 64 were linked to death records 1990–98 ( n ?=?88,159). All inhabitants were included except those who lacked census data on the independent variables. The relative index of inequality (RII) for each indicator was calculated. Main results: Education, occupation, and housing conditions had similar RIIs for all-cause mortality in both sexes. Household income had low RIIs, particularly in men. For the 12 most common causes of death some heterogeneity in the relative ranking between the four indicators was observed, with causes of death known to be related to early-life social circumstances (stomach cancer, cardiovascular disease, chronic obstructive pulmonary disease) being particularly strongly related to education, and causes of death which were likely to be determined by adult social circumstances (violence, sudden unexpected death) being particularly strongly related to occupation and housing conditions. Conclusions: Education, occupational class, and housing conditions all seemed to discriminate all-cause mortality to a similar degree. However, the cause-specific analysis revealed a heterogeneous pattern. [ABSTRACT FROM AUTHOR]

Background: Variations in early sexual debut among 16 year olds were investigated by social level variables, parental occupation, gender, ethnicity, family structure, family functioning, and individual level variables, future aspirations, academic and social self-perception, and depressed moods. Methods: The variations in sexual debut were investigated by examining proportions of 16 year olds reporting their first intercourse before age 16. The data were collected by self-reporting questionnaires administered to in-school-youth, in Oslo. Multivariate logistic regression analyses were used to test for associations. Gender interactions with all variables were tested. Results: Overall, 25% reported early debut. Independent effect of social class on differences in proportions in early sexual debut were found. Gender interaction with social class, ethnicity and academic self-perception as they associate to proportions having had early sexual debut, were found. For girls the pattern of social class differences was linear and the highest proportions were found among working classes. For boys the pattern was U-shaped and upper managerial and manual working class youth had similar, higher proportions of early debutants. High scores of parental monitoring, future aspirations and academic self-concept and low scores of depressed moods, are protective factors. While high social self-perception is positively associated with early debut for both genders. Conclusion: Early sexual debut varies according to social class, following gender-specific patterns, among 16 year olds in Oslo. The negative association between early debut and academic self-perception are for boys less influenced by other social and individual level factors, than for girls. [ABSTRACT FROM AUTHOR]

Background: The protective role of high-density lipoprotein (HDL) in the cardiovascular system is related to its role in the reverse transport of cholesterol from the arterial wall to the liver for subsequent excretion via the bile. Scavenger receptor class B type I (SR-BI) binds HDL and mediates selective uptake of cholesterol ester and cellular efflux of cholesterol to HDL. The role of SR-BI in atherosclerosis has been well established in murine models but it remains unclear whether SR-BI plays an equally important role in atherosclerosis in humans. The aim of this study was to investigate the expression of SR-BI and its isoforms in human macrophages and atherosclerotic plaques. Methods: The effect of hypoxia and minimally modified low-density lipoprotein (mmLDL), two proatherogenic stimuli, on SR-BI expression was studied in human monocyte-derived macrophages from healthy subjects using real-time PCR. In addition, SR-BI expression was determined in macrophages obtained from subjects with atherosclerosis (n = 15) and healthy controls (n = 15). Expression of SR-BI isoforms was characterized in human atherosclerotic plaques and macrophages using RT-PCR and DNA sequencing. Results: SR-BI expression was decreased in macrophages after hypoxia (p < 0.005). In contrast, SR-BI expression was increased by exposure to mmLDL (p < 0.05). There was no difference in SR-BI expression in macrophages from patients with atherosclerosis compared to controls. In both groups, SR-BI expression was increased by exposure to mmLDL (p < 0.05). Transcripts corresponding to SR-BI and SR-BII were detected in macrophages. In addition, a third isoform, referred to as SR-BIII, was discovered. All three isoforms were also expressed in human atherosclerotic plaque. Compared to the other isoforms, the novel SR-BIII isoform was predicted to have a unique intracellular C-terminal domain containing 53 amino acids. Conclusion: We conclude that SR-BI is regulated by proatherogenic stimuli in humans. However, we found no differences between subjects with atherosclerosis and healthy controls. This indicates that altered SR-BI expression is not a common cause of atherosclerosis. In addition, we identified SR-BIII as a novel isoform expressed in human macrophages and in human atherosclerotic plaques. [ABSTRACT FROM AUTHOR]

Aim It has recently been suggested that exercise testing may be more valuable prognostically than it is diagnostically in apparently healthy subjects. We wanted to compare the accuracy of CHD risk assessment based on classical risk factors with an assessment also based on multiple exercise test parameters. [ABSTRACT FROM PUBLISHER]

Background: The response of serum cholesterol to diet may be affected by the apolipoprotein E (APOE) ε2/ε3/ε4 polymorphism, which also is a significant predictor of variation in the risk of coronary heart disease (CHD) and CHD death. Here, we test the hypothesis that the APOE polymorphism may modulate the cholesterol-raising effect of coffee. Objective: We determined the effect of a coffee abstention period and a daily intake of 600 mL coffee on serum cholesterol and triglycerides with respect to the APOE polymorphism. Design: 121 healthy, non-smoking men (22%) and women (78%) aged 29-65 years, took part in a study with four intervention periods: 1 and 3) a coffee free period of three weeks, 2 and 4) 600 mL coffee/day for four weeks. Results: APOE ε2 positive individuals had significantly lower total cholesterol concentration at baseline (4.68 mmol/L and 5.28 mmol/L, respectively, p = 0.01), but the cholesterol-raising effect of coffee was not influenced significantly by APOE allele carrier status. Conclusions: The APOE ε 2 allele is associated with lower serum cholesterol concentration. However, the APOE polymorphism does not seem to influence the cholesterol-raising effect of coffee. [ABSTRACT FROM AUTHOR]

Dietary trials with subjects on a freely selected diet may be affected by unwanted behavioural changes. Few studies, if any, have examined changes in coffee consumption and possible concomitant changes in diet and health-related habits. The aim of the present study was to examine whether induced changes in coffee consumption lead to changes in food habits and leisure-time physical activity. Healthy, non-smoking coffee-drinkers (n 214) were asked to change their coffee habits in a controlled clinical trial on the metabolic effects of coffee. The participants were asked to maintain their usual dietary habits. Self-perceived changes in diet and physical activity during the 6-week intervention period were assessed at the end. In the analyses, the participants were rearranged into groups reflecting the difference in coffee intake during the trial as compared with habitual intake. Associations with changes in food intake or physical activity were analysed by Spearman rank correlation. Changes in intake of ???chocolate, sweets??? (r 0??179, P<0??05), ???cakes, sweet biscuits, pastry??? (r 0??306, P<0??001), and ???jam??? (r 0??198, P<0??05) showed positive associations with change in coffee intake during the trial. Negative associations were found for ???dishes with fish??? (r -0??204, P<0??01) and many of the drinks as well as with physical activity (r -0??164, P<0??05). Induced changes in coffee intake seem to alter ad libitum intake of several foods. The recognized associations between health behaviours may have physiological explanations. [ABSTRACT FROM PUBLISHER]

Background: Elevated concentrations of plasma total homocysteine (tHcy) and serum total cholesterol are risk factors for ischemic heart disease (IHD). Previous studies showed that the consumption of very high doses of unfiltered coffee increases tHcy and total cholesterol. Objective: A prospective intervention study was performed to assess the effects of coffee consumption on the concentrations of tHcy and total cholesterol by using doses and brewing methods common in southeastern Norway. Design: The study was an unblinded, controlled trial with 191 healthy, nonsmoking, coffee-drinking volunteers aged 24-69 y randomly assigned to 3 groups who were asked to consume for 6 consecutive weeks no coffee, 1-3 cups (≈175-525 mL)/d, or ≥4 cups(≈700 mL)/d prepared in the manner to which they were accustomed. Blood samples were drawn when the subjects were randomly assigned and at 3 and 6 wk of the trial. Dietary data were collected by questionnaire. Results: Ninety-seven percent of the participants reported being regular consumers of caffeinated filtered coffee. Abstention from coffee for 6 wk was associated with a decrease in the tHcy concentration of 1.08 µmol/L and a decrease in the total cholesterol concentration of 0.28 mmol/L in participants who had been drinking on average 4 cups of filtered coffee daily for the past year. Adjustments for several possible confounders did not alter the results. Conclusion: Abstention from filtered coffee in doses that are commonly consumed was associated with lower concentrations of tHcy and total cholesterol. [ABSTRACT FROM AUTHOR]

The aim of the present study was to evaluate the importance of social status and lifestyle for dietary habits, since these factors may influence life expectancy. We studied the association of four indicators for healthy dietary habits (fruits and vegetables, fibre, fat and Hegsted score) with sex, age, socio-economic status, education, physical leisure exercise, smoking and personal attention paid to keeping a healthy diet. Data were gathered with a self-administered quantitative food-frequency questionnaire distributed to a representative sample of Norwegian men and women aged 16–79 years in a national dietary survey, of whom 3144 subjects (63%) responded. Age and female sex were positively associated with indicators for healthy dietary habits. By separate evaluation length of education, regular physical leisure exercise and degree of attention paid to keeping a healthy diet were positively associated with all four indicators for healthy dietary habits in both sexes. Socio-economic status, location of residence and smoking habits were associated with from one to three indicators for healthy dietary habits. In a multiple regression model, age, education and location of residence together explained from 1 to 9% of the variation (R2) in the four dietary indicators. Length of education was significantly associated with three of four dietary indicators both among men and women. By including the variable ‘attention paid to keeping a healthy diet’ in the model, R2 increased to between 4 and 15% for the four dietary indicators. Length of education remained correlated to three dietary indicators among women, and one indicator among men, after adjusting for attention to healthy diet, age and location of residence. Residence in cities remained correlated to two indicators among men, but none among women, after adjusting for age, education and attention to healthy diet. In conclusion, education was associated with indicators of a healthy diet. Attention to healthy diet showed the strongest and most consistent association with all four indicators for healthy dietary habits in both sexes. This suggests that personal preferences may be just as important for having a healthy diet as social status determinants. [ABSTRACT FROM PUBLISHER]

Evaluates the relative cost effectiveness of various cholesterol lowering programs through retrospective analysis in Norway. Composition of health intervention; Projection of the cost per life year gained; Importance of marginal cost effectiveness analyses for incremental programs of health care.

In 1988/89, 10,497 men and women aged 40–42 were invited to a health screening in the County of Nordland in northern Norway. The screening procedure comprised completion of a questionnaire, measurement of blood pressure, weight, height and collection of a non-fasting blood sample. Eighty-two percent of the invited population attended the screening. They were given another questionnaire which covered a broad spectrum of relevant topics. Eighty-seven percent of the attenders returned this questionnaire by mail. Non-attenders to the screening tended to be single. Non-responders to the second questionnaire did not differ much from responders, the most consistent finding was a slightly higher heart rate in non-responders. Non-responding men had somewhat higher serum total cholesterol and tended to be smokers. [ABSTRACT FROM PUBLISHER]

Univariate analysis of the cross-sectional data of the Tromsø Heart Study revealed group differences in the levels of blood pressure and serum lipids. In order to isolate the contribution from each of the physical and social variables which characterized these groups, a multiple variate analysis was carried out with serum triglycerides, serum cholesterol, systolic and diastolic blood pressure as dependent variables. Besides age, height and weight, seasonal variation contributed substantially to the explanation of the variance of the dependent variables. The influence of the social variables was somewhat reduced compared to the univariate analysis, though most of them did remain significant also in the multivariate analysis. The explained percentage of the total variance ranged from 13% for systolic blood pressure to 26% for serum cholesterol. [ABSTRACT FROM PUBLISHER]