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Background: Positive association between body weight and bone mass is well established, and the concept of body mass index (BMI) is associated with higher areal bone mineral density (aBMD) and reduced fracture risk. BMI, that comprises both fat mass (FM) and lean mass (LM) may contribute to peak bone mass achievement in different ways. This study explored the influence of body composition in terms of total body LM and FM on hip aBMD-values in adolescence.Methods: In 2010/2011, 93% of the region's first-year upper-secondary school students (15-17 years old) in Tromsø, Norway attended the Tromsø Study, Fit Futures. Areal BMD at femoral neck (aBMDFN) and total hip (aBMDTH) (g/cm2), total body LM and FM (g) were measured by dual energy X-ray absorptiometry (DXA). Height and weight were measured, and BMI calculated. Lifestyle variables were collected by self-administered questionnaires and interviews, including questions on time spent on leisure time physical activity. Stratified analyses of covariance and regression models included 395 girls and 363 boys. Crude results were adjusted for age, height, sexual maturation, physical activity levels, vitamin D levels, calcium intake, alcohol consumption and smoking habits.Results: Unadjusted distribution indicated higher aBMD-levels at higher LM-levels in both genders (p < 0.001), but higher aBMD at higher FM-levels were found only in girls (p < 0.018). After multiple adjustments, aBMDFN-levels in girls were associated by 0.053 g/cm2 and 0.032 g/cm2 per standard deviation (SD) change in LM and FM (p < 0.001). Corresponding values in boys were 0.072 and 0.025 (p < 0.001). The high LM groups accounted for the highest aBMD-levels, while aBMD-levels at the LM/FM-combinations indicated different patterns in girls compared to boys. The adjusted odds ratio (95% CI) for low levels of aBMDFN was 6.6 (3.4,13.0) in boys, compared to 2.8 (1.6,4.9) in girls per SD lower LM.Conclusions: LM and FM should be regarded as strong predictors for bone mass and hence bone strength in adolescents. A gender specific difference indicated that high lean mass is of crucial importance prominently in boys. In adolescents with low lean mass, especially in girls, high fat mass may partially ameliorate the effect of deficient lean mass levels. [ABSTRACT FROM AUTHOR]

Background: Disability in older adults is associated with loss of independence, institutionalization, and death. The aim of this study was to study the association between the Timed Up and Go (TUG) test and all-cause mortality in a population-based sample of older men and women.Methods: Our study population was home dwellers aged 65 and above, who participated in the fifth wave of the Tromsø study. This study included the TUG test and a range of lifestyle and mortality predictors. Participants were linked to the Cause of Death Registry and followed up for mortality for a maximum of 11.8 years. Cox regression was used to investigate the association between TUG and total mortality.Results: Mean TUG score was 12.6 s, and men performed better than women. The oldest participants had poorer TUG score compared to younger participants, increasing 0.25 s per year. There was a significant association between TUG and all-cause mortality, and the association was equally strong in men and women. Across the TUG-score categories, from quickest fifth to slowest fifth, the mortality increased in a step-wise fashion. Compared to the quickest fifth, the slowest fifth had hazard ratio (HR) of 1.79 (95% confidence interval (CI) 1.33, 2.42) in a model adjusted for age and gender. For each standard deviation TUG-score the increase in HR was 1.23 (95% CI 1.14, 1.33). The association between the TUG score and mortality remained significant after adjusting for self-reported health, body mass index, smoking and education.Conclusions: A significant association between the TUG score and mortality was observed in both men and women. Identifying older people with poor TUG may aid in identifying those at risk and thus targeted interventions may be applied. [ABSTRACT FROM AUTHOR]

Background: The aim was to describe secular trends in leisure time physical activity (LTPA) and work related physical activity (WPA) from 1979 to 2008. Additionally, we explored potential cross-sectional and longitudinal correlates of LTPA and WPA.Methods: Data are collected from 34,898 individuals (49.7% men) aged >20 years who participated in at least one Tromsø Study survey between 1979 and 2008. In each survey, the participants completed a self-administered questionnaire and underwent physical examinations. LTPA and WPA were assessed by the validated "Saltin-Grimby" 4-scale questions. Potential correlates of LTPA and WPA (sex, age, body mass index (BMI), education, smoking, self-reported cardiovascular disease, self-perceived health, and employment status) were tested using ordinal logistic regression.Results: The age-adjusted prevalence of participants being inactive in leisure time remained relatively stable around 20% from 1979 to 2008 (range 19.9-23.6%). The age-adjusted prevalence of moderate-vigorous LTPA decreased from 23.2% in 1979-80 to 16.0% in 2001, thereafter the prevalence increased to 24.3% in 2007-08 (P <0.05). The age-adjusted prevalence of being mostly sedentary at work increased gradually from 35.5% in 1979-80 to 53.4% in 2007-08 (P <0.05). Sex, age, education, and smoking were identified as cross-sectional correlates of LTPA and WPA (P <0.05). Men had higher odds of engaging in LTPA than women (adjusted OR 1.52 [95% CI 1.39-1.67] in 2007-08), whereas the association between sex and WPA shifted over time. High education level, not being a smoker, and high WPA were associated with high LTPA, whereas low education level, being a smoker, and high levels of LTPA were associated with high WPA (P <0.05). In general, odds of engaging in LTPA and WPA decreased with age (P <0.05). Individuals with healthy BMI had higher odds of being in a higher LTPA level than those who were underweight and obese (P <0.05). Longitudinal analyses identified sex, age, education, smoking, WPA, and LTPA measured in 1979-80 as determinants of LTPA in 2007-08.Conclusions: In Norwegian adults, the proportion of sedentary WPA increased from 1979 to 2008, whereas the proportion of inactive LTPA remained stable. Being female, older, smoker, obese or underweight, and low education level were associated with low LTPA levels. [ABSTRACT FROM AUTHOR]

Background: Knowledge about early physiotherapy to preterm infants is sparse, given the risk of delayed motor development and cerebral palsy., Methods/design: A pragmatic randomized controlled study has been designed to assess the effect of a preventative physiotherapy program carried out in the neonatal intensive care unit. Moreover, a qualitative study is carried out to assess the physiotherapy performance and parents' experiences with the intervention. The aim of the physiotherapy program is to improve motor development i.e. postural control and selective movements in these infants. 150 infants will be included and randomized to either intervention or standard follow-up. The infants in the intervention group will be given specific stimulation to facilitate movements based on the individual infant's development, behavior and needs. The physiotherapist teaches the parents how to do the intervention and the parents receive a booklet with photos and descriptions of the intervention. Intervention is carried out twice a day for three weeks (week 34, 35, 36 postmenstrual age). Standardized tests are carried out at baseline, term age and at three, six, 12 and 24 months corrected age. In addition eight triads (infant, parent and physiotherapist) are observed and videotaped in four clinical encounters each to assess the process of physiotherapy performance. The parents are also interviewed on their experiences with the intervention and how it influences on the parent-child relationship. Eight parents from the follow up group are interviewed about their experience. The interviews are performed according to the same schedule as the standardized measurements. Primary outcome is at two years corrected age., Discussion: The paper presents the protocol for a randomized controlled trial designed to study the effect of physiotherapy to preterm infants at neonatal intensive care units. It also studies physiotherapy performance and the parent's experiences with the intervention., Trial Registration: ClinicalTrials.gov NCT01089296.