The healthy Nordic diet predicts muscle strength 10 years later in old women, but not old men.

Background: a number of nutrients have been found to be associated with better muscle strength and mass; however, the role of the whole diet on muscle strength and mass remains still unknown. Objective: to examine whether the healthy Nordic diet predicts muscle strength, and mass 10 years later among men and women. Methods: about 1,072 participants belong to the Helsinki Birth Cohort Study, born 1934-44. Diet was assessed with a validated food-frequency questionnaire during 2001-04. The Nordic diet score (NDS) was calculated. The score included Nordic fruits, vegetables, cereals, ratio of polyunsaturated to saturated fatty acids, low-fat milk, fish, red meat, total fat and alcohol. Higher scores indicated better adherence to the healthy Nordic diet. Hand grip strength, leg strength (knee extension) and muscle mass were measured during the follow-up, between 2011 and 2013. Results: in women, each 1-unit increase in the NDS was related to 1.83 N greater leg strength (95% confidence interval [CI] 0.14-3.51; P = 0.034), and 1.44 N greater hand grip strength (95% CI: 0.04-2.84; P = 0.044). Women in the highest quartile of the NDS had on average 20.0 N greater knee extension results, and 14.2 N greater hand grip results than those in the lowest quartile. No such associations were observed among men. The NDS was not significantly related to muscle mass either in men or women. Conclusions: adherence to the healthy Nordic diet seems to protect from weaker muscle strength in old women. Therefore, the healthy Nordic diet may help to prevent disability.

Objectively measured physical activity and physical performance in old age.

Background: physical performance is a key factor that determines how older people cope with daily tasks and maintain independency. There is strong evidence suggesting that physical activity (PA) is important in maintaining physical performance in old age. However, most studies have been done using self-reported PA. Our aim was to explore the association between objectively measured PA and physical performance in old age. Methods: we studied 695 participants (mean age 70.7 years, SD 2.7) from the Helsinki Birth Cohort Study. Physical performance was assessed with the Senior Fitness Test (SFT) and PA with a multisensory activity monitor SenseWear Pro 3 Armband. Results: total volume of PA was significantly associated with the overall SFT score (ß = 0.08; 95% confidence interval: 0.07-0.10, P < 0.001). There were no significant differences between men and women. Both light and moderate to vigorous level of PA were positively associated with the overall SFT score, while sedentary time was negatively associated with the overall SFT score. Conclusions: volume of objectively measured PA among older people was positively associated with the physical performance measured with a validated fitness test battery.

A healthy Nordic diet and physical performance in old age: findings from the longitudinal Helsinki Birth Cohort Study.

Epidemiological studies have shown that a number of nutrients are associated with better physical performance. However, little is still known about the role of the whole diet, particularly a healthy Nordic diet, in relation to physical performance. Therefore, we examined whether a healthy Nordic diet was associated with measures of physical performance 10 years later. We studied 1072 participants from the Helsinki Birth Cohort Study. Participants' diet was assessed using a validated 128-item FFQ at the mean age of 61 years, and a priori-defined Nordic diet score (NDS) was calculated. The score included Nordic fruits and berries, vegetables, cereals, PUFA:SFA and trans-fatty acids ratio, low-fat milk, fish, red and processed meat, total fat and alcohol. At the mean age of 71 years, participants' physical performance was measured using the Senior Fitness Test (SFT), and an overall SFT score was calculated. Women in the highest fourth of the NDS had on average 5 points higher SFT score compared with those in the lowest fourth (P for trend 0·005). No such association was observed in men. Women with the highest score had 17% better result in the 6-min walk test, 16% better arm curl and 20% better chair stand results compared with those with the lowest score (all P values<0·01). In conclusion, a healthy Nordic diet was associated with better overall physical performance among women and might help decrease the risk of disability in old age.

Association between dog ownership and type 2 diabetes in later life: the Helsinki birth cohort study.

Dog ownership has been reported to have beneficial effects on physical activity and emotional well-being, both known to reduce the risk for type 2 diabetes (T2D). The aim of this study was to evaluate the association between dog ownership during the whole life course and having T2D in later life. The study subjects consisted of 731 people (307 men and 424 women) from the Helsinki Birth Cohort Study. We assessed dog ownership with questionnaires, for every decade of life as well as current dog ownership. We investigated the associations between dog ownership and T2D with generalised estimating equation models and with generalised linear models. At a mean age of 71.0 (standard deviation [SD] 2.6) years, 13% of the participants had T2D. Dog ownership prior to the clinical examination was not associated with T2D (p ≥ 0.51). In men, but not in women, current dog owners had greater odds of having T2D compared with the non-owners when adjusted for age when clinically examined, socio-economic status, smoking, leisure-time physical activity, chronic diseases (OR = 3.32, 95% confidence interval 1.25-8.79, p = 0.016). In the age group of people around 70 years, dog ownership is not associated with reduced odds for developing T2D. Abbreviations: BMI: body mass index; CI: confidence interval; GEE: generalised estimating equation; HBCS: Helsinki Birth Cohort Study; KIHD: Kuopio Ischemic Heart Disease; LTPA: leisure-time physical activity; MET: metabolic equivalent of task; OGTT: oral glucose tolerance test; OR: Odds ratio; SD: standard deviation; SES: socio-economic status; T2D: type 2 diabetes.

The Healthy Nordic Diet and Mediterranean Diet and Incidence of Disability 10 Years Later in Home-Dwelling Old Adults.

BACKGROUND/OBJECTIVE: Diet has a major impact on a person's health. However, limited information exists on the long-term role of the whole diet on disability. We investigated the association of the healthy Nordic diet and the Mediterranean diet with incident disability 10 years later. DESIGN: Longitudinal, with a follow-up of 10 years. SETTINGS/PARTICIPANTS: A total of 962 home-dwelling men and women from the Helsinki Birth Cohort Study, mean age 61.6 years, who were free of disability at baseline. MEASUREMENTS: At baseline, 2001-2004, the Nordic diet score (NDS) and modified Mediterranean diet score (mMDS) were calculated using a validated 128-item food-frequency questionnaire. Higher scores indicated better adherence to the diet. Participants' incident disability was assessed during 2011-2013 by a self-reported questionnaire and was based on mobility limitations and difficulties to perform self-care activities. Analyses were performed using logistic regression and adjusted for potential confounding factors. RESULTS: In total, 94 participants (9.8%) developed mobility limitations and 45 participants (4.7%) developed difficulties in self-care activities during 10 year follow-up. The likelihood of having mobility limitations (odds ratio (OR) 0.42, 95% confidence interval (CI) 0.22-0.80) and difficulties in self-care activities (OR 0.38, 95% CI 0.15-0.94) were lower among those in the highest NDS tertile than among those in the lowest NDS tertile. Greater mMDS was associated with a lower disability incidence; however, the association was not statistically significant. CONCLUSIONS/IMPLICATIONS: Adherence to the healthy Nordic diet predicts 10-year incidence of mobility limitations and difficulties to perform self-care activities in old age and may thus be protective against disability in Nordic population.

Telomere length and physical performance among older people-The Helsinki Birth Cohort Study.

Telomere length has been suggested a biomarker of aging and is associated with several chronic diseases. However, the association between telomere length and physical performance is not well known. Using both cross-sectional and longitudinal data, we studied 582 women and 453 men from the Helsinki Birth Cohort Study at two time-points; a baseline examination in 2001-2004 at a mean age of 61 years and a follow-up examination approximately 10 years later in 2011-2013. Telomere length was measured both at baseline and at follow-up using real-time quantitative polymerase chain reaction. Physical performance was evaluated only at follow-up using the Senior Fitness Test (SFT), which assesses strength, flexibility and endurance. In women, shorter telomere length at follow-up (p = 0.044) and greater telomere attrition during follow-up time (p = 0.022) were associated with poorer physical performance after adjusting for covariates (age at baseline, smoking status, body mass index at baseline, follow-up time and educational attainment). No similar associations were found for men. This indicates that, at least in women, telomere length could potentially be used as a biomarker for physical performance, however, more longitudinal studies are needed to confirm this association.

Effect of maternal weight during pregnancy on offspring muscle strength response to resistance training in late adulthood.

PURPOSE: Maternal obesity can unfavorably influence offspring body composition, muscle strength, and possibly muscle's adaptability to training, but the human studies are scarce. Therefore, we aimed to investigate the effect of maternal obesity on offspring muscle strength responses to resistance training intervention in elderly frail women. MATERIALS/METHODS: Recruited participants were elderly frail women offspring of lean/normal weight mothers (n = 19, mean body mass index (BMI): 22.8 kg/m2, range: 19.9-24.5) or overweight/obese mothers (n = 16, mean BMI: 29.7 kg/m2, range: 28.2-34.2). Information on maternal BMI immediately prior to delivery was collected from the birth registers. All women participated in a 4-month supervised progressive resistance training intervention three times a week for 60 min. Predicted 1-RM of abdominal crunch, hip abduction, leg curl, leg press, seated row, and total strength were measured at baseline and after each month of training. RESULTS: According to rANOVA, strength increased significantly in both groups (p for time <0.001), but no significant between the group difference were detected (p for time x group interaction > 0.072). On average, muscle strength of the women offspring of overweight/obese mothers tended to be lower than in women offspring of lean/normal weight mothers, but the only significant difference was found in leg curl (p = 0.006). No significant differences between the groups were found in relative strength changes from baseline to 4-months. CONCLUSIONS: Muscle strength response to supervised resistance training is not modulated by maternal adiposity in late pregnancy in elderly frail female offspring.

Glucose regulation and physical performance among older people: the Helsinki Birth Cohort Study.

AIMS: To assess whether disturbances in glucose regulation are associated with impairment in physical performance during a 10-year follow-up. METHODS: 475 Men and 603 women from the Helsinki Birth Cohort Study were studied. Glucose regulation was evaluated with a 2-h 75-g oral glucose tolerance test (OGTT) in 2001-2004. Subjects were categorised as having either impaired fasting glucose (IFG), impaired glucose tolerance (IGT), newly diagnosed diabetes or previously known diabetes. Physical performance was assessed approximately 10 years later using the validated senior fitness test (SFT). The relationship between glucose regulation and the overall SFT score was estimated using multiple linear regression models. RESULTS: The mean age was 70.8 years for men and 71.0 years for women when physical performance was assessed. The mean SFT score for the whole population was 45.0 (SD 17.5) points. The SFT score decreased gradually with increased impairment in glucose regulation. Individuals with previously known diabetes had the lowest overall SFT score in the fully adjusted model (mean difference compared to normoglycaemic individuals - 11.56 points, 95% CI - 16.15 to - 6.98, p < 0.001). Both individuals with newly diagnosed diabetes and individuals with IGT had significantly poorer physical performance compared to those with normoglycaemia. No significant difference in physical performance was found between those with IFG and those with normoglycaemia. CONCLUSIONS: Among older people, impaired glucose regulation is strongly related with poor physical performance. More severe disturbances in glucose regulation are associated with a greater decrease in physical function, indicating the importance of diagnosing these disturbances at an early stage.

Dog Ownership from a Life Course Perspective and Leisure-time Physical Activity in Late Adulthood: The Helsinki Birth Cohort Study.

Objective We investigated the association between dog ownership during the life course and leisure-time PA (LTPA) in late adulthood. Methods We included 714 participants (mean age = 70.8 ± 2.6 years) from the Helsinki Birth Cohort Study (HBCS). Dog ownership for every decade of life, current dog ownership, and current LTPA in metabolic equivalents of task (MET) were assessed with questionnaires. Age and sex adjusted generalized estimating equation models and analysis of regression were applied for the analyses. Results No significant age by dog ownership interaction on total, conditioning or non-conditioning LTPA was found (p ≥ .68). However, after the age of 40 years, dog ownership was increasingly associated with greater total and non-conditioning LTPA in later life. The mean difference in total LTPA, which was mostly explained by non-conditioning LTPA, was largest between the current dog owners and non-owners (15.2 MET-hours/week, 95% CI: 5.5-24.8, p = .002). ConclusionsCurrent dog ownership is associated with 15.2 MET-hours/week greater total LTPA compared to the non-owners. The differences were already observable after the age of 40. Thus, dog ownership induced increase in LTPA can have a positive influence on the aging processes and consequently positively influence healthy active aging.

Body composition as a predictor of physical performance in older age: A ten-year follow-up of the Helsinki Birth Cohort Study.

BACKGROUND: This study assessed how different measures of body composition predict physical performance ten years later among older adults. METHODS: The participants were 1076 men and women aged 57 to 70 years. Body mass index (BMI), waist circumference, and body composition (bioelectrical impedance analysis) were measured at baseline and physical performance (Senior Fitness Test) ten years later. Linear regression analyses were adjusted for age, education, smoking, duration of the follow-up and physical activity. RESULTS: Greater BMI, waist circumference, fat mass, and percent body fat were associated with poorer physical performance in both sexes (standardized regression coefficient [ß] from -0.32 to -0.40, p < 0.001). Lean mass to BMI ratio was positively associated with later physical performance (ß = 0.31 in men, ß = 0.30 in women, p < 0.001). Fat-free mass index (lean mass/height2) in both sexes and lean mass in women were negatively associated with later physical performance. Lean mass residual after accounting for the effect of height and fat mass was not associated with physical performance. CONCLUSIONS: Among older adults, higher measures of adiposity predicted poorer physical performance ten years later whereas lean mass was associated with physical performance in a counterintuitive manner. The results can be used when appraising usefulness of body composition indicators for definition of sarcopenic obesity.

Telomere Length and Frailty: The Helsinki Birth Cohort Study.

OBJECTIVES: Telomere length is associated with aging-related pathologies. Although the association between telomere length and frailty has been studied previously, only a few studies assessing longitudinal changes in telomere length and frailty exist. DESIGN: Longitudinal cohort study. SETTING AND PARTICIPANTS: A subpopulation of the Helsinki Birth Cohort Study consisting of 1078 older adults aged 67 to 79 years born in Helsinki, Finland, between 1934 and 1944. MEASURES: Relative leukocyte telomere length (LTL) was measured using quantitative real-time polymerase chain reaction at the average ages of 61 and 71 years, and at the latter the participants were assessed for frailty according to Fried criteria. RESULTS: The mean ± SD relative LTLs were 1.40 ± 0.29 (average age 61 years) and 0.86 ± 0.30 (average age 71 years) for the cohort. A trend of shorter mean relative LTL across frailty groups was observed at 61 years (P = .016) and at 71 years (P = .057). Relative LTL at age 61 years was significantly associated with frailty: per 1-unit increase in relative LTL, the corresponding relative risk ratio (RRR) of frailty was 0.28 (95% confidence interval [CI] 0.08-0.97), adjusting for several confounders. Also, LTL at age 71 years was associated with frailty (RRR 0.18, 95% CI 0.04-0.81) after adjustment for sex, age, and adult socioeconomic status, but further adjustment attenuated the association. No associations between telomere shortening and frailty were observed during the 10-year follow-up. CONCLUSIONS: Shorter relative LTL was associated with frailty in cross-sectional and longitudinal analyses, but telomere shortening was not, suggesting that short LTL may be a biomarker of frailty.

Prenatal and childhood growth and physical performance in old age--findings from the Helsinki Birth Cohort Study 1934-1944.

Health in adulthood is in part a consequence of development and growth taking place during sensitive periods in early life. It has not been explored previously whether early growth is associated with physical performance in old age from a life course perspective taking into account health-related behavior, biological risk factors, and early life experiences. At a mean age of 71 years, physical performance was assessed using the Senior Fitness Test (SFT) in 1078 individuals belonging to the Helsinki Birth Cohort Study. We used multiple linear regression analysis to assess the association between the SFT physical fitness scores and individual life course measurements. Several adult characteristics were associated with physical performance including socioeconomic status, lifestyle factors, and adult anthropometry. Higher birth weight and length were associated with better physical performance, even after adjusting for potential confounders (all p values <0.05). The strongest individual association between life course measurements and physical performance in old age was found for adult body fat percentage. However, prenatal growth was independently associated with physical performance seven decades later. These findings suggest that physical performance in old age is at least partly programmed in early life.

Formulation in clinical interviews.

Formulation, according to Garfinkel and Sacks (1986 [1969]), refers to speakers' ways of talking about the current interaction. This article explores how formulations are used in clinical assessment interviews as a way of providing evidence of the respondent's capacities that are currently assessed. The videotaped data are drawn from the clinical interviews of unemployed adults and older persons. The data are analyzed using conversation analysis (CA). The article shows how formulation is achieved through vocalized and/or embodied actions (e.g., nodding index finger pointing), in conjunction with the speaker's gaze directed to the recipient. It argues that these formulations enable access to the shared epistemic domain of the current interaction. This domain is an interactional achievement and, as a resource, it allows the participants to designate viewpoints regarding the respondent's social competence. In sum, the paper demonstrates how participants can show an explicit orientation to the interactional substrate of interview.