Impact of gender on vitamin D deficiency in morbidly obese patients: a cross-sectional study.

BACKGROUND/OBJECTIVE: Obesity is associated with vitamin D deficiency (25-hydroxyvitamin D (25(OH)D) <50 nmol/l). We aimed to examine the effect of gender on vitamin D status in severe obesity. SUBJECTS/METHODS: Cross-sectional study of 2026 morbidly obese patients examined consecutively at a tertiary care centre between November 2005 and June 2010. Serum 25(OH)D concentration and use of vitamin D supplements were registered in all patients. Total vitamin D intake (µg/day) was assessed in a subgroup of 154 patients using a validated food frequency questionnaire. RESULTS: The male (n=690) and female (n=1336) patients had a mean (s.d.) age of 45.0 (12.1) years and 42.2 (12.2) years (P<0.001), body mass index (BMI) of 44.6 (6.0) kg/m(2) and 44.3 (5.9) kg/m(2) (P=0.30) and waist circumference (WC) of 140 (13) cm and 127 (13) cm (P<0.001), respectively. Male patients had significantly lower mean 25(OH)D concentrations than female patients 50.0 (22.0) nmol/l versus 53.6 (22.4) nmol/l (P=0.001) and a higher rate of vitamin D deficiency (56% versus 47%; P<0.001). Obese men had significantly higher odds of vitamin D deficiency than women (odds ratio=1.41; 95% confidence interval: 1.17-1.70, P<0.001), also after adjustment for season, age, current smoking, intake of vitamin D supplements, BMI and WC (odds ratio=1.39; 95% confidence interval: 1.10-1.76). CONCLUSIONS: Morbidly obese Norwegian men seeking weight loss treatment have significantly higher odds of vitamin D deficiency than women. Monitoring of 25(OH)D concentrations in obese patients should therefore take gender into account.

Validation of a semi-quantitative food-frequency questionnaire used among 12-month-old Norwegian infants.

OBJECTIVE: To assess the validity of a semi-quantitative food-frequency questionnaire (SFFQ) used in a large nation-wide dietary survey among 12-month-old Norwegian infants. METHODS: The SFFQ was administered to the parents about 1 week before the infants turned 12-month-old. The participants filled in the SFFQ and 1-2 weeks later they kept weighed food records for a total of 7 days. Both methods were completed for 64 infants. RESULTS: The SFFQ overestimated energy intake with 25% and gave significantly higher estimates of all nutrients compared with the records, except for calcium. Much of the difference between the methods disappeared when nutrient density was compared. Spearman correlation coefficients between pairwise measurements of nutrient intakes from the food records and the SFFQ ranged from 0.18 for vitamin D to 0.72 for polyunsaturated fatty acid intake (median r=0.50). On average 38% of the infants were classified in the same quartile with the two methods, and 3% in the opposite quartile. The correlations for food items varied from 0.28 for sweetened drinks to 0.83 for commercial porridge (median r=0.62). CONCLUSION: This study indicated that the SFFQ overestimates average absolute nutrient intakes. However, the questionnaire gave better estimates for average nutrient densities than for absolute nutrient intakes. The capability of the questionnaire to rank infants according to intake of nutrients and food items was moderate, but at the same level as others have observed with food-frequency questionnaires.

Infant feeding practices and associated factors in the first six months of life: the Norwegian infant nutrition survey.

AIM: To describe and evaluate infant feeding practices during the first 6 mo of life in relation to recommendations, and to study infant feeding practices in relation to maternal and infant characteristics. METHODS: Data from 2383 Norwegian infants aged 6 mo were collected by a self-administered semi-quantitative food-frequency questionnaire measuring feeding practices at 6 mo and feeding practices retrospectively at < or = 5.5 mo of age. RESULTS: Only 1% of the infants had never been breastfed. The proportion of breastfed infants was 96% at 1 mo, 85% at 4 mo and 80% at 6 mo. The proportion of exclusively breastfed infants was 90% at 1 mo, 44% at 4 mo and 7% at 6 mo. Twenty-one percent of the infants were introduced to solid foods before the age of 4 mo. For exclusive breastfeeding at 4 mo, breastfeeding at 6 mo and timely introduction of solid foods (not before 4 mo) significant positive trends were found for maternal age, education and degree of urbanization. Negative associations were found for maternal smoking. Furthermore, exclusive breastfeeding at 4 mo was associated with infant gender and marital status, and the odds of breastfeeding at 6 mo significantly decreased with decreasing infant birthweight. Finally, both the odds of exclusive breastfeeding at 4 mo and of breastfeeding at 6 mo increased with increasing numbers of children. CONCLUSION: These results indicate that a majority of Norwegian infants are fed in accordance with infant feeding recommendations during their first 6mo of life. However, the duration of exclusive breastfeeding is shorter than recommended. Infant feeding practices are significantly associated with maternal and infant characteristics.

Thermal balloon endometrial ablation: safety aspects evaluated by serosal temperature, light microscopy and electron microscopy.

OBJECTIVES: Thermal balloon endometrial ablation is a new method for treating menorrhagia. The technique appears to be less difficult compared to standard hysteroscopic ablation techniques and to be significantly safer. The influence into the uterine wall of the thermal balloon ablation procedure was investigated with special reference to the ability of total destruction of the endometrium and the thermal action on the myometrium and the serosa. STUDY DESIGN: Temperatures were measured at the uterine serosal surface during thermal balloon endometrial ablation for 8-16 min in eight patients. After subsequent hysterectomy the extent of thermal damage into the myometrium was assessed by light and electron microscopy. RESULTS: The highest temperature measured on the uterine serosa was 39.1 degrees C. Coagulation of the myometrium adjacent to the endometrium could be demonstrated by light microscopy in all patients, with a maximum depth of 11.5 mm. By electron microscopy no influence of heat could be demonstrated beyond 15 mm from the endometrial surface. CONCLUSION: Up to 16 min of thermal balloon endometrial ablation therapy can destroy the endometrium and the submucosal layers. The myometrium is only coagulated to a depth where full thickness necrosis or injury is unlikely.

Very-long-chain n-3 fatty acids as biomarkers for intake of fish and n-3 fatty acid concentrates.

We examined how supplementation with very-long-chain n-3 fatty acids was reflected in the concentration of these fatty acids in plasma phospholipids of 363 Norwegian men and women. The concentration of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in plasma phospholipids was significantly higher among individuals supplemented with n-3 fatty acids after the supplementation period than before. We also examined the relation between dietary intake of fatty acids measured with a 180-item quantitative food-frequency questionnaire and the concentration of the same fatty acids in plasma phospholipids in 579 men and women. Correlation coefficients between plasma phospholipid fatty acids and dietary intake of fatty acids were 0.51 and 0.49 for EPA and DHA, respectively. The correlation between fish intake and n-3 fatty acids in plasma phospholipids was 0.37. These results suggest that dietary intake measured with our food-frequency questionnaire may be used to predict the biological availability of some of the essential n-3 fatty acids.

[Condylomata acuminata in children]. / Condylomata acuminata hos børn.

During the period 1.1.1967 to 31.12.1986, a total of 34 children with condylomata acuminata were treated in the County Hospitals in Copenhagen. Nineteen of these were treated during the last five years of the period. A retrospective study revealed that 12 of the children were under the age of two years when the condylomata appeared. In eight of these, one or both of the parents had condylomata at the time of the child's birth suggesting that infection of the child may have occurred during delivery. Among the remaining 22 children, a possible source of infection was revealed in only one case. In the children, condylomata were much more frequently localized perianally or anally than in adults. There was no evidence of sexual abuse in any of the children but systematic investigation with this in mind was not undertaken. The finding of condylomata in children raises the suspicion of sexual abuse but does not prove this. Investigation and treatment should, as a rule, be undertaken by a multidisciplinary team preferably in a paediatric department.