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Egan, K. B., Ettinger, A. S., DeWan, A. T., Holford, T. R., Holmen, T. L., & Bracken, M. B. (2014). General, but not abdominal, overweight increases odds of asthma among Norwegian adolescents: the Young-HUNT study. Acta Paediatr, .
Abstract: AIM: The aim of this analysis was to examine the association between asthma and general and abdominal weight status, defined by age- and sex-specific cut-offs for body mass index (BMI) and waist circumference (WC) in adolescents. METHODS: Participants aged 12-19 years in the Young-HUNT (YH) Study (YH1 1995-1997: n = 8222; YH3 2006-2008: n = 7403) completed self-administered questionnaires in school as part of a series of cross-sectional, population-based studies conducted in Nord-Trondelag, Norway. Weight, height and WC were measured. Adjusted odds ratios (ORs) and 95% Confidence Intervals (CI) for asthma, defined by self-reported physician diagnosis, were calculated. Potential effect modifiers evaluated included sex and pubertal development status (PDS). RESULTS: Asthma was reported by 11.8% of the adolescents in YH1 and 17.0% in YH3. Asthma odds significantly increased for adolescents with general (OR = 1.33; 95%CI: 1.13, 1.56), but not abdominal, overweight and increased for adolescents with general (OR = 1.34; 95%CI: 1.02, 1.75) or abdominal obesity (OR = 1.36; 95%CI: 1.16, 1.60). Underweight had no association with asthma regardless of weight assessment type, and PDS did not meaningfully influence the associations between asthma and weight. CONCLUSION: Overweight and obesity both increased the odds of asthma in 12-19 year-old Norwegians. WC did not add further information to that already provided by BMI to improve our understanding of the association between asthma and weight.
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Jacobsena, B. A., Dyb, G., Hagen, K., Stovner, L. J., Holmen, T. L., & Zwart, J. - A. (2018). The Nord-Trondelag Health Study shows increased prevalence of primary recurrent headaches among adolescents over a four-year period. Scand J Pain, 2(3), 148–152.
Abstract: Objective Earlier epidemiological studies have shown that headaches are frequent among adolescents, especially girls. In particular, recurrent primary headache disorders such as migraine and tension-type headaches are common complaints in this age group. Headaches are increasingly being recognized as a significant health problem in adolescents and can lead to significant disabilities by affecting their lives, their school performance and their social lives. The aim of this study was to compare the prevalence of primary headaches among adolescents aged 16-20 years in Norway in two periods. Very few replicate studies have re-evaluated the prevalence of primary headaches in this age range and it is uncertain whether the prevalence is increasing. Methods Two cross-sectional, population-based studies were conducted in Norway from 1995 to 1997 (Young-HUNT 1) and from 1999 to 2001 (Young-HUNT 2). In Young-HUNT 1, 2594 adolescents in 2nd and 3rd grade in upper secondary school (aged 16-20 years) completed a comprehensive questionnaire including one question regarding headache during the last 12 months. In addition, 1730 of the students were interviewed about their headache complaints. In Young-HUNT 2, 2373 adolescents aged 16-20 years completed the same questionnaire and 1655 were interviewed in the same way as the earlier survey. The interviews were performed by trained nurses, and respondents were asked if they had experienced recurrent headache during the last year. If so, the headache was classified as migraine (MI), tensiontype headache (TTH) or non-classifiable headache (NCH). Headache frequency during the past year was recorded according to the following categories: Less than 1 day per month (less than monthly), 1-3 days per month (monthly), 1-5 days per week (weekly), or more than 5 days per week (daily). Results The participation rate was 88% in Young-HUNT 1 and 81% in Young-HUNT 2. The overall prevalence of having had headaches during the last 12 months did not change significantly (79.4% versus 77.5%; OR: 0.89, 95%CI: 0.79-1.02, p = 0.09), whereas the prevalence of recurrent headaches increased from 30.3% in Young-HUNT 1 to 35.4% in Young-HUNT 2 (OR: 1.26, 95%CI: 1.09-1.46, p = 0.002). The prevalence of tension-type headache changed significantly from 19.0% to 21.9% (OR: 1.20, 95%CI: 1.02-1.42, p = 0.03). Also the prevalence of migraine tended to increase (7.5% versus 8.7%, OR: 1.18, 95%CI: 0.92-1.52, p = 0.18). The overall frequency of recurrent headache changed towards more monthly and less weekly headache. Conclusions This is the first large-scale population-based study among adolescents in Norway assessing changes in the prevalence of primary headaches over a four-year period of time. The overall prevalence of recurrent headaches increased significantly from Young-HUNT 1 to Young-HUNT 2. An increase was seen in all types of recurrent headaches and was significant for tension-type headache. Implications Earlier follow-up studies have examined changes in prevalence of recurrent headaches in young age, but the results are diverging. Our findings support the impression that the prevalence of recurrent headache among adolescents is increasing, and underlines the need for prospective designed studies with emphasis on prognosis and etiological factors.
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Kaasboll, J., Lydersen, S., Ranoyen, I., Nilsen, W., & Indredavik, M. S. (2018). Parental chronic pain and internalizing symptoms in offspring: the role of adolescents' social competence – the HUNT study. J Pain Res, 11, 2915–2928.
Abstract: Background: A growing body of research suggests that the children of parents with chronic pain are at risk for internalizing symptoms. The mechanisms of such associations have not been as thoroughly examined. The aim of the present study was to investigate whether adolescents' social competence mediates the association between parental chronic pain and offspring internalizing symptoms as well as whether these associations are moderated by adolescent gender. Methods: The current study was based on cross-sectional data from the Nord-Trondelag Health Study (HUNT 3), a Norwegian population-based health survey conducted in 2006-2008. The present sample comprised adolescents who had both parents participating (n=9,681). Structural equation modeling was used for the data analysis. Results: Our results indicated that the association between concurrent maternal and paternal chronic pain and offspring's symptoms of anxiety and depression was partly mediated by low social competence for girls (b(SE)=0.060 [0.030], P=0.043) but not for boys (b(SE)=-0.059 [0.040], P=0.146). This suggests that these associations are moderated by offspring gender. Conclusion: The study extends the existing literature on the possible pathways between parental chronic pain and internalizing symptoms in the offspring. Identifying protective factors in the pathways between parental chronic pain and mental distress in children could guide measures that promote the wellbeing of the child and family of chronic pain sufferers.
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Magnusson, M., Sorensen, T. I., Olafsdottir, S., Lehtinen-Jacks, S., Holmen, T. L., Heitmann, B. L., et al. (2014). Social Inequalities in Obesity Persist in the Nordic Region Despite Its Relative Affluence and Equity. Current obesity reports, 3, 1–15.
Abstract: Social inequalities in overweight and obesity (OWOB) have persisted in the affluent and reputedly egalitarian Nordic countries. In this review we examine associations between socioeconomic position (SEP) and OWOB, and secular trends in such associations. Determinants and possible causes of the relations are discussed together with opportunities to cope with OWOB as a public health problem. The findings show a persisting inverse social gradient. An interaction between SEP and gender is noted for adults in Denmark, Finland and Iceland and for children in Sweden. There are overall tendencies for increased inequality, however no consistent trend for an increased social gradient in OWOB. Reasons that increased inequality does not unequivocally mirror in a steepened social gradient in obesity may include methodological questions as well as societal efforts to counteract obesity. Multi-level efforts are needed to prevent OWOB.
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Pape, K., Bjorngaard, J. H., De Ridder, K. A. A., Westin, S., Holmen, T. L., & Krokstad, S. (2013). Medical benefits in young Norwegians and their parents, and the contribution of family health and socioeconomic status. The HUNT Study, Norway. Scand J Public Health, 41(5), 455–462.
Abstract: AIMS: Family and intergenerational perspectives might contribute to a better understanding of why young people in many European countries experience work impairment and end up being dependent on public benefits for life sustenance. The aim of this cohort study was to explore the relationship between the receipt of medical benefits in parents and their young adult offspring and the contributions of family health and family socioeconomic status. METHODS: Baseline information on the health of 7597 adolescents and their parents who participated in the HUNT Study 1995-1997 was linked to national registers to identify long-term receipt of medical benefits for parents (1992-1997) and adolescents as they entered adulthood (1998-2008). We used logistic regression to explore the association between parent and offspring receipt of medical benefits, adjusting for family health and socioeconomic status. RESULTS: Among adolescents, 13% received medical benefits from age 20-29. Adolescents whose parents had received medical benefits (26%) were more likely to receive such benefits themselves from age 20-29 compared with adolescents without benefit-receiving parents (age- and sex-adjusted odds ratio (OR) 2.16, 95 % confidence interval (CI) 1.86-2.49). Adjustment for family health reduced this estimate considerably (to OR 1.66, 95% CI 1.38-1.99), whereas adjustment for family socioeconomic status had less impact. CONCLUSIONS: Adolescents whose parents receive medical benefits enter adult working life with an elevated risk of health-related work exclusion. Family health vulnerability appears to be a key to understanding this association, suggesting that more attention to intergenerational continuities of health could be a way to prevent welfare dependence in future generations.
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Ranøyen, I., Klöckner, C. A., Wallander, J., & Jozefiak, T. (2014). Associations Between Internalizing Problems in Adolescent Daughters Versus Sons and Mental Health Problems in Mothers Versus Fathers (The HUNT Study). J Child Fam Stud, .
Abstract: Very little research has examined familial aggregation of different mental health problems and distinguished between mothers and fathers as well as daughters and sons in large community samples. The purpose ofthe study was to examine associations between mental health problems in mothers versus fathers and internalizing problems in adolescent daughters versus sons. This crosssectional study used data from a Norwegian community study (the HUNT3 study) consisting of 5,732 adolescents (ages 13–18) who had one (N =2,503) or both parents (N=3,229) participating. In adolescents, we measured subjective well-being (SWB), self-esteem, and symptoms of anxiety, depression, and social anxiety, and in parents, symptoms of anxiety and depression, alcohol abuse, and maternal eating problems. We analyzed data with structural equation modeling. Findings showed that both maternal and paternal anxiety and depression were significantly associated with SWB, self-esteem, anxiety/depression, and social anxiety in both daughters and sons. The results indicated that associations between these problems were not dependent on parental or offspring sex. Parental alcohol abuse and maternal eating problems were not associated with any of the measured mental health problems in adolescents. Internalizing mental health problems appear aggregated in families, but do not seem to be affected by parental or offspring sex. When clinicians meet parents or adolescents displaying mental distress, it may be beneficial to assess the mental status of the entire family in order to evaluate the need for intervention.
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Sardahaee, F. S., Holmen, T. L., Micali, N., & Kvaloy, K. (2017). Effects of single genetic variants and polygenic obesity risk scores on disordered eating in adolescents – The HUNT study. Appetite, 118, 8–16.
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.
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