The effect of a smoking cessation program for patients in cancer treatment: a quasi-experimental intervention study.

BACKGROUND: Compared to non-smokers, smokers have reduced effects of cancer treatment, and increased risk of treatment-related toxicity. Quitting smoking can improve treatment effects and reduce side effects. This study reports on the potential impact of a smoking cessation program on smoking cessation rates among patients in cancer treatment. MATERIAL AND METHODS: Cancer patients 18 years and older who smoked, with survival prognosis ≥12 months, not suffering dementia or other mental illness, and who were referred to cancer treatment at six Norwegian hospitals were invited to participate. The study took place from 2017 to 2020 and used a pre-test-posttest non-equivalent control group design. The intervention group received structured smoking cessation guidance based on Motivational Interviewing combined with cost-free nicotine replacement products, while the control group received standard smoking cessation treatment. Self-reported smoking status were registered at baseline and at 6 months' follow up. RESULTS: 76% of patients smoked at baseline and 44% at follow-up in the intervention group, correspondingly 72% and 49% in the control group. In an analysis of differences in within-person change, the reduction in the intervention group was 13 percentage points larger (95% CI = (0.25, -0.005), p = 0.041). Adjusting for gender, age, education, labour market participation and partnership status did not attenuate the estimated effect (18 percentage point difference, 95% CI = (-0.346, -0.016), p = 0.032). Demographic factors and dropout rate differed somewhat between the groups with a higher dropout rate in the intervention group, 54% vs. 51%, respectively). CONCLUSION: Offering a structured smoking cessation program based on Motivational Interviewing and cost-free nicotine replacement products to cancer patients can increase cessation rates in comparison to standard smoking cessation care.

Associations between snus use, body mass index and general health in a cross-sectional population-based sample of women.

BACKGROUND: In Norway, snus use among women has increased substantially over the last decade, particularly in younger age groups. Snus use is associated with increased morbidity among men, but few studies have addressed health consequences of snus use among women. AIM: To investigate the associations between body mass index (BMI) and female snus use, and between self-rated general health and female snus use. METHODS: A nationally representative net sample of 13,756 women in Norway, aged 18-45 years, participated in a survey on lifestyle and health. Ordinal logistic regression was applied to address associations between snus use and BMI/general health, adjusting for age and lifestyle factors. RESULTS: Compared to never users of snus, daily snus users had a lower likelihood of high BMI (OR: 0.83, 95% CI: 0.68-1.00), a higher likelihood of low BMI (OR: 1.63, 95% CI: 1.14-2.33), and a higher likelihood of poor/fair health (OR: 1.43, 95% CI: 1.08-1.90). Former and occasional snus users did not differ from never users in terms of BMI or general health in multiply adjusted models. Daily smokers had the highest likelihood of reporting poor/fair health (OR: 2.18, 95% CI: 1.8-2.63) relative to never smokers. CONCLUSIONS: Daily female snus use was associated with a lower likelihood of being overweight, and a higher likelihood of being underweight. Moreover, daily snus use was associated with a higher likelihood of worse general health. Former and occasional female snus use was not associated with BMI or general health.

Lifestyle Correlates of Female Snus Use and Smoking: A Large Population-Based Survey of Women in Norway.

INTRODUCTION: While smoking in Norway has become less prevalent, snus use has increased, including among women. The aims of this study were to describe female snus use and its correlates, and to contrast patterns of snus use and smoking. METHODS: In 2011-2012, data on tobacco use, age, education, alcohol consumption, sexual behaviors, and physical activity were collected from a population based sample of 13 756 Norwegian women aged 18-45 years, using a self-administered questionnaire. RESULTS: Ever-use prevalence of snus ranged from 29.6% to 4.5% among those aged 18-19 years and 40-45 years, respectively. In contrast, the corresponding figures for smoking were 24.1% and 44.1%. Among snus users, 54.1% and 22.8% of 18-19 and 40 to 45-year-olds had never smoked, respectively. Debut age for snus use increased markedly with age, and was higher than debut age for smoking. Female snus use was positively associated with intermediate education, alcohol consumption, number of sexual partners, and hard physical activity. Smoking was also positively associated with alcohol consumption and number of sexual partners, but negatively associated with physical activity and education. CONCLUSION: While most snus users among older women were former or current smokers, this was not the case among younger women. Low snus debut age and extensive snus use among younger women suggest that measures to reduce snus use should be targeted at young adolescents. The correlates of female snus use and smoking were not identical, and were similar to those previously documented for men.

Accumulation of material and lifestyle problems among daily smokers in Norway 1999 to 2013 - a cross-sectional analysis.

BACKGROUND: International studies have found that smoking is increasingly concentrated among lesser-privileged individuals and marginalised groups, indicating a possible rise in daily smokers' accumulated problem burden. The study asks whether material shortages and occurrence of behaviours related to poor health are increasing among daily smokers in Norway, and whether the time trends differ between daily smokers on the one hand, and occasional and non-smokers on the other. METHOD: The study used data acquired by biennial cross-sectional surveys from 1999 to 2013 of the adult (i.e. over 15) Norwegian population. Time trends in individual and accumulated material and lifestyle problems among daily smokers and non-daily and non-smokers combined were assessed using logistic regression analyses for men and women separately. RESULTS: The accumulation of problems in any isolated survey is higher among daily smokers than other respondents. Over the longer term, however, there are few signs of decline in any group, except in regards to frequent alcohol drinking, which increased in all studied groups. The only problem factor differentiating daily smokers from occasional smokers/non-smokers that did change during the period was quality of diet. While problem accumulation declined in all but one group, i.e., male daily smokers, the difference between them and the group of occasional smokers and non-smokers was not significant. CONCLUSION: Daily smokers are generally worse off than occasional smokers and non-smokers combined. However, the accumulation of material problems and health-risk behaviours by daily smokers and occasional smokers/non-smokers did not change significantly and all groups had fewer problems in 2013 than in 1999.

Nondaily smoking: a population-based, longitudinal study of stability and predictors.

BACKGROUND: Nondaily smoking appears to have remained stable in Western countries in recent years, alongside a steep decline in daily smoking. Nondaily smoking increases the risk of several diseases and premature mortality, but our knowledge about nondaily smoking is limited. The present study was designed to examine the stability of nondaily smoking during young adulthood, and to identify adolescent factors predictive of nondaily smoking compared with nonsmoking and non-nicotine-dependent and nicotine-dependent daily smoking. METHODS: A population-based sample (n = 942) of Norwegians was followed up by surveys for 13 years, from adolescence to young adulthood. Information about smoking patterns, nicotine dependence, school achievement, parents' and peers' smoking, and parental monitoring was collected. Data on parental and participants' education were obtained from a national register. RESULTS: Of all nondaily smokers at age 21 years, 26% were still nondaily smokers at 27 years, while 17% had become daily smokers and 57% had quit. Bivariate analyses revealed that young adult nondaily smokers did not differ from nonsmokers on any of the included variables, while a number of differences in parental, peers' and individual characteristics were observed between nondaily smokers and the two categories of smokers in young adulthood. Longitudinal analyses revealed that unorganized leisure time activities and peers' smoking differentiated nondaily smoking from nonsmoking. Higher educational achievement and less parental binge drinking predicted nondaily smoking and differentiated it from both categories of daily smoking. CONCLUSIONS: The degree of nondaily smoking-stability from 21 to 27 years of age was modest, and most nondaily smokers quit smoking in the course of young adulthood. Young adult nondaily smokers were quite similar to nonsmokers, but differed substantially from both nicotine-dependent and nondependent daily smokers. The study suggests that nondaily smoking--at least in the absence of traditional risk factors for smoking--is usually a transitory behavior, with most people returning to nonsmoking.

Do smoking and fruit and vegetable intake mediate the association between socio-economic status and plasma carotenoids?

BACKGROUND: The aim was to study whether the association between educational attainment and antioxidant status is mediated by smoking and fruit and vegetable intake. METHODS: Cross-sectional analyses of the Oslo Youth Study 2006 wave were carried out. Information about education, smoking habits and diet was collected by questionnaire for 261 subjects (142 women and 119 men aged 38-42 years). Blood samples, height and weight measurements were taken by the participants' General Practitioner. Blood were analysed for plasma carotenoids. Linear regression analyses were used to examine whether smoking and fruit and vegetable intake mediate the association between education and plasma carotenoids. RESULTS: Educational level was positively associated with ß-cryptoxanthin, α-carotene and lutein/zeaxanthin, but not with total carotenoids, ß-carotene or lycopene. Education was negatively associated with smoking and positively associated with fruit and vegetable intake. Smoking was negatively associated with ß-cryptoxanthin, and fruit and vegetable intake was positively associated with ß-cryptoxanthin (adjusted for educational level). Moreover, cigarette consumption mediated the association between education and ß-cryptoxanthin by 37%, while fruit and vegetable intake mediated this association by 18%. The total mediation effect was 55%. CONCLUSION: Smoking seemed to be more important as a mediator between education and plasma levels of ß-cryptoxanthin than the intake of fruit and vegetables, but more studies are needed to establish the relative importance of smoking and diet as mediators of the association between education and antioxidant status.

[Occasional smoking in Norway]. / Av-og-til-røyking i Norge.

BACKGROUND: In recent decades, daily smoking has become less common, while occasional smoking has stayed at the same level. The purpose of the study is to describe occasional smokers on the basis of their smoking behaviour and socio-demographic characteristics. MATERIAL AND METHOD: Data from Statistics Norway's quarterly surveys of tobacco use in 2010 and 2011 were used. Information on smoking habits, smoking-related behaviour and the respondents' attitudes to their own smoking was collected in telephone interviews. RESULTS: Of the 8,700 men and women aged 16-74 (response rate 57%) who were included, altogether 1,583 were daily smokers and 907 occasional smokers. The occasional smokers were younger, more frequently lived in large cities and had a higher level of education and income than the daily smokers. Twenty-nine of 174 (17%) occasional smokers used snus on a daily basis, compared to 10 of 394 (3%) of the daily smokers. The occasional smokers had great confidence in their ability to quit: 95% responded that they would be smoke-free in five years, compared to 55% of the daily smokers (n = 2,158). Fifty-five (35%) of the occasional smokers lit up several times weekly (16 cigarettes per week on average), while the remaining (65%) smoked only once per week as a maximum (five cigarettes per week on average). Those who smoked several times each week had attitudes to their own smoking and usage pattern for tobacco that were similar to those of the daily smokers. Nearly half of the occasional smokers defined themselves as non-smokers. INTERPRETATION: Norwegian occasional smokers are a heterogeneous group in terms of their smoking pattern and frequency, and many define themselves as non-smokers.

Parental education as a predictor of offspring behavioural and physiological cardiovascular disease risk factors.

BACKGROUND: Childhood socio-economic disadvantage has been shown to be associated with an elevated rate of cardiovascular disease (CVD) events in adulthood. The objective of this study is to examine associations between mothers' and fathers' education and offspring CVD risk factors. METHODS: The Oslo Youth Study (n = 498) was initiated in 1979. Children (age 11-15 years) attending six schools and their parents were included. Information on education was collected for parents and participants. Participants were followed through 2006 (age 40 years). Information about physical activity, diet, smoking, binge drinking, body mass index (BMI), s-cholesterol, s-triglycerides and blood pressure was collected in 1981, 1991 and 2006. RESULTS: Fathers' education was inversely associated with participants' BMI at 15 and 25 years, cholesterol at 25 and 40 years, triglycerides at 25 years and systolic blood pressure at 15 and 25 years (regression coefficients -0.18 to -0.11; P < 0.05 for all). The effects were weakened after adjusting for participants' own education. Maternal education showed no association with these risk factors. After controlling for participants' own education, associations between parental education and behavioural risk factors in adulthood were few. CONCLUSION: Any impact of parental education on offspring CVD risk factors seemed to be mediated via subject's own education. Parental education offered little predictive capacity for offspring CVD risk factors.

Hardcore smokers in Norway 1996-2009.

INTRODUCTION: The aim of this study was to investigate changes in the relative proportion of hardcore smokers (HCS) in Norway for the years 1996-2009. METHODS: Data were derived from Statistics Norway's annually cross-sectional representative samples of the adult population. The total sample size of smokers each year was between 250 and 500. The outcome measure was HCS, defined by their intention not to quit smoking and absence of attempts to quit during the last 12 months. Logistic regression analysis was conducted to estimate the association between time (survey year) and the number of HCS. RESULTS: We identified three groups of smokers: occasional smokers, daily non-HCS, and HCS. The relative proportion of HCS declined in the period 1996-2009, from 30% to 23%. A model adjusted for gender, age, educational level, and the use of snus (smokeless tobacco) showed the same downward trend. CONCLUSIONS: Within this sample of Norwegian smokers, the relative share of HCS is not increasing. This knowledge is important for tobacco prevention policy. The result does not support a hardening hypothesis regarding changes in the size of the group of HCS. Further analysis is needed to investigate individual resistance to smoking cessation.

Methods Used in Smoking Cessation and Reduction Attempts: Findings from Help-Seeking Smokers.

In addition to traditional smoking cessation methods like nicotine replacement therapy (NRT), new methods such as mobile applications and e-cigarettes have been added to the toolbox. The purpose of this study was to examine which methods smokers currently use in quit or reduction attempts and map characteristics of users of the various methods. In this study, participants were smokers who visited a website or called a quit line for smoking cessation and who were currently in quit or reduction attempts (N = 740). Data were collected in Norway in 2013-2017 through a web survey. Most smokers were currently trying to quit, and the most frequently used methods were a smoking cessation app for mobile phones, nicotine replacement therapies (NRTs), and e-cigarettes. Logistic regression analyses identified older daily smokers with high cigarette consumption as NRT users, while the users of a cessation app were younger females. The use of e-cigarettes was associated with older, low educated smokers with low cigarette consumption. The use of the mobile phone app was associated with having made several recent quit attempts. The study provides insight into help-seeking smokers' preferences for smoking cessation methods and user characteristics. This knowledge is relevant for further work in smoking cessation planning and policies.

Biomarker-assessed passive smoking in relation to cause-specific mortality: pooled data from 12 prospective cohort studies comprising 36 584 individuals.

AIMS: While investigators have typically quantified the health risk of passive (secondhand) smoking by using self-reported data, these are liable to measurement error. By pooling data across studies, we examined the prospective relation of a biochemical assessment of passive smoking, salivary cotinine, with mortality from a range of causes. METHODS: We combined data from 12 cohort studies from England and Scotland initiated between 1998 and 2008. A total of 36 584 men and women aged 16-85 years of age reported that they were non-smoking at baseline, provided baseline salivary cotinine and consented to mortality record linkage. RESULTS: A mean of 8.1 years of mortality follow-up of 36 584 non-smokers (16 792 men and 19 792 women) gave rise to 2367 deaths (775 from cardiovascular disease, 779 from all cancers and 289 from smoking-related cancers). After controlling for a range of covariates, a 10 ng/mL increase in salivary cotinine was related to an elevated risk of total (HRs; 95% CI) (1.46; 1.16 to 1.83), cardiovascular disease (1.41; 0.96 to 2.09), cancer (1.49; 1.00 to 2.22) and smoking-related cancer mortality (2.92; 1.77 to 4.83). CONCLUSIONS: Assessed biomedically, passive smoking was a risk factor for a range of health outcomes known to be causally linked to active smoking.

Monitoring young lifestyles (MyLife) - a prospective longitudinal quantitative and qualitative study of youth development and substance use in Norway.

PURPOSE: The Monitoring Young Lifestyles (MyLife) project was initiated as an integrated quantitative and qualitative prospective investigation of correlates, causes, and consequences of adolescent substance use and other addictive behaviours in Norway. PARTICIPANTS: The MyLife cohort was recruited from middle schools in Norway, which were selected from low, medium and high standard of living areas in both rural and urban regions of the country. A total of 3512 eighth, ninth and tenth graders (55% girls) from 33 schools were enrolled in the quantitative project arm (QT), while a total of 120 eighth graders (52% girls) from six schools were enrolled in the qualitative project arm (QL). FINDINGS TO DATE: QT baseline was conducted in the fall of 2017, when 2975 adolescents completed an online questionnaire at school during a regular class time. A total of 2857 adolescents participated in the first QT follow-up 1 year later. QL baseline was conducted across the fall semesters of 2014 (one class) and 2015 (five classes), when a total of 118 eighth graders completed face-to-face interviews. QL follow-ups were conducted in the spring of 2015 and fall of 2017 (n=98) for group interviews, and in the spring of 2017 and 2018 (n=95) for individual interviews. In terms of additional data sources, a total of 3035 parents consented to own participation, of which 1899 completed a brief online questionnaire at QT baseline in late 2017. School principals completed brief surveys at the same time. FUTURE PLANS: Both QT and QL arms have planned follow-ups through 2021. Consents were obtained for individual-level linkages of adolescent and parental quantitative surveys to each other, as well as to the information available in multiple national registries and databases. These supplemental data sources will provide key information on additional putative exposures as well as on the long-term health, educational, and social outcomes of the MyLife participants.

Biomarker assessment of tobacco smoking exposure and risk of dementia death: pooling of individual participant data from 14 cohort studies.

BACKGROUND: While there is a suggestion that self-reported tobacco smoking may be a risk factor for dementia, to date, it has not been possible to explore the thresholds at which this exposure elevates risk. Accordingly, our aim was to relate cotinine, a biomarker of tobacco smoking, to risk of dementia death. METHODS: We pooled 14 prospective cohort studies that held data on cotinine (plasma or saliva), covariates and death records. RESULTS: In the 33 032 study members (17 107 women) with salivary cotinine data, a mean duration of 8.3 years of follow-up gave rise to 135 deaths ascribed to dementia; while in 15 130 study members (7995 women) with plasma cotinine data, there were 119 dementia deaths during 14.3 years of mortality surveillance. After multiple adjustment, both plasma cotinine (per 1 SD higher cotinine; 95% CI 1.29; (1.05 to 1.59)) and salivary cotinine (1.10 (0.89 to 1.36)) were positively related to dementia risk, with stronger effects apparent for plasma. CONCLUSION: Our finding that plasma cotinine was related to an elevated risk of dementia death warrants testing in studies with measures of disease onset as opposed to just mortality.

[Five a day--ten years later]. / Fem om dagen--ti år etter.

BACKGROUND: Measures aimed at increasing fruit and vegetable consumption were implemented in the 1990ies. Official recommendations were published in 1996. The objective of this paper is to describe fruit and vegetable intake before and after introduction of the official recommendation. MATERIAL AND METHODS: Data were obtained from Food Balance Sheets, household consumption surveys, the WHO's study "Health Behaviour in School-Aged Children" and market surveys. The development in fruit and vegetable consumption after 1996 is compared to that in previous years. RESULTS: Food supply and household consumption surveys show that fruit and vegetable consumption have increased the last 10 years. The increase after 1996 seems to be of the same relative magnitude as the years before. Pupils' fruit intake varied between 1993 and 2005, and vegetable intake increased between 1993 and 2005. The proportion of adults that had fruit or vegetables at least daily increased considerably between 1999 and 2005. INTERPRETATION: It is difficult to give an unambiguous answer as to whether there has been an accelerating increase in consumption after 1996, representing a trend break. A large proportion of the population were still not having fruit or vegetables daily in 2005. Increased efforts are necessary to reach the target of at least five portions of fruit and vegetables daily.

Social Media Use and Episodic Heavy Drinking Among Adolescents.

Objectives Little is known about the consequences of adolescent social media use. The current study estimated the association between the amount of time adolescents spend on social media and the risk of episodic heavy drinking. Methods A school-based self-report cross-sectional study including 851 Norwegian middle and high school students (46.1% boys). MEASURES: frequency and quantity of social media use. Frequency of drinking four or six (girls and boys, respectively) alcoholic drinks during a single day (episodic heavy drinking). The MacArthur Scale of Subjective Social Status, the Barratt Impulsiveness Scale - Brief, the Brief Sensation Seeking Scale, the Patient Health Questionnaire-9 items for Adolescents, the Strengths and Difficulties Questionnaire Peer Relationship problems scale, gender, and school grade. Results Greater amount of time spent on social media was associated with greater likelihood of episodic heavy drinking among adolescents ( OR = 1.12, 95% CI (1.05, 1.19), p = 0.001), even after adjusting for school grade, impulsivity, sensation seeking, symptoms of depression, and peer relationship problems. Conclusion The results from the current study indicate that more time spent on social media is related to greater likelihood of episodic heavy drinking among adolescents.

Surveys of Norwegian youth indicated that breast feeding reduced subsequent risk of obesity.

BACKGROUND AND OBJECTIVE: Breast-feeding protects against overweight in childhood, while it is uncertain if it is protective against adolescent and adult overweight. The objective of this study was to examine whether having been breast fed protects against adolescent and adult overweight and obesity. METHODS: Participants in the Oslo Youth study examined in 1979/1981 (n=635, mean age 13.1 years) and in 1999. Weight and height were measured in 1979/1981 and self-reported in 1999. Breast-feeding information was provided by the parents in 1979/1981. Potential confounders adjusted for included parents' body mass index and education, mother's smoking habits, participants' physical activity, smoking status, education and energy intake. RESULTS: Comparing those having been breast fed more than 3 months with those never breast fed, the adjusted odds ratios (95% confidence interval [CI]) between the two groups were 0.27 (0.13-0.56) for being overweight and 0.15 (0.03-0.72) for being obese in adolescent. In adulthood, the corresponding odds ratios were 0.64 (0.33-1.26) and 0.34 (0.12-1.01), respectively. CONCLUSION: Breast feeding during infancy appears to protect against adolescent overweight and obesity, while the effect on adult weight status is weaker. With increasing age, the impact of any protective physiologic mechanisms of breast feeding seen earlier in life tends to diminish.

Psychosocial predictors of eating habits among adults in their mid-30s: the Oslo Youth Study follow-up 1991-1999.

BACKGROUND: The predictive value of the psychosocial constructs of Theory of Planned Behaviour (TPB) on subsequent dietary habits has not been previously investigated in a multivariate approach that includes demographic factors and past dietary behaviour among adults. The aim of this study was to investigate to what extent TPB constructs, including intention, attitudes, subjective norms, perceived behavioural control, and perceived social norms, measured at age 25 predicted four eating behaviours (intake of fruits and vegetables, whole grains, total fat and added sugar) eight years later. METHODS: Two hundred and forty men and 279 women that participated in the Oslo Youth Study were followed from 1991 to 1999 (mean age 25 and 33 years, respectively). Questionnaires at baseline (1991) included the constructs of the TPB and dietary habits, and at follow-up (1999) questionnaires included demographic factors and diet. For the assessment of diet, a food frequency questionnaire (FFQ) with a few food items was used at baseline while an extensive semi-quantitative FFQ was used at follow-up. RESULTS: Among men, attitudes, subjective norms and previous eating behaviour were significant predictors of fruit and vegetable intake, while education and past eating behaviour were predictive of whole grain intake in multivariate analyses predicting dietary intake at follow-up. For women, perceived behavioural control, perceived social norms and past behaviour were predictive of fruit and vegetable intake, while subjective norms, education and past eating behaviour were predictive of whole grain intake. For total fat intake, intention was predictive for men and perceived behavioural control for women. Household income and past consumption of sugar-rich foods were significant predictors of added sugar intake among men, while past intake of sugar-rich foods was a significant predictor of added sugar intake among women. CONCLUSION: After adjusting for potential confounding factors, all psychosocial factors assessed among young adults appeared predictive of one or more eating behaviours reported eight years later. Results point to the influence of psychosocial factors on future eating behaviours and the potential for interventions targeting such factors.

Can vitamin D supplementation reduce the risk of fracture in the elderly? A randomized controlled trial.

Randomized controlled trials have shown that a combination of vitamin D and calcium can prevent fragility fractures in the elderly. Whether this effect is attributed to the combination of vitamin D and calcium or to one of these nutrients alone is not known. We studied if an intervention with 10 microg of vitamin D3 per day could prevent hip fracture and other osteoporotic fractures in a double-blinded randomized controlled trial. Residents from 51 nursing homes were allocated randomly to receive 5 ml of ordinary cod liver oil (n = 569) or 5 ml of cod liver oil where vitamin D was removed (n = 575). During the study period of 2 years, fractures and deaths were registered, and the principal analysis was performed on the intention-to-treat basis. Biochemical markers were measured at baseline and after 1 year in a subsample. Forty-seven persons in the control group and 50 persons in the vitamin D group suffered a hip fracture. The corresponding figures for all nonvertebral fractures were 76 persons (control group) and 69 persons (vitamin D group). There was no difference in the incidence of hip fracture (p = 0.66, log-rank test), or in the incidence of all nonvertebral fractures (p = 0.60, log-rank test) in the vitamin D group compared with the control group. Compared with the control group, persons in the vitamin D group increased their serum 25-hydroxyvitamin D concentration with 22 nmol/liter (p = 0.001). In conclusion, we found that an intervention with 10 microg of vitamin D3 alone produced no fracture-preventing effect in a nursing home population of frail elderly people.

Predictors and tracking of body mass index from adolescence into adulthood: follow-up of 18 to 20 years in the Oslo Youth Study.

OBJECTIVES: To examine tracking of body mass index (BMI) (weight in kilograms divided by the square of height in meters) from age 15 to 33 years, to examine the effect of adolescent and adult health-related behavior and parents' BMI and education on adult BMI; and to examine changes in lifestyle factors as predictors of adult overweight and obesity. METHODS: A longitudinal study with 18 to 20 years of follow-up in a cohort from Oslo, Norway (N = 485); mean age was 15 years at baseline. Weight, height, physical fitness, leisure time physical activity (LTPA), smoking, and education were assessed at baseline and follow-up. Parents' height, weight, and education were assessed at baseline. RESULTS: Tracking of BMI from age 15 to 33 years was high (r = 0.54). Adolescent BMI, father's BMI, the subject's own LTPA, adult smoking, and sex explained 44.1% of the variation in adult BMI. The odds ratio (95% confidence interval) of having a BMI of 25 or more as an adult was 0.07 (0.03-0.14) for lowest vs highest quartile of adolescent BMI. The corresponding odds ratio of having a BMI of 30 or more was 0.02 (0.002-0.14). Those who increased their LTPA level between adolescence and adulthood had a lower risk of adult overweight than those with a stable low LTPA level. CONCLUSIONS: Tracking of BMI from adolescence into adulthood was substantial. Changes in LTPA between adolescence and adulthood predicted the risk of adult overweight, suggesting that the foundation for adult body weight is laid during adolescence. Implications of this would be to emphasize physical activity among youths.