Serum osteoprotegerin levels are related to height loss: The Tromsø Study

Severe loss of body height is often a consequence of osteoporotic vertebral fractures. Osteoprotegerin (OPG) and receptor activator of nuclear factor-kB ligand (RANKL) are cytokines essential for the regulation of bone resorption. The aim of this study was to assess the relationship between the OPG/RANKL system and height loss. A total of 4,435 inhabitants from the municipality of Tromsø, Norway (2,169 men and 2,266 women) were followed for 6 years. Baseline measurements included height, weight, bone mineral density, OPG, RANKL, serum parathyroid hormone and information about lifestyle, prevalent diseases and use of medication. Height was measured again at follow-up, and the loss of height was categorized into 4 groups: ≤1, 1.1–2, 2.1–3, >3 cm. We found increasing height loss with increasing baseline OPG levels in both men and women (P trend = 0.02 and 0.001, respectively), after adjustments for age and other confounders. However, when the women were stratified according to menopausal status and use of hormone replacement therapy (HRT), a significant relationship was present only among postmenopausal women not using HRT (P trend = 0.02). No relations between OPG and height loss were found in post-menopausal HRT-users and premenopausal women (P trend ≥0.39). We conclude that height loss is positively associated with OPG in men and in postmenopausal women not using HRT. No relationship was found between RANKL and height loss

Mental distress in subjects who did, or did not, move from rural Sami core areas to cities in Norway: The impact of Sami ethnicity

Source: https://socialmedicinsktidskrift.se/index.php/smt/article/view/2623/2477The aim of the study was to compare the level of mental distress of Sami and non-Sami residents in rural Sami core areas with that of people who have moved from these areas to cities in Norway. Previous research on mental health among the adult Sami population has mainly been conducted in rural areas, and there is a knowledge gap concerning the mental health of urban Sami. This study has a cross-sectional design and is based on self-administered questionnaires in two different surveys: the SAMINOR 2 Questionnaire Survey (2012) and the survey From Rural to Urban Living (2014). The total analytical sample consists of 5942 individuals: 3955 rural participants (SAMINOR 2) and 1987 urban participants (From Rural to Urban Living). Chisquare tests, two-sample t-tests, and Wilcoxon’s rank sum tests were used for testing differences between the groups. Multiple linear regression analysis was applied to explore the association between place of residence and a continuous mental distress (HSCL-10) score. Logistic regression analysis was performed to explore the association between place of residence and the prevalence of mental distress, as defined as a HSCL-10 score of ≥1.85. The analyses were stratified by gender and Sami and non-Sami ethnicity. The results show that when comparing people who have moved to a city with people living in rural areas, differences in mental distress were found among non-Sami women only, with a lower level of mental distress in urban nonSami women. In men, regardless of ethnicity and in Sami women, living in rural or urban areas did not make a difference in their mental distress status

Impact of parents' education on variation in hospital admissions for children: a population-based cohort study

Objectives To assess the impact of parental educational level on hospital admissions for children, and to evaluate whether differences in parents' educational level can explain geographic variation in admission rates. Design National cohort study. Setting The 18 hospital referral areas for children in Norway. Participants All Norwegian children aged 1–16 years in the period 2008–2016 and their parents. Main outcome measures Age- and gender-adjusted admission rates and probability of admission. Results Of 1 538 189 children, 156 087 (10.2%) had at least one admission in the study period. There was a nearly twofold (1.9) variation in admission rates between the hospital referral areas (3113 per 100 000 children, 95% CI: 3056 to 3169 vs 1627, 95% CI: 1599 to 1654). Area level variances in multilevel analysis did not change after adjusting for parental level of education. Children of parents with low level of education (maternal level of education, low vs high) had the highest admission rates (2016: 2587, 95% CI: 2512 to 2662 vs 1810, 95% CI: 1770 to 1849), the highest probability of being admitted (OR: 1.18, 95% CI: 1.16 to 1.20), the highest number of admissions (incidence rate ratio: 1.05, 95% CI: 1.01 to 1.10) and admissions with lower cost (−0.5%, 95% CI: −1.2% to 0.3%). Conclusions Substantial geographic variation in hospital admission rates for children was found, but was not explained by parental educational level. Children of parents with low educational level had the highest admission probability, and the highest number of admissions, but the lowest cost of admissions. Our results suggest that the variation between the educational groups is not due to differences in medical needs, and may be characterised as unwarranted. However, the manner in which health professionals communicate and interact with parents with different educational levels might play an important role

Body mass index and mortality in elderly men and women: the Tromsø and HUNT studies

The impact of body mass index (BMI; kg/m2) and waist circumference (WC) on mortality in elderly individuals is controversial and previous research has largely focused on obesity. With special attention to the lower BMI categories, associations between BMI and both total and cause-specific mortality were explored in 7604 men and 9107 women aged ≥65 years who participated in the Tromsø Study (1994–1995) or the North-Trøndelag Health Study (1995–1997). A Cox proportional hazards model adjusted for age, marital status, education and smoking was used to estimate HRs for mortality in different BMI categories using the BMI range of 25–27.5 as a reference. The impact of each 2.5 kg/m2 difference in BMI on mortality in individuals with BMI<25.0 and BMI≥25.0 was also explored. Furthermore, the relations between WC and mortality were assessed. We identified 7474 deaths during a mean follow-up of 9.3 years. The lowest mortality was found in the BMI range 25–29.9 and 25–32.4 in men and women, respectively. Mortality was increased in all BMI categories below 25 and was moderately increased in obese individuals. U-shaped relationships were also found between WC and total mortality. About 40% of the excess mortality in the lower BMI range in men was explained by mortality from respiratory diseases. BMI below 25 in elderly men and women was associated with increased mortality. A modest increase in mortality was found with increasing BMI among obese men and women. Overweight individuals (BMI 25–29.9) had the lowest mortality

Replacing red and processed meat with lean or fatty fish and all-cause and cause specific mortality in Norwegian women. the Norwegian Women and Cancer Study (NOWAC): A prospective cohort study

Nordic Nutrition Recommendations recommend reducing red and processed meat and increasing fish consumption, but the impact of this replacement on mortality is understudied. This study investigated the replacement of red and processed meat with fish in relation to mortality. Of 83 304 women in the Norwegian Women and Cancer Study (NOWAC) study, 9420 died during a median of 21·0 years of follow-up. The hazard ratios (HR) for mortality were estimated using Cox proportional hazards regression with analyses stratified on red and processed meat intake due to non-linearity. Higher processed meat (> 30 g/d), red and processed meat (> 50 g/d), and fatty fish consumption were associated with higher mortality, while red meat and lean fish consumption were neutral or beneficial. Among women with higher processed meat intake (> 30 g/d), replacing 20 g/d with lean fish was associated with lower all-cause (HR 0·92, 95 % CI 0·89, 0·96), cancer (HR 0·92, 95 % CI 0·88, 0·97) and CVD mortality (HR 0·82, 95 % CI 0·74, 0·90), while replacing with fatty fish was associated with lower CVD mortality (HR 0·87, 95 % CI 0·77, 0·97), but not with all-cause or cancer mortality. Replacing processed meat with fish among women with lower processed meat intake (≤ 30 g/d) or replacing red meat with fish was not associated with mortality. Replacing processed meat with lean or fatty fish may lower the risk of premature deaths in Norwegian women, but only in women with high intake of processed meat. These findings suggest that interventions to reduce processed meat intake should target high consumers

Norske pasienter med tykktarmskreft kommer for seint i gang med tilleggsbehandling

BAKGRUNN - For pasienter med tykktarmskreft som ifølge nasjonale retningslinjer skal ha tilleggsbehandling med kjemoterapi, skal denne igangsettes innen 4 – 6 uker etter det kirurgiske inngrepet. Vi ønsket å undersøke om retningslinjene ble fulgt. Vi ønsket også å undersøke om hvorvidt type kirurgisk behandling (åpen eller laparoskopisk) hadde betydning for tid til oppstart av tilleggsbehandling. MATERIALE OG METODE - Materialet består av 1 132 pasienter som var operert for tykktarmskreft i perioden 2008 – 13 og som fikk tilleggsbehandling med kjemoterapi. Kirurgisk behandling og tilleggsbehandling med kjemoterapi er definert ved diagnose- og prosedyrekoder fra Norsk pasientregister for perioden 2008 – 13. RESULTATER - Det tok gjennomsnittlig 44,7 dager etter det kirurgiske inngrepet før pasientene var i gang med tilleggsbehandling med kjemoterapi. Hos 49 % av pasientene kom ikke tilleggsbehandlingen i gang innen seksukersfristen. Pasienter operert laparoskopisk hadde kortere liggetid (6,5 dager versus 10,7 dager) og færre komplikasjoner (7,6 % versus 16,4 %) enn pasienter som hadde fått åpen operasjon, likevel kom de ikke i gang med tilleggsbehandlingen tilsvarende tidligere. FORTOLKNING - Det bør gjøres kvalitetsforbedrende tiltak som sikrer at retningslinjene blir fulgt og at pasientene kommer raskere i gang med nødvendig tilleggsbehandling. For dem som behandles laparoskopisk, bør det være enkelt å hente ut gevinsten av kortere liggetid og færre komplikasjoner med raskere oppstart av tilleggsbehandling

Er konsum av melk og egg assosiert med risiko for kreft? Foreløpige resultater fra en prospektiv undersøkelse

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A comprehensive assessment of fish and other seafood in the Norwegian diet.

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Is the ongoing obesity epidemic partly explained by concurrent decline in cigarette smoking? Insights from a longitudinal population study. The Tromsø Study 1994–2016

The increase of obesity coincides with a substantial decrease in cigarette smoking. We assessed post-cessation weight change and its contribution to the obesity epidemic in a general population in Norway. A total of 14,453 participants (52.6% women), aged 25–54 years in 1994, who attended at least two of four surveys in the Tromsø Study between 1994 and 2016, were included in the analysis. Hereof 77% participated in both the first and the last survey. Temporal trends in mean body mass index (BMI), prevalence of obesity (BMI ≥ 30 kg/m2) and daily smoking were estimated with generalized estimation equations. We assessed BMI change by smoking status (ex-smoker, quitter, never smoker, daily smoker), and also under a scenario where none quit smoking. In total, the prevalence of daily smoking was reduced over the 21 years between Tromsø 4 (1994–1995) and Tromsø 7 (2015–2016) by 22 percentage points. Prevalence of obesity increased from 5 – 12% in 1994–1995 to 21–26% in 2015–2016, where obesity in the youngest (age 25–44 in 1994) increased more than in the oldest (p < 0.0001). Those who quit smoking had a larger BMI gain compared to the other three smoking subgroups over the 21 years (p < 0.0001). The scenario where none quit smoking would imply a 13% reduction in BMI gain in the population, though substantial age-related differences were noted. We conclude that smoking cessation contributed to the increase in obesity in the population, but was probably not the most important factor. Public health interventions should continue to target smoking cessation, and also target obesity prevention