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Background. The relationship between protein energy malnutrition (PEM) and malaria is controversial. While most studies demonstrate that PEM is associated with greater malaria morbidity, some indicate that PEM may in fact have a protective effect. PEM is differentiated into three subgroups: kwashiorkor (marked protein deficiency), marasmus (calorie deficiency), and kwashiorkor/marasmus. None of the studies concerning PEM and malaria seem to distinguish between these subgroups, and significant differences in susceptibility to malaria between these subgroups may have been overlooked. Plasmodium parasites and malaria infected erythrocytes are sensitive to oxidative stress. Since kwashiorkor patients seem to display an excess of prooxidants and as serum albumin is an important antioxidant, we hypothesized that patients with different forms of PEM might have different levels of malaria parasitaemia. Methods. 72 PEM children older than 6 months admitted to Kwale Family Life Training Programme (Kenya) were included in the study. Results. Mean parasitaemia was significantly lower in the kwashiorkor group than in the marasmus group (p < 0,001). There was no correlation between serum albumin and parasitaemia. Conclusion. Our study suggests a protective effect of kwashiorkor against malaria, warranting further studies.

The purpose of the present study was to test if one bout of moderate exercise performed in either the fasted or the postprandial state affects glucose values measured over 22 hours. Twelve participants diagnosed with hyperglycemia not using antidiabetic medications underwent 3 test days in a randomized cross-over design encompassing one test day without exercise, one test day with 60 min of treadmill walking prior to breakfast, and one test day with an identical bout of exercise 30 min after the start of breakfast. Continuous glucose monitoring was performed until the next morning (>22 hours). There was no significant effect of type of test day on the area under the glucose curve for the entire 22 hours period (p = 0.111). None of the exercise interventions had a significant effect on the area under the glucose curve after breakfast, lunch or dinner. However, the postprandial exercise bout tended to decrease the area under the glucose curve after the evening meal compared to the fasted exercise bout (24.2 ± 6.2 vs. 27.6 ± 6.0 mmol·hour·L-1, p = 0.031). Furthermore, the postprandial exercise decreased the mean of the 10 highest glucose values measured in each individual (8.6 ± 1.9 mmol·L-1) over 22 hours compared to both the control day (9.3 ± 2.1 mmol.L-1) and the day with fasted exercise (9.6 ± 1.7 mmol·L-1, p = 0.012 and 0.009 respectively). Postprandial exercise also decreased the glycemic variability compared to the control day (1.22 ± 0.49 vs. 1.58 ± 0.52 mmol·L-1, p = 0.015). We conclude that performing moderate exercise in the postprandial state after breakfast, but not in the fasted state, decreases glucose excursions during the subsequent 22 hours period in hyperglycemic individuals not using antidiabetic medications.

Purpose Systemic inflammation is involved in the development of several diseases, including cardiovascular disease and type 2 diabetes. It is known that vigorous exercise affects systemic inflammation, but less is known about exercise at lower intensities. Hyperglycemia can also entail pro-inflammatory responses; however, postprandial hyperglycemia is blunted if the meal is followed by exercise. Hypotheses were: (1) moderate physical exercise acutely affects levels of C-reactive protein (CRP) and serum soluble vascular cell adhesion molecule 1 (sVCAM-1) in hyperglycemic individuals and (2) the effect depends on whether the activity is performed in a post-absorptive or postprandial state. Methods Twelve participants diagnosed with hyperglycemia, but not using anti-diabetic medication, underwent three test days in a randomized cross-over study; 1 control day without exercise, 1 day with 60 min of treadmill walking ending 30 min before breakfast, and 1 day with an identical bout of activity 30 min after the start of breakfast. Food intake was strictly standardized and venous blood for CRP, and sVCAM-1 analysis was sampled at standardized timepoints during the first 3.5 h after breakfast and once 24 h later. Results Merged data from the two exercise days showed that sVCAM-1 increased from baseline (4 ± 16 ng/mL) compared to the control condition (−28 ± 47 ng/mL, ES = 0.7, p = 0.024). There was no statistically significant difference in changes in sVCAM-1 levels between the two exercise test days. Exercise did not affect CRP values. Conclusion Moderate exercise increases sVCAM-1 in hyperglycemic individuals, whereas it does not affect CRP.

The purpose of the present study was to test if one bout of moderate exercise performed in either the fasted or the postprandial state affects glucose values measured over 22 hours. Twelve participants diagnosed with hyperglycemia not using antidiabetic medications underwent 3 test days in a randomized cross-over design encompassing one test day without exercise, one test day with 60 min of treadmill walking prior to breakfast, and one test day with an identical bout of exercise 30 min after the start of breakfast. Continuous glucose monitoring was performed until the next morning (>22 hours). There was no significant effect of type of test day on the area under the glucose curve for the entire 22 hours period (p = 0.111). None of the exercise interventions had a significant effect on the area under the glucose curve after breakfast, lunch or dinner. However, the postprandial exercise bout tended to decrease the area under the glucose curve after the evening meal compared to the fasted exercise bout (24.2 ± 6.2 vs. 27.6 ± 6.0 mmol·hour·L-1, p = 0.031). Furthermore, the postprandial exercise decreased the mean of the 10 highest glucose values measured in each individual (8.6 ± 1.9 mmol·L-1) over 22 hours compared to both the control day (9.3 ± 2.1 mmol.L-1) and the day with fasted exercise (9.6 ± 1.7 mmol·L-1, p = 0.012 and 0.009 respectively). Postprandial exercise also decreased the glycemic variability compared to the control day (1.22 ± 0.49 vs. 1.58 ± 0.52 mmol·L-1, p = 0.015). We conclude that performing moderate exercise in the postprandial state after breakfast, but not in the fasted state, decreases glucose excursions during the subsequent 22 hours period in hyperglycemic individuals not using antidiabetic medications.

Physical activity (PA) is thought to prevent the metabolic syndrome (MetS), which is prevalent among south Asian immigrants in Western countries. The purpose of this study was to explore whether increasing PA improves the MetS and associated components in a group of Pakistani immigrant men living in Norway. One- hundred and fifty physically inactive Pakistani immigrant men were randomized to either a control group (CG) or an intervention group (IG). The 5 months intervention focused on increasing PA level, which was assessed using accelerometer recordings. Total PA level (counts min(-1)) increased significantly more in the IG than in the CG. The mean difference between the two groups was 49 counts min(-1), which translates into a 15% (95% CI = 8.7% to 21.2%; P = 0.01) greater increase in total PA level in the IG than in the CG. Serum insulin concentration and waist circumference decreased more in the IG compared with the CG. Other MetS related factors and the prevalence of the MetS did not differ between the groups after the intervention. A five- month intervention program can increase PA level and cardiorespiratory fitness, and reduce insulin concentration and waist circumference. However this intervention program may not lower the prevalence of the complete MetS in Pakistani immigrant men.

It has been reported that the frequency of cola intake (COLA) is positively associated with serum triglycerides and negatively associated with high-density-lioprotein (HDL) cholesterol, both components of the metabolic syndrome (MetS). The question now is whether noncola soft drink intake (NCOLA) is associated with MetS. Among the 18 770 participants in the Oslo Health Study, 5373 men and 6181 women had data on COLA and NCOLA and risk factors for MetS (except fasting glucose). Main MetS requirements are central obesity and 2 of the following: increased triglycerides, low HDL cholesterol, increased systolic or diastolic blood pressure, and elevated fasting blood glucose. The MetSRisk index was calculated to estimate many MetS components. Using regression analyses, the association between COLA (NCOLA) and MetS (MetSRisk) was studied. In young (aged 30 years), middle-aged (aged 40 and 45 years), and senior (aged 59 and 60 years) men and women, there was, in general, a positive correlation between COLA and MetSRisk, and between COLA and single MetS risk factors, except HDL cholesterol, which was negatively correlated. A less consistent picture was found for NCOLA. By regression analyses, after adjustment for sex, age, time since last meal, and use of sugar-sweetened soft drinks, a positive association between COLA (NCOLA) and MetSRisk (MetS) was still found. However, when also controlling for cheese, fatty fish, coffee, alcohol, smoking, physical activity, education, and birthplace, only the association with COLA remained significant, irrespective of the presence or absence of sugar. In conclusion, the self-reported intake frequency of soft drinks can be positively associated with MetS.

The objective of this study was to assess the nutritional adequacy of sub-elite runners with irregular menstrual function (n=10) and that of a comparable group of runners with regular menstrual function (n=10), with a special focus on vitamin E. Based on 3 days' records of weighed dietary intake, the mean energy intakes of micro- and macronutrients were estimated. Both estimated daily energy intake (irregular: 9.9+/-0.4 MJ; regular: 12.2+/-0.7 MJ; mean+/-sx) and intake of dietary fat (irregular: 61+/-6 g; regular: 98+/-12 g) were lower in athletes with irregular menstrual function than in athletes with regular menstrual function (P=0.01). Estimated intake of vitamin E was below recommended values in both groups. Serum concentrations of alpha-tocopherol were used to evaluate vitamin E status, which were normal in athletes with regular menstrual function (27.3+/-3.6 micromol.l(-1)) but below normal values in athletes with irregular menstrual function (15.7+/-0.8 micromol.l(-1); P=0.01). Furthermore, post-exercise osmotic fragility in red blood cells was inversely related to resting alpha-tocopherol concentrations. Our results indicate that irregular menstrual function in athletes on a low-fat diet is associated with low concentrations of circulating alpha-tocopherol, rendering the red blood cells more susceptible to haemolysis in connection with physical activity.

The objective of this study was to examine the impact of post-meal light exercise on the rise in blood glucose and insulin. After fasting overnight, nine healthy subjects (age 37.3 ± 12.2 years) participated in three experiments in a crossover design: Day 1 (no exercise), the subjects were given cornflakes, and blood glucose and plasma insulin were determined before meal, and each 15 min for the next 165 min. Day 2 and 3 were similar to Day 1, but included 30 min very light and light intensity bicycle exercise after the meal. Both levels of exercise blunted and delayed the rise in blood glucose and plasma insulin. Bicycling-related reductions in peak glucose and insulin values correlated with peak values the control day (r = -0.83 to -0.93, P � 0.006), as did reductions in AUC and IAUC. We conclude that even very light exercise after a carbohydrate meal blunts the rise in blood glucose and insulin.

The postprandial blood glucose elevation (PPG) seems to be an important risk factor for diabetes Type 2 and coronary heart disease. We have tested whether high responders have a greater PPG reduction than low responders when changing from high to low glycemic foods, as might be anticipated. In 25 healthy, young men the glycemic effects of six different, low glycemic foods (each ingested in portions providing 50 g carbohydrates) were determined and compared with the glycemic response after intake of 50 g glucose. The reduction in glycemia (delta incremental area under the curve) was proportional to the glycemic response after ingesting glucose (r > 0.8; p

Background – Since n-3 fatty acids, abundant in fatty fish, may improve health, we raised the question whether self-reported intake frequency of fatty fish (FF) might be related to the percentage of n-3 fatty acids in serum phospholipids (PL-n-3), and also to self-rated health (H). Design – The study followed a cross-sectional design. Methods – In the cross-sectional Oslo Health Study, PL-n-3 were determined in 121 middle-aged ethnic Norwegians and 102 immigrants from the Indian subcontinent and correlated with FF and H. Logistic regression was used to study the relationship between PL-n-3 and H (dichotomized, i.e. Poor vs. Good health). Results – FF correlated positively with PL20:5n-3 (PL-EPA, r = 0.467, p

Oxidative stress might exert deleterious cardiovascular effects. The aim of the present study was to compare the antioxidative effects of carvedilol and atenolol. Levels of oxidized low-density lipoprotein cholesterol (ox-LDL), vitamin E, and thiobarbituric acid reactive substances (TBARS) were measured. In a prospective, open, and end-point-blinded study, 232 patients with an acute myocardial infarction (AMI) were randomized to receive either carvedilol or atenolol at equipotent doses, and the previously mentioned 3 parameters were measured at baseline and after 12 months of active treatment, with changes during the study period being compared both within and between the groups. Ox-LDL decreased in both treatment modalities, from 40.5 +/- 15.6 to 35.0 +/- 13.8 U/L, P = 0.0001, in the carvedilol group and from 40.3 +/- 16.5 to 37.4 +/- 13.1 U/L, P = 0.044, in the atenolol group, with a significant between-group difference in the changes (P = 0.036). The levels of vitamin E did not change during carvedilol treatment (31.0 +/- 10.2 vs 31.7 +/- 11.1 micromol/L), but it decreased marginally in the atenolol group (30.8 +/- 12.1 vs 27.2 +/- 9.1 micromol/L, P = 0.056), with a significant between-group difference (P = 0.008). No significant change in TBARS was observed between the carvedilol and atenolol groups (P = 0.454). These results indicate that carvedilol has a more pronounced antioxidative effect than atenolol in post-AMI patients, which might be of clinical importance.

BACKGROUND: Since information about the association between serum albumin and risk of stroke is limited the purpose of the present paper was to re-investigate this relationship. DESIGN: The study followed a cross-sectional design. METHODS: In the cross-sectional Norwegian Oslo Health Study the concentration of serum albumin and blood pressure was determined in a random sample of 5071 men and women, 30-75 years of age. Logistic regression was used to study the association between the serum albumin concentration and self-reported prevalence of stroke. In the sample there were 122 subjects with a history of stroke and 4949 subjects without. RESULTS: Low albumin (i.e. 47 g/l) was associated with increased prevalence of self-reported stroke (odds ratio 1.83; 95% confidence interval, 1.20-2.78; P=0.005), after adjusting for age ( or =59 years) and sex. Including smoking, blood pressure and length of education into the model did not have any major influence on the result. CONCLUSION: Low serum albumin is associated with increased prevalence of self-reported stroke.

Familial adenomatous polyposis (FAP) provides a model of APC inactivation as an early genetic event for the approximately 85% of colorectal cancers that develop from polyps. Abnormal fatty acid composition of tissues and serum phospholipids has been linked to cancer risk. Our aim was to describe the composition of fatty acids in serum phospholipids in 38 colectomized FAP patients as compared to 160 healthy subjects. Mean fatty acid intakes were similar between the groups. Colectomy was done on average 16 years prior to inclusion, and 18% were diagnosed with colorectal cancer at colectomy. The levels (weight %) of linoleic and alpha-linolenic acid were higher among the reference subjects (difference: 3.96, 95% confidence interval (CI) = 2.87, 5.04, and difference: 0.06, 95% CI = 0.04, 0.08, respectively), and the levels of arachidonic and docosahexaenoic acid were lower (difference: -3.70, 95% CI = -4.35, -3.06, and difference: -5.26, 95% CI = -6.25, -4.28, respectively) as compared to the FAP patients (all p < or = 0.0001). The abnormal fatty acid composition was not related to time since colectomy, intestinal reconstruction or history of colorectal cancer for any of the fatty acids assessed. Compositional differences in the fatty acid profile of serum phospholipids have not been described before in FAP patients. Further studies are needed to confirm these findings and assess clinical significances of a possible distorted fatty acid metabolism, including a potentially different dietary need of essential fatty acids. The relevance of these findings for APC induced cancers remains unclear.

Objectives This study examines whether intensive acupuncture treatment can improve several social and psychological variables for women with chronic pain in the neck and shoulders, and whether possible effects are long-lasting. The effects on pain have been reported elsewhere. Methods Twenty-four female office workers (47±9 years old, mean ± SD) who had had neck and shoulder pain for 12±9 years, were randomly assigned to a test group or a control group. Acupuncture was applied 10 times during three to four weeks either at presumed acupuncture points for pain (test group) or at sham points (control group). In addition, acupressure was given to patients between treatments, at either real or sham points. Questionnaires for social and psychological variables were completed before each treatment, just after the course, and six months and three years later. Results The pain-related activity impairment at work was significantly less in the test group than the controls by the end of treatment (PConclusion Intensive acupuncture treatment may improve activity at work and several relevant social and psychological variables for women with chronic pain in the neck and shoulders. The effect may last for at least three years.

The study was carried out to examine whether acupuncture treatment can reduce chronic pain in the neck and shoulders and related headache, and also to examine whether possible effects are long-lasting. Therefore, 24 female office workers (47+/-9 years old, mean+/-SD) who had had neck and shoulder pain for 12+/-9 years were randomly assigned to a test group (TG) or a control group (CG). Acupuncture was applied 10 times during 3-4 weeks either at presumed anti-pain acupoints (TG) or at placebo-points (CG). A physician measured the pain threshold (PPT) in the neck and shoulder regions with algometry before the first treatment, and after the last one and six months after the treatments. Questionnaires on muscle pain and headache were answered at the same occasions and again 3 years after the last treatment. The intensity and frequency of pain fell more for TG than for CG (Pbor = 0.04) during the treatment period. Three years after the treatments TG still reported less pain than before the treatments (Pw0.001) contrary to what CG did (Pb0.04) The degree of headache fell during the treatment period for both groups, but more for TG than for CG (Pb=0.02) Three years after the treatments the effect still lasted for TG (Pw0.01) while the degree of headache for CG was back to the pre-treatment level (Pb0.001) PPT of some muscles rose during the treatments for TG and remained higher 6 months after the treatments (Pw0.05) which contrasts the situation for CG. Adequate acupuncture treatment may reduce chronic pain in the neck and shoulders and related headache. The effect lasted for 3 years.

The purpose of this study was to characterize the extent of immune, endocrine, substrate and metabolic changes during a long-distance cross-country ski race in extremely well-trained athletes and evaluate if the blood perturbations would indicate signs of health risk. Ten male (M) and six female (F) national team skiers were investigated as they followed their usual routines of race preparations. Blood samples were drawn before and immediately after a World Cup 50-km M and 30-km F ski race with a mean finish time of 142 and 104 min, respectively. Hemoglobin, electrolytes, and C-reactive protein remained unchanged for both M and F. Serum testosterone remained unchanged in M, but doubled in F. Significant increases were observed in concentrations of granulocytes (F: 5 x, M: 5 x), natural killer cells (F: 2 x, M: 1.5 x), adrenaline (F: 12 x, M:10 x), noradrenaline (F: 7 x, M:5 x), growth hormone (F: 30 x, M: 2 x), cortisol (F: 1.5 x, M:2 x), glucose (F: 2 x, M:1.5 x), creatine kinase (F: 2 x, M:2 x), uric acid (F: 1.5 x, M: 1.5 x) and non-organic phosphate (F:2 x, M:2 x), while insulin concentration decreased (F: 0.5x, M: 0.8 x). Free fatty acid (FFA) concentration increased (F:2 x, M: 3 x). In conclusion, we observed substantial changes in several immuno-endocrine, substrate and metabolic measurements after long distance cross-country ski racing and suggest that some of these marked changes may reflect the large amount of muscle mass involved during skiing.

Background The conversions of the n-3 and n-6 fatty acid of plant origin to the C20 and C22 very long chain fatty acids (LCPUFAs) is regulated by several cellular enzymes such as elongases and desaturases. Methods Sixty-five male one-day old chickens (Ross 308) were randomly divided into four groups and given one of four diets; with or without linseed oil (LO), (the diets contained equal amounts of fat) and with low or high selenium (Se). Final body weight, amount of Se and fat in breast muscle, fatty acid profile, and gene expression for fatty acid desaturases (Fads1, Fads2, Fads9), HMG-CoA reductase, Acyl-CoA oxidase (Acox), carnitine palmitoyl transferase1 (Cpt1), superoxide dismutase (Sod) and glutathione peroxidase4 (Gpx4) were analyzed in all animals, and Gpx activity in whole blood was determined. Results mRNA expression of elongases and desaturases in chicken breast muscle was not affected by feed rich in C18:3n-3. The highly positive correlation between amount of fat in breast muscle and the product/precursor indices of monounsaturated fatty acid synthesis, and the negative correlation between muscle fat and indices of LCPUFA synthesis should be further studied. Conclusion mRNA expression in chicken breast muscle of elongases and desaturases was not affected by feed rich in C18:3n-3. The highly positive correlation between amount of fat in breast muscle and the product/precursor indices of monounsaturated fatty acid synthesis, and the negative correlation between muscle fat and indices of LCPUFA synthesis should be further studied.

Oral glucose tolerance test (OGTT) is used as a standard to diagnose people with diabetes. However, it does not reflect the total glucose load. The aim of this study was to explore correlation between blood glucose values at different times during OGTT and the Incremental Area under the Curve (IAUC), to investigate whether there might be a time point for glucose measurement which would best represent the total glucose load. OGTT were performed in 196 Norwegian-Pakistani women, and glucose was measured fasting and every 15 minute up to 2 hours. The results indicate that fasting values are least correlated with total glucose load, but that values measured at 75, 90 and 60 minutes represent it the best. We suggest that fasting values fail to mirror total glucose load in many cases, and that 2 hour values may be inferior to earlier ones in representing glucose load. High-risk groups, such as Pakistani immigrants, may especially take advantage from improvements in methods to diagnose diabetes.

Strenuous endurance exercise in fasted subjects is accompanied by increased plasma levels of catecholamines, leucocytosis, low insulin, and elevated plasma free fatty acids (FFA). Immediately after such exercise, plasma FFA may rise to high and potentially harmful levels, whereas the white blood cell count (WBCC) rapidly decreases towards or below baseline values. The present work investigated how active recovery (AR) for 15 min at 50% of maximal oxygen consumption (\(\dot V{\rm O}_{{\rm 2max}} \) ), after 60 min of uphill running at 83% of \(\dot V{\rm O}_{{\rm 2max}} \) , influenced plasma FFA, lymphocyte, neutrophil, granulocyte, and monocyte count, as well as adrenaline, noradrenaline, insulin and cortisol concentrations until 120 min post-exercise. Thirteen endurance athletes participated in the study [24.2 (3.7) years, 1.82 (0.06) m, 76.7 (7.9) kg and \(\dot V{\rm O}_{{\rm 2max}} \) 69.2 (6.8) ml min–1 kg–1]. In a randomized order, the subjects completed two sets of strenuous workouts, followed by either AR or complete rest in the supine position (RR). Compared with RR, AR strongly counteracted the rapid increase in plasma FFA 5 min post-exercise. The decreases in neutrophil and monocyte counts post-exercise were nullified by AR, and the cell count stayed above resting values throughout the observation period. AR also counteracted the rapid return of hormone concentration towards baseline levels. It would appear that active recovery at low intensity after strenuous exercise can maintain sufficient adrenergic activation to counteract the post-exercise drop in WBCC. However, in spite of keeping the catecholamine concentration high and insulin levels low, AR can also maintain a low plasma FFA concentration, probably because of the continued use of FFA in muscle. It remains to be elucidated whether the observed high FFA and low WBCC values after RR have a negative effect on health. If so, AR could be a preventive measure.

The present study investigated the effect of active recovery (AR) as compared to rest recovery (RR) upon FFA concentrations following moderate- (MI) or high-intensity (HI) running. Fourteen well-trained males (23.7±6 years. V̇O2max = 69.5±1.8ml · min−1kg−1) were randomly assigned into two trials (HI = 30 min at 82% of V̇O2max; MI = 60 min at 75% of V̇O2max). Within each group, the subject completed two sets of experiments of running followed by either AR (15 min running at 50% of V̇O2max) or RR (complete rest in the supine position). Plasma volume changes after the exercise did not deviate between the AR or RR trials. In both the HI and Ml trials, AR resulted in lower FFA peaks and lower overall FFA concentrations while performing AR (p

Chloro-containing fatty acids are a major fraction of extractable, organically bound chlorine in fish. It has been suggested that dichloro stearic acid (9,10-dichlorooctadecanoic acid) (C18) is metabolized to dichloro myristic acid (5,6-dichlorotetradecanoic acid) (C14) which accumulates in tissues. Hence, the biological effects of the C18 dichloro fatty acid could be due to formation of the C14 dichloro fatty acid. In this study we have compared the effects of dichloro stearic and dichloro myristic acid on growth of three widely differing cell lines. Both fatty acids inhibited cell growth; however, dichloro myristic acid had a weaker growth inhibitory effect than dichloro stearic acid. Dichloro myristic acid had a biphasic effect (i.e. growth was stimulated at low concentrations, followed by inhibition at higher concentrations) on the growth of human hepatoma cells and immortalized human kidney epithelial cells, but no such effect on human microvascular endothelial cells. The order of potency for growth inhibition by dichloro myristic acid was consistently human hepatoma cells>immortalized human kidney epithelial cells >human microvascular endothelial cells, whereas the relative potency of dichloro stearic acid was variable. Albumin alone stimulated cell growth and had a stronger protective effect against growth inhibition by dichloro myristic acid than against that of dichloro stearic acid. It seems unlikely that a major part of the effect of dichloro stearic acid on cell growth is caused by conversion to dichloro myristic acid.

After strenuous exercise there is a sustained increase in resting O2 consumption. The magnitude and duration of the excess post-exercise O2 consumption (EPOC) is a function of exercise intensity and exercise duration. Some of the mechanisms underlying the rapid EPOC component ( 1 h) are not fully understood. It has been suggested that beta-adrenergic stimulation is of importance for the prolonged component. There is an increased level of plasma adrenaline and noradrenaline during exercise, and it is shown that catecholamines stimulate energy expenditure through beta-adrenoceptors. After exercise an increased fat oxidation and an increased rate of triglyceride fatty acid (TG-FA) cycling may account for a significant part of the prolonged EPOC component. These processes may be stimulated by catecholamines. However, the return of plasma concentration of catecholamines to resting levels after exercise is more rapid than the return of O2 uptake. But plasma concentration of catecholamines may be an insensitive indicator of sympathetic activity, since the clearance rate of catecholamines is high. Also, the sensitivity to catecholamines may be increased after exercise. A decreased post-exercise O2 uptake has been shown when beta-blockade is administered in dogs before the exercise bout. In a pilot study in humans, administration of beta-antagonist after exercise did not seem to change EPOC.

The object of the study was to evaluate blood pressure, insulin and glucose metabolism, and serum lipids in hypertensive patients, during 8 weeks on a moderately salt-restricted diet. A double-blind, cross-over study was conducted with hypertensive patients following a moderately salt-restricted diet. Patients were randomised to sodium capsules in one period and placebo capsules during the other period. After a 1-month run-in period, 13 males and three females with mild to moderate essential hypertension (mean age 50 years) complied with a salt-reduced diet. They were randomized to a salt-supplemented group (5 capsules of 10 mmol sodium per capsule) or a salt reduced diet group (5 capsules of placebo) with cross-over after 8 weeks. Serum insulin, insulin C-peptide, and glucose were measured, fasting and 30 min after a 75-g glucose load. Serum lipids and lipoproteins constituting an atherogenic index were measured, along with blood pressure and 24-h urine excretion of sodium and chloride. Non-significant reductions of systolic and diastolic blood pressure (4 mmHg, p = 0.06, and 2 mmHg, p = 0.13, respectively) were observed during the reduced-salt period. The changes observed for fasting insulin, insulin C-peptide, glucose, serum lipids and the atherogenic index were also non-significant. It is concluded that moderate salt restriction seems not to adversely influence insulin resistance or serum lipids in hypertensive patients.

Dietary intake of fish oils, rich in the polyunsaturated fatty acids (PUFAs) docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), has given inconsistent results as to their influence on the plasma fibrinogen level (1, 2, 3, 4, 5, 6). In the present study we have examined the effects of various fatty acids, the PUFAs DHA, EPA and arachidonic acid (AA), the monounsaturated fatty acid oleic acid (OA) and the saturated fatty acid palmitic acid (PA), alone or combined with the antioxidant vitamin E (Vit.E), on the fibrinogen concentration in the growth medium of human hepatoma (HepG2) cells. Vit.E alone decreased the amount of fibrinogen in the medium in a dose dependent fashion, where fibrinogen was measured as Fibrinopeptide A (FPA) releasable by thrombin. EPA and Vit.E decreased the amount of fibrinogen additively. PUFAs alone increased the fibrinogen concentration in a dose dependent manner. PUFAs combined with a fixed dose of Vit.E decreased the fibrinogen concentration, also dose dependently. OA and PA had an inhibitory effect, both alone and combined with Vit.E. These results indicate that Vit.E may be necessary for PUFAs to have a fibrinogen lowering effect, whereas both OA and PA apparently may decrease the fibrinogen concentration in the cell medium of HepG2 cells, both alone and combined with Vit.E. Possibly, peroxidation of the PUFAs may increase the fibrinogen production, that may be counteracted and reversed by the simultaneous presence of Vit.E.

Previous studies indicate a suppressive influence of fish oils on rodent malaria. The present work was carried out to study (i) the dose-effect relation between dietary fish oils and lethality of primary malaria infection in mice; (iii) the modifying influence of vitamin E; and (iii) the effect of previous fish oil feeding on parasitemia and lethality of a rechallenge infection. For two or four weeks, groups of weanling male mice were fed a standard laboratory diet or one of eight purified diets containing various amounts of fish oil (providing 6–21% of energy). The diets were prepared with and without vitamin E. After the two-or four-week feeding period, the mice were injected intraperitoneally withPlasmodium yoelii yoelii-infected erythrocytes. Six months after the primary infection (four months after discontinuing fish oil feeding), the surviving mice were again injected intraperitoneally with parasitized red blood cells (or even better—erythrocytes, erythrocytes are used elsewhere). Primary malaria infection was lethal in mice fed standard diet alone or with fish oil and vitamin E added. In contrast, feeding a fish oil-based diet without vitamin E improved survival to at least 70% if the mice had been fed these diets for four weeks. Protection against malaria did not seem to be related to the fish oil dose used. Regardless of the previous fish oil dose, all the mice surviving the primary infection survived the rechallenge infection with low parasitaemias. The results suggest that the prooxidant nature of highly unsaturated fatty acids in fish oils may beneficially influence malaria infection, and may also increase the resistance against reinfection for some time after discontinuing fish oil intake.

Hsstmark AT, Stensrsd B, Jebens E, Lystad E, Kierulf P, Laake K. Blood reticulocyte count and plasma lactate dehydrogenase activity are positively related to the free fatty acid/albumin ratio in geriatric patients. Scand J Clin Lab Invest 1995; 55: 649-53. The objective of this study was to investigate the in vivo relationship between plasma free fatty acid (FFA)/albumin molar ratio and indicators of cellular damage. A case series study was carried out in 20 geriatric patients in a stable clinical condition. Their plasma albumin concentration was in the range 26-42 g 1-' . There was a significant positive correlation between the FFA/albumin ratio and (a) reticulocyte count (r = 0.61, p =0.006), (b) lactate dehydrogenase activity (r=0.69, p=0.002), and (c) haptoglobin concentration (r=0.46, p=0.05). The haemoglobin concentration was inversely related to relative reticulocyte count (r = -0.55, p = 0.01). Absolute and relative reticulocyte counts were positively associated (r=0.92, p

Since the amounts of arachidonic acid (AA) and EPA in food may have implications for human health, we investigated whether a small change in chicken feed influenced the blood lipid concentration in humans ingesting the chicken. Forty-six young healthy volunteers (age 20–29) were randomly allocated into two groups in a double-blind dietary intervention trial, involving ingestion of about 160 g chicken meat per day for 4 weeks. The ingested meat was either from chickens given a feed concentrate resembling the commercial chicken feed, containing 4% soybean oil (SO), or the meat was from chickens given a feed where the soybean oil had been replaced by 2% rapeseed oil plus 2% linseed oil (RLO). Serum total cholesterol, LDL and HDL cholesterol, triacylglycerols, serum phospholipid fatty acid concentration, blood pressure, body weight and C-reactive protein were determined at baseline and post-intervention. In subjects consuming chicken meat from the RLO group there was a significantly (p < 0.001) increased concentration of EPA in serum phospholipids, and a reduced ratio between AA and EPA. The participants that had a low% of EPA + DHA in serum phospholipids (less than 4.6%), all increased their% of EPA + DHA after the four week intervention period when consuming the RLO chicken. No significant response differences in cholesterol, triacylglycerol, C-reactive protein, body weight or blood pressure were observed between the groups. This trial demonstrates that a simple change in chicken feed can have beneficial effects on amount of EPA and the AA/EPA ratio in human serum phospholipids.

Postprandial physical activity may blunt the blood glucose response. In diabetes prone female immigrants only slow walking is regularly performed raising the question of whether also this type of physical activity can attenuate their post meal blood glucose elevation. Using a cross over design, 11 female Pakistani immigrants living in Oslo were recruited to participate in three experiments where their blood glucose concentration was measured every 15 min for 2 h after intake of a high glycemic food, either while resting after the meal or doing very light post meal walking of two durations. Postprandial blood glucose peak value and incremental area under the 2 h blood glucose curve decreased with increasing duration of slow post meal walking. Also the blood pressure was lowered. Post meal walking can strongly attenuate the glycemic response to carbohydrates and reduce blood pressure in a high risk group of immigrants.

Intake of lovastatin, an inhibitor of endogenous cholesterol synthesis, leads to a compensatory increase in the uptake of cholesterol from plasma (low density lipoprotein endocytosis). The drug might exert effects also by facilitating uptake of fatty acids carried in low density lipoprotein. It has been reported that dietary fat may alter physical properties of erythrocytes as well as adrenergic effects in heart muscle. We have therefore studied osmotic fragility of erythrocytes and inotropic and lusitropic responses of isolated heart papillary muscles taken from rats fed for 3 weeks either a purified high fat diet (olive oil/coconut oil 16 g/6 g/100 g diet), prepared plus and minus lovastatin, or similar diets in which 4 g/100 g diet of the olive oil was replaced by cod liver oil. Three weeks feeding of a high fat diet containing cod liver oil did not affect osmotic fragility of erythrocytes or indices of inotropy or lusitropy in papillary muscles in response to noradrenaline stimulation neither in the absence nor in the presence of lovastatin. In contrast, purified high fat diet lacking cod liver oil increased osmotic fragility in a fraction of the erythrocytes. When lovastatin was added to this diet the osmotic fragility was increased for the whole population of erythrocytes. In this situation the "relaxation-onset index"--an index of early relaxation in the papillary muscles--was shifted to higher concentrations of noradrenaline. Thus, intake of lovastatin may lead to an early appearance of effects of dietary fat on osmotic fragility of erythrocytes and on heart muscle responses to catecholamines. These effects of lovastatin are, however, apparently dependent upon the kind of dietary fat as they are prevented by the presence of cod liver oil.

The protective influence of bovine serum albumin against growth inhibition caused by fatty acids was studied in human hepatoma (HepG2) and immortalized human kidney epithelial (IHKE) cells. In general, growth inhibition by unsaturated fatty acids (0.15 mmol/liter) increased with increasing number of double bonds. For HepG2 cells crude albumin (1 g/100 ml) did not greatly modify growth inhibition by arachidonic, eicosapentaenoic, and docosahexaenoic acid. With oleic, linoleic, and linolenic acids, crude and defatted albumin stimulated cell growth. In contrast, for IHKE cells both albumins counteracted growth inhibition by unsaturated fatty acids to approximately the same extent. When HepG2 cells were cultured in the presence of saturated fatty acids (0.3 mmol/liter), C2, C6, and C8 had no or little inhibitory effect. C10 and C12 inhibited cell growth appreciably, whereas C14, and especially C16, had poor inhibitory effects. Crude albumin counteracted growth inhibition by all these fatty acids. In contrast, defatted albumin had little or no effect (except against C10 and C12), and even increased the growth inhibition by C14 and C16. With unsaturated fatty acids there seemed to be an inverse relationship between cell growth and the concentration of thiobarbituric acid reactive substances (TBARS) in media. Vitamin E abolished growth inhibition (and the increase in TBARS concentration) by unsaturated fatty acids. The complex interaction between fatty acids and albumins calls for great caution when interpreting data on growth effects.

Epidemiologic studies have shown an association between seafood consumption and risk of thyroid cancer. Fish meals increase the serum concentrations of the longchain fatty acids, eicosapentaenoic acid (20∶5,n-3) (EPA) and docosahexaenoic acid (22∶6,n-3) (DHA), for days. The hypothesis that serum concentrations of fatty acids may be associated with thyroid cancer risk therefore was tested in a population-based case-control study with 74 cases and 221 matched controls. Seventy-three cases with sera in the Norwegian serum bank (JANUS) were identified in the Norwegian Cancer Registry and matched with three controls, also in JANUS, on age, gender, place of residence, and time of blood sampling. Each case was matched with two controls. Serum concentrations of 11 longchain fatty acids were determined blindly by gas chromatography for all subjects. Controls were divided into three groups with increasing serum fatty acid concentrations, and odds ratios between cases and controls were estimated relative to the group with lowest serum level by univariate and multivariate analyses. The main finding was a significant inverse relation between the sum of arachidonic acid (20∶4,n-6) (AA) and DHA serum concentrations and thyroid cancer risk. The significance of this association was weakened when the analyses were restricted to the papillary type of thyroid carcinoma. It was of the same order of magnitude whether the period between blood sampling and diagnosis was greater than eight years, or eight or less years. High EPA/AA ratio, indicating consumption of fish fat, was not associated significantly with increased thyroid-cancer risk. These data indicate that the association between seafood ingestion and increased thyroid-cancer risk may not be caused by the marine fatty acids.

NORSK SAMMENDRAG Det er kjent at lav konsentrasjon av serumalbumin er en risikofaktor for hjerte- og karsykdommer. I Helseundersokelsen i Oslo inngar blant annet sporsmal om hjerteinfarkt. Konsentrasjonen av serumalbumin ble malt pa 5224 individer. Verdiene er naer normalfordelt hos begge kjonn, med en forskyvning mot noe lavere verdier hos kvinner. For menn er det fallende albuminverdier med okende alder. Hos kvinner er det liten forskjell i albuminverdien i de to laveste aldersgruppene (30 og 40+45aringene), men deretter fallende verdier. Lav albumin (≤47 g/l) vs hoy (>47 g/l) er assosiert med okt prevalens av (selvrapportert) hjerteinfarkt (Odds Ratio=1,95; 95% CI=1,30–2,93; p=0,001), angina pectoris (OR=1,44; 95% CI=1,04–2,01; p=0,03) og brystsmerter ved a ga i trapper/bakker (OR=1,36; 95% CI=1,12–1,64; p=0,002), etter justering for alder, kjonn og royking. Albumin er en viktig ekstracellulaer antioksidant. Peroksidering av lipider (bl.a. av LDL) kan oke risikoen for koronar hjertesykdom. I materialet ble det funnet positiv sammenheng mellom alder (og LDL) og serum TBARS, som er et mal pa lipidperoksidering. Hos menn var det invers sammenheng mellom albumin og TBARS. Lave TBARS-verdier var assosiert med redusert ’risiko’ for a rapportere angina pectoris (OR=0,80; 95% CI=0,688–0,933; p=0,004), noe som reiser sporsmalet om den antatt beskyttende effekten av serumalbumin mot koronarsykdom delvis kunne bero pa beskyttelse mot lipidperoksider. Det forhold at albuminverdien hos kvinner ikke faller for etter menopausen, kunne vaere en medvirkende arsak til at kvinner sjeldnere far koronarsykdom premenopausalt. Det er imidlertid ikke mulig a si noe sikkert om kausale sammenhenger pa basis av dette tverrsnittsmaterialet.

We previously reported that the frequency of cheese intake (FCI) was negatively associated with serum triglycerides and positively associated with high-density lipoprotein cholesterol (HDL), both components of the metabolic syndrome (MetS). We therefore wanted to study whether FCI is associated with MetS.The Oslo Health Study (18,770 subjects), obtained data from 7815 men and 9685 women on cheese intake and risk factors for MetS, except for fasting glucose. MetS requires central obesity and at least 2 of the following: increased triglycerides, low HDL cholesterol, increased systolic or diastolic blood pressure, and elevated fasting blood glucose. We calculated the index SumRisk, providing the number of MetS factors present, and MetSRisk to reflect the combined levels of many MetS factors. The association between FCI and MetSRisk (SumRisk) was studied using regression analyses.In young (30 years), middle-aged (40 and 45 years), seniors (59-60), and old (75-76 years) subjects, there was an inverse association between FCI and MetSRisk (p ≤ 0.005, except in old men). Using regression, we found a consistent negative association (p0.001) between FCI and MetSRisk, SumRisk, single MetS components, and the complete MetS, prevailing after controlling for sex, age, time since last meal, intake of fruit/berries, fruit juice, fatty fish, coffee, alcohol, smoking, leisure time physical activity, years at school, and birthplace. FCI was also negatively associated with body mass index (p0.02), except in old women.Cheese intake can be negatively and independently associated with (1) an index including the level of many risk factors for MetS, (2) the number of MetS requirements present, (3) single MetS components, and (4) the complete MetS.

Fysisk aktivitet kan redusere risikoen for flere kroniske sykdommer, og kan vurderes ved bruk av spørreskjema, eller måles objektivt. I en undersøkelse blant innvandrerkvinner fra Pakistan (n=86) har vi sammenlignet selvrapportert (International Physical Activity Questionnaire, IPAQ) og objektivt målt fysisk aktivitet (SenseWear Armband). For å sikre at kvinnene forsto hva det ble spurt om ble det benyttet prosjektmedarbeidere fra Pakistan og India som hjalp deltakerne til å svare på spørreskjemaet, som dessuten var oversatt til urdu, punjabi og engelsk. Vi fant ingen signifikant korrelasjon (Spearman) mellom de to målemetodene. Selvrapportert fysisk aktivitet var ikke signifikant korrelert med: alder, BMI, livvidde, HbA1c, fastende og ’2-timers glukose’, fastende insulin, C-peptid, sittende systolisk- og diastolisk blodtrykk, totalkolesterol, LDL-kolesterol og triglyserider. På den annen side fant vi en invers relasjon mellom objektivt målt fysisk aktivitet og nevnte variabler. Sammenhengene holdt seg ved aldersjustering (lineær regresjon). Deltakere med selvrapportert god fysisk form hadde lavere BMI, livvidde, serum insulin, triglyserider og diastolisk blodtrykk. Resultatene tyder på at selvrapportering av fysisk aktivitet ikke alltid gir god nok opplysning til å bedømme graden av fysisk aktivitet, slik det ble funnet ved å bruke spørreskjemaet IPAQ på dette utvalget av innvandrerkvinner. Objektiv måling av energiomsetning kan synes nødvendig for å få gode estimater på fysisk aktivitet og dens gunstige helseeffekter. Hjellset VT, Høstmark AT. Is self-reported physical activity suitable for studying health effects of light physical activity? Nor J Epidemiol 2011; 20 (2): 135-142.ENGLISH SUMMARYPhysical activity can reduce the risk of many chronic diseases, and may be estimated using questionnaires, or measured objectively. In a group of Pakistani immigrant women living in Oslo, Norway, we found no significant correlations between use of the self report International Physical Activity Questionnaire (IPAQ) and objectively measured physical activity as assessed using the accelerometer SenseWear Armband. To ensure that the women understood the questions, the questionnaire had been translated to urdu and punjabi, and interpreters from Pakistan and India helped them in filling in IPAQ. There was an inverse relationship between objectively measured physical activity and age, BMI, waist circumference, HbA1c, fasting and 2-h glucose value, fasting insulin and C-peptide, systolic- and diastolic blood pressure (sitting), total cholesterol, LDL cholesterol and triglycerides, persisting after adjustment for age. Participants reporting good physical fitness had lower BMI, waist circumference, serum insulin, triglycerides and diastolic bloodpressure as compared with those reporting bad fitness. The results suggest that self reporting may not be appropriate to evaluate the degree of physical activity, as shown in this group of immigrant women when using the International Physical Activity Questionnaire. An objective measure of energy expenditure seems to be necessary to obtain good estimates of physical activity and its beneficial health effects.

Background: The level of physical fitness in south Asian immigrants living in Norway is largely unknown, but the level of physical activity seems to be low, possibly in part explaining their high prevalence of diabetes and cardiovascular diseases. However, previous studies have used self-reported measures of physical activity, and it might be questioned whether the previous data reflect the true physical activity level.Aim: To describe objectively measured physical activity level, cardiorespiratory fitness and diabetes risk in a group of Pakistani immigrant men living in Oslo, Norway.Methods: One hundred and fifty Pakistani immigrant men in the age group 25-60 years were included. Physical activity level was assessed with an accelerometer. Cardiorespiratory fitness was measured until exhaustion on a treadmill, and diabetes risk was evaluated with an oral glucose tolerance test.Results: Mean age was 37.3 years (SD=7.7). Total physical activity level was 308 counts/min (SD=131), and peak oxygen uptake was 34.2 ml·kg-1·min-1 (SD=5.6). Fifty percent of the participants had the metabolic syndrome, and 76% were obese. Physical activity level and cardiorespiratory fitness level were lower, and prevalence of the metabolic syndrome higher in a subgroup of taxi drivers as compared with those inother occupations (PConclusions: Physical activity and cardiorespiratory fitness levels are low and diabetes risk high among Pakistani immigrant men living in Oslo, especially in taxi drivers

Background. The magnitude and duration of postprandial blood glucose (PPG) elevations are important risk factors of diabetes and coronary heart diseases.Aim. To study PPG after ingestion of breads with and without pea fibre and rapeseed oil.Methods. After fasting overnight, 10 Pakistani immigrant women participated in three experiments having a crossover design and involving ingestion of various types of bread: regular coarse bread or fibre enriched-bread with two levels of rapeseed oil, all providing 25 g available carbohydrates (CHO). Blood glucose and satiety were determined before the meal and every 15 min over the next 2 hours.Results. Intake of an amount of pea fibre-enriched bread containing 25 g CHO attenuated, the postprandial peak glucose value, the incremental area under the glucose versus time curve during 15 to 75 min, and the glycemic profile, and increased duration of satiety (), as compared with intake of regular bread with 25 g carbohydrate.Conclusion. Pea fibre-enriched breads can reduce PPG and prolong satiety.

I Norge er det lagret store mengder nedfrosne blodprøver fra helseundersøkelser av ulike slag. Stabilitet av målinger av apolipoproteiner fra langtids nedfrosne blodprøver er lite dokumentert. Ny forståelse av lipoproteinenes fysiologi og betydning for utvikling av ateromatose reiser spørsmålet om andre lipoproteinkomponenter enn total (TC), LDL (LDL-C) og HDL-kolesterol (HDL-C) bør vurderes som risikomarkører. Ikke minst gjelder dette apolipoproteinene og balansen mellom apolipoprotein B (apoB) og apolipoprotein A-1 (apoA-1). Nedfrosne blodprøver kunne kanskje anvendes til å analysere sammenheng mellom nivåer på apolipoproteiner og utvikling av kardiovaskulære hendelser, hvis det ikke har skjedd vesentlige konsentrasjonsforandringer under lagring. For å undersøke dette ble det foretatt en pilotstudie av blodprøver fra 300 personer i HUNT 2. For disse hadde en ferske blodprøver, og i 2009 opptinte blodprøvemålinger av lipoproteiner samt apoB og apo A-1. Disse har bare vært lagret ved –40 ºC. Resultatene viste at TC var øket med 0,3 mmol/L fra fersk til smeltet tilstand til tross for at HDL-C var blitt redusert med 0,25 mmol/L. Korrelasjonene mellom ferske og opptinte prøver var høye (0,93-0,99). Variasjonskoeffisientene var derimot høye (5,8-13,7%) og endringene var nivåavhengige. Nivåene på apolipoproteinene var klart høyere, mens apoB/apoA-1 ratio samsvarte mer med andre studierapporter. Korrelasjonene mellom apo-og lipoproteiner var på et nivå man gjenfinner i andre studier. Resultatene må tolkes som bare indikative på at apolipoproteiner, og da spesielt ratio apoB/apoA-1, kan brukes i HUNT 2 til prognostiske studier av kardiovaskulære hendelser og død. Hoveddelen av HUNT 2 biobank har imidlertid ligget i ro i –80 ºC og lipoproteiner endres neppe ved denne temperatur. Prognostiske studier med apolipoproteiner som prediktorer burde derfor med rimelig sikkerhet kunne utføres i HUNT 2. Endelig bevis for dette kan imidlertid først oppnås når slike opptinte prøver blir analysert.Can frozen and thawed blood samples stored for 12-14 years be used to measure levels of apolipoproteins? Analysis from HUNT 2 data. English Summary: In Norway, large numbers of frozen blood samples from health surveys are stored in freezers at –70 to –80 ºC. An assumption has been that levels of lipoproteins (total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG)) have been kept at constant levels during long-term storage. The stability of long-term storage of apolipoproteins is weakly documented. The Health Survey of Nord-Trøndelag in 1995-97 (HUNT 2) provides the possibility to analyse relationships between levels of lipoproteins and incident cardiovascular disease. A project group consisting of the present authors questioned whether use of apolipoproteins as risk markers may give at least as good predictive value as the traditional lipoproteins and whether the frozen samples in HUNT 2 can be used for this purpose. To investigate this issue a pilot study based on 300 thawed blood samples from HUNT 2 was performed. For these subjects lipoprotein levels measured at screening in 1995-97 were available as well as the same levels from the thawed samples including also apolipoprotein B (apoB) and apolipoprotein A-1 (apoA-1). For special reasons these samples had only been frozen down to –40 ºC.

We have examined basal and stimulated monocyte procoagulant activity (PCA) in 10 persons with high HDL (1.62-2.47 mmol/L) and 10 persons with low HDL (0.43-1.29 mmol/L). Heparinized whole blood was incubated at 37 degrees C for 2 hours with 100 ng/ml of E. Coli lipopolysaccharide (LPS). Monocytes were isolated by density gradient centrifugation (purity > 70%), and PCA measured with a chromogenic peptide substrate assay. LPS-induced PCA was significantly higher in the high HDL group (p = 0.02), whereas basal levels were similar. Furthermore, the levels of total HDL, HDL2, as well as apo-A1 were all significantly correlated with LPS-induced monocyte PCA (p < 0.01, p < 0.01, and p = 0.03), whereas VLDL was inversely correlated (p = 0.02). PAI-I activity was significantly lower in the high HDL group (p < 0.01). LPS recovery in plasma after incubation, by LAL test, was significantly higher in the high HDL group (p = 0.02) and correlated to HDL2 (p = 0.04), and inversely correlated with triglycerides (p = 0.04). There was no significant difference between the two groups in plasma fibrinopeptide A (FPA) levels after LPS incubation.

The influence of a 3-week vegetarian diet and fasting on serum concentration of peroxides, lipids, apolipoproteins, and plasma fibrinogen was studied in ten middle-aged fibromyalgia/fibrositis patients (eight women, two men). Mean serum peroxide concentration (estimated as thiobarbituric acid reacting substances) was reduced from 3.60 +/- 0.14 to 2.82 +/- 0.15 umol/l (p = 0.01) and plasma fibrinogen from 3.33 +/- 0.25 to 2.74 +/- 0.15 g/l (p = 0.02). Serum total cholesterol fell from 6.61 +/- 0.50 to 4.83 +/- 0.35 mmol/l (p0.0001), apolipoprotein B from 1.77 +/- 0.14 to 1.31 +/- 0.11 g/l (p0.0001), and apolipoprotein A from 1.41 +/- 0.09 to 1.23 +/- 0.05 g/l (p = 0.03). High density lipoprotein cholesterol concentration also decreased somewhat (from 1.26 +/- 0.09 to 1.07 +/- 0.04 mmol/l, p = 0.03) An atherogenic index, reflecting the balance between low and high density lipoproteins, was reduced by 31% (from 5.74 +/- 0.79 to 3.97 +/- 0.60, p = 0.02). The results suggest that vegetarian diet/fasting may have a beneficial influence on the concentration of serum peroxides and plasma fibrinogen concentration, and on the serum level of several lipoprotein-related coronary risk factors.

The influence of fish oil supplementation on several coronary risk factors in blood was studied in 165 middle-aged employed men (69 smokers, 96 nonsmokers). In earlier studies smoking has been shown to increase, and fish oils to reduce the coronary risk. This raises the question whether the effect of fish oils on coronary risk factors in blood might differ in smokers and nonsmokers. Groups were supplemented for 10 weeks with either various fish oils, or with olive oil. In response to fish oil supplementation, mean serum triglyceride concentration was reduced from 1.4 to 1.1 mmol/1, and - regardless of smoking habits - total cholesterol (TC) levels were reduced from 6.2 to 6.0 mmol/1, and high density lipoprotein cholesterol (HDLc) increased from 1.2 to 1.4 mmol/1 at the end of the supplementation period. In the olive oil group there was no effect on serum triglycerides, but TC fell from 6.4 to 5.9 mmol/1, and HDLc rose from 1.3 to 1.4 mmol/1 during the supplementation period. Apolipoprotein A levels fell significantly (by 7% to 8%) in both the pooled fish oil group and the olive oil group, whereas apolipoprotein B levels remained unchanged. A compound atherogenic index including TC, HDLc and apolipoproteins, was significantly reduced only in nonsmokers given fish oil. The effect of various commercially available concentrates of fish oils seemed to differ according to their content of omega-3 fatty acids. The results suggest that cessation of smoking may be of significance in increasing the benefit from intake of fish oils.

A previous finding that soft drink intake is associated with increased serum triglycerides and decreased high-density-lipoprotein (HDL) cholesterol, both components of the metabolic syndrome (MetS), raises the question of whether other aspects of an unhealthy diet might be associated with MetS. Main MetS requirements are central obesity and 2 of the following: increased triglycerides, low HDL, increased systolic or diastolic blood pressure, and elevated fasting blood glucose. Of the 18 770 participants in the Oslo Health Study, there were 13 170 respondents (5997 men and 7173 women) with data on MetS factors (except fasting glucose) and on the components used to determine the Dietary Index score (calculated as the intake estimate of soft drinks divided by the sum of intake estimates of fruits and vegetables). MetSRisk was calculated as the sum of arbitrarily weighted factors positively associated with MetS divided by HDL cholesterol. Using regression analyses, the association of the Dietary Index with MetSRisk, with the number of MetS requirements present, and with the complete MetS was studied. In young, middle-aged, and senior men and women, there was, in general, a positive association (p < 0.001) between the Dietary Index and the MetS estimates, which persisted in regression models adjusted for sex, age, time since the last meal, intake of cheese, intake of fatty fish, intake of coffee, intake of alcohol, smoking, physical activity, education, and birthplace. Thus, an index reflecting a high intake of soft drinks and a low intake of fruit and vegetables was positively and independently associated with aspects of MetS.

The increasingly high number of immigrants from South-East Asia with The Metabolic Syndrome (MetS) is an important challenge for the public health sector. Impaired glucose is essential in MetS. The blood glucose concentration is not only governed by diet and physical activity, but also by psychological distress which could contribute to the development of MetS. The aim of this study is to describe health-related quality of life, subjective health complaints (SHC), psychological distress, and coping in Pakistani immigrant women, with and without MetS. As a part of an randomized controlled intervention study in Oslo, Norway, female Pakistani immigrants (n = 198) answered questionnaires regarding health related quality of life, SHC, psychological distress, and coping. Blood variables were determined and a standardized oral glucose tolerance test was performed. The participants had a high score on SHC and psychological distress. About 40% of the participants had MetS, and this group showed significantly lower general health, lower physical function, and more bodily pain, than those without MetS. Those with MetS also had more SHC, depressive symptoms, higher levels of somatisation, and scored significantly lower on the coping strategy of active problem solving. Pakistani immigrant women seem to have a high prevalence of SHC and psychological distress, especially those with MetS. publishedVersion

Coronary risk factors in middle-aged men as related to smoking, coffee intake and physical activity. Høstmark, A. T., Berg, J., Brudal, S., Berge, S., Kierulf, P. and Bjerkedal, T. (Department of Preventive Medicine, University of Oslo, Occupational Health Service for STK-Alcatel, and Oslo Transport. Research Group, Central Laboratory, Ullevål Hospital, Oslo). The relationship between lifestyle and coronary risk factors in blood was investigated in 165 middle-aged men. Plasma fibrinogen, serum triacylglycerols (TG), and apolipoprotein B (apo B) were higher, and high density lipoprotein cholesterol (HDLc) lower in smokers ( n = 69) than in non-smokers ( n = 96). By linear regression analysis there was a significant positive association between degree of smoking and either total cholesterol (TC), apo B, or plasma fibrinogen, whereas smoking was inversely related to HDLc. Smoking and coffee intake were positively correlated with an atherogenic index, reflecting the balance between low and high density lipoproteins. Sedentary men (n = 59) had higher mean TC, apo B, and atherogenic index than physically active men (n = 104). Smokers used salt more often than non-smokers. Physically active men used vegetables more often than sedentary men. Combining several habits into a “badhabit” score gave a high level of significance for its association with TC, apo B, and the atherogenic index. The results indicate that lifestyle may influence several blood factors involved in atherosclerosis development.

Albumin carries fatty acids and has also been suggested to act as an antioxidant. In the present work, polyunsaturated fatty acids (linoleic, arachidonic, eicosapentaenoic and docosahexaenoic acids) - but not palmitic and oleic acid - inhibited growth of human hepatoma cells in low albumin concentration (0.5%). Growth inhibition by polyunsaturated fatty acids was prevented by albumin in a dose-related manner in the range 0.7–5.0%. Albumin also protected against growth inhibition following catabolism (by lipoprotein lipase) of very low density lipoproteins. Vitamin E strongly counteracted the inhibitory effect of polyunsaturated fatty acids. Vitamin E and albumin appeared to have additive effects in protecting against growth inhibition by polyunsaturated fatty acids. Indomethacin did not greatly modify the polyunsaturated fatty acids effect. Growth inhibition by polyunsaturated fatty acids, as well as the level of thiobarbituric acid reacting substances (a measure of lipid peroxidation) in growth media, increased with increasing number of fatty acids double bonds. Vitamin E and albumin prevented both thiobarbituric acid reacting substances formation and growth inhibition by polyunsaturated fatty acids. The results suggest that the concentrations of albumin and vitamin E in the incubation medium are essential when studying polyunsaturated fatty acids effects on cell growth.

Postprandial blood glucose concentration is a risk factor for the development of cardiovascular diseases and diabetes, even at states well below hyperglycemic levels. A previous study has shown that postmeal exercise of moderate intensity blunts the blood glucose increase after carbohydrate intake (Høstmark et al. Prev. Med. 42(5): 369–371). The objective of the present study was to examine whether even postmeal slow walking would have a similar effect. Fourteen healthy women aged >50 years participated in 3 experiments in a random crossover design: after a carbohydrate-rich meal, either they were seated (control experiment) or they performed slow postmeal walking for 15 min (W15) or 40 min (W40). Blood glucose concentration was determined prior to the meal (fasting), and at 11 time points throughout each experiment. The W15 trial lowered the blood glucose values during walking and delayed the peak blood glucose value (p = 0.003). In W40, the postmeal blood glucose increase during walking was blunted, the peak glucose value was delayed (p = 0.001), and the incremental area under the 2-h blood glucose curve (IAUC) was reduced (p = 0.014). There was a negative relationship between IAUC and walking time (p = 0.016). The individual reducing effect of walking on IAUC correlated strongly with IAUC on the control day (p < 0.001). We conclude that even slow postmeal walking can reduce the blood glucose response to a carbohydrate-rich meal. The magnitude of this effect seems to be related to the duration of walking and to the magnitude of the postprandial blood glucose response when resting after a carbohydrate-rich meal.

Soft drinks can be a major source of sucrose, which may influence serum lipid concentration. We have examined the association between intake frequency of various types of soft drinks and the concentration of serum triglycerides (TG) and high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol in the cross-sectional Oslo Health Study. A total of 14 188 subjects of the altogether 18 770 participants of the study had data on intake frequency of colas and non-colas, with or without sugar. The population sample consisted of both sexes and 3 age groups: group1 (30 years of age), group 2 (40 and 45 years of age), and group 3 (59–60 years of age). In both sexes, HDL decreased and TG increased significantly (p < 0.001) with increasing intake frequency of colas. In contrast, no consistent associations were found between the reported intake of non-cola soft drinks and the serum lipids. We found no significant differences related to the reported presence or absence of sugar in the soft drinks. In multiple linear regression analyses, the colas vs. serum lipid associations prevailed (p < 0.001) after including 13 possible confounders: sex; age group; time since last meal; physical activity; intake of alcohol, coffee, cheese, fruit and (or) berries, and fatty fish; smoking; length of education; use of cholesterol-lowering drugs; and intake of non-colas. Thus, the self-reported intake frequency of colas, but not other soft drinks, was negatively associated with serum HDL, and positively associated with TG and LDL.