Diabetes susceptibility in ethnic minority groups from Turkey, Vietnam, Sri Lanka and Pakistan compared with Norwegians - the association with adiposity is strongest for ethnic minority women

<p>Abstract</p> <p>Background</p> <p>The difference in diabetes susceptibility by ethnic background is poorly understood. The aim of this study was to assess the association between adiposity and diabetes in four ethnic minority groups compared with Norwegians, and take into account confounding by socioeconomic position.</p> <p>Methods</p> <p>Data from questionnaires, physical examinations and serum samples were analysed for 30-to 60-year-olds from population-based cross-sectional surveys of Norwegians and four immigrant groups, comprising 4110 subjects born in Norway (n = 1871), Turkey (n = 387), Vietnam (n = 553), Sri Lanka (n = 879) and Pakistan (n = 420). Known and screening-detected diabetes cases were identified. The adiposity measures BMI, waist circumference and waist-hip ratio (WHR) were categorized into levels of adiposity. Gender-specific logistic regression models were applied to estimate the risk of diabetes for the ethnic minority groups adjusted for adiposity and income-generating work, years of education and body height used as a proxy for childhood socioeconomic position.</p> <p>Results</p> <p>The age standardized diabetes prevalence differed significantly between the ethnic groups (women/men): Pakistan: 26.4% (95% CI 20.1-32.7)/20.0% (14.9-25.2); Sri Lanka: 22.5% (18.1-26.9)/20.7% (17.3-24.2), Turkey: 11.9% (7.2-16.7)/12.0% (7.6-16.4), Vietnam: 8.1% (5.1-11.2)/10.4% (6.6-14.1) and Norway: 2.7% (1.8-3.7)/6.4% (4.6-8.1). The prevalence increased more in the minority groups than in Norwegians with increasing levels of BMI, WHR and waist circumference, and most for women. Highly significant ethnic differences in the age-standardized prevalence of diabetes were found for both genders in all categories of all adiposity measures (<it>p </it>< 0.001). The Odds Ratio (OR) for diabetes adjusted for age, WHR, body height, education and income-generating work with Norwegians as reference was 2.9 (1.30-6.36) for Turkish, 2.7 (1.29-5.76) for Vietnamese, 8.0 (4.19-15.14) for Sri Lankan and 8.3 (4.37-15.58) for Pakistani women. Men from Sri Lanka and Pakistan had identical ORs (3.0 (1.80-5.12)).</p> <p>Conclusions</p> <p>A high prevalence of diabetes was found in 30-to 60-year-olds from ethnic minority groups in Oslo, with those from Sri Lanka and Pakistan at highest risk. For all levels of adiposity, a higher susceptibility for diabetes was observed for ethnic minority groups compared with Norwegians. The association persisted after adjustment for socioeconomic position for all minority women and for men from Sri Lanka and Pakistan.</p

The prevalence of low back pain among former elite cross-country skiers, rowers, orienteerers, and nonathletes: A 10-year cohort study

Background: Some cross-sectional studies have suggested that the prevalence of low back pain (LBP) may be high among endurance athletes with repetitive back loading, but there are no large, prospective cohort studies addressing this issue. Purpose: To compare the prevalence of symptoms of low back pain (LBP) among former endurance athletes with different loading characteristics on the lumbar region: cross-country skiing (flexion loading), rowing (extension loading), and orienteering (no specific loading), as well as a nonathletic control group. Conclusion: Low back pain was not more common among former endurance athletes with specific back loading compared with non-athletes. The results indicate that years of prolonged and repetitive flexion or extension loading in endurance sports does not lead to more LBP. However, a large training volume in the past year and previous episodes with LBP are risk factors for LBP. Comparing the sports of rowing, cross-country skiing, and orienteering, it appears that whereas orienteering is protective, rowing can provoke LBP

Increases in physical activity is as important as smoking cessation for reduction in total mortality in elderly men: 12 years of follow-up of the Oslo II study

Background: Physical activity (PA) at leisure by the elderly, and its relationship to cardiovascular (CV) and non-CV mortality, with and without competing risk, has been scarcely described. We determined the relationships between PA, smoking and 12-year CV, non-CV and all-cause mortality in elderly Oslo men screened for CV disease in 1972–1973 and 2000. Methods: Among 14 846 men born during 1923–1932 and participating in 1972–1973, there were 5738 participants in 2000. During the 12 years follow-up 2154 died. Cox regression modelling of mortality endpoints, with and without competing risk, was applied analysing PA variables hours per week of light or vigorous PA intensity and degree of PA at leisure. Comparisons of predictive ability between PA and smoking were done by receiver operating characteristics. Results: Thirty minutes of PA per 6 days a week was associated with about 40% mortality risk reduction. There was a 5 years increased lifetime when comparing sedentary and moderate to vigorous physically active men. Associations to CV or non-CV mortality were slightly weakened, allowing competing risk. Conditional on the prevalence of smoking and PA, the degree of PA at leisure was almost as predictive as smoking with regard to the effects on mortality. Increase in PA was as beneficial as smoking cessation in reducing mortality. Conclusions: Even at the age of 73 years, PA is associated highly with mortality between groups of sedentary and active persons. Allowing for competing risk did not weaken these associations markedly. Public health strategies in elderly men should include efforts to increase PA in line with efforts to reduce smoking behaviour

Helmet use and risk of head injuries in alpine skiers and snowboarders: changes after an interval of one decade

Background: In a previous study, we concluded that a safety helmet can reduce the risk for head injury by 60%. Other studies reported similar effects, resulting in a general recommendation to wear a helmet while skiing or snowboarding. Aim: To determine the effect of the expected increased helmet wear on the risk of head injury one decade after the recommendation. Methods: Ski patrols reported injury cases in major Norwegian alpine ski resorts. Injury type, helmet use and other risk factors were recorded. A multiple logistic regression analysis was used to assess the relation between individual risk factors and the risk of head injuries by comparing head injured skiers (cases) with skiers and snowboarders who reported other injuries (controls). Results: Helmet use was associated with improved odds for head injuries (OR: 0.45, 95% CI 0.34 to 0.60; p<0.001) in 2002; this effect was attenuated in 2010 (OR: 0.79, 95% CI 0.63 to 0.98; p=0.02), and not significant in 2011 (OR: 0.80, 95% CI 0.60 to 1.06; p=0.12). For potentially severe head injuries, the protective effect of using a helmet was better sustained over the observation period, from an OR of 0.44 (95% CI 0.28 to 0.68, p<0.001) in 2002 to an OR of 0.74 (95% CI 0.57 to 0.97, p=0.02) in 2010 and 0.67 (95% CI 0.47 to 0.96; p=0.03) in 2011. Conclusions: We observed an unexpected reduction in the protective effect of a skiing helmet. This may be due to new skiing trends in the alpine resorts

6-year follow-up of 84 patients with cartilage defects in the knee : knee scores improved but recovery was incomplete

Open Access - This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the source is credited.Background and purpose: The natural history of focal cartilage injury is largely unknown. In this study we investigated 6-year outcomes in patients with arthroscopically verified, focal, fullthickness cartilage injuries of the knee. Methods: In a previous report (baseline study) of 993 knee arthroscopies, 98 patients were less than 50 years old at baseline and showed grade 3–4 focal cartilage injury, as assessed with the International Cartilage Repair Society (ICRS) scale. In the present study, 84 of the 98 patients completed follow-ups at median 6.1 (5.3–7.8) years after baseline assessments. At baseline, the patients had undergone different types of cartilage repair (n = 34) or had no treatment or only debridement (n = 64) for their cartilage injury. The follow-up included evaluations with the ICRS knee evaluation form, the Lysholm score, and other knee evaluation tests. 68 patients underwent radiographic assessments with weight bearing. Results: Improvements compared to baseline were noted in the average ICRS functional score, visual analog scale (VAS) pain score, and the patients’ rating of the function in the affected knee compared to the contra-lateral knee. However, the average ICRS activity level had decreased from baseline. The average Lysholm score was 76 (SD 21). 19 patients had Kellgren-Lawrence grades 2–3 in the affected knee and 6 patients had grades 2–3 in the contralateral knee. There was a statistically significant difference between affected and contralateral knees. Interpretation: Patients with arthroscopically diagnosed ICRS grade 3–4 cartilage injuries in the knee may show improvement in knee function over the following 5–8 years, with or without cartilage repair. However, knee function remains substantially affected. Further studies are needed to determine whether cartilage surgery can yield better functional outcomes than non-surgical or less invasive surgical treatments

Intervention effects on physical activity and insulin levels in men of Pakistani origin living in Oslo: a randomised controlled trial

High prevalence of type 2 diabetes (T2D) is seen in some immigrant groups in Western countries, particularly in those from the Indian subcontinent. Our aims were to increase the physical activity (PA) level in a group of Pakistani immigrant men, and to see whether any increase was associated with reduced serum glucose and insulin concentrations. The intervention was developed in collaboration with the Pakistani community. It used a social cognitive theory framework and consisted of structured supervised group exercises, group lectures, individual counselling and telephone follow-up. One- hundred and fifty physically inactive Pakistani immigrant men living in Oslo, Norway, were randomised to either a control group or an intervention group. The 5-month intervention focused on increasing levels of PA, which were assessed by use of accelerometer (Actigraph MTI 7164) recordings. Risk of diabetes was assessed by serum glucose and insulin concentrations determined in a fasted state, and after an oral glucose tolerance test (OGTT). ANCOVA was used to assess differences between groups. There was a mean difference in PA between the two groups of 49 counts per minute per day, representing a 15 % (95 % CI = 8.7–21.2; P = 0.01) higher increase in total PA level in the intervention group than in the control group. Insulin values taken 2 h after an OGTT were reduced in the intervention group by 27 % (95 % CI = 18.9–35.0; P = 0.02) more than those in the control group. There were no differences in fasting or postprandial glucose values between the groups at the follow-up test. This type of intervention can increase PA and reduce serum insulin in Pakistani immigrant men, thereby presumably reducing their risk of T2D

6-year follow-up of 84 patients with cartilage defects in the knee : knee scores improved but recovery was incomplete

Background and purpose: The natural history of focal cartilage injury is largely unknown. In this study we investigated 6-year outcomes in patients with arthroscopically verified, focal, fullthickness cartilage injuries of the knee. Methods: In a previous report (baseline study) of 993 knee arthroscopies, 98 patients were less than 50 years old at baseline and showed grade 3–4 focal cartilage injury, as assessed with the International Cartilage Repair Society (ICRS) scale. In the present study, 84 of the 98 patients completed follow-ups at median 6.1 (5.3–7.8) years after baseline assessments. At baseline, the patients had undergone different types of cartilage repair (n = 34) or had no treatment or only debridement (n = 64) for their cartilage injury. The follow-up included evaluations with the ICRS knee evaluation form, the Lysholm score, and other knee evaluation tests. 68 patients underwent radiographic assessments with weight bearing. Results: Improvements compared to baseline were noted in the average ICRS functional score, visual analog scale (VAS) pain score, and the patients’ rating of the function in the affected knee compared to the contra-lateral knee. However, the average ICRS activity level had decreased from baseline. The average Lysholm score was 76 (SD 21). 19 patients had Kellgren-Lawrence grades 2–3 in the affected knee and 6 patients had grades 2–3 in the contralateral knee. There was a statistically significant difference between affected and contralateral knees. Interpretation: Patients with arthroscopically diagnosed ICRS grade 3–4 cartilage injuries in the knee may show improvement in knee function over the following 5–8 years, with or without cartilage repair. However, knee function remains substantially affected. Further studies are needed to determine whether cartilage surgery can yield better functional outcomes than non-surgical or less invasive surgical treatments

Intrinsic risk factors for hamstring injuries among male soccer players: a prospective cohort study

Background: Strain injuries of the posterior thigh are common in soccer. It seems that previous injury and age are important risk factors, but the literature is limited. This study was conducted to see if we could identify intrinsic risk factors for hamstring injuries among male soccer players. Hypothesis: We hypothesized that previous hamstring injuries, reduced function scores, abnormalities on a clinical examination, high maximum sprint speed, poor hamstring strength, or low hamstring/quadriceps ratio can predict increased risk of new hamstring injuries. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 508 players representing 31 amateur teams were tested during the 2004 preseason for potential risk factors for hamstring injury through a questionnaire on previous injury and function score (Hamstring Outcome Score [HaOS]), a clinical examination of the hamstring, and specific hamstring relevant tests. Generalized estimating equations were used in univariate analyses to identify candidate risk factors, and factors with a P value of\.10 were then examined in a multivariate model. Results: During the soccer season, 76 hamstring injuries, affecting 65 legs (61 players), were registered. Univariate analyses revealed previous acute hamstring injury (yes/no) (odds ratio [OR], 2.62; 95% confidence interval [CI], 1.54-4.45), HaOS function score with all subscores except ‘‘Soreness’’ (OR for a 10-point difference in total score, 1.29; 95% CI, 1.08-1.54), age (OR, 1.25; 95% CI, 0.96-1.63), and player position (P 5 .09) as candidate predictors of high injury risk. In a multivariate analysis, the most important risk factor for injuries to the hamstring was previous acute hamstring injury (yes/no) (adjusted OR, 2.19; 95% CI, 1.19- 4.03; P 5 .01). Conclusion: In a multivariate analysis, previous acute hamstring injury was found to be a significant risk factor for new hamstring injuries. Previously injured players have more than twice as high a risk of sustaining a new hamstring injury

Physical activity and cardiovascular risk factors in a 40- to 42-year-old rural Norwegian population from 1975–2010: repeated cross-sectional surveys

Background: Geographical differences in cardiovascular diseases (CVD) have been observed among Norwegian counties. Better long-term health status and higher physical activity (PA) levels have been documented in the county of Sogn & Fjordane compared with other counties. However, recent trends in CVD risk factors have not been documented. The aim of this study was to investigate the secular trends in leisure time physical activity (LTPA) and other CVD risk factors over a 35-year period in a rural population of 40- to 42-year-olds in western Norway and to compare these trends with national trends. Methods: Data from eight cross-sectional studies from 1975–2010 (n = 375,682) were obtained from questionnaires and physical examinations and were analyzed using mixed model regression analyses. Results: Decreasing trends were observed for sedentary behavior (for women), moderate PA, smoking, systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein (HDL-c) and total cholesterol (TC), whereas increasing trends were observed for body mass index (BMI), triglycerides (TG), light PA, vigorous PA and sedentary behavior for men. Compared to the national trends, the trends in the 40-42-year-olds from Sogn & Fjordane were more beneficial in terms of TG, HDL-c and BMI but less beneficial in terms of SBP and DBP. Conclusions: Over a 35-year-period, this study indicates that the LTPA level has been relatively stable in the county of Sogn & Fjordane. Upward trends were observed in light and vigorous PA, whereas a downward trend was observed in moderate PA. For sedentary behavior, an upward trend was observed in men, whereas a downward trend was observed in women. For smoking, BP and cholesterol decreasing trends were found, but increasing trends were observed in BMI and TG. Compared with the national data, the trends in Sogn & Fjordane were more beneficial for TG, HDL-c and BMI but less beneficial for BP

The "Romsas in Motion" Community Intervention: mediating effects of psychosocial factors on forward transition in the stages of change in physical activity

This study examines whether a community-based physical activity intervention influenced movement in stages of change in physical activity in an adult population, whether any such effect was mediated by psychosocial influences, and whether any such mediations were moderated by sociodemographic or anthropometric factors. The 3-year-long pseudoexperimental intervention included physical activity, communication, environmental, and participatory components. Questionnaires assessed stages of change in physical activity and potential psychosocial mediators. Regression analyses revealed a significant favorable intervention effect on stages of change, partially mediated by enhanced support from family, perceived control, and physical activity identity. No moderation effects by gender, age, ethnicity, education, or body mass index were observed. Support from family, perceived control, and identity might be important intervention target points for inducing forward movement in the stages of change in physical activity, regardless of sociodemographic and anthropometric background factors