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Author Jolle, A.; Midthjell, K.; Holmen, J.; Tuomilehto, J.; Carlsen, S.M.; Shaw, J.; Asvold, B.O. url  doi
  Title Impact of sex and age on the performance of FINDRISC: the HUNT Study in Norway Type Journal Article
  Year 2016 Publication BMJ Open Diabetes Res Care Abbreviated Journal BMJ open diabetes research & care  
  Volume 4 Issue 1 Pages e000217  
  Keywords  
  Abstract OBJECTIVE: The Finnish Diabetes Risk Score (FINDRISC) is recommended as a screening tool for diabetes risk. However, there is a lack of well-powered studies examining the performance of FINDRISC by sex and age. We aim to estimate, by sex and age, the prevalence of elevated FINDRISC and positive predictive value (PPV) of FINDRISC for identifying impaired glucose metabolism (IGM) in a general Norwegian population. RESEARCH DESIGN AND METHODS: We estimated the prevalence of elevated FINDRISC (>/=15) among 47 694 adults in the third survey of the Nord-Trondelag Health Study (HUNT3, 2006-08). Among 2559 participants who participated in oral glucose tolerance testing, we estimated the PPV of elevated FINDRISC for identifying unknown prevalent diabetes and other forms of IGM. RESULTS: The prevalence of elevated FINDRISC was 12.1% in women, 9.6% in men, and increased from 1.5% at age 20-39 to 25.1% at age 70-79 years. The PPVs of elevated FINDRISC were 9.8% for diabetes, 16.9% for impaired glucose tolerance, 8.2% for impaired fasting glucose, and 34.9% for any form of IGM. The PPV for IGM was lower in women (31.2%) than in men (40.4%), and increased from 19.1% at age 20-39 to 55.5% at age >/=80 years. CONCLUSIONS: FINDRISC identified more women than men as high-risk individuals for diabetes. FINDRISC had a high PPV for detecting prevalent IGM, and the PPV was higher in men than in women and in the older individuals. Our data indicate that the impact of sex and age on diabetes risk is not fully captured by FINDRISC, and that refinements to it might improve diabetes prediction.  
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  Publisher Place of Publication Faculty of Medicine, Department of Public Health and General Practice , HUNT Research Centre, NTNU, Editor  
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  Notes Jolle, AnneMidthjell, KristianHolmen, JosteinTuomilehto, JaakkoCarlsen, Sven MShaw, JonathanAsvold, Bjorn OengEngland2016/07/13 06:00BMJ Open Diabetes Res Care. 2016 Jun 22;4(1):e000217. doi: 10.1136/bmjdrc-2016-000217. eCollection 2016. Approved no  
  Call Number HUNT @ maria.stuifbergen @ Jolle2016 Serial 1758  
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Author Letnes, J.M.; Torske, M.O.; Hilt, B.; Bjorngaard, J.H.; Krokstad, S. url  doi
  Title Symptoms of depression and all-cause mortality in farmers, a cohort study: the HUNT study, Norway Type Journal Article
  Year 2016 Publication BMJ Open Abbreviated Journal BMJ open  
  Volume 6 Issue 5 Pages e010783  
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  Abstract OBJECTIVES: To explore all-cause mortality and the association between symptoms of depression and all-cause mortality in farmers compared with other occupational groups, using a prospective cohort design. METHODS: We included adult participants with a known occupation from the second wave of the Nord-Trondelag Health Study (Helseundersokelsen i Nord-Trondelag 2 (HUNT2) 1995-1997), Norway. Complete information on emigration and death from all causes was obtained from the National Registries. We used the depression subscale of the Hospital Anxiety and Depression Scale (HADS) to measure symptoms of depression. We compared farmers to 4 other occupational groups. Our baseline study population comprised 32 618 participants. Statistical analyses were performed using the Cox proportional hazards models. RESULTS: The estimated mortality risk in farmers was lower than in all other occupations combined, with a sex and age-adjusted HR (0.91, 95% CI 0.82 to 1.00). However, farmers had an 11% increased age-adjusted and sex-adjusted mortality risk compared with the highest ranked socioeconomic group (HR 1.11, 95% CI 0.98 to 1.25). In farmers, symptoms of depression were associated with a 13% increase in sex-adjusted and age-adjusted mortality risk (HR 1.13, 95% CI 0.88 to 1.45). Compared with other occupations this was the lowest HR, also after adjusting for education, marital status, long-lasting limiting somatic illness and lifestyle factors (HR 1.08, 95% CI 0.84 to 1.39). CONCLUSIONS: Farmers had lower all-cause mortality compared with the other occupational groups combined. Symptoms of depression were associated with an increased mortality risk in farmers, but the risk increase was smaller compared with the other occupational groups.  
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  Publisher Place of Publication Norwegian University of Science and Technology, NTNU, Trondheim, Norway.HUNT Research Centre, Depart Editor  
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  Notes Letnes, Jon MagneTorske, Magnhild OustHilt, BjornBjorngaard, Johan HakonKrokstad, SteinarengEngland2016/05/18 06:00BMJ Open. 2016 May 17;6(5):e010783. doi: 10.1136/bmjopen-2015-010783. Approved no  
  Call Number HUNT @ maria.stuifbergen @ Letnes2016 Serial 1764  
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Author Eik-Nes, T.; Romild, U.; Guzey, I.; Holmen, T.; Micali, N.; Bjornelv, S.   
  Title Women's weight and disordered eating in a large Norwegian community sample: the Nord-Trondelag Health Study (HUNT) Type Journal Article
  Year 2015 Publication BMJ Open Abbreviated Journal BMJ open  
  Volume 5 Issue 10 Pages e008125  
  Keywords HUNT3; Adult; Aged; Aged, 80 and over; *Body Weight; Cross-Sectional Studies; *Feeding Behavior; Feeding and Eating Disorders/*epidemiology/physiopathology; Female; Humans; Middle Aged; Norway/epidemiology; Prevalence; Young Adult  
  Abstract OBJECTIVES: An increasing part of the population is affected by disordered eating (DE) even though they do not meet the full eating disorder (ED) criteria. To improve treatment in the range of weight-related disorders, there is a need to improve our knowledge about DE and relevant correlates of weight problems such as underweight, overweight and obesity. However, studies investigating DE and weight problems in a wide range of ages in the general population have been lacking. This paper explores DE, weight problems, dieting and weight dissatisfaction among women in a general population sample. DESIGN: Cross-sectional study. SETTING: The third survey of the Nord-Trondelag Health Study (HUNT3). PARTICIPANTS: The population included 27 252 women, aged 19-99 years, with information on DE outcomes and covariates. OUTCOMES: DE was assessed with an 8-item version of the Eating Attitude Test and the Eating Disorder Scale-5. Body mass index (BMI) was objectively measured. Data on dieting and weight dissatisfaction were collected from self-reported questionnaires and analysed across weight categories. Crude and adjusted logistic and multinomial logistic regression models were used. RESULTS: High rates of overweight (38%) and obesity (23%) were found. DE was associated with weight problems. In women aged  
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  Publisher Place of Publication Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway Depart Editor  
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  Call Number HUNT @ maria.stuifbergen @ Eik-Nes2015 Serial 1804  
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Author Heuch, I.; Hagen, K.; Zwart, J.A.   
  Title Association between body height and chronic low back pain: a follow-up in the Nord-Trondelag Health Study Type Journal Article
  Year 2015 Publication BMJ Open Abbreviated Journal BMJ open  
  Volume 5 Issue 6 Pages e006983  
  Keywords HUNT2; HUNT3; Adult; Aged; Biomechanical Phenomena/physiology; *Body Height; Chronic Disease; Female; Follow-Up Studies; Humans; Low Back Pain/*epidemiology; Male; Middle Aged; Norway/epidemiology; Prospective Studies; Risk Factors  
  Abstract OBJECTIVE: To study potential associations between body height and subsequent occurrence of chronic low back pain (LBP). DESIGN: Prospective cohort study. SETTING: The North-Trondelag Health Study (HUNT). Data were obtained from a whole Norwegian county in the HUNT2 (1995-1997) and HUNT3 (2006-2008) surveys. PARTICIPANTS: Altogether, 3883 women and 2662 men with LBP, and 10,059 women and 8725 men without LBP, aged 30-69 years, were included at baseline and reported after 11 years whether they suffered from LBP. MAIN OUTCOME MEASURE: Chronic LBP, defined as pain persisting for 3 months during the previous year. RESULTS: Associations between body height and risk and recurrence of LBP were evaluated by generalised linear modelling. Potential confounders, such as BMI, age, education, employment, physical activity, smoking, blood pressure and lipid levels were adjusted for. In women with no LBP at baseline and body height >/= 170 cm, a higher risk of LBP was demonstrated after adjustment for other risk factors (relative risk 1.19, 95% CI 1.03 to 1.37; compared with height  
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  Publisher Place of Publication Department of Neurology and FORMI, Oslo University Hospital, Oslo, Norway.Department of Mathematics, Editor  
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  Call Number HUNT @ maria.stuifbergen @ Heuch2015 Serial 1818  
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Author Sorgjerd, E.P.; Thorsby, P.M.; Torjesen, P.A.; Skorpen, F.; Kvaloy, K.; Grill, V.   
  Title Presence of anti-GAD in a non-diabetic population of adults; time dynamics and clinical influence: results from the HUNT study Type Journal Article
  Year 2015 Publication BMJ Open Diabetes Res Care Abbreviated Journal BMJ open diabetes research & care  
  Volume 3 Issue 1 Pages e000076  
  Keywords HUNT2; HUNT3  
  Abstract BACKGROUND: It is well known that anti-GAD (glutamic acid decarboxylase) serves as a marker for development of autoimmune diabetes in adults. On the other hand, the clinical implications of anti-GAD positivity in persistently non-diabetic (PND) adults are poorly elucidated. Our aim was to establish the frequency of anti-GAD in PNDs in an all-population-based cohort from the Nord-Trondelag health study (HUNT) and to prospectively test for associations with glucose tolerance and thyroid autoimmunity. METHODS: We formed a primary study population (4496 individuals), selected randomly from the age group 20-90 years (50% men/women), who were non-diabetic both at HUNT2 (1995-1997) and HUNT3 (2006-2008). Anti-GAD-positive individuals at HUNT2, together with anti-GAD-negative individuals aged 20-29 years, were retested for anti-GAD positivity at HUNT3. A secondary study population consisted of individuals with type 2 diabetes (T2D, n=349) at HUNT3 who developed diabetes between HUNT2 and HUNT3. RESULTS: The frequency of anti-GAD positivity in PND was 1.7% (n=76) at HUNT2. Positivity did not associate with gender, family history of diabetes, or glucose levels, but was associated with thyroid-associated autoimmunity (increased frequency of positivity for anti-TPO (thyroid peroxidase), p  
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  Publisher Place of Publication Department of Public Health and General Practice, Faculty of Medicine , HUNT Research Centre, The No Editor  
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  Call Number HUNT @ maria.stuifbergen @ Sorgjerd2015 Serial 1862  
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Author Torske, M.O.; Hilt, B.; Bjorngaard, J.H.; Glasscock, D.; Krokstad, S. url  doi
  Title Disability pension and symptoms of anxiety and depression: a prospective comparison of farmers and other occupational groups. The HUNT Study, Norway Type Journal Article
  Year 2015 Publication BMJ Open Abbreviated Journal BMJ open  
  Volume 5 Issue 11 Pages e009114  
  Keywords HUNT2  
  Abstract OBJECTIVES: Agriculture has undergone major changes, and farmers have been found to have a high prevalence of depression symptoms. We investigated the risk of work disability in Norwegian farmers compared with other occupational groups, as well as the associations between symptoms of anxiety and depression and future disability pension. METHODS: We linked working participants of the HUNT2 Survey (1995-97) aged 20-61.9 years, of whom 3495 were farmers and 25 521 had other occupations, to national registry data on disability pension, with follow-up until 31 December 2010. We used Cox proportional hazards regression to estimate hazard ratios (HRs) of disability pension, and to investigate the associations between symptoms of anxiety and depression caseness at baseline (score on the anxiety or depression subscales of the Hospital Anxiety and Depression Scale (HADS) >/=8) and disability pension. RESULTS: Farmers had a twofold increased risk of disability pension (age-adjusted and sex-adjusted HR 2.07, 95% CI 1.80 to 2.38) compared with higher grade professionals. Farmers with symptoms of depression caseness had a 53% increased risk of disability pension (HR 1.53, 95% CI 1.25 to 1.87) compared with farmers below the cut-off point of depression caseness symptoms, whereas farmers with symptoms of anxiety caseness had a 51% increased risk (HR 1.51, 95% CI 1.23 to 1.86). CONCLUSIONS: Farmers have an increased risk of disability pension compared with higher grade professionals, but the risk is lower than in most other manual occupational groups. Farmers who report high levels of depression or anxiety symptoms are at substantially increased risk of future work disability, and the risk increase appears to be fairly similar across most occupational groups.  
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  Publisher Place of Publication Hunt Research Centre, Department of Public Health and General Practice, Faculty of Medicine, the Nor Editor  
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  Notes Torske, Magnhild OustHilt, BjornBjorngaard, Johan HakonGlasscock, DavidKrokstad, SteinarengEngland2015/11/04 06:00BMJ Open. 2015 Nov 2;5(11):e009114. doi: 10.1136/bmjopen-2015-009114. Approved no  
  Call Number HUNT @ maria.stuifbergen @ Torske2015 Serial 1868  
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Author Stensland, S.O.; Dyb, G.; Thoresen, S.; Wentzel-Larsen, T.; Zwart, J.-A. url  doi
  Title Potentially traumatic interpersonal events, psychological distress and recurrent headache in a population-based cohort of adolescents: the HUNT study Type Journal Article
  Year 2013 Publication BMJ Open Abbreviated Journal BMJ Open  
  Volume 3 Issue 7 Pages  
  Keywords Public Health  
  Abstract OBJECTIVES: Recurrent headache co-occurs commonly with psychological distress, such as anxiety or depression. Potentially traumatic interpersonal events (PTIEs) could represent important precursors of psychological distress and recurrent headache in adolescents. Our objective was to assess the hypothesised association between exposure to PTIEs and recurrent migraine and tension-type headache (TTH) in adolescents, and to further examine the potential impact of psychological distress on this relationship. DESIGN: Population-based, cross-sectional cohort study. The study includes self-reported data from youth on exposure to potentially traumatic events, psychological distress and a validated interview on headache. SETTING: The adolescent part of the Nord-Trondelag Health Study 2006-2008 (HUNT), conducted in Norway. PARTICIPANTS: A cohort of 10 464 adolescents were invited to the study. Age ranged from 12 to 20 years. The response rate was 73% (7620), of whom 50% (3832) were girls. MAIN OUTCOME MEASURES: Data from the headache interview served as the outcome. Recurrent headache was defined as headache recurring at least monthly during the past year, and was subclassified into monthly, weekly and daily complaints. Subtypes were classified as TTH, migraine, migraine with TTH and/or non-classifiable headache, in accordance with the International Classification of Headache Disorders criteria, second edition. RESULTS: Multiple logistic regression analysis, adjusted for sociodemographics, showed consistently significant associations between exposure to PTIEs and recurrent headache, regardless of the frequency or subtype of headache. Increasing exposure to PTIEs was associated with higher prevalence of recurrent headache, indicating a dose-response relationship. The strength of associations between exposure to PTIEs and all recurrent headache disorders was significantly attenuated when psychological distress was entered into the regression equation. CONCLUSIONS: The empirical evidence of a strong and cumulative relationship between exposure to PTIEs, psychological distress and recurrent headache indicates a need for the integration of somatic and psychological healthcare services for adolescents in the prevention, assessment and treatment of recurrent headache. Prospective studies are needed.  
  Address Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway  
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  Notes PMID:23901028; PMC3731723 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1397  
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Author Jacobsen, L.M.; Winsvold, B.S.; Romundstad, S.; Pripp, A.H.; Holmen, J.; Zwart, J.-A. url  doi
  Title Urinary albumin excretion as a marker of endothelial dysfunction in migraine sufferers: the HUNT study, Norway Type Journal Article
  Year 2013 Publication BMJ Open Abbreviated Journal BMJ Open  
  Volume 3 Issue 8 Pages  
  Keywords Vascular Medicine  
  Abstract OBJECTIVE: To investigate urine albumin leakage as a marker of endothelial dysfunction in migraine patients. DESIGN: A population-based health study. PARTICIPANTS: 303 patients with migraine, 1009 patients with non-migraine headache and 5287 headache-free controls. OUTCOMES: The association between urine albumin- to-creatine ratio (ACR) and headache status was investigated in the Nord-Trondelag Health Study (HUNT-2). Patients were selected in two strata, based on either (1) self-reported hypertension/diabetes (morbid sample) or (2) a random sample. Analyses were performed using analysis of covariance. RESULTS: There was no association between headache status and ACR in the study population (p=0.23, mean ACR for migraine 1.66, 95% CI 1.31 to 2.01, for non-migraine headache 1.90, 95% CI 1.71 to 2.09 and for no headache 1.73, 95% CI 1.64 to 1.81) after relevant adjustments. Similarly, no association between headache status and ACR was seen when the analysis was stratified for morbid and random samples, or for migraine with and without aura. CONCLUSIONS: We found no evidence of increased urine albumin leakage in migraine sufferers when compared with headache-free controls. This could indicate that systemic endothelial dysfunction is not a prominent feature of migraine.  
  Address FORMI, Oslo University Hospital, Oslo, Norway  
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  Notes PMID:23943777; PMC3740253 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1439  
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Author Engdahl, B.; Krog, N.H.; Kvestad, E.; Hoffman, H.J.; Tambs, K. url  doi
  Title Occupation and the risk of bothersome tinnitus: results from a prospective cohort study (HUNT) Type Journal Article
  Year 2012 Publication BMJ Open Abbreviated Journal BMJ Open  
  Volume 2 Issue 1 Pages e000512  
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  Abstract Objectives Estimates of occupation-specific tinnitus prevalence may help identify high-risk occupations where interventions are warranted. The authors studied the effect of occupation on prevalence of bothersome tinnitus and estimated the attributable fraction due to occupation. The authors also studied how much of the effect remained after adjusting for noise exposure, education income, hearing thresholds and other risk factors. Design A prospective cohort study. Setting A health survey of the Nord-Trondelag county of Norway. Participants A sample of the general adult population (n=49 948). Primary outcome measure The primary outcome measure is bothersome tinnitus. Results Occupation had a marked effect on tinnitus prevalence. The effect of occupation on tinnitus was reduced in men by controlling for self-reported occupational noise exposure and in women by controlling for education and income. Adding hearing loss as a predictor increased the effect of occupation somewhat. In men, age-adjusted prevalence ratios of tinnitus ranged from 1.5 (workshop mechanics) to 2.1 (crane and hoist operators) in the 10 occupations with highest tinnitus prevalence. In women, the most important contribution to the tinnitus prevalence was from the large group of occupationally inactive persons, with a prevalence ratio of 1.5. Conclusion This study found a moderate association between occupation and bothersome tinnitus.  
  Address Norwegian Institute of Public Health, Division of Mental Health, Oslo, Norway  
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  Notes PMID:22267709; PMC3269045 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1522  
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Author Pape, K.; Bjorngaard, J.H.; Holmen, T.L.; Krokstad, S. url  doi
  Title The welfare burden of adolescent anxiety and depression: a prospective study of 7500 young Norwegians and their families: the HUNT study Type Journal Article
  Year 2012 Publication BMJ Open Abbreviated Journal BMJ Open  
  Volume 2 Issue 6 Pages  
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  Abstract OBJECTIVES: To examine the association between anxiety and depression symptoms in adolescents and their families and later medical benefit receipt in young adulthood. DESIGN: Prospective cohort study. Norwegian population study linked to national registers. PARTICIPANTS: Data from the Nord-Trondelag Health Study 1995-1997 (HUNT) gave information on anxiety and depression symptoms as self-reported by 7497 school-attending adolescents (Hopkins Symptoms Checklist-SCL-5 score) and their parents (Hospital Anxiety and Depression Scale score). There were 2711 adolescents with one or more siblings in the cohort. OUTCOME MEASURES: Adolescents were followed for 10 years in national social security registers, identifying long-term receipt of medical benefits (main outcome) and unemployment benefits for comparison from ages 20-29. METHODS: We used logistic regression to estimate OR of benefit receipt for groups according to adolescent and parental anxiety and depression symptom load (high vs low symptom loads) and for a one point increase in the continuous SCL-5 score (range 1-4). We adjusted for family-level confounders by comparing siblings differentially exposed to anxiety and depression symptoms. RESULTS: Comparing siblings, a one point increase in the mean SCL-5 score was associated with a 65% increase in the odds of medical benefit receipt from age 20-29 (adjusted OR, 1.65, 95% CI 1.10 to 2.48). Parental anxiety and depression symptom load was an indicator of their adolescent's future risk of medical benefit receipt, and adolescents with both parents reporting high symptom loads seemed to be at a particularly high risk. The anxiety and depression symptom load was only weakly associated with unemployment benefits. CONCLUSIONS: Adolescents in families hampered by anxiety and depression symptoms are at a substantially higher risk of medical welfare dependence in young adulthood. The prevention and treatment of anxiety and depression in adolescence should be family-oriented and aimed at ensuring work-life integration.  
  Address Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway  
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  Notes PMID:23144262; PMC3533058 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1566  
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Author Rommen, K.; Schei, B.; Rydning, A.; H Sultan, A.; Morkved, S. url  doi
  Title Prevalence of anal incontinence among Norwegian women: a cross-sectional study Type Journal Article
  Year 2012 Publication BMJ Open Abbreviated Journal BMJ Open  
  Volume 2 Issue 4 Pages  
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  Abstract OBJECTIVE: Anal incontinence (AI) is a symptom associated with age, bowel symptoms and obstetric injuries. Primary aim of the study was to establish the prevalence of AI among women and secondarily to evaluate the impact on daily life and conditions associated with AI. DESIGN: A cross-sectional study. SETTING: Participants attended research stations located in different parts of Nord-Trondelag county, Norway. Data were collected through interviews, questionnaires and clinical examinations. PARTICIPANTS: In total, 40 955 community-dwelling women aged 30 years and older were invited. A total of 25 037 women participated, giving a participation rate of 61.1%. PRIMARY AND SECONDARY OUTCOME MEASURES: Fecal incontinence and flatal incontinence was defined as involuntary loss of feces and flatus weekly or more, respectively. AI was defined as the involuntary loss of feces and/or flatus weekly or more. Urgency was defined as the inability to defer defecation for 15 min. Statistical methods included prevalence estimates and logistic regression analysis. RESULTS: Questions about AI were completed by 20 391 (82.4%) women. Among the 20 391 women, AI was reported by 19.1% (95% CI 18.6% to 19.7%) and fecal incontinence was reported by 3.0% (95% CI 2.8% to 3.2%). Urgency was experienced by 2586 women (12.7%, 95% CI 12.2 to 13.1). Impact on daily life was stated by 794 (26.0%, 95% CI 24.4 to 27.5) women with AI. In bivariate age-adjusted analysis of AI, OR and CI for urgency (OR 3.19, 95% CI 2.92 to 3.49) and diarrhoea (OR 3.81, 95% CI 3.32 to 4.38) revealed strongest associations with AI. CONCLUSIONS: AI affects one in five women older than 30 years. Strongest associated symptoms are urgency and diarrhoea. TRIAL REGISTRATION NUMBER: The study was approved by the Regional Committee for Medical and Health Research Ethics (No. 2009/1214) and followed the Declaration of Helsinki.  
  Address Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway  
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  Notes PMID:22850167 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1572  
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Author Jorgensen, P.; Langhammer, A.; Krokstad, S.; Forsmo, S. url  doi
  Title Is there an association between disease ignorance and self-rated health? The HUNT Study, a cross-sectional survey Type Journal Article
  Year 2014 Publication BMJ Open Abbreviated Journal BMJ Open  
  Volume 4 Issue 5 Pages e004962  
  Keywords HUNT2; Primary Care  
  Abstract OBJECTIVE: To explore whether awareness versus unawareness of thyroid dysfunction, diabetes mellitus or hypertension is associated with self-rated health. DESIGN: Large-scale, cross-sectional population-based study. The association between thyroid function, diabetes mellitus and blood pressure and self-rated health was explored by multiple logistic regression analysis. SETTING: The second survey of the Nord-Trondelag Health Study, HUNT2, 1995-1997. PARTICIPANTS: 33 734 persons aged 40-70 years. PRIMARY OUTCOME MEASURES: Logistic regression was used to estimate ORs for good self-rated health as a function of thyroid status, diabetes mellitus status and blood pressure status. RESULTS: Persons aware of their hypothyroidism, diabetes mellitus or hypertension reported poorer self-rated health than individuals without such conditions. Women with unknown and subclinical hypothyroidism reported better self-rated health than women with normal thyroid status. In women and men, unknown and probable diabetes as well as unknown mild/moderate hypertension was not associated with poorer health. Furthermore, persons with unknown severe hypertension reported better health than normotensive persons. CONCLUSIONS: People with undiagnosed but prevalent hypothyroidism, diabetes mellitus and hypertension often have good self-rated health, while when aware of their diagnoses, they report reduced self-rated health. Use of screening, more sensitive tests and widened diagnostic criteria might have a negative effect on perceived health in the population.  
  Address Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway  
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  Notes PMID:24871539; PMC4039843; NLM: Original DateCompleted: 20140529 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1649  
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Author Strandheim, A.; Bjerkeset, O.; Gunnell, D.; Bjornelv, S.; Holmen, T.L.; Bentzen, N. url  doi
  Title Risk factors for suicidal thoughts in adolescence--a prospective cohort study: the Young-HUNT study Type Journal Article
  Year 2014 Publication BMJ Open Abbreviated Journal BMJ Open  
  Volume 4 Issue 8 Pages e005867  
  Keywords Preventive Medicine; Young-HUNT1; Young-HUNT2; Young-HUNT  
  Abstract OBJECTIVES: Examining the associations between health and lifestyle factors recorded in the participants' early teens and development of suicidal thoughts recorded 4 years later. DESIGN: Population-based prospective cohort study. SETTINGS: All students in the two relevant year classes in Nord-Trondelag County were invited, 80% attended both waves of data collection. PARTICIPANTS: 2399 secondary school students who participated in the Young-HUNT1 study in 1995-1997 (13-15 years old) were included in a follow-up study 4 years later (17-19 years old). PRIMARY OUTCOME MEASURE: Suicidal thoughts reported at age 17-19 years. RESULTS: 408 (17%, 95% CI 15.5% to 18.5%) of the adolescents reported suicidal thoughts at follow-up, 158 (14.2%, CI 13.6% to 16.4%) boys and 250 (19.5%, CI 18.8% to 22.0%) girls. Baseline anxiety and depressive symptoms (adjusted OR (aOR) 1.9, CI 1.4 to 2.6), conduct problems (aOR 1.8, CI 1.3 to 2.6), overweight (aOR 1.9 CI 1.4 to 2.4), and muscular pain and tension (aOR 1.8, CI 1.4 to 2.4), were all associated with reporting suicidal thoughts at follow-up. CONCLUSIONS: One in six young adults experienced suicidal thoughts, girls predominating. Suicidal thoughts were most strongly associated with symptoms of anxiety/depression, conduct problems, pain/tension and overweight reported when participants were 13-15 years old. Specific preventive efforts in these groups might be indicated. Future research should investigate whether similar associations are seen with suicide/suicidal attempts as endpoints.  
  Address Department of Public Health and General Practice, Faculty of Medicine (ISM), HUNT Research Centre, Norwegian University of Science and Technology (NTNU), Levanger, Norway  
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  ISSN (up) 2044-6055 ISBN Medium  
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  Notes PMID:25142264; PMC4139646 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1660  
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Author Almkvist, O.; Bosnes, O.; Bosnes, I.; Stordal, E. url  doi
  Title Selective impact of disease on short-term and long-term components of self-reported memory: a population-based HUNT study Type Journal Article
  Year 2017 Publication BMJ Open Abbreviated Journal BMJ Open  
  Volume 7 Issue 5 Pages e013586  
  Keywords Hunt; disease; health; long-term memory; short-term memory; subjective memory  
  Abstract BACKGROUND: Subjective memory is commonly considered to be a unidimensional measure. However, theories of performance-based memory suggest that subjective memory could be divided into more than one dimension. OBJECTIVE: To divide subjective memory into theoretically related components of memory and explore the relationship to disease. METHODS: In this study, various aspects of self-reported memory were studied with respect to demographics and diseases in the third wave of the HUNT epidemiological study in middle Norway. The study included all individuals 55 years of age or older, who responded to a nine-item questionnaire on subjective memory and questionnaires on health (n=18 633). RESULTS: A principle component analysis of the memory items resulted in two memory components; the criterion used was an eigenvalue above 1, which accounted for 54% of the total variance. The components were interpreted as long-term memory (LTM; the first component; 43% of the total variance) and short-term memory (STM; the second component; 11% of the total variance). Memory impairment was significantly related to all diseases (except Bechterew's disease), most strongly to brain infarction, heart failure, diabetes, cancer, chronic obstructive pulmonary disease and whiplash. For most diseases, the STM component was more affected than the LTM component; however, in cancer, the opposite pattern was seen. CONCLUSIONS: Subjective memory impairment as measured in HUNT contained two components, which were differentially associated with diseases.  
  Address Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway  
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  Notes PMID:28490551; PMCID:PMC5566596 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1874  
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Author Heuch, I.; Heuch, I.; Hagen, K.; Mai, X.-M.; Langhammer, A.; Zwart, J.-A. url  doi
  Title Is there an association between vitamin D status and risk of chronic low back pain? A nested case-control analysis in the Nord-Trondelag Health Study Type Journal Article
  Year 2017 Publication BMJ Open Abbreviated Journal BMJ Open  
  Volume 7 Issue 11 Pages e018521  
  Keywords back pain; epidemiology; vitamin D and low back  
  Abstract OBJECTIVES: To explore potential associations between vitamin D status and risk of chronic low back pain (LBP) in a Norwegian cohort, and to investigate whether relationships depend on the season of blood sample collection. DESIGN: A nested case-control study in a prospective data set. SETTING: The Norwegian community-based Nord-Trondelag Health Study (HUNT). Data were collected in the HUNT2 (1995-1997) and HUNT3 (2006-2008) surveys. MAIN OUTCOME MEASURE: Chronic LBP, defined as LBP persisting at least 3 months continuously during the past year. PARTICIPANTS: Among individuals aged 19-55 years without LBP in HUNT2, a data set was generated including 1685 cases with LBP in HUNT3 and 3137 controls without LBP. METHODS: Blood samples from the participants collected in HUNT2 were analysed for serum 25-hydroxyvitamin D (25(OH)D) level. Associations with LBP in HUNT3 were evaluated by unconditional logistic regression analysis with adjustment for age, sex, work status, physical activity at work and in leisure time, education, smoking, and body mass index. RESULTS: No association between vitamin D status and risk of chronic LBP was found in the total data set (OR per 10 nmol/L 25(OH)D=1.01, 95% CI 0.97 to 1.06) or in individuals with blood samples collected in summer/autumn (OR per 10 nmol/L 25(OH)D=0.99, 95% CI 0.93 to 1.06). For blood samples drawn in winter/spring, associations differed significantly between women and men (p=0.004). Among women a positive association was seen (OR per 10 nmol/L 25(OH)D=1.11, 95% CI 1.02 to 1.20), but among men no significant association was observed (OR per 10 nmol/L 25(OH)D=0.90, 95% CI 0.81 to 1.01). CONCLUSIONS: Overall, no association between vitamin D status and risk of LBP was demonstrated. The association suggested in women for the winter/spring season cannot be regarded as established.  
  Address Faculty of Medicine, University of Oslo, Oslo, Norway  
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  Notes PMID:29175890; PMCID:PMC5719329 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1928  
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Author Hjerkind, K.V.; Stenehjem, J.S.; Nilsen, T.I.L. url  doi
  Title Adiposity, physical activity and risk of diabetes mellitus: prospective data from the population-based HUNT study, Norway Type Journal Article
  Year 2017 Publication BMJ Open Abbreviated Journal BMJ Open  
  Volume 7 Issue 1 Pages e013142  
  Keywords *Adiposity; Adult; Aged; Aged, 80 and over; Body Mass Index; Comorbidity; Diabetes Mellitus/*epidemiology; *Exercise; Female; Humans; Longitudinal Studies; Male; Middle Aged; Norway/epidemiology; Odds Ratio; Overweight/*epidemiology; Prospective Studies; Risk Factors; Young Adult; *Epidemiology; *Public Health  
  Abstract BACKGROUND: Physical activity may counteract the adverse effects of adiposity on cardiovascular mortality; however, the evidence of a similar effect on diabetes is sparse. This study examines whether physical activity may compensate for the adverse effect of adiposity on diabetes risk. METHODS: The study population consisted of 38 231 individuals aged 20 years or more who participated in two consecutive waves of the prospective longitudinal Nord-Trondelag Health Study in Norway: in 1984-1986 and in 1995-1997. A Poisson regression model with SEs derived from robust variance was used to estimate adjusted risk ratios of diabetes between categories of body mass index and physical activity. RESULTS: Risk of diabetes increased both with increasing body mass (Ptrend <0.001) and with decreasing physical activity level (Ptrend <0.001 in men and 0.01 in women). Combined analyses showed that men who were both obese and had low activity levels had a risk ratio of 17 (95% CI 9.52 to 30) compared to men who were normal weight and highly active, whereas obese men who reported high activity had a risk ratio of 13 (95% CI 6.92 to 26). Corresponding analysis in obese women produced risk ratios of 15 (95% CI 9.18 to 25) and 13 (95% CI 7.42 to 21) among women reporting low and high activity levels, respectively. CONCLUSIONS: This study shows that overweight and obesity are associated with a substantially increased risk of diabetes, particularly among those who also reported being physically inactive. High levels of physical activity were associated with a lower risk of diabetes within all categories of body mass index, but there was no clear evidence that being physically active could entirely compensate for the adverse effect of adiposity on diabetes risk.  
  Address Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway  
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  Notes PMID:28093432; PMCID:PMC5253523 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1929  
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Author Amorim, A.B.; Ferreira, P.H.; Ferreira, M.L.; Lier, R.; Simic, M.; Pappas, E.; Zadro, J.R.; Mork, P.J.; Nilsen, T.I. url  doi
  Title Influence of family history on prognosis of spinal pain and the role of leisure time physical activity and body mass index: a prospective study using family-linkage data from the Norwegian HUNT study Type Journal Article
  Year 2018 Publication BMJ Open Abbreviated Journal BMJ Open  
  Volume 8 Issue 10 Pages e022785  
  Keywords chronic pain; family study; low back pain; neck pain; obesity; physical activity  
  Abstract OBJECTIVES: To investigate the influence of parental chronic spinal pain on prognosis of chronic spinal pain in adult offspring, and whether offspring physical activity level and body mass index (BMI) modified this association. DESIGN: Prospective cohort study. SETTING: We used family-linked longitudinal data from the Norwegian HUNT study collected in HUNT2 (1995-1997) and HUNT3 (2006-2008). PARTICIPANTS: A total of 1529 offspring who reported spinal pain in HUNT2 were linked with parental data and followed up in HUNT3. OUTCOMES: We estimated relative risk (RR) with 95% CI for recovery from chronic spinal pain, and also from activity limiting spinal pain, in offspring related to chronic spinal pain in parents. We also investigated whether offspring leisure time physical activity and BMI modified these intergenerational associations in spinal pain. RESULTS: A total of 540 (35%) offspring were defined as recovered after approximately 11 years of follow-up. Offspring with both parents reporting chronic spinal pain were less likely to recover from chronic spinal pain (RR 0.83, 95% CI 0.69 to 0.99) and activity limiting spinal pain (RR 0.71, 95% CI 0.54 to 0.94), compared with offspring of parents without chronic spinal pain. Analyses stratified by BMI and physical activity showed no strong evidence of effect modification on these associations. However, offspring who were overweight/obese and with both parents reporting chronic spinal pain had particularly low probability of recovery from activity limiting spinal pain, compared with those who were normal weight and had parents without chronic spinal pain (RR 0.57, 95% CI 0.39 to 0.84). CONCLUSION: Offspring with chronic spinal pain are less likely to recover if they have parents with chronic spinal pain, particularly if offspring are overweight/obese.  
  Address Clinic of Anaesthesia and Intensive Care, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway  
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  ISSN (up) 2044-6055 ISBN Medium  
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  Notes PMID:30341129; PMCID:PMC6196861 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 2069  
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Author Gemes, K.; Janszky, I.; Strand, L.B.; Laszlo, K.D.; Ahnve, S.; Vatten, L.J.; Dalen, H.; Mukamal, K.J. url  doi
  Title Light-moderate alcohol consumption and left ventricular function among healthy, middle-aged adults: the HUNT study Type Journal Article
  Year 2018 Publication BMJ Open Abbreviated Journal BMJ Open  
  Volume 8 Issue 5 Pages e020777  
  Keywords *cardiac epidemiology; *echocardiography; *epidemiology; *moderate alcohol consumption  
  Abstract OBJECTIVES: To investigate the association between alcohol consumption and left ventricular (LV) function in a population with low average alcohol intake. DESIGN, SETTING AND PARTICIPANTS: A total of 1296 healthy participants, free from cardiovascular diseases, were randomly selected from the third wave of the Norwegian HUNT study (2006-2008) and underwent echocardiography. After validation of the inclusion criteria, 30 participants were excluded due to arrhythmias or myocardial or valvular pathology. Alcohol consumption, sociodemographic and major cardiovascular risk factors were assessed by questionnaires and clinical examination in the HUNT3. General linear models were used to analyse the cross-sectional associations between alcohol intake and LV indices. PRIMARY AND SECONDARY OUTCOME MEASURES: LV functional and structural indices were measured with tissue Doppler and speckle tracking echocardiography. RESULTS: We observed no associations between alcohol consumption and multivariable-adjusted LV functional indices. Excluding abstainers who reported regular alcohol consumption 10 years prior to the baseline did not change the results. Alcohol consumption was positively associated with LV mass indices (p<0.01 for linear trend of the means); there was no such association among participants with non-risky drinking characteristics (p=0.67 for linear trend of the means). CONCLUSIONS: We found no clear evidence that light-moderate alcohol consumption is associated with measures of LV function, although our results indicate that consumption, especially when marked by binge drinking, is progressively associated with greater LV mass.  
  Address Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA  
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  ISSN (up) 2044-6055 ISBN Medium  
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  Notes PMID:29724742; PMCID:PMC5988097 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 2084  
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Author Nordstoga, A.L.; Nilsen, T.I.L.; Vasseljen, O.; Unsgaard-Tondel, M.; Mork, P.J. url  doi
  Title The influence of multisite pain and psychological comorbidity on prognosis of chronic low back pain: longitudinal data from the Norwegian HUNT Study Type Journal Article
  Year 2017 Publication BMJ Open Abbreviated Journal BMJ Open  
  Volume 7 Issue 5 Pages e015312  
  Keywords back pain; epidemiology; musculoskeletal disorders; spine  
  Abstract OBJECTIVES: This study aimed to investigate the prospective influence of multisite pain, depression, anxiety, self-rated health and pain-related disability on recovery from chronic low back pain (LBP). SETTING: The data is derived from the second (1995-1997) and third (2006-2008) wave of the Nord-Trondelag Health Study (HUNT) in Norway. PARTICIPANTS: The study population comprises 4484 women and 3039 men in the Norwegian HUNT Study who reported chronic LBP at baseline in 1995-1997. PRIMARY OUTCOME MEASURES: The primary outcome was recovery from chronic LBP at the 11-year follow-up. Persons not reporting pain and/or stiffness for at least three consecutive months during the last year were defined as recovered. A Poisson regression model was used to estimate adjusted risk ratios (RRs) with 95% CIs. RESULTS: At follow-up, 1822 (40.6%) women and 1578 (51.9%) men reported recovery from chronic LBP. The probability of recovery was inversely associated with number of pain sites (P-trend<0.001). Compared with reporting 2-3 pain sites, persons with only LBP had a slightly higher probability of recovery (RR 1.10, 95% CI 0.98 to 1.22 in women and RR 1.10, 95% CI 1.01 to 1.21 in men), whereas people reporting 6-9 pain sites had substantially lower probability of recovery (RR 0.58, 95% CI 0.52 to 0.63 in women and RR 0.70, 95% CI 0.63 to 0.79 in men). Poor/not so good self-rated general health, symptoms of anxiety and depression, and pain-related disability in work and leisure were all associated with reduced probability of recovery, but there was no statistical interaction between multisite pain and these comorbidities. CONCLUSIONS: Increasing number of pain sites was inversely associated with recovery from chronic LBP. In addition, factors such as poor self-rated health, psychological symptoms and pain-related disability may further reduce the probability of recovery from chronic LBP.  
  Address Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway  
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  Notes PMID:28592580; PMCID:PMC5734202 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1967  
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Author Sun, Y.-Q.; Langhammer, A.; Skorpen, F.; Chen, Y.; Mai, X.-M. url  doi
  Title Serum 25-hydroxyvitamin D level, chronic diseases and all-cause mortality in a population-based prospective cohort: the HUNT Study, Norway Type Journal Article
  Year 2017 Publication BMJ Open Abbreviated Journal BMJ Open  
  Volume 7 Issue 6 Pages e017256  
  Keywords 25-hydroxyvitamin D (25(OH)D); all-cause mortality; chronic diseases; prospective cohort study; vitamin D  
  Abstract OBJECTIVE: To investigate the association of vitamin D status with all-cause mortality in a Norwegian population and the potential influences of existing chronic diseases on the association. DESIGN: A population-based prospective cohort study. SETTING: Nord-Trondelag County, Norway. PARTICIPANTS: A random sample (n=6613) of adults aged 20 years or older in a cohort. METHODS: Serum 25-hydroxyvitamin D (25(OH)D) levels were measured in blood samples collected at baseline (n=6377). Mortality was ascertained from the Norwegian National Registry. Cox regression models were applied to estimate the HRs with 95% CIs for all-cause mortality in association with serum 25(OH)D levels after adjustment for a wide spectrum of confounding factors as well as chronic diseases at baseline. RESULTS: The median follow-up time was 18.5 years, during which 1539 subjects died. The HRs for all-cause mortality associated with the first quartile level of 25(OH)D (<34.5 nmol/L) as compared with the fourth quartile (>/=58.1 nmol/L) before and after adjustment for chronic diseases at baseline were 1.30 (95% CI 1.11 to 1.51) and 1.27 (95% CI 1.09 to 1.48), respectively. In the subjects without chronic diseases at baseline and with further exclusion of the first 3 years of follow-up, the corresponding adjusted HR was 1.34 (95% CI 1.09 to 1.66). CONCLUSIONS: Low serum 25(OH)D level was associated with increased all-cause mortality in a general Norwegian population. The association was not notably influenced by existing chronic diseases.  
  Address Department of Public Health and Nursing, Norwegian University of Science and Technology, NTNU, Trondheim, Norway  
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  Notes PMID:28674149; PMCID:PMC5734252 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1990  
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Author Naess, M.; Sund, E.R.; Holmen, T.L.; Kvaloy, K. url  doi
  Title Implications of parental lifestyle changes and education level on adolescent offspring weight: a population based cohort study – The HUNT Study, Norway Type Journal Article
  Year 2018 Publication BMJ Open Abbreviated Journal BMJ Open  
  Volume 8 Issue 8 Pages e023406  
  Keywords Bmi; lifestyle; parent-offspring weight associations; parental physical activity change; parental weight-change  
  Abstract OBJECTIVE: Obesity tends to cluster in families reflecting both common genetics and shared lifestyle patterns within the family environment. The aim of this study was to examine whether parental lifestyle changes over time, exemplified by changes in weight and physical activity, could affect offspring weight in adolescents and if parental education level influenced the relationship. DESIGN, SETTING AND PARTICIPANTS: The population-based cohort study included 4424 parent-offspring participants from the Nord-Trondelag Health Study, Norway. Exposition was parental change in weight and physical activity over 11 years, and outcome was offspring weight measured in z-scores of body mass index (BMI) in mixed linear models. RESULTS: Maternal weight reduction by 2-6 kg was significantly associated with lower offspring BMI z-scores: -0.132 (95% CI -0.259 to -0.004) in the model adjusted for education. Parental weight change displayed similar effect patterns on offspring weight regardless of parents' education level. Further, BMI was consistently lower in families of high education compared with low education in the fully adjusted models. In mothers, reduced physical activity level over time was associated with higher BMI z-scores in offspring: 0.159 (95% CI 0.030 to 0.288). Associations between physical activity change and adolescent BMI was not moderated by parental education levels. CONCLUSION: Lifestyle changes in mothers were associated with offspring BMI; reduced weight with lower-and reduced physical activity with higher BMI. Father's lifestyle changes, however, did not significantly affect adolescent offspring's weight. Overall, patterns of association between parental changes and offspring's BMI were independent of parental education levels, though adolescents with parents with high education had lower weight in general.  
  Address Department of Research and Development, Levanger Hospital, Nord-Trondelag Health Trust, Levanger, Norway  
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  Notes PMID:30166309; PMCID:PMC6119406 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 2140  
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Author Storeng, S.H.; Sund, E.R.; Krokstad, S. url  doi
  Title Factors associated with basic and instrumental activities of daily living in elderly participants of a population-based survey: the Nord-Trondelag Health Study, Norway Type Journal Article
  Year 2018 Publication BMJ Open Abbreviated Journal BMJ Open  
  Volume 8 Issue 3 Pages e018942  
  Keywords *Activities of Daily Living; Aged; Depression/epidemiology; Disabled Persons/*psychology; Exercise; Female; Follow-Up Studies; Health Services for the Aged/*statistics & numerical data; Health Status; *Health Surveys; Humans; Logistic Models; Male; Middle Aged; Norway/epidemiology; Prospective Studies; Quality of Life/*psychology; Self Report; Smoking/epidemiology; Social Participation/*psychology; *epidemiology; *public health; *social medicine  
  Abstract OBJECTIVES: To investigate factors associated with the need for assistance in basic and instrumental activities of daily living in Norwegian elderly. DESIGN: Prospective cohort study. SETTING: The Nord-Trondelag Health Study (HUNT), a large population-based health survey in Norway. PARTICIPANTS: 5050 individuals aged 60-69 years old at baseline in HUNT2 (1995-1997) who also participated in HUNT3 (2006-2008) were included in the study. 676/693 individuals were excluded in the analyses due to missing outcomes. OUTCOMES: Needing assistance in one or more basic or instrumental activities of daily living reported in HUNT3. RESULTS: In adjusted multinomial logistic regression analyses, poor self-rated health and depression were the strongest risk factors for needing assistance in one or more basic activities of daily living in HUNT3, with ORs of 2.13 (1.35 to 3.38) and 1.58 (0.91 to 2.73). Poor self-rated health and poor life satisfaction were the strongest risk factors for needing assistance in one or more instrumental activities of daily living in HUNT3, with ORs of 2.30 (1.93 to 2.74) and 2.29 (1.86 to 2.81), respectively. Excessive sitting time, short or prolonged sleeping time, and physical inactivity seemed to be the most important lifestyle risk factors for basic/instrumental activities of daily living (ADL/IADL) disability. The studied factors were, in general, greater risk factors for mortality during follow-up than for ADL/IADL disability. Smoking was the strongest risk factor for mortality during follow-up and non-participation in HUNT3. Smoking and low social participation were the strongest risk factors for non-participation in HUNT3. CONCLUSIONS: Subjective health perception, life satisfaction and depression were the strongest risk factors for needing assistance in one or more basic/instrumental activities of daily living later in life. These factors could be possible targets for prevention purposes.  
  Address Levanger Hospital, Nord-Trondelag Hospital Trust, Levanger, Norway  
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  Notes PMID:29530908; PMCID:PMC5857703 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 2175  
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Author Folling, I.S.; Kulseng, B.; Midthjell, K.; Rangul, V.; Helvik, A.-S. url  doi
  Title Individuals at high risk for type 2 diabetes invited to a lifestyle program: characteristics of participants versus non-participants (the HUNT Study) and 24-month follow-up of participants (the VEND-RISK Study) Type Journal Article
  Year 2017 Publication BMJ Open Diabetes Research & Care Abbreviated Journal BMJ Open Diabetes Res Care  
  Volume 5 Issue 1 Pages e000368  
  Keywords Findrisc; lifestyle programme; non-participants; primary health care; type 2 diabetes  
  Abstract OBJECTIVE: Prevention of type 2 diabetes mellitus is possible through lifestyle programs, but the effect depends on the program's content, resources, and setting. Lifestyle programs are often confronted with high rates of non-participation and attrition. This study invited individuals at high risk for type 2 diabetes to a lifestyle program in the Norwegian primary healthcare setting. The aims were to investigate possible differences in characteristics between participants and non-participants and to study the effect of the lifestyle program at 24-month follow-up for participants. RESEARCH DESIGN AND METHODS: Individuals identified at high risk for type 2 diabetes during the third survey of the Nord-Trondelag Health Study (HUNT3) from two municipalities (n=332) were invited to a lifestyle program (the VEND-RISK Study). A cross-sectional design was used to explore if the participants' characteristics differed from non-participants. A non-randomized, single-arm, pre-post examination was used to examine the effect of the lifestyle program on participants' characteristics at 24-month follow-up. RESULTS: Of all individuals at high risk for type 2 diabetes invited to the lifestyle program, 86% (287/332) declined to participate. Non-participating women had fewer years of education (p<0.001), compared with participating women. For men, no differences were seen between non-participants and participants. Among all participants (n=45) at 24-month follow-up, none had developed type 2 diabetes, and HbA1c (p<0.001) had decreased significantly. There was a small reduction in mean body mass index from baseline to 24 months that was not statistically significant. For women, waist circumference (-4.0 cm, p<0.001) decreased significantly. CONCLUSIONS: Future research regarding individuals at high risk for type 2 diabetes in the primary healthcare lifestyle program should focus on how to promote recruitment of women with low education. Participants attending this study's lifestyle program improved their cardiometabolic markers. CLINICAL TRIALS REGISTRATION: NCT01135901; Results.  
  Address St. Olavs University Hospital, Trondheim, Norway  
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  ISSN (up) 2052-4897 ISBN Medium  
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  Notes PMID:28878932; PMCID:PMC5574427 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1899  
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Author Jolle, A.; Asvold, B.O.; Holmen, J.; Carlsen, S.M.; Tuomilehto, J.; Bjorngaard, J.H.; Midthjell, K. url  doi
  Title Basic lifestyle advice to individuals at high risk of type 2 diabetes: a 2-year population-based diabetes prevention study. The DE-PLAN intervention in the HUNT Study, Norway Type Journal Article
  Year 2018 Publication BMJ Open Diabetes Research & Care Abbreviated Journal BMJ Open Diabetes Res Care  
  Volume 6 Issue 1 Pages e000509  
  Keywords lifestyle change(s); prevention; screening; type 2 diabetes  
  Abstract Objective: Among individuals at high risk for diabetes identified through a population survey, we performed an intervention study with basic lifestyle advice aiming to prevent diabetes. Research design and methods: Among 50 806 participants in the HUNT3 Survey (2006-2008), 5297 individuals with Finnish Diabetes Risc Score (FINDRISC >/=15 were invited to an oral glucose tolerance test (OGTT) and an education session with lifestyle advice, and 2634 (49.7%) attended. Among them, 2380 people without diabetes were included in the prevention study with repeated examinations and education sessions after 6, 12, and 24 months. We examined participation, diabetes incidence, glycemia, and adiposity during follow-up. Results: Of 2380 participants, 1212 (50.9%) participated in >/=3 of the four examinations. Diabetes was detected in 3.5%, 3.1%, and 4.0% of individuals at the 6-month, 12-month, and 24-month examinations, respectively, indicating a 10.3% 2-year diabetes incidence. Mean (95% CI) increases from baseline to 2-year follow-up were 0.30 (0.29 to 0.32) percentage points (3.3 (3.2 to 3.5) mmol/mol) for Hemoglobin A1c, 0.13 (0.10 to 0.16) mmol/L for fasting serum-glucose, 0.46 (0.36 to 0.56) mmol/L for 2-hour OGTT s-glucose, 0.30 (0.19 to 0.40) kg/m(2) forbody mass index (BMI) (all p<0.001) and -0.5 (-0.9 to -0.2) cm for waist circumference (p=0.004), with broadly similar estimates by baseline age, sex, education, depressive symptoms, BMI, physical activity, and family history of diabetes. Only 206 (8.7%) participants had evidence of >5% weight loss during follow-up; their fasting and 2-hour s-glucose did not increase, and HbA1c increased less than in other participants. Conclusion: Basic lifestyle advice given to high-risk individuals during three group sessions with 6-month intervals was not effective in reducing 2-year diabetes risk.  
  Address HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway  
  Corporate Author Thesis  
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  Language English Summary Language Original Title  
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  Series Volume Series Issue Edition  
  ISSN (up) 2052-4897