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The aim was to study long-term effects on motor skills and school performance of increased physical education (PE). All pupils born 1990-1992 from one school were included in a longitudinal study over nine years. An intervention group ( n = 129) achieved daily PE (5 × 45 min/week) and if needed one extra lesson of adapted motor training. The control group ( n = 91) had PE two lessons/week. Motor skills were evaluated by the Motor Skills Development as Ground for Learning observation checklist and school achievements by marks in Swedish, English, Mathematics, and PE and proportion of pupils who qualified for upper secondary school. In school year 9 there were motor skills deficits in 7% of pupils in the intervention group compared to 47% in the control group ( P < 0.001), 96% of the pupils in the intervention group compared to 89% in the control group ( P < 0.05) qualified for upper secondary school. The sum of evaluated marks was higher among boys in the intervention group than in the control group ( P < 0.05). The sum of marks was also higher in pupils with no motor skills deficit than among pupils with motor skills deficits ( P < 0.01), as was the proportion of pupils who qualified for upper secondary school (97% vs 81%, P < 0.001). Daily PE and adapted motor skills training during the compulsory school years is a feasible way to improve not only motor skills but also school performance and the proportion of pupils who qualify for upper secondary school. [ABSTRACT FROM AUTHOR]

Mechanical load through physical activity has been shown to be one of the best stimuli to increase the bone strength. This effect of mechanical load accounts for both the accrual of bone mineral and structural skeletal adaptations. Exercise prescription also includes a 'window of opportunity' in the late pre- and early peri-pubertal period, where exercise is supposed to insert the most obvious beneficial effects, even if physical activity provides recordable skeletal benefits during all growth. There is also evidence that benefits in bone mass and bone structure obtained by mechanical load during growth may be maintained at advanced age. The notion that former male athletes have lower fracture risk than expected by age, support this view. Physical activity could therefore to be recommended at growth and adolescence as one possible strategy to reduce the future burden of fragility fractures. [ABSTRACT FROM AUTHOR]

Aim: An audit of platelet transfusion was performed to assess adherence to local prophylactic policy and to assess if therapeutic transfusions were administered in line with international recommendations. Methods: A prospective audit of platelet transfusion therapy was conducted at the Wellington Cancer Centre in patients with hypoproliferative thrombocytopenia over a 3-month period from 26 January 2008 to 30 April 2008. There were 398 episodes of evaluable clinical decision activity generated through either platelet counts <50 × 109/L or platelet transfusion events. Each episode was assessed and defined as either adhering to or breaching the local prophylactic platelet transfusion policy. Results: Thrombocytopenia and/or platelet transfusion occurred in 63 patients aged 16-84 years with either a haematological or solid organ malignancy. Decisions to withhold prophylactic platelet transfusion in thrombocytopenic patients adhered to policy for 99% of platelet counts <50 × 109/L. Where transfusions were administered, 77% were prophylactic and 23% were for therapeutic indications. Prophylactic transfusions adhered to policy for 72% of platelet counts <50 × 109/L. Adherence to prophylactic transfusion policy for febrile patients with a threshold of ≤15 × 109/L was 84%, compared to 63% for stable afebrile patients with a threshold of ≤10 × 109/L. Where policy was breached, in 80% of cases the platelet count had not reached the prophylactic transfusion threshold. Of the clinical decisions leading to therapeutic transfusions, 67% were deemed appropriate and predominantly a single adult therapeutic dose of platelets was administered. Where multiple doses of platelets were transfused, 86% of these transfusion events either breached policy or were deemed suboptimal management. Conclusion: The audit demonstrated a high rate of adherence to local transfusion policy. Where policy was breached, predominantly a transfusion had occurred prior to a platelet count reaching the pre-defined trigger. The use of multiple dose platelet transfusions was almost never appropriate. Educating staff in the use of a stringent transfusion policy may lead to reductions in platelet product use. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the effect of increasing the amount of time spent in physical education classes on bone mineral accrual and gain in bone size in prepubertal Danish children. A total of 135 boys and 108 girls, aged 6–8 years, were included in a school-based curriculum intervention program where the usual time spent in physical education classes was doubled to four classes (180 min) per week. The control group comprised age-matched children (62 boys and 76 girls) recruited from a separate community who completed the usual Danish school curriculum of physical activity (90 min/week). Dual-energy X-ray absorptiometry was used to evaluate bone mineral content (BMC; g), bone mineral density (g/cm2), and bone width at the calcaneus and distal forearm before and after 3 years of intervention. Anthropometrics and Tanner stages were evaluated on the same occasions. General physical activity was measured with an accelerometer worn for 4 days. In girls, the intervention group had a 12.5% increase ( P = 0.04) in distal forearm BMC and a 13.2% increase ( P = 0.005) in distal forearm scanned area compared with girls in the control group. No differences were found between the intervention and control groups in boys. Increasing the frequency of physical education classes for prepubertal children is associated with a higher accrual of bone mineral and higher gain in bone size after 3 years in girls but not in boys. [ABSTRACT FROM AUTHOR]

The objective of this study was to analyze the long-term morbidity and mortality in patients with a clinically diagnosed vertebral fracture. Seventy men with a mean age of 70 years (range 50–91 years) and 187 women with a mean age of 72 years (range 50–96 years) were radiographically diagnosed as having a vertebral fracture in the thoracic or lumbar spine at the Malmö University Hospital (Sweden) during 1979. At the time of a follow-up examination 12 years later, 56 of the 76 patients who were still alive participated in an investigation that evaluated back pain and subjective health status by a questionnaire. Forty-four of these subjects also participated in a further radiologic examination of the spine. Serving as controls were age- and gender-matched subjects from the Malmö cohort of the European Vertebral Osteoporosis Study (EVOS). A mortality analysis was also conducted, covering 22 years following the baseline fracture. There were more female patients, who, in comparison with the controls, 12 years after the diagnosis, had had back pain during the year preceding the follow-up (72% vs 33%, P < 0.001), had current back pain (42% vs. 19%, P = 0.006), and had a subjectively impaired health status (44% vs. 17%, P < 0.001). The corresponding differences in men reached only a borderline significance, for both back pain during the year preceding the follow-up (60% vs. 28%, P = 0.07) and current back pain (40% vs. 15%, P = 0.09), whereas there was no difference in subjective health status. The incidence of new vertebral fractures in individuals with a clinically diagnosed vertebral fracture during the following 12 years was in men 25 per 1,000 person-years and in women 49 per 1000 person-years. There were more women with a new vertebral fracture at the 12-year follow-up examination who, in comparison with women without a new fracture, had had back pain during the year preceding the follow-up examination (90% vs. 50%, age-adjusted P = 0.02) and had current back pain (65% vs. 21%, age-adjusted P = 0.03). Women with a new vertebral fracture at the 12-year follow-up examination had a higher subsequent mortality rate in the next 10 years [age-adjusted hazard ratio 2.8 (95% CI 1.0–7.9)] as compared with women without. The mortality rate during the 22 years following the diagnosis among the male patients was 111.7 per 1,000 person-years as compared with 73.4 per 1,000 person-years among the male population at risk. The mortality rate among the female patients was 95.1 per 1,000 person-years as compared with 62.0 per 1,000 person-years among the female population at risk. We conclude that a clinically diagnosed thoracic or lumbar vertebral fracture in the elderly can be regarded as a risk factor for subsequent, long-term morbidity, especially in women, and for mortality in both genders. [ABSTRACT FROM AUTHOR]

Summary: In elderly men included in MrOS-Sweden, subclinical hyperthyroidism (SHyper) was markedly associated with increased risk of vertebral fractures. Introduction: Overt hyperthyroidism is associated with increased risk of fractures. However, only a few studies have investigated whether SHyper is associated with fracture risk in elderly men. We therefore investigated if SHyper was a risk factor for fractures in Swedish men. Methods: We followed (median 9.8 years) elderly men (n = 1856; mean age 75, range 69–81 years) participating in the Gothenburg and Malmö subcohorts of the prospective, population-based MrOS-Sweden study. The statistical analyses included Cox proportional hazards regression. SHyper was defined as serum thyroid-stimulating hormone (TSH) < 0.45 mIU/L (n = 38). Results: SHyper was associated with increased risk of all fractures [n = 456; hazard ratio (HR) adjusted for age, study center, and levothyroxine treatment = 1.99, 95% confidence interval (CI): 1.20–3.32], major osteoporotic fractures (MOF, n = 338; HR 2.44, 95% CI: 1.42–4.21), and vertebral fractures (n = 176; HR 3.79, 95% CI: 2.02–7.11). These associations remained after full adjustment for covariates including total hip bone mineral density and in subanalyses including only men with serum free thyroxine ≤ the upper normal limit. However, after exclusion of men receiving levothyroxine treatment, the associations with all fractures and MOF lost significance. Conclusions: In elderly Swedish men, there was a strong association between SHyper and increased risk of vertebral fractures, whereas the associations with all incident fractures and MOF need to be confirmed in further studies. [ABSTRACT FROM AUTHOR]

If exercise is to be recommended during growth, benefits in bone mineral density (BMD) must be maintained in old age and shown to prevent fractures. Our cross-sectional study of soccer players suggests that a high BMD is no longer recorded after retirement and fracture frequency is no less than predicted in old age. [ABSTRACT FROM AUTHOR]

Background: It has been suggested that osteoblasts are involved in the regulation of haematopoietic stem cells. Whether osteocalcin, which is derived from osteoblasts and is metabolically active, influences blood haemoglobin (Hb) levels is not known.Objective: To determine whether plasma osteocalcin is a determinant of Hb in elderly men.Methods: A total of 993 men (mean age 75.3 ± 3.2 years) participated in the population-based MrOS (osteoporotic fractures in men) study. Plasma osteocalcin concentration was evaluated in relation to Hb and adjustments were made for potential confounders (i.e. age, body mass index, erythropoietin, total oestradiol, fasting insulin, adiponectin, ferritin and cystatin C).Results: Hb correlated (age adjusted) negatively with osteocalcin in the total study group (r = -0.12, P < 0.001) as well as in the subgroup of nondiabetic men (r = -0.16, P < 0.001). In nondiabetic men with higher osteocalcin levels, it was more likely that Hb would be in the lowest quartile (odds ratio per SD decrease in osteocalcin 1.32, 95% confidence interval 1.13-1.53). Quartiles of Hb were negatively associated (age adjusted) with osteocalcin (P < 0.001). Anaemic men (47/812) (Hb <130 g L(-1) ) had significantly higher mean osteocalcin levels than nonanaemic men (33.9 vs. 27.1 μg L(-1) , P < 0.001). In multiple stepwise linear regression analyses (adjusted for age, body mass index, total oestradiol, adiponectin, erythropoietin, fasting insulin, cystatin C, leptin, ferritin and holotranscobalamin), osteocalcin was an independent predictor of Hb concentration in nondiabetic men (P < 0.05).Conclusions: These data add further support to the evidence indicating that the bone-specific protein osteocalcin has several endocrine functions targeting the pancreas, testes, adipocytes, brain. An additional novel finding is that osteocalcin may also have a paracrine function as a regulator of haematopoiesis. [ABSTRACT FROM AUTHOR]

Intervention studies have shown that high-intensity training programs with duration of 1-3 years can influence bone mass in post-menopausal women. We wanted to investigate whether moderate physical activity could be associated with reduced post-menopausal bone loss also in the long-term perspective. We evaluated changes in bone mass and bone structure by repeated single-photon absorptiometry measurements of the distal forearm in 91 moderately physically active and 21 inactive women, categorized according to information from questionnaires, from menopause and on average 25 years onwards. Data were calculated with analysis of variance and analysis of covariance tests and presented as means with 95% confidence interval. There were no group differences in bone mass or bone structure at menopause. The mean annual loss in bone mineral content was 1.2% (1.1, 1.3) in the physically active and 1.6% (1.3, 1.8) in the inactive women (after adjustment for menopausal age P = 0.02) and the mean decline in a strength index based on bone mass and bone structure was 0.7% (0.6, 0.8) in the physically active and 1.2% (0.8, 1.5) in the inactive women ( P = 0.004). There were no group differences in the changes in bone structure. Physical activity is also in a long-term perspective associated with reduced post-menopausal bone loss. [ABSTRACT FROM AUTHOR]

Professional cycling combines extensive endurance training with non weight-bearing exercise, two factors often associated with lower bone mineral density (BMD). Therefore BMD was measured with dual-energy x-ray absorptiometry in 30 professional road cyclists (mean (SD) age: 29.1 (3.4) years: height: 178.5 (6.7)cm: weight: 71.3 (6.1)kg: %fat mass: 9.7 (3.2)%: VO2max: 70.5 (5.5)ml·kg-1·min-1) and in 30 young healthy males used as reference (28.6 (4.5) years; 176.5 (6.3)cm; 73.4 (7.3)kg; 20.7 (5.8)%). Adjusting for differences in age, height, fat mass, lean body mass, and calcium intake by ANCOVA, professional cyclists had similar head BMD (p=0.383) but lower total body (1.135 (0.071) vs. 1.248 (0.104)g·cm-2 p<0.001), arms (0.903 (0.075) vs. 0.950 (0.085), p=0.028), legs (1.290 (0.112) vs. 1.479 (0.138); p<0.001), spine (0.948 (0.100) vs. 1.117 (0.147)g·cm-2: p <0.001), pelvis (1.054 (0.084) vs. 1.244 (0.142), p<0.001), lumbar spine (1.046 (0.103) vs. 1.244 (0.167), P< 0.001). and femoral neck BMD (0.900 (0.115) vs. 1.093 (0.137), p<0.001) compared to reference subjects. Professional cycling appears to negatively affect BMD in young healthy and highly active males, the femoral neck being the most affected site (-18%) in spite of the elevated muscle contractions inherent to the activity. [ABSTRACT FROM AUTHOR]

Training studies in children have suggested that endurance training can give enlargement of cardiac dimensions. This relationship has not been studied on a population-based level in young children with objective methods. A cross-sectional study was made of 248 children (140 boys and 108 girls), aged 8–11 years, from a population-based cohort. Left ventricular end-diastolic diameter (LVDD) and left atrial end-systolic diameter (LA) were measured with echocardiography and indexed for body surface area (BSA). Physical activity was assessed by accelerometry, and the duration of vigorous physical activity per day (VPA) was calculated. Acceptable accelerometer and echocardiography measurements were obtained in 228 children (boys=127, girls=101). Univariate correlations between VPA and LVDD were indexed for BSA in boys ( r=0.27, P<0.05) and in girls ( r=0.10, NS). Multiple regression analysis showed that independent factors for LVDD, indexed for BSA for boys, were age and VPA. LA indexed for BSA was not related to physical activity variables in either gender. No clear relationship exists between cardiac size and daily physical activity in children aged 8–11 years. This suggests that significant cardiac remodelling due to volume exposure secondary to a high amount of physical activity begins later in life. [ABSTRACT FROM AUTHOR]

This study evaluates associations between objectively measured daily physical activity vs aerobic fitness and body fat in children aged 8–11 years. A cross-sectional study of 225 children aged 7.9–11.1 years was performed. Abdominal fat mass (AFM) and total body fat (TBF) were quantified by dual-energy x-ray absorptiometry. TBF was calculated as percentage of total body mass (BF%). Body fat distribution was calculated as AFM/TBF. Aerobic fitness was measured by indirect calorimetry during a maximal cycle ergometer exercise test. Daily physical activity was assessed by accelerometers for 4 days and daily accumulation of moderate-to-vigorous and vigorous activity was calculated. Significant relationships ( P<0.05) existed for vigorous activity vs ln BF% ( r=−0.40), ln AFM ( r=−0.35), TBF/AFM ( r=−0.22) and aerobic fitness ( r=0.38), whereas moderate-to-vigorous activity displayed weaker relationships (−0.22, −0.18, −0.12 NS, and 0.25). Multiple regression analyses with inclusion of possible confounders concluded that vigorous activity was independently related to aerobic fitness and ln BF% or ln AFM. Moderate-to-vigorous activity was only independently related to aerobic fitness. In this population, low daily accumulation of vigorous activity was, already in children aged 8–11 years, associated with more body fat and lower aerobic fitness. A similar relation was not found for daily accumulation of moderate-to-vigorous activity. [ABSTRACT FROM AUTHOR]

Introduction: Physical inactivity is hypothesized to be a contributing factor in the development of a variety of diseases. Recommendations for an adequate level of physical activity have been proposed. There are few studies in which the physical activity in children has been objectively assessed. The purpose of this study was to estimate objectively the level of physical activity in Swedish children. Materials and methods: We studied 248 children (140 boys and 108 girls) aged 7.9–11.1 years from Malmö, Sweden. Physical activity was measured with accelerometers. Children were instructed to wear the accelerometers for 4 days. The mean daily activity was expressed as the mean counts per minute of recording. The time that the child spent performing moderate or vigorous activity was calculated by using previously established cutoff points. Results: The mean daily activity was higher in boys than in girls, 751±243 vs 618±154 counts/min ( P<0.001). All children fulfilled the recommendation for moderate physical activity for 60 min or more per day. Ninety-two percent of the boys and 86% of the girls performed vigorous activity, for 20 min or more per day. Conclusion: All children, aged 8–11 years, who participated in this study reached the recommended level of physical activity, with boys being more active than girls. [ABSTRACT FROM AUTHOR]

Aim: Physical activity (PA) has been associated with enhanced cognition, brain development and concentration. This study evaluated whether increased physical education (PE) improved academic achievement.Methods: We recruited 304 children (55% boys) from a Swedish school in Skane County in 1998-2002 when they were six to seven years of age and followed them through all nine mandatory school years. Their PE level was increased from 60 to 200 minutes per week, and their results were compared with 73 885 control children (51% boys) in the county who graduated in the same years and did the standard 60 minutes of PE per week. Their academic achievements were measured as their final grade scores and the proportion of students eligible for upper secondary school.Results: The eligibility for further education increased in the intervention boys by 6.8 percentage points and the mean grade score by 12.1 points, while in the control group as a whole, the eligibility rate decreased by 0.7 percentage points and the mean grade score increased by 1.7 points. No changes in eligibility rates or mean grade scores were seen in the intervention girls.Conclusion: Increasing weekly PE over nine years was associated with improved academic achievement in boys. [ABSTRACT FROM AUTHOR]

Background: Bone loss at peripheral sites in the elderly is mainly cortical and involves increased cortical porosity. However, an association between bone loss at these sites and 25-hydroxyvitamin D has not been reported.Objective: To investigate the association between serum levels of 25-hydroxyvitamin D, bone microstructure and areal bone mineral density (BMD) in elderly men.Methods: A population-based cohort of 444 elderly men (mean ± SD age 80.2 ± 3.5 years) was investigated. Bone microstructure was measured by high-resolution peripheral quantitative computed tomography, areal BMD by dual-energy X-ray absorptiometry and serum 25-hydroxyvitamin D and parathyroid hormone levels by immunoassay.Results: Mean cortical porosity at the distal tibia was 14.7% higher (12.5 ± 4.3% vs. 10.9 ± 4.1%, P < 0.05) whilst cortical volumetric BMD, area, trabecular bone volume fraction and femoral neck areal BMD were lower in men in the lowest quartile of vitamin D levels compared to the highest. In men with vitamin D deficiency (<25 nmol L-1 ) or insufficiency [25-49 nmol L-1 , in combination with an elevated serum level of parathyroid hormone (>6.8 pmol L-1 )], cortical porosity was 17.2% higher than in vitamin D-sufficient men (P < 0.01). A linear regression model including age, weight, height, daily calcium intake, physical activity, smoking vitamin D supplementation and parathyroid hormone showed that 25-hydroxyvitamin D independently predicted cortical porosity (standardized β = -0.110, R2 = 1.1%, P = 0.024), area (β = 0.123, R2 = 1.4%, P = 0.007) and cortical volumetric BMD (β = 0.125, R2 = 1.4%, P = 0.007) of the tibia as well as areal BMD of the femoral neck (β = 0.102, R2 = 0.9%, P = 0.04).Conclusion: Serum vitamin D is associated with cortical porosity, area and density, indicating that bone fragility as a result of low vitamin D could be due to changes in cortical bone microstructure and geometry. [ABSTRACT FROM AUTHOR]

Physical activity is favorable for peak bone mass but if the skeletal benefits remain and influence fracture risk in old age is debated. In a cross-sectional controlled mixed model design, we compared dual X-ray absorptiometry-derived bone mineral density ( BMD) and bone size in 193 active and retired male elite soccer players and 280 controls, with duplicate measurements of the same individual done a mean 5 years apart. To evaluate lifetime fractures, we used a retrospective controlled study design in 397 retired male elite soccer players and 1368 controls. Differences in bone traits were evaluated by Student's t-test and fracture risk assessments by Poisson regression and Cox regression. More than 30 years after retirement from sports, the soccer players had a Z-score for total body BMD of 0.4 (0.1 to 0.6), leg BMD of 0.5 (0.2 to 0.8), and femoral neck area of 0.3 (0.0 to 0.5). The rate ratio for fracture after career end was 0.6 (0.4 to 0.9) and for any fragility fracture 0.4 (0.2 to 0.9). Exercise-associated bone trait benefits are found long term after retirement from sports together with a lower fracture risk. This indicates that physical activity in youth could reduce the burden of fragility fractures. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Blood haemoglobin (Hb) concentration declines in elderly men, whilst the level of the adipocyte-derived protein adiponectin increases with age. The association between erythropoiesis and adiponectin in elderly men is unclear. The aim of this study was to determine whether adipokines such as adiponectin and leptin are associated with anaemia and Hb concentration in elderly community-dwelling men. DESIGN AND SETTING: The Gothenburg part of the population-based Swedish Osteoporotic Fractures in Men (MrOS) cohort (n = 1010; median age 75.3 years, range 69-81). MAIN OUTCOME MEASURES: We investigated the associations between levels of adiponectin and Hb before and after adjusting for potential confounders [i.e. age, body composition, erythropoietin (EPO), total oestradiol, leptin, cystatin C and iron and B vitamin status]. RESULTS: In these elderly men, age was negatively associated with Hb (r = -0.12, P < 0.001) and positively associated with adiponectin level (r = 0.13, P < 0.001). In age-adjusted partial correlations, Hb and adiponectin levels were negatively correlated (r = -0.20, P < 0.001); this association remained significant after multivariable adjustment for age, body composition, EPO, fasting insulin, sex hormones, leptin and ferritin. Age-adjusted mean adiponectin concentrations were significantly higher in anaemic men (66/1005; Hb <130 g L(-1) ) compared to nonanaemic men (14.0 vs. 11.7 [mu]g mL(-1) , P < 0.05). In multivariate analysis, adiponectin together with EPO, total oestradiol, insulin, albumin, transferrin saturation, HDL cholesterol, cystatin C, total body fat mass and free thyroxine, but not leptin, explained 35% of the variation in Hb level. These results remained essentially unchanged after exclusion of men with diabetes. CONCLUSIONS: Serum adiponectin, but not leptin, was negatively and independently associated with Hb. This finding suggests a possible role of adiponectin in the age-related decline in Hb level observed in apparently healthy elderly men. [ABSTRACT FROM AUTHOR]

Objectives Blood haemoglobin (Hb) concentration declines in elderly men, whilst the level of the adipocyte-derived protein adiponectin increases with age. The association between erythropoiesis and adiponectin in elderly men is unclear. The aim of this study was to determine whether adipokines such as adiponectin and leptin are associated with anaemia and Hb concentration in elderly community-dwelling men. Design and setting The Gothenburg part of the population-based Swedish Osteoporotic Fractures in Men (Mr OS) cohort ( n = 1010; median age 75.3 years, range 69-81). Main outcome measures We investigated the associations between levels of adiponectin and Hb before and after adjusting for potential confounders [i.e. age, body composition, erythropoietin ( EPO), total oestradiol, leptin, cystatin C and iron and B vitamin status]. Results In these elderly men, age was negatively associated with Hb ( r = −0.12, P < 0.001) and positively associated with adiponectin level ( r = 0.13, P < 0.001). In age-adjusted partial correlations, Hb and adiponectin levels were negatively correlated ( r = −0.20, P < 0.001); this association remained significant after multivariable adjustment for age, body composition, EPO, fasting insulin, sex hormones, leptin and ferritin. Age-adjusted mean adiponectin concentrations were significantly higher in anaemic men (66/1005; Hb <130 g L−1) compared to nonanaemic men (14.0 vs. 11.7 μg mL−1, P < 0.05). In multivariate analysis, adiponectin together with EPO, total oestradiol, insulin, albumin, transferrin saturation, HDL cholesterol, cystatin C, total body fat mass and free thyroxine, but not leptin, explained 35% of the variation in Hb level. These results remained essentially unchanged after exclusion of men with diabetes. Conclusions Serum adiponectin, but not leptin, was negatively and independently associated with Hb. This finding suggests a possible role of adiponectin in the age-related decline in Hb level observed in apparently healthy elderly men. [ABSTRACT FROM AUTHOR]

Background Dysbiosis is associated with many diseases, including irritable bowel syndrome ( IBS), inflammatory bowel diseases ( IBD), obesity and diabetes. Potential clinical impact of imbalance in the intestinal microbiota suggests need for new standardised diagnostic methods to facilitate microbiome profiling. Aim To develop and validate a novel diagnostic test using faecal samples to profile the intestinal microbiota and identify and characterise dysbiosis. Methods Fifty-four DNA probes targeting ≥300 bacteria on different taxonomic levels were selected based on ability to distinguish between healthy controls and IBS patients in faecal samples. Overall, 165 healthy controls (normobiotic reference collection) were used to develop a dysbiosis model with a bacterial profile and Dysbiosis Index score output. The model algorithmically assesses faecal bacterial abundance and profile, and potential clinically relevant deviation in the microbiome from normobiosis. This model was tested in different samples from healthy volunteers and IBS and IBD patients ( n = 330) to determine the ability to detect dysbiosis. Results Validation confirms dysbiosis was detected in 73% of IBS patients, 70% of treatment-naïve IBD patients and 80% of IBD patients in remission, vs. 16% of healthy individuals. Comparison of deep sequencing and the GA-map Dysbiosis Test, (Genetic Analysis AS, Oslo, Norway) illustrated good agreement in bacterial capture; the latter showing higher resolution by targeting pre-determined highly relevant bacteria. Conclusions The GA-map Dysbiosis Test identifies and characterises dysbiosis in IBS and IBD patients, and provides insight into a patient's intestinal microbiota. Evaluating microbiota as a diagnostic strategy may allow monitoring of prescribed treatment regimens and improvement in new therapeutic approaches. [ABSTRACT FROM AUTHOR]

Aim: To test the hypothesis that there is a subgroup of children with attention deficit hyperactivity disorder (ADHD) who show a decline in ADHD-symptoms that is associated with signs of biological maturation, a phenomenon referred to as a 'maturation catch-up'. Methods: The parents of 147 children who were given an examination in grades one and two 1999-2000 that included assessment of ADHD-symptoms and estimation of skeletal bone-age by use of hand radiographs (which was repeated in the eighth grade), were contacted 2008-2009 and were asked to answer questions concerning ADHD-symptoms and behavioural maturity in their children. The response frequency was 67%. A complete dataset was achieved in 57 children. A reduction of Conners scores for ADHD-symptoms of eight or more between the evaluations was defined as a marked reduction in symptoms. Results: When the children with a marked symptom reduction (n = 6) were compared with children without such a reduction (n = 51), we found a significant difference in skeletal maturation (p < 0.05). Conclusion: This study gives support to the theory that there is a group of children with ADHD-symptoms who have a biological maturational-lag who will show a decrease in their ADHD-symptoms as they show a maturation catch-up with increasing age. [ABSTRACT FROM AUTHOR]

Aim: To test the hypothesis that there is a subgroup of children with attention deficit hyperactivity disorder (ADHD) who show a decline in ADHD-symptoms that is associated with signs of biological maturation, a phenomenon referred to as a ‘maturation catch-up’. Methods: The parents of 147 children who were given an examination in grades one and two 1999–2000 that included assessment of ADHD-symptoms and estimation of skeletal bone-age by use of hand radiographs (which was repeated in the eighth grade), were contacted 2008–2009 and were asked to answer questions concerning ADHD-symptoms and behavioural maturity in their children. The response frequency was 67%. A complete dataset was achieved in 57 children. A reduction of Conners scores for ADHD-symptoms of eight or more between the evaluations was defined as a marked reduction in symptoms. Results: When the children with a marked symptom reduction (n = 6) were compared with children without such a reduction (n = 51), we found a significant difference in skeletal maturation (p < 0.05). Conclusion: This study gives support to the theory that there is a group of children with ADHD-symptoms who have a biological maturational-lag who will show a decrease in their ADHD-symptoms as they show a maturation catch-up with increasing age. [ABSTRACT FROM AUTHOR]

Context:Regulation of fat mass appears to be associated with immune functions. Studies of knockout mice show that endogenous interleukin (IL)-6 can suppress mature-onset obesity.Objective:To systematically investigate associations of single nucleotide polymorphisms (SNPs) near the IL-6 (IL6) and IL-6 receptor (IL6R) genes with body fat mass, in support for our hypothesis that variants of these genes can be associated with obesity.Design and Study Subjects:The Gothenburg Osteoporosis and Obesity Determinants (GOOD) study is a population-based cross-sectional study of 18- to 20-year-old men (n=1049), from the Gothenburg area (Sweden). Major findings were confirmed in two additional cohorts consisting of elderly men from the Osteoporotic Fractures in Men (MrOS) Sweden (n=2851) and MrOS US (n=5611) multicenter population-based studies.Main Outcome:The genotype distributions and their association with fat mass in different compartments, measured with dual-energy X-ray absorptiometry.Results:Out of 18 evaluated tag SNPs near the IL6 and IL6R genes, a recently identified SNP rs10242595 G/A (minor allele frequency=29%) 3′ of the IL6 gene was negatively associated with the primary outcome total body fat mass (effect size −0.11 standard deviation (s.d.) units per A allele, P=0.02). This negative association with fat mass was also confirmed in the combined MrOS Sweden and MrOS US cohorts (effect size −0.05 s.d. units per A allele, P=0.002). When all three cohorts were combined (n=8927, Caucasian subjects), rs10242595*A showed a negative association with total body fat mass (effect size −0.05 s.d. units per A allele, P<0.0002). Furthermore, the rs10242595*A was associated with low body mass index (effect size −0.03, P<0.001) and smaller regional fat masses. None of the other SNPs investigated in the GOOD study were reproducibly associated with body fat.Conclusions:The IL6 gene polymorphism rs10242595*A is associated with decreased fat mass in three combined cohorts of 8927 Caucasian men. [ABSTRACT FROM AUTHOR]

The present intervention was designed to investigate whether a 14-week period of regular recreational association football (F) or endurance running (R) has an effect on the risk of falls and bone fractures due to gains in muscle function and volumetric bone mineral density (vBMD). Fifty healthy untrained Danish premenopausal women were randomized into two training groups (F and R) that trained 1.8±0.3 (±SD) and 1.9±0.3 h/week, respectively, and these groups were compared with an inactive control group (C). Jumping and dynamic muscle strength were tested and tibial vBMD was measured using peripheral quantitative computed tomography. Total vBMD in left and right tibia increased by 2.6±2.3% and 2.1±1.8% ( P<0.005), respectively, in F and by 0.7±1.3% ( P=0.05) and 1.1±1.5% ( P<0.01), respectively, in R without any significant changes in C. Similar results were found for trabecular vBMD. In F, peak jump power increased by 3±6% ( P<0.05), and hamstring strength during fast (240°/s) and slow (30°/s) contractions increased by 11±25% and 9±21%, respectively, ( P<0.05) without any significant changes in R or C. In conclusion, 14 weeks of regular recreational football improved peak jump power, maximal hamstring strength and vBMD in the distal tibia, suggesting a decreased fracture risk due to stronger bones and a reduced risk of falling. [ABSTRACT FROM AUTHOR]

Context:Immune functions seem to have connections to variations in body fat mass. Studies of knockout mice indicate that endogenous interleukin (IL)-1 can suppress mature-onset obesity.Objective:To systematically investigate our hypotheses that single-nucleotide polymorphisms (SNPs) and/or haplotypes variants in the IL-1 gene system are associated with fat mass.Subjects:The Gothenburg osteoporosis and obesity determinants (GOOD) study is a population-based cross-sectional study of 18–20 year-old men (n=1068), from Gothenburg, Sweden. Major findings were confirmed in elderly men (n=3014) from the Swedish part of the osteoporotic fractures in men (MrOS) multicenter population-based study.Main Outcome Measure:The genotype distributions and their association with body fat mass in different compartments, measured with dual-energy X-ray absorptiometry (DXA).Results:Out of 15 investigated SNPs in the IL-1 receptor antagonist (IL1RN) gene, a recently identified 3′ untranslated region C>T (rs4252041, minor allele frequency=4%) SNP was associated with the primary outcome total fat mass (P=0.003) and regional fat masses, but not with lean body mass or serum IL-1 receptor 1 (IL1RN) levels. This SNP was also associated with body fat when correcting the earlier reported IL1RN+2018 T>C (rs419598) SNP (in linkage disequilibrium with a well-studied variable number tandem repeat of 86 bp). The association between rs4252041 SNP and body fat was confirmed in the older MrOS population (P=0.03). The rs4252041 SNP was part of three haplotypes consisting of five adjacent SNPs that were identified by a sliding window approach. These haplotypes had a highly significant global association with total body fat (P<0.001). None of the other investigated members of the IL-1 gene family displayed any SNPs that have not been described previously to be significantly associated with body fat.Conclusions:The IL1RN gene, shown to enhance obesity by suppressing IL-1 effects in experimental animals, have no previously described gene polymorphisms and haplotypes that are associated with fat, but not lean mass in two populations of men.International Journal of Obesity (2009) 33, 525–533; doi:10.1038/ijo.2009.47; published online 17 March 2009 [ABSTRACT FROM AUTHOR]

Aim: To study if age and non-behavioural measures of biological maturity have any associations with attention deficit hyperactivity disorder (ADHD). Methods: Two hundred fifty-one children 7 to 9 years of age in a Swedish school were screened for ADHD-symptom. ADHD-symptoms were estimated by Conners Abbreviated Questionnaire by both parents and teachers. Motor function, body weight and body height were measured. Skeletal age was estimated through hand radiographs. Results: Height, weight and skeletal bone-age did correlate significantly with age (rs = 0.44–0.69, p < 0.001) but not with ADHD symptom scores. Motor dysfunction had a weak negative correlation with age (rs =−0.21, p < 0.05). Parent and teacher scores of ADHD-symptoms did not correlate with age. Conclusion: This study showed that the variables measuring general biological maturity had a strong association with age, whereas motor dysfunction and ADHD symptoms had no significant association with age. ADHD symptoms did not correlate with the variables measuring general biological maturity. These results do not support the hypothesis that a general biological immaturity is an important etiologic factor for ADHD symptomatology. [ABSTRACT FROM AUTHOR]

This non-randomized prospective controlled study evaluates a daily school-based exercise intervention program of 40 min/school day for 1 year in a population-based cohort of 81 boys aged 7–9 years. Controls were 57 age-matched boys assigned to the general school curriculum of 60 min/week. Bone mineral content (BMC; g) and areal bone mineral density (aBMD; g/cm2) were measured with dual X-ray absorptiometry (DXA) of the total body, the third lumbar vertebra (L3) and the femoral neck (FN). Bone width for L3 and FN was calculated from the lumbar spine and hip scan. No differences between the groups were found at baseline in age, anthropometrics or bone parameters. The mean annual gain in L3 BMC was 5.9 percentage points higher ( P<0.001), L3 aBMD a mean 2.1 percentage points higher ( P=0.01) and L3 width a mean 2.3 percentage points higher ( P=0.001) in the cases than in the controls. When all individuals were included in one cohort, the total duration of exercise including both school-based and spare-time training correlated with L3 BMC ( r=0.26, P=0.003), L3 aBMD ( r=0.18, P=0.04) and L3 width ( r=0.24, P=0.006). The study suggests that exercise in pre-pubertal boys influences the accrual of bone mineral and bone width and that a 1-year school-based exercise program confers skeletal benefits, at least in the lumbar spine. [ABSTRACT FROM AUTHOR]

Aim: Predictive equations for estimating body composition from bioelectrical impedance analysis (BIA) among Scandinavian children are lacking. In the present study, equations for estimation of fat-free body mass (FFM) and lean tissue mass (LTM) were developed and cross-validated from BIA using dual-energy X-ray absorptiometry (DXA) as the reference measurement of body composition. Methods: The study population consisted of 49 girls and 52 boys aged 9–11 years from Malmö, Sweden. Bioelectrical impedance was measured between hand and foot at 50 kHz. Predictive equations were developed by multiple linear regression and cross-validated against DXA measurements of body composition. Results: FFM was predicted from BIA and anthropometric variables with an adjusted R2= 0.95 and root mean square error (RMSE) = 0.84 kg, and LTM was predicted with an adjusted R2= 0.95 and RMSE = 0.87 kg. Cross-validation revealed a mean RMSE = 0.95 kg FFM and a mean RMSE = 0.96 kg LTM. Prediction of body composition from equations developed in previous literature was mixed when applied to the present cohort of children. Conclusions: FFM and LTM are predicted with sufficient accuracy at the population level. We recommend that the predictive equations developed in the present study are used in prepubescent European children aged 9–11 years only in order to minimize confounding of results because of possible differences in population samples. [ABSTRACT FROM AUTHOR]

The forced oscillation technique makes it possible to evaluate the mechanical properties of the respiratory system with a minimum of cooperation. The method is therefore especially useful in children. Impulse oscillometry (IOS) is a commercially available version of this technique. There is, as yet, limited information on reference values for IOS in children. The aim of this study was to extend the reference values for IOS variables and to study their correlation with height, weight and age in healthy children. A sample ( n = 360) of children (age 2·1–11·1 years) was measured by using impulse oscillometry (IOS; Jaeger, Würzburg, Germany). The sample was based on children attending kindergarten in Finland and children attending primary school in Sweden. Measurements of respiratory resistance (Rrs) and reactance (Xrs) at 5, 10, 15 and 20 Hz, total respiratory impedance (Zrs) and the resonance frequency (Fr) were made. All variables were related to body height. Most of them were also weakly related to weight. Reference equations for children (height 90–160 cm) are presented. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate a general school-based 1-year exercise intervention program in a population-based cohort of girls at Tanner stage I. Fifty-three girls aged 7–9 years were included. The school curriculum-based exercise intervention program included 40 minutes/school day. Fifty healthy age-matched girls assigned to the general school curriculum of 60 minutes physical activity/week served as controls. Bone mineral content (BMC, g) and areal bone mineral density (aBMD, g/cm2) were measured with dual X-ray absorptiometry (DXA) of the total body (TB), lumbar spine (L2–L4 vertebrae), third lumbar vertebra (L3), femoral neck (FN), and leg. Volumetric bone mineral density (g/cm3) and bone width were calculated at L3 and FN. Total lean body mass and total fat mass were estimated from the TB scan. No differences at baseline were found in age, anthropometrics, or bone parameters when the groups were compared. The annual gain in BMC was 4.7 percentage points higher in the lumbar spine and 9.5 percentage points higher in L3 in cases than in controls (both P < 0.001). The annual gain in aBMD was 2.8 percentage points higher in the lumbar spine and 3.1 percentage points higher in L3 in cases than in controls (both P < 0.001). The annual gain in bone width was 2.9 percentage points higher in L3 in cases than in controls ( P < 0.001). A general school-based exercise program in girls aged 7–9 years enhances the accrual of BMC and aBMD and increases bone width. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the association between physical activity (PA) and skeletal growth in girls during adolescence. Design: A 5-year, observational, population-based study (Reykjavik, Iceland). Subjects: Seventy-eight Caucasian girls, mean age 13.4±1.0 (mean±SD) years at baseline. Methods: Bone mineral density (BMD, g/cm2) and bone width (cm) were measured in the forearm by single-photon absorptiometry at baseline and with dual-energy X-ray absorptiometry after 3 and 5 years, when lumbar spine, femoral neck (FN) and total body were also evaluated. Half of the physically active girls were compared with the other half of less active girls. Results: BMD in physically active girls was higher in the forearm at both baseline ( P=0.001) and after 5 years ( P=0.04) in comparison with less active girls. BMD was higher for the total body ( P=0.0001), spine L2–L4 ( P=0.02) and FN ( P=0.002) in the active girls at age 18. The accrual of forearm BMD and bone width from age 13 to 18 was no different when comparing the two groups. Conclusions: Pre-pubertal PA is associated with high BMD at age 13 and continued PA is associated with maintenance of high BMD until age 18. [ABSTRACT FROM AUTHOR]

Aim: This study assessed whether a Swedish school-based exercise intervention programme could increase total physical activity.Methods: We followed up 228 children who started school in 1998-2000 seven years later, when they had reached a mean age of 14.8. The 152 children (59% boys) at the intervention school did 200 minutes of physical education per week during that period, and the 76 children (50% boys) in the three control schools did the standard 60 minutes. Questionnaires assessed the durations of total and leisure-time physical activity and screen-time activity at baseline and after five and seven years.Results: Physical activity and screen-time activity were similar between the two groups before the study started. The intervention group then achieved higher durations of total physical activity than the controls (p < 0.001) and these levels remained in the sex-specific evaluations. There were no differences between the groups in the durations of leisure-time activity (p 0.08-0.77) or screen-time activity (p 0.31-0.91).Conclusion: A school-based exercise intervention programme increased the total duration of physical activity in both sexes without any compensatory increase in screen-time activity. The findings contradict the activity-stat theory, which stated that the duration of physical activity in children is constant. [ABSTRACT FROM AUTHOR]

If exercise is to be recommended during growth, benefits in bone mineral density (BMD) must be maintained in old age and shown to prevent fractures. Our cross-sectional study of soccer players suggests that a high BMD is no longer recorded after retirement and fracture frequency is no less than predicted in old age. [ABSTRACT FROM AUTHOR]

A correction to the article in the conclusions section of "International Journal of Obesity," that was published in the March 17, 2009 issue is presented.