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Author Gabin, J.M.; Tambs, K.; Saltvedt, I.; Sund, E.; Holmen, J. url  doi
  Title Association between blood pressure and Alzheimer disease measured up to 27 years prior to diagnosis: the HUNT Study Type Journal Article
  Year 2017 Publication Alzheimer's Research & Therapy Abbreviated Journal (up) Alzheimers Res Ther  
  Volume 9 Issue 1 Pages 37  
  Keywords Age Distribution; Aged; Aged, 80 and over; Alzheimer Disease/*diagnosis/*epidemiology; Asymptomatic Diseases/*epidemiology; Blood Pressure Determination/statistics & numerical data; Comorbidity; Dementia/diagnosis/epidemiology; Disease Progression; Female; Humans; Hypertension/*diagnostic imaging/*epidemiology; Incidence; Longitudinal Studies; Male; Middle Aged; Norway/epidemiology; Prevalence; Reproducibility of Results; Risk Factors; Sensitivity and Specificity; Sex Distribution; Alzheimer disease; Blood pressure; Epidemiology; Prospective case cohort; Risk factors; Vascular dementia  
  Abstract BACKGROUND: A lot of attention has been paid to the relationship of blood pressure and dementia because epidemiological research has reported conflicting evidence. Observational data has shown that midlife hypertension is a risk factor for cognitive decline and dementia later in life, whereas there is evidence that low blood pressure is predictive in later life. The aim of the present study was to examine the association between dementia and blood pressure measured up to 27 years (mean 17.6 years) prior to ascertainment. METHODS: In Nord-Trondelag County, Norway, incident dementia data were collected during 1995-2011, and the diagnoses were validated by a panel of experts in the field. By using the subjects' personal identification numbers, the dementia data were linked to data from the Nord-Trondelag Health Study (the HUNT Study), a large, population-based health study performed in 1984-1986 (HUNT 1) and 1995-1997 (HUNT 2). A total of 24,638 participants of the HUNT Study were included in the present study, 579 of whom were diagnosed with Alzheimer disease, mixed Alzheimer/vascular dementia, or vascular dementia. Multiple logistic regression analyses were conducted to analyze the association between dementia and blood pressure data from HUNT 1 and HUNT 2. RESULTS: Over the age of 60 years, consistent inverse associations were observed between systolic blood pressure and all-cause dementia, mixed Alzheimer/vascular dementia, and Alzheimer disease, but not with vascular dementia, when adjusting for age, sex, education, and other relevant covariates. This was observed for systolic blood pressure in both HUNT 1 and HUNT 2, regardless of antihypertensive medication use. There was an adverse association between systolic blood pressure, pulse pressure, and Alzheimer disease in individuals treated with antihypertensive medication under the age of 60 years. CONCLUSIONS: Our data are in line with those in previous studies demonstrating an inverse association between dementia and systolic blood pressure in individuals over the age of 60 years. We cannot exclude a survival effect, however. Among middle-aged subjects (<60 years), elevated systolic blood pressure and pulse pressure were associated with eventual Alzheimer disease in individuals who reported using antihypertensive medication.  
  Address HUNT Research Centre, Faculty of Medicine and Health Sciences , Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Forskningsveien 2, 7600, Levanger, Norway  
  Corporate Author Thesis  
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  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1758-9193 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28569205; PMCID:PMC5452294 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1900  
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Author Haug, E.B.; Horn, J.; Fraser, A.; Markovitz, A.R.; Rich-Edwards, J.W.; Davey Smith, G.; Romundstad, P.R.; Asvold, B.O. url  doi
  Title Pre-pregnancy Blood Pressure and Offspring Sex in the HUNT Study, Norway Type Journal Article
  Year 2017 Publication American Journal of Hypertension Abbreviated Journal (up) Am J Hypertens  
  Volume 30 Issue 9 Pages e7-e8  
  Keywords  
  Abstract  
  Address Department of Endocrinology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0895-7061 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28633300 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1923  
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Author Retnakaran, R.; Wen, S.W.; Tan, H.; Zhou, S.; Ye, C.; Shen, M.; Smith, G.N.; Walker, M.C. url  doi
  Title Response to Pre-Pregnancy Blood Pressure and Offspring Sex in the HUNT Study, Norway Type Journal Article
  Year 2017 Publication American Journal of Hypertension Abbreviated Journal (up) Am J Hypertens  
  Volume 30 Issue 9 Pages e9  
  Keywords  
  Abstract  
  Address Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0895-7061 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28633294 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1973  
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Author Nes, B.M.; Gutvik, C.R.; Lavie, C.J.; Nauman, J.; Wisloff, U. url  doi
  Title Personalized Activity Intelligence (PAI) for Prevention of Cardiovascular Disease and Promotion of Physical Activity Type Journal Article
  Year 2017 Publication The American Journal of Medicine Abbreviated Journal (up) Am J Med  
  Volume 130 Issue 3 Pages 328-336  
  Keywords Adult; Age Factors; Aged; Algorithms; Cardiovascular Diseases/mortality/*prevention & control; *Exercise; Female; Health Promotion/*methods; Humans; Male; Middle Aged; Proportional Hazards Models; Risk Assessment/*methods; Risk Factors; Sex Factors; Young Adult; Activity tracking; Cardiovascular disease mortality; Physical activity; Prevention  
  Abstract PURPOSE: To derive and validate a single metric of activity tracking that associates with lower risk of cardiovascular disease mortality. METHODS: We derived an algorithm, Personalized Activity Intelligence (PAI), using the HUNT Fitness Study (n = 4631), and validated it in the general HUNT population (n = 39,298) aged 20-74 years. The PAI was divided into three sex-specific groups (</=50, 51-99, and >/=100), and the inactive group (0 PAI) was used as the referent. Hazard ratios for all-cause and cardiovascular disease mortality were estimated using Cox proportional hazard regressions. RESULTS: After >1 million person-years of observations during a mean follow-up time of 26.2 (SD 5.9) years, there were 10,062 deaths, including 3867 deaths (2207 men and 1660 women) from cardiovascular disease. Men and women with a PAI level >/=100 had 17% (95% confidence interval [CI], 7%-27%) and 23% (95% CI, 4%-38%) reduced risk of cardiovascular disease mortality, respectively, compared with the inactive groups. Obtaining >/=100 PAI was associated with significantly lower risk for cardiovascular disease mortality in all prespecified age groups, and in participants with known cardiovascular disease risk factors (all P-trends <.01). Participants who did not obtain >/=100 PAI had increased risk of dying regardless of meeting the physical activity recommendations. CONCLUSION: PAI may have a huge potential to motivate people to become and stay physically active, as it is an easily understandable and scientifically proven metric that could inform potential users of how much physical activity is needed to reduce the risk of premature cardiovascular disease death.  
  Address K.G. Jebsen Center of Exercise in Medicine at the Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Faculty of Medicine, Trondheim, Norway; School of Human Movement & Nutrition Sciences, University of Queensland, St. Lucia, QLD, Australia  
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  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0002-9343 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:27984009 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1964  
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Author Andre, B.; Canhao, H.; Espnes, G.A.; Ferreira Rodrigues, A.M.; Gregorio, M.J.; Nguyen, C.; Sousa, R.; Gronning, K. url  doi
  Title Is there an association between food patterns and life satisfaction among Norway's inhabitants ages 65 years and older? Type Journal Article
  Year 2017 Publication Appetite Abbreviated Journal (up) Appetite  
  Volume 110 Issue Pages 108-115  
  Keywords Anxiety; Depression; Elderly adults; Food patterns; Life satisfaction  
  Abstract The lack of information regarding older adults' health and lifestyles makes it difficult to design suitable interventions for people at risk of developing unhealth lifestyles. Therefore, there is a need to increase knowledge about older adults' food patterns and quality of life. Our aim was to determine associations among food patterns, anxiety, depression, and life satisfaction in Norwegian inhabitants ages 65+. The Nord-Trondelag Health Study (The HUNT Study) is a large, population-based cohort study that includes data for 125 000 Norwegian participants. The cohort used for this study is wave three of the study, consisting of 11 619 participants age 65 and over. Cluster analysis was used to categorize the participants based on similarities in food consumption; two clusters were identified based on similarities regarding food consumption among participants. Significant differences between the clusters were found, as participants in the healthy food-patterns cluster had higher life satisfaction and lower anxiety and depression than those in the unhealthy food-patterns cluster. The associations among food patterns, anxiety, depression, and life satisfaction among older adults show the need for increased focus on interactions among food patterns, food consumption, and life satisfaction among the elderly in order to explore how society can influence these patterns.  
  Address Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Norway; NTNU Center for Health Promotion Research, Norway  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0195-6663 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:27988367 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1878  
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Author Sardahaee, F.S.; Holmen, T.L.; Micali, N.; Kvaloy, K. url  doi
  Title Effects of single genetic variants and polygenic obesity risk scores on disordered eating in adolescents – The HUNT study Type Journal Article
  Year 2017 Publication Appetite Abbreviated Journal (up) Appetite  
  Volume 118 Issue Pages 8-16  
  Keywords Adolescents; Comt; Disordered eating; Eat-12; Hunt; Obesity polygenic risk score  
  Abstract PURPOSE: Improving the understanding of the role of genetic risk on disordered eating (DE). METHODS: A case-control study including 1757 (F: 979, M: 778) adolescents (aged 13-19 years) from the Nord-Trondelag Health Study (HUNT), an ethnically homogenous Norwegian population based study. Cases and controls were defined using a shortened version of the Eating Attitude Test. Logistic regression was employed to test for associations between DE phenotypes and 24 obesity and eating disorder susceptibility SNPs, and the joint effect of a subset of these in a genetic risk score (GRS). RESULTS: COMT was shown to be associated with poor appetite/undereating (OR: 0.6, CI 95%: 0.43-0.83, p = 0.002). Independent of obesity associations, the weighted GRS was associated to overeating in 13-15 year old females (OR: 2.07, CI 95%: 1.14-3.76, p = 0.017). Additionally, a significant association was observed between the GRS and loss of control over eating in the total sample (OR: 1.62, CI 95%: 1.01-2.61, p = 0.046). CONCLUSIONS: The COMT variant (rs4680) was associated with poor appetite/undereating. Our study further confirms prior findings that obesity risk also confers risk for loss of control over eating; and overeating amongst girls.  
  Address HUNT Research Center, Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology, Trondheim, Norway; Department of Research and Development, Levanger Hospital, Nord-Trondelag Health Trust, Levanger, Norway. Electronic address: kirsti.kvaloy@ntnu.no  
  Corporate Author Thesis  
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  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0195-6663 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28694222 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1975  
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Author Ness-Jensen, E.; Lagergren, J. url  doi
  Title Tobacco smoking, alcohol consumption and gastro-oesophageal reflux disease Type Journal Article
  Year 2017 Publication Best Practice & Research. Clinical Gastroenterology Abbreviated Journal (up) Best Pract Res Clin Gastroenterol  
  Volume 31 Issue 5 Pages 501-508  
  Keywords Causality; Disease management; Ethanol; Gastroesophageal reflux; Smoking; Tobacco  
  Abstract Gastro-oesophageal reflux disease (GORD) develops when reflux of gastric content causes troublesome symptoms or complications. The main symptoms are heartburn and acid regurgitation and complications include oesophagitis, strictures, Barrett's oesophagus and oesophageal adenocarcinoma. In addition to hereditary influence, GORD is associated with lifestyle factors, mainly obesity. Tobacco smoking is regarded as an aetiological factor of GORD, while alcohol consumption is considered a triggering factor of reflux episodes and not a causal factor. Yet, both tobacco smoking and alcohol consumption can reduce the lower oesophageal sphincter pressure, facilitating reflux. In addition, tobacco smoking reduces the production of saliva rich in bicarbonate, which is important for buffering and clearance of acid in the oesophagus. Alcohol also has a direct noxious effect on the oesophageal mucosa, which predisposes to acidic injury. Tobacco smoking cessation reduces the risk of GORD symptoms and avoidance of alcohol is encouraged in individuals where alcohol consumption triggers reflux.  
  Address Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, 171 76 Stockholm, Sweden; School of Cancer Sciences, King's College London, SE1 9RT, United Kingdom. Electronic address: jesper.lagergren@ki.se  
  Corporate Author Thesis  
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  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1521-6918 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:29195669 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1965  
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Author Jorgensen, P.; Langhammer, A.; Krokstad, S.; Forsmo, S. url  doi
  Title Mortality in persons with undetected and diagnosed hypertension, type 2 diabetes, and hypothyroidism, compared with persons without corresponding disease – a prospective cohort study; The HUNT Study, Norway Type Journal Article
  Year 2017 Publication BMC Family Practice Abbreviated Journal (up) BMC Fam Pract  
  Volume 18 Issue 1 Pages 98  
  Keywords Chronic disease; Diabetes; Hypertension; Primary care; Public health; Thyroid disorders  
  Abstract BACKGROUND: Suggested strategies in reducing the impact of non-communicable diseases (NCD) are early diagnosing and screening. We have limited proof of benefit of population screening for NCD. Increased mortality in persons with diagnosed NCD has been shown for decades. However, mortality in undetected NCD has barely been studied. This paper explores whether all-cause mortality differed between persons with diagnosed hypothyroidism, type 2 diabetes (T2DM), and hypertension, compared with persons with undetected-, and with persons without the corresponding disease. METHODS: A prospective cohort study of the general population in Nord-Trondelag, Norway. Persons >/=20 years at baseline 1995-97 were followed until death or June 15, 2016. Cox proportional hazards models were used to compute age and multiple adjusted hazard ratios (HR) with 95% confidence intervals (CI) for the association between disease status and all-cause mortality. The number of participants in the hypothyroidism study was 31,960, in the T2DM study 37,957, and in the hypertension study 63,371. RESULTS: Mortality was increased in persons with diagnosed type 2 diabetes and hypertension, compared to persons without corresponding disease; HR 1.69 (95% CI 1.55-1.84) and HR 1.23 (95% CI 1.09-1.39), respectively. Among persons with undetected T2DM, the HR was 1.21 (95% CI 1.08-1.37), whilst among undetected hypothyroidism and hypertension, mortality was not increased compared with persons without the diseases. Further, the association with mortality was stronger in persons with long duration of T2DM (HR 1.96 (95% CI 1.57-2.44)) and hypertension (HR 1.32 (95% CI 1.17-1.49)), compared with persons with short duration (HR 1.29 (1.09-1.53) and HR 1.16 (1.03-1-30) respectively). CONCLUSIONS: Mortality was increased in persons with diagnosed T2DM and hypertension, and in undetected T2DM, compared with persons without the diseases. The strength of the association with mortality in undetected T2DM was however lower compared with persons with diagnosed T2DM, and mortality was not increased in persons with undetected hypothyroidism and hypertension, compared with persons without the diseases. Thus, future research needs to test more thoroughly if early diagnosing of these diseases, such as general population screening, is beneficial for health.  
  Address Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Postbox 8905, 7491, Trondheim, Norway  
  Corporate Author Thesis  
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  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1471-2296 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:29212453; PMCID:PMC5719734 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1935  
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Author Li, J.; Wu, B.; Selbaek, G.; Krokstad, S.; Helvik, A.-S. url  doi
  Title Factors associated with consumption of alcohol in older adults – a comparison between two cultures, China and Norway: the CLHLS and the HUNT-study Type Journal Article
  Year 2017 Publication BMC Geriatrics Abbreviated Journal (up) BMC Geriatr  
  Volume 17 Issue 1 Pages 172  
  Keywords Abstainers; Alcohol consumption; China; Elderly; Norway; Older adults  
  Abstract BACKGROUND: There is little knowledge about the consumption of alcohol among Chinese and Norwegian older adults aged 65 years and over. The aim of this study was to investigate the prevalence and factors related to alcohol consumption among older adults in China and Norway. METHODS: The Chinese Longitudinal Healthy Longevity Survey (CLHLS) data in 2008-2009 conducted in China and The Nord-Trondelag Health Study data in 2006-2008 (HUNT3) conducted in Norway were used. Mulitvariable logistic regression was used to test the factors related to alcohol consumption. RESULTS: The prevalence of participants who drink alcohol in the Chinese and Norwegian sample were 19.88% and 46.2%, respectively. The weighted prevalence of participants with consumption of alcohol in the Chinese sample of women and men were 7.20% and 34.14%, respectively. In the Norwegian sample, the prevalence of consumption of alcohol were 43.31% and 65.35% for women and men, respectively. Factors such as younger age, higher level of education, living in urban areas, living with spouse or partner, and better health status were related to higher likelihood of alcohol consumption among Norwegian older women and men; while reported better health status and poorer life satisfaction were related to higher likelihood of alcohol consumption among Chinese. In addition, rural males and older females with higher level of education were more likely to consume alcohol. CONCLUSION: The alcohol consumption patterns were quite different between China and Norway. Besides economic development levels and cultures in the two different countries, demographic characteristics, socioeconomic status, overall health status, and life satisfaction were associated with alcohol consumption as well.  
  Address St. Olav's University Hospital, Trondheim, Norway  
  Corporate Author Thesis  
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  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1471-2318 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28760157; PMCID:PMC5537928 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1947  
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Author Hellevik, A.I.; Johnsen, M.B.; Langhammer, A.; Fenstad, A.M.; Furnes, O.; Storheim, K.; Zwart, J.A.; Flugsrud, G.; Nordsletten, L. url  doi
  Title Incidence of total hip or knee replacement due to osteoarthritis in relation to thyroid function: a prospective cohort study (The Nord-Trondelag Health Study) Type Journal Article
  Year 2017 Publication BMC Musculoskeletal Disorders Abbreviated Journal (up) BMC Musculoskelet Disord  
  Volume 18 Issue 1 Pages 201  
  Keywords Hip joint replacement; Knee joint replacement; Osteoarthritis; Thyroid function; Thyroid stimulating hormone  
  Abstract BACKGROUND: To study whether thyroid function was associated with risk of hip or knee replacement due to primary osteoarthritis. METHODS: In a prospective cohort study, data from the second and third survey of the Nord-Trondelag Health Study were linked to the Norwegian Arthroplasty Register in order to identify total hip or knee replacement as a result of primary osteoarthritis. RESULTS: Among 37 891 participants without previously known thyroid disease we recorded 978 total hip replacements (THRs) and 538 total knee replacements (TKRs) during a median follow-up time of 15.7 years. The analyses were adjusted for sex, age, BMI (body mass index), smoking, physical activity and diabetes. We did not find any association between TSH (thyroid stimulating hormone) and THR or TKR due to osteoarthritis. Neither were changes in TSH over time, or overt hypo- or hyperthyroidism, associated with incidence of THR or TKR. CONCLUSION: No association was found between thyroid function and hip or knee joint replacement due to osteoarthritis.  
  Address Faculty of Medicine, University of Oslo, Oslo, Norway  
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  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1471-2474 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28521834; PMCID:PMC5437592 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1924  
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Author Bauman, A.E.; Grunseit, A.C.; Rangul, V.; Heitmann, B.L. url  doi
  Title Physical activity, obesity and mortality: does pattern of physical activity have stronger epidemiological associations? Type Journal Article
  Year 2017 Publication BMC Public Health Abbreviated Journal (up) BMC Public Health  
  Volume 17 Issue 1 Pages 788  
  Keywords Cardiovascular disease; Hip circumference; Waist circumference  
  Abstract BACKGROUND: Most studies of physical activity (PA) epidemiology use behaviour measured at a single time-point. We examined whether 'PA patterns' (consistently low, consistently high or inconsistent PA levels over time) showed different epidemiological relationships for anthropometric and mortality outcomes, compared to single time-point measure of PA. METHODS: Data were the Danish MONICA (MONItoring Trends and Determinants in CArdiovascular Disease) study over three waves 1982-3 (time 1), 1987-8 (time 2) and 1993-4 (time 3). Associations between leisure time single time-point PA levels at time 1 and time 3, and sport and active travel at times 1 and 2 with BMI, waist, hip circumference and mortality (death from coronary heart disease (CHD) and cardiovascular disease (CVD)) were compared to 'PA patterns' spanning multiple time points. PA pattern classified participants' PA as either 1) inactive or low PA at both time points; 2) moderate level PA at time 1 and high activity at time 3; or 3) a 'mixed PA pattern' indicating a varying levels of activity over time. Similarly, sport and active travel were also classified as indicating stable low, stable high and mixed patterns. RESULTS: The moderately and highly active groups for PA at times 1 and 3 had up to 1.7 cm lower increase in waist circumference compared with the inactive/low active group. Across 'PA patterns', 'active maintainers' had a 2.0 cm lower waist circumference than 'inactive/low maintainers'. Waist circumference was inversely related to sport but not active travel. CHD risk did not vary by activity levels at time 1, but was reduced significantly by 43% for high PA at time 3 (vs 'inactive' group) and among 'active maintainers' (vs 'inactive/low maintainers') by 62%. 'Sport pattern' showed stronger reductions in mortality for cardiovascular disease and CHD deaths among sport maintainers, than the single time point measures. CONCLUSIONS: PA patterns demonstrated a stronger association with a number of anthropometric and mortality outcomes than the single time-point measures. Operationalising PA as a sustained behavioural pattern may address some of the known under-estimation of risk for poor health in PA self-report measurements and better reflect exposure for epidemiological analysis of risk of health outcomes.  
  Address Copenhagen Center for Preventive Medicine, Glostrup Hospital, Copenhagen Capital Region, Denmark  
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  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1471-2458 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28982371; PMCID:PMC5629749 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1880  
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Author Krokstad, S.; Ding, D.; Grunseit, A.C.; Sund, E.R.; Holmen, T.L.; Rangul, V.; Bauman, A. url  doi
  Title Multiple lifestyle behaviours and mortality, findings from a large population-based Norwegian cohort study – The HUNT Study Type Journal Article
  Year 2017 Publication BMC Public Health Abbreviated Journal (up) BMC Public Health  
  Volume 17 Issue 1 Pages 58  
  Keywords Adult; Aged; Alcohol Drinking/epidemiology; Cohort Studies; Diet/adverse effects; Female; Follow-Up Studies; Humans; *Life Style; Male; Middle Aged; Norway/epidemiology; Proportional Hazards Models; Risk Factors; *Risk-Taking; Sleep; Smoking/adverse effects; Social Behavior; Young Adult; *All-cause mortality; *Cardiovascular disease; *Cohort study; *Lifestyle behaviour; *Metabolic disease; *Risk factors  
  Abstract BACKGROUND: Lifestyle risk behaviours are responsible for a large proportion of disease burden and premature mortality worldwide. Risk behaviours tend to cluster in populations. We developed a new lifestyle risk index by including emerging risk factors (sleep, sitting time, and social participation) and examine unique risk combinations and their associations with all-cause and cardio-metabolic mortality. METHODS: Data are from a large population-based cohort study in a Norway, the Nord-Trondelag Health Study (HUNT), with an average follow-up time of 14.1 years. Baseline data from 1995-97 were linked to the Norwegian Causes of Death Registry. The analytic sample comprised 36 911 adults aged 20-69 years. Cox regression models were first fitted for seven risk factors (poor diet, excessive alcohol consumption, current smoking, physical inactivity, excessive sitting, too much/too little sleep, and poor social participation) separately and then adjusted for socio-demographic covariates. Based on these results, a lifestyle risk index was developed. Finally, we explored common combinations of the risk factors in relation to all-cause and cardio-metabolic mortality outcomes. RESULTS: All single risk factors, except for diet, were significantly associated with both mortality outcomes, and were therefore selected to form a lifestyle risk index. Risk of mortality increased as the index score increased. The hazard ratio for all-cause mortality increased from 1.37 (1.15-1.62) to 6.15 (3.56-10.63) as the number of index risk factors increased from one to six respectively. Among the most common risk factor combinations the association with mortality was particularly strong when smoking and/or social participation were included. CONCLUSIONS: This study adds to previous research on multiple risk behaviours by incorporating emerging risk factors. Findings regarding social participation and prolonged sitting suggest new components of healthy lifestyles and potential new directions for population health interventions.  
  Address Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, NSW, Australia  
  Corporate Author Thesis  
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  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1471-2458 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28068991; PMCID:PMC5223537 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1946  
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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 (up) 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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  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 2044-6055 ISBN Medium  
  Area Expedition Conference  
  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 (up) 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  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 2044-6055 ISBN Medium  
  Area Expedition Conference  
  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 (up) 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  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 2044-6055 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28093432; PMCID:PMC5253523 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1929  
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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 (up) 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  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 2044-6055 ISBN Medium  
  Area Expedition Conference  
  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 (up) 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  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 2044-6055 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28674149; PMCID:PMC5734252 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1990  
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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 (up) 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  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 2052-4897 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28878932; PMCID:PMC5574427 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1899  
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Author Talseth, A.; Edna, T.-H.; Hveem, K.; Lydersen, S.; Ness-Jensen, E. url  doi
  Title Quality of life and psychological and gastrointestinal symptoms after cholecystectomy: a population-based cohort study Type Journal Article
  Year 2017 Publication BMJ Open Gastroenterology Abbreviated Journal (up) BMJ Open Gastroenterol  
  Volume 4 Issue 1 Pages e000128  
  Keywords Cholecystectomy; Gastrointestinal Function; Quality Of Life  
  Abstract OBJECTIVE: The study aims to examine gastrointestinal symptoms, quality of life and the risk of psychological symptoms after cholecystectomy. DESIGN: This is a prospective population-based cohort study based on the Nord-Trondelag Health Study (HUNT) Norway. HUNT is a repeated health survey of the county population and includes a wide range of health-related items. In the present study, all 3 HUNT surveys were included, performed between 1984 and 2008. Selected items were scores on quality of life, the Hospital Anxiety and Depression Scale (HADS) and selected gastrointestinal symptoms. Participants who underwent cholecystectomy for gallstone disease between 1 January 1990 and until 1 year before attending HUNT3 were compared with the remaining non-operated cohort. Associations between cholecystectomy and the postoperative scores and symptoms were assessed by multivariable regression models. RESULTS: Participants in HUNT1, HUNT2 and HUNT3 were 77 212 (89.4% of those invited), 65 237 (69.5%) and 50 807 (54.1%), respectively. In the study period, 931 participants were operated with cholecystectomy. Cholecystectomy was associated with an increased risk of diarrhoea and stomach pain postoperatively. In addition, cholecystectomy was associated with an increased risk of nausea postoperatively in men. We found no associations between cholecystectomy and quality of life, symptoms of anxiety and depression, constipation, heartburn, or acid regurgitation following surgery. CONCLUSIONS: In this large population-based cohort study, cholecystectomy was associated with postoperative diarrhoea and stomach pain. Cholecystectomy for gallstone colic was associated with nausea in men. There were no associations between quality of life, symptoms of anxiety and depression, constipation, heartburn, or acid regurgitation.  
  Address Department of Medicine, Levanger Hospital, Nord-Trondelag Hospital Trust, Levanger, Norway  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 2054-4774 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28761686; PMCID:PMC5508800 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 2008  
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Author Modalsli, E.H.; Asvold, B.O.; Romundstad, P.R.; Langhammer, A.; Hoff, M.; Forsmo, S.; Naldi, L.; Saunes, M. url  doi
  Title Psoriasis, fracture risk and bone mineral density: the HUNT Study, Norway Type Journal Article
  Year 2017 Publication The British Journal of Dermatology Abbreviated Journal (up) Br J Dermatol  
  Volume 176 Issue 5 Pages 1162-1169  
  Keywords  
  Abstract BACKGROUND: An association between psoriasis and osteoporosis has been reported. OBJECTIVES: To investigate, in a large prospective population-based Norwegian study, whether psoriasis is associated with increased risk of forearm or hip fracture; to investigate the cross-sectional association between psoriasis and bone mineral density (BMD) T-score in a subpopulation. METHODS: Hospital-derived fracture data from Nord-Trondelag County (1995-2013) were linked to psoriasis information, BMD measurements and lifestyle factors from the third survey of the Nord-Trondelag Health Study 2006-08 (HUNT3); socioeconomic data from the National Education Database; and use of medication from the Norwegian Prescription Database. RESULTS: Among 48 194 participants in HUNT3, we found no increased risk of forearm or hip fracture in 2804 patients with self-reported psoriasis [overall age- and sex-adjusted hazard ratio 1.03, 95% confidence interval (CI) 0.82-1.31]. No clear association was found between psoriasis and mean BMD T-score; overall age- and sex-adjusted differences in total hip, femoral neck and lumbar spine BMD T-scores were 0.02 (95% CI -0.11 to 0.14), 0.05 (95% CI -0.06 to 0.17) and 0.07 (95% CI -0.09 to 0.24), respectively. No clear association was found between psoriasis and prevalent osteoporosis in either total hip, femoral neck or lumbar spine; overall age- and sex-adjusted odds ratio was 0.77 (95% CI 0.54-1.10). Associations did not change substantially after adjustment for education, smoking, systemic steroid use and body mass index. CONCLUSIONS: We found no association between psoriasis and risk of fracture. The study did not indicate reduced BMD T-score or higher prevalence of osteoporosis among patients with psoriasis.  
  Address Department of Cancer Research and Molecular Medicine, Faculty of Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0007-0963 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:27718508 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1955  
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Author Perreault, K.; Bauman, A.; Johnson, N.; Britton, A.; Rangul, V.; Stamatakis, E. url  doi
  Title Does physical activity moderate the association between alcohol drinking and all-cause, cancer and cardiovascular diseases mortality? A pooled analysis of eight British population cohorts Type Journal Article
  Year 2017 Publication British Journal of Sports Medicine Abbreviated Journal (up) Br J Sports Med  
  Volume 51 Issue 8 Pages 651-657  
  Keywords Adult; Aged; Aged, 80 and over; Alcohol Drinking/*adverse effects; Cardiovascular Diseases/*mortality; England; *Exercise; Female; Health Surveys; Humans; Male; Middle Aged; Mortality; Neoplasms/*mortality; Proportional Hazards Models; Prospective Studies; Risk Factors; Cancer; Epidemiology; Physical activity; Public health  
  Abstract OBJECTIVE: To examine whether physical activity (PA) moderates the association between alcohol intake and all-cause mortality, cancer mortality and cardiovascular diseases (CVDs) mortality. DESIGN: Prospective study using 8 British population-based surveys, each linked to cause-specific mortality: Health Survey for England (1994, 1998, 1999, 2003, 2004 and 2006) and Scottish Health Survey (1998 and 2003). PARTICIPANTS: 36 370 men and women aged 40 years and over were included with a corresponding 5735 deaths and a mean of 353 049 person-years of follow-up. EXPOSURES: 6 sex-specific categories of alcohol intake (UK units/week) were defined: (1) never drunk; (2) ex-drinkers; (3) occasional drinkers; (4) within guidelines (<14 (women); <21 (men)); (5) hazardous (14-35 (women); 21-49 (men)) and (6) harmful (>35 (women) >49 (men)). PA was categorised as inactive (</=7 MET-hour/week), active at the lower (>7.5 MET-hour/week) and upper (>15 MET-hour/week) of recommended levels. MAIN OUTCOMES AND MEASURES: Cox proportional-hazard models were used to examine associations between alcohol consumption and all-cause, cancer and CVD mortality risk after adjusting for several confounders. Stratified analyses were performed to evaluate mortality risks within each PA stratum. RESULTS: We found a direct association between alcohol consumption and cancer mortality risk starting from drinking within guidelines (HR (95% CI) hazardous drinking: 1.40 (1.11 to 1.78)). Stratified analyses showed that the association between alcohol intake and mortality risk was attenuated (all-cause) or nearly nullified (cancer) among individuals who met the PA recommendations (HR (95% CI)). CONCLUSIONS: Meeting the current PA public health recommendations offsets some of the cancer and all-cause mortality risk associated with alcohol drinking.  
  Address Department of Epidemiology and Public Health, University College London, London, UK  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0306-3674 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:27581162 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1970  
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Author Yu, D.; Takata, Y.; Smith-Warner, S.A.; Blot, W.; Sawada, N.; White, E.; Freedman, N.; Robien, K.; Giovannucci, E.; Zhang, X.; Park, Y.; Gao, Y.-T.; Chlebowski, R.T.; Langhammer, A.; Yang, G.; Severi, G.; Manjer, J.; Khaw, K.-T.; Weiderpass, E.; Liao, L.M.; Caporaso, N.; Krokstad, S.; Hveem, K.; Sinha, R.; Ziegler, R.; Tsugane, S.; Xiang, Y.-B.; Johansson, M.; Zheng, W.; Shu, X.-O. url  doi
  Title Prediagnostic Calcium Intake and Lung Cancer Survival: A Pooled Analysis of 12 Cohort Studies Type Journal Article
  Year 2017 Publication Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology Abbreviated Journal (up) Cancer Epidemiol Biomarkers Prev  
  Volume 26 Issue 7 Pages 1060-1070  
  Keywords  
  Abstract Background: Lung cancer is the leading cause of cancer death. Little is known about whether prediagnostic nutritional factors may affect survival. We examined the associations of prediagnostic calcium intake from foods and/or supplements with lung cancer survival.Methods: The present analysis included 23,882 incident, primary lung cancer patients from 12 prospective cohort studies. Dietary calcium intake was assessed using food-frequency questionnaires at baseline in each cohort and standardized to caloric intake of 2,000 kcal/d for women and 2,500 kcal/d for men. Stratified, multivariable-adjusted Cox regression was applied to compute hazard ratios (HR) and 95% confidence intervals (CI).Results: The 5-year survival rates were 56%, 21%, and 5.7% for localized, regional, and distant stage lung cancer, respectively. Low prediagnostic dietary calcium intake (<500-600 mg/d, less than half of the recommendation) was associated with a small increase in risk of death compared with recommended calcium intakes (800-1,200 mg/d); HR (95% CI) was 1.07 (1.01-1.13) after adjusting for age, stage, histology, grade, smoking status, pack-years, and other potential prognostic factors. The association between low calcium intake and higher lung cancer mortality was evident primarily among localized/regional stage patients, with HR (95% CI) of 1.15 (1.04-1.27). No association was found for supplemental calcium with survival in the multivariable-adjusted model.Conclusions: This large pooled analysis is the first, to our knowledge, to indicate that low prediagnostic dietary calcium intake may be associated with poorer survival among early-stage lung cancer patients.Impact: This multinational prospective study linked low calcium intake to lung cancer prognosis. Cancer Epidemiol Biomarkers Prev; 26(7); 1060-70. (c)2017 AACR.  
  Address Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee. xiao-ou.shu@vanderbilt.edu  
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  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1055-9965 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28264875; PMCID:PMC5500413 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 2025  
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Author Hansen, A.G.; Stovner, L.J.; Hagen, K.; Helvik, A.-S.; Thorstensen, W.M.; Nordgard, S.; Bugten, V.; Eggesbo, H.B. url  doi
  Title Paranasal sinus opacification in headache sufferers: A population-based imaging study (the HUNT study-MRI) Type Journal Article
  Year 2017 Publication Cephalalgia : an International Journal of Headache Abbreviated Journal (up) Cephalalgia  
  Volume 37 Issue 6 Pages 509-516  
  Keywords Paranasal sinuses; headache; magnetic resonance imaging; migraine; opacification; sinus headache; tension headache  
  Abstract Background The association between headache and paranasal sinus disease is still unclear. Because of symptom overlap, the two conditions are not easily studied on the basis of symptoms alone. The aim of the present study was to investigate whether paranasal sinus opacification on magnetic resonance imaging (MRI) was associated with migraine, tension-type headache (TTH) or unclassified headache. Methods This was a cross-sectional study of 844 randomly selected participants (442 women, age range 50-65 years, mean age 57.7 years). Based on 14 headache questions, participants were allocated to four mutually exclusive groups: migraine, TTH, unclassified headache or headache free. On MRI, opacifications as mucosal thickening, polyps/retention cysts and fluid in the five paired sinuses were measured and recorded if >/=1 mm. For each participant, opacification thickness was summed for each sinus and, in addition, a total sum of all sinuses was calculated. Opacification in each sinus was compared between headache-free participants and the headache groups using non-parametric tests, and the total sum was compared by logistical regression. Results No significant association was found between paranasal sinus opacification and headache in general, nor when headache was differentiated into migraine, TTH and unclassified headache. This was also true in separate analyses of mucosal thickening and fluid and of opacification from each paranasal sinus. Conclusion Migraine, TTH and unclassified headache were found not to be associated with an increased degree of paranasal sinus opacification at MRI.  
  Address 5 Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway  
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  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0333-1024 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:27215544 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1921  
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Author Quanjer, P.H.; Ruppel, G.L.; Langhammer, A.; Krishna, A.; Mertens, F.; Johannessen, A.; Menezes, A.M.B.; Wehrmeister, F.C.; Perez-Padilla, R.; Swanney, M.P.; Tan, W.C.; Bourbeau, J. url  doi
  Title Bronchodilator Response in FVC Is Larger and More Relevant Than in FEV1 in Severe Airflow Obstruction Type Journal Article
  Year 2017 Publication Chest Abbreviated Journal (up) Chest  
  Volume 151 Issue 5 Pages 1088-1098  
  Keywords Adolescent; Adult; Aged; Aged, 80 and over; Airway Obstruction/*diagnosis/physiopathology; Asthma/*diagnosis/physiopathology; *Bronchodilator Agents; Canada; Child; Child, Preschool; Female; Forced Expiratory Volume/*physiology; Healthy Volunteers; Humans; Latin America; Male; Middle Aged; Netherlands; New Zealand; Norway; Pulmonary Disease, Chronic Obstructive/*diagnosis/physiopathology; Severity of Illness Index; Treatment Outcome; United States; Vital Capacity/*physiology; Young Adult; airways obstruction; asthma; bronchodilator responsiveness; chronic obstructive pulmonary disease; respiratory physiology  
  Abstract BACKGROUND: Recommendations on interpreting tests of bronchodilator responsiveness (BDR) are conflicting. We investigated the dependence of BDR criteria on sex, age, height, ethnicity, and severity of respiratory impairment. METHODS: BDR test data were available from clinical patients in the Netherlands, New Zealand, and the United States (n = 15,278; female subjects, 51.7%) and from surveys in Canada, Norway, and five Latin-American countries (n = 16,250; female subjects, 54.7%). BDR calculated according to FEV1, FVC, and FEV1/FVC was expressed as absolute change, a percentage of the baseline level (% baseline), a percentage of the predicted value (% predicted), and z score. RESULTS: Change (Delta) in FEV1 and FVC, in milliliters, was unrelated to the baseline value but was biased toward age, height, sex, and level of airways obstruction; DeltaFEV1 was significantly lower in African Americans. In 1,106 subjects with low FEV1 (200-1,621 mL) the FEV1 increased by 12% to 44.7% relative to baseline but < 200 mL. Expressing BDR as a percentage of the predicted value or as a z score attenuated the bias and made the 200-mL criterion redundant, but reduced positive responses by half. DeltaFEV1 % baseline increased with the level of airflow obstruction but decreased with severe obstruction when expressed as z scores or % predicted; DeltaFVC, however expressed, increased with the level of airflow obstruction. CONCLUSIONS: Expressing FEV1 responsiveness as % baseline spuriously suggests that responsiveness increases with the severity of respiratory impairment. Expressing change in FEV1 or FVC as % predicted or as z scores eliminates this artifact and renders the required 200-mL minimum increase redundant. In severe airways obstruction DeltaFVC should be critically evaluated as an index of clinically important relief of hyperinflation, with implications for bronchodilator drug trials.  
  Address Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, McGill University, Montreal, QC, Canada  
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