Overall and peripheral lung function assessment by spirometry and forced oscillation technique in relation to asthma diagnosis and control.

BACKGROUND: Classic spirometry is effort dependent and of limited value in assessing small airways. Peripheral airway involvement, and relation to poor control, in asthma, has been highlighted recently. Forced oscillation technique (FOT) offers an effort-independent assessment of overall and peripheral lung mechanics. We studied the association between lung function variables, obtained either by spirometry or multifrequency (5, 11 and 19 Hz) FOT, and asthma diagnosis and control. METHODS: Spirometry measures, resistance at 5 (R5) and 19 Hz (R19), reactance at 5 Hz (X5), resonant frequency (fres ), resistance difference between 5-19 Hz (R5-R19) and Asthma Control Test scores were determined in 234 asthmatic and 60 healthy subjects (aged 13-39 years). We used standardized lung function variables in logistic regression analyses, unadjusted and adjusted for age, height, gender and weight. RESULTS: Lower FEV1 /FVC (OR [95% CI] 0.47 [0.32, 0.69]) and FEF50 (0.62 [0.46, 0.85]) per standard deviation increase, and higher R5 (3.31 [1.95, 5.62]) and R19 (2.54 [1.65, 3.91]) were associated with asthma diagnosis. Independent predictive effects of FEV1 /FVC and R5 or R19, respectively, were found for asthma diagnosis. Lower FEV1 /FVC and altered peripheral FOT measures (X5, fres and R5-R19) were associated with uncontrolled asthma (P-values < .05). CONCLUSIONS: Resistance FOT measures were equally informative as spirometry, related to asthma diagnosis, and, furthermore, offered additive information to FEV1 /FVC, supporting a complementary role for FOT. Asthma control was related to FOT measures of peripheral airways, suggesting a potential use in identifying such involvement. Further studies are needed to determine a clinical value and relevant reference values in children, for the multifrequency FOT measurements.

Consumption of fructose-sweetened beverages for 10 weeks reduces net fat oxidation and energy expenditure in overweight/obese men and women.

BACKGROUND/OBJECTIVES: The results of short-term studies in humans suggest that, compared with glucose, acute consumption of fructose leads to increased postprandial energy expenditure and carbohydrate oxidation and decreased postprandial fat oxidation. The objective of this study was to determine the potential effects of increased fructose consumption compared with isocaloric glucose consumption on substrate utilization and energy expenditure following sustained consumption and under energy-balanced conditions. SUBJECTS/METHODS: As part of a parallel arm study, overweight/obese male and female subjects, 40-72 years, consumed glucose- or fructose-sweetened beverages providing 25% of energy requirements for 10 weeks. Energy expenditure and substrate utilization were assessed using indirect calorimetry at baseline and during the 10th week of intervention. RESULTS: Consumption of fructose, but not glucose, led to significant decreases of net postprandial fat oxidation and significant increases of net postprandial carbohydrate oxidation (P<0.0001 for both). Resting energy expenditure (REE) decreased significantly from baseline values in subjects consuming fructose (P=0.031) but not in those consuming glucose. CONCLUSIONS: Increased consumption of fructose for 10 weeks leads to marked changes of postprandial substrate utilization including a significant reduction of net fat oxidation. In addition, we report that REE is reduced compared with baseline values in subjects consuming fructose-sweetened beverages for 10 weeks.

Changes in food habits in healthy Swedish adolescents during the transition from adolescence to adulthood.

OBJECTIVE: To investigate the change in food habits in Swedish adolescents between 15 and 21 y of age with reference to age, sex, region and socioeconomic background. DESIGN: A longitudinal study from 1993 to 1999. SETTING: Two different regions in Sweden, the university city of Uppsala and the industrial town of Trollhättan. SUBJECTS: On three different occasions, 1993, 1995 and 1999, 208 adolescents, 96 males and 112 females, were studied. METHODS: A food frequency questionnaire containing 29 different food groups was used. The questionnaire also contained questions about food habits and amounts of some food items and socioeconomic conditions of the participants and their families. RESULTS: At 17 and 21 y of age, the adolescents consumed significantly more often pasta, vegetables, coffee and tea compared to age 15, while the frequency consumption of fat spread, milk, bread, potatoes, carrots and buns and biscuits decreased. The changes between 15 and 17 were smaller than between age 17 and 21. At age 21, the males decreased their intake of fruit, while the females decreased their intake of meat. No-meat consumers among females increased from 2 to 13%. Higher educational level of the mothers of the adolescents was associated with more frequent consumption of vegetables and pasta between ages 17 and 21. Milk consumption decreased significantly in both sexes. Breakfast habits did not change: 90% had breakfast five times/week or more. CONCLUSIONS: Food habits change significantly during adolescence along with lifestyle changes. Therefore, health promotion during adolescence ought to be more supported by the society.

Longitudinal study and cost-benefit analysis of the effect of early treatment of posterior cross-bites in the primary dentition.

The aim of this study was to follow longitudinally a cohort of preschool children regarding the prevalence of lateral cross-bites and the effect of treatments carried out. Two-hundred-and-twenty-four children were examined when they were 3-5 years old and re-examined at 13-15 years of age. Orthodontic treatment of lateral cross-bites was registered from annual dental records from the Public Dental Service. In the primary dentition, 23.3 per cent of the children showed lateral cross-bites, of whom 5.7 per cent showed a lateral edge-to-edge relation. Selective grinding was carried out in the Public Dental Service in 62 per cent of the cross-bite children. Correction was registered in 64 per cent of these cases. Nine (45 per cent) of the 20 children with untreated lateral deviation showed spontaneous correction. Of the 171 children without cross-bites in the primary dentition, 14 (8 per cent) developed cross-bites in the permanent dentition. Although the benefits of early treatment for the developing dentition are obvious for functional reasons, the effectiveness of grinding, the type of treatment and the timing can be discussed from a cost-benefit point of view.