The effects of fatty fish intake on adolescents' nutritional status and associations with attention performance: results from the FINS-TEENS randomized controlled trial.

BACKGROUND: Adolescence involves changes in dietary habits that may induce imbalances in the intake of different nutrients. Fish is an important dietary source of omega-3 (n-3) long-chain polyunsaturated fatty acids (LCPUFAs), vitamin D, several minerals and high-quality protein. By using secondary outcomes and exploratory analyses, the aims of this paper were to evaluate if nutritional biomarkers (red blood cell fatty acids, serum (s)-25(OH)D, s-ferritin and urinary iodine concentration (UIC)) were altered during a dietary intervention, and if they mediated previously reported changes in attention performance. In addition, to examine the status of the biomarkers and explore associations between dietary pattern, biomarkers and attention performance cross-sectionally at baseline. METHODS: The Fish Intervention Studies-TEENS (FINS-TEENS) was a three-armed intervention trial, including adolescents from eight secondary schools (n = 415; age: 14-15y) in Bergen, Norway. Participants were individually randomized to receive either fish meals, meat meals or n-3 LCPUFA supplements, three times a week for a total of 12 weeks. Blood and urine samples were collected pre and post intervention and attention performance was assessed with the d2 test of attention. Analyses of covariance (ANCOVA) assessed differences between groups in changes of biomarkers and linear mixed models were applied in analyses of attention performance and biomarkers. The trial is registered in ClinicalTrials.gov (NCT02350322). RESULTS: At baseline, the mean omega-3 index was 5.8 ± 1.3% and deficient status were identified for s-25(OH)D (54%), s-ferritin (10%) and UIC (40%). The intervention resulted in an increase in DHA and the omega-3 index which was larger in the supplement group compared to the fish and meat group (P < 0.01), and in the fish group compared to the meat group (P < 0.01). No differences between the groups were observed for changes in 25(OH)D, s-ferritin or UIC. None of the biomarkers mediated performance in the d2 test. The intake of fatty fish and a healthy dietary pattern was associated with scores in processing speed at baseline. CONCLUSIONS: These results show that Norwegian adolescents have insufficient status of important nutrients, which may be improved with fatty fish consumption or n-3 LCPUFA supplements. However, nutritional status was not associated with scores in the d2 test of attention.

Fatty fish intake and attention performance in 14-15 year old adolescents: FINS-TEENS - a randomized controlled trial.

BACKGROUND: Fatty fish is the dominant dietary source of n-3 LCPUFAs but it also contains other micronutrients considered important for brain development and function. To our knowledge, the effect of fatty fish intake on cognitive function in adolescents has not been investigated in randomized controlled trials (RCTs) previously. The aim of the present trial was to investigate whether consumption of fatty fish meals three times per week for 12 weeks could alter attention performance in adolescents compared to similar meals with meat or n-3 LCPUFA supplements. METHODS: In the Fish Intervention Studies-TEENS (FINS-TEENS), adolescents from eight secondary schools (n = 426; age: 14-15y) were individually randomized. Attention performance was assessed with the d2 test of attention. Differences between groups from pre to post intervention were assessed with linear mixed effect models and general estimates equation. The fish group was set as reference. Dietary compliance was recorded for each meal throughout the trial and controlled for in the adjusted analyses. RESULTS: The improvement in processing speed was significantly lower in the meat (-11.8; 95% CI: -23.3, -0.4) and supplement (-13.4; 95% CI: -24.9, -1.8) group compared to the fish group (reference). The supplement group also showed inferior improvement in total performance (-10.4; 95% CI: -20.0, -0.7) compared to the fish group (reference). The results were slightly affected when controlling for dietary compliance. Omission errors decreased in the meat group compared to the fish group (Incidence rate ratio = 0.85; 95% CI: 0.74, 0.98), but the difference disappeared when controlling for dietary compliance. CONCLUSIONS: We observed a small beneficial effect of fatty fish, compared to meat meals and supplements on processing speed. However, these results are difficult to interpret due to low dietary compliance. This study shows that different taste preferences among participants is challenging in intervention trials with food. A prospective cohort design may be a better alternative when studying diet in the future. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov registration number: NCT02350322 .

Quality of life following hip fractures: results from the Norwegian hip fracture register.

BACKGROUND: Patient-reported health-related quality of life is an important outcome measure when assessing the quality of hip fracture surgery. The frequently used EQ-5D index score has unfortunately important limitations. One alternative can be to assess the distribution of each of the five dimensions of the patients' descriptive health profile. The objective of this paper was to investigate health-related quality of life (HRQoL) after hip fractures. METHODS: Data from hip fracture operations from 2005 through 2012 were obtained from The Norwegian Hip Fracture Register. Patient reported HRQoL, (EQ-5D-3L) was collected from patients preoperatively and at four and twelve months postoperatively n = 10325. At each follow-up the distribution of the EQ-5D-3L and mean pain VAS was calculated. RESULTS: Generally, a higher proportion of patients reported problems in all 5 dimensions of the EQ-5D-3L at all follow-ups compared to preoperative. Also a high proportion of patients with no preoperative problems reported problems after surgery; At 4 and 12 months follow-ups 71 % and 58 % of the patients reported walking problems, and 65 % and 59 % of the patients reported pain respectively. Patients with femoral neck fractures and the youngest patients (age < 70 years) reported least problems both preoperatively and at all follow-ups. CONCLUSIONS: A hip fracture has a dramatic impact on the patients' HRQoL, and the deterioration in HRQoL sustained also one year after the fracture. Separate use of the descriptive profile of the EQ-5D is informative when assessing quality of life after hip fracture surgery.

Associations between self-reported working conditions and registered health and safety results.

OBJECTIVE: To investigate the association between self-reported working conditions and registered health and safety results in a petroleum company in Norway. METHODS: We analyzed data from company surveys of working and organizational conditions in 2003 and 2004 and data from the company's files of sickness absence, personal injuries, serious incidents, and undesirable incidents in 2003 and 2004 as well as personal injuries from 2000 to 2004 using Pearson's correlation analysis and multiple linear regression analyses. RESULTS: Good perception of confidence in management in 2003 and 2004 was significantly negatively correlated with the number of personal injuries from 2000 to 2004. CONCLUSIONS: Management style and trust in the manager are important factors for predicting personal injuries. The company's working and organizational survey might be used as an indicator for injury risk.

Folate supplementation and twin pregnancies.

BACKGROUND: Women in many countries are advised to increase their folate intake to lower the risk of neural tube defects. For this purpose several countries add folate to the flour. Therefore, it is important to monitor possible adverse effects of this B vitamin. We have assessed the effect of folate on twin pregnancies. METHODS: We conducted a retrospective, population-register based study of 176,042 women who gave birth from December 1998 through the end of 2001. Use of folate and multivitamin supplements was recorded on the mandatory birth notification form of the Medical Birth Registry of Norway. Pregnancies after in vitro fertilization (IVF) were reported separately. RESULTS: With adjustment for maternal age and parity, we observed an increased risk of twin pregnancies associated with preconceptional use of folate (odds ratio = 1.59; 95% confidence interval = 1.41-1.78). This association was largely explained by confounding with IVF pregnancies, which were strongly associated both with twin pregnancies and folate use. After exclusion of known IVF pregnancies, and accounting for underreporting of both IVF pregnancies and folate use, the risk was no longer elevated (1.02; 0.85-1.24). Weak associations with twin pregnancies were observed for use of multivitamins and folate during pregnancy, but could be due to increased use of vitamins after a recognized twin pregnancy. CONCLUSIONS: The association between preconceptional folate use and twin pregnancies was strongly confounded by IVF. After accounting for IVF pregnancies and underreporting, we found no evidence for an association between preconceptional folate supplements and twinning.