DHA reduces oxidative stress following hypoxia-ischemia in newborn piglets: a study of lipid peroxidation products in urine and plasma.

BACKGROUND: Lipid peroxidation mediated by reactive oxygen species is a major contributor to oxidative stress. Docosahexaenoic acid (DHA) has anti-oxidant and neuroprotective properties. Our objective was to assess how oxidative stress measured by lipid peroxidation was modified by DHA in a newborn piglet model of hypoxia-ischemia (HI). METHODS: Fifty-five piglets were randomized to (i) hypoxia, (ii) DHA, (iii) hypothermia, (iv) hypothermia+DHA or (v) sham. All groups but sham were subjected to hypoxia by breathing 8% O2. DHA was administered 210 min after end of hypoxia and the piglets were euthanized 9.5 h after end of hypoxia. Urine and blood were harvested at these two time points and analyzed for F4-neuroprostanes, F2-isoprostanes, neurofuranes and isofuranes using UPLC-MS/MS. RESULTS: F4-neuroprostanes in urine were significantly reduced (P=0.006) in groups receiving DHA. Hypoxia (median, IQR 1652 nM, 610-4557) vs. DHA (440 nM, 367-738, P=0.016) and hypothermia (median, IQR 1338 nM, 744-3085) vs. hypothermia+DHA (356 nM, 264-1180, P=0.006). The isoprostane compound 8-iso-PGF2α was significantly lower (P=0.011) in the DHA group compared to the hypoxia group. No significant differences were found between the groups in blood. CONCLUSION: DHA significantly reduces oxidative stress by measures of lipid peroxidation following HI in both normothermic and hypothermic piglets.

Effects of physical activity on schoolchildren's academic performance: The Active Smarter Kids (ASK) cluster-randomized controlled trial.

OBJECTIVE: To investigate the effect of a seven-month, school-based cluster-randomized controlled trial on academic performance in 10-year-old children. METHODS: In total, 1129 fifth-grade children from 57 elementary schools in Sogn og Fjordane County, Norway, were cluster-randomized by school either to the intervention group or to the control group. The children in the 28 intervention schools participated in a physical activity intervention between November 2014 and June 2015 consisting of three components: 1) 90min/week of physically active educational lessons mainly carried out in the school playground; 2) 5min/day of physical activity breaks during classroom lessons; 3) 10min/day physical activity homework. Academic performance in numeracy, reading and English was measured using standardized Norwegian national tests. Physical activity was measured objectively by accelerometry. RESULTS: We found no effect of the intervention on academic performance in primary analyses (standardized difference 0.01-0.06, p>0.358). Subgroup analyses, however, revealed a favorable intervention effect for those who performed the poorest at baseline (lowest tertile) for numeracy (p=0.005 for the subgroup∗group interaction), compared to controls (standardized difference 0.62, 95% CI 0.19-1.07). CONCLUSIONS: This large, rigorously conducted cluster RCT in 10-year-old children supports the notion that there is still inadequate evidence to conclude that increased physical activity in school enhances academic achievement in all children. Still, combining physical activity and learning seems a viable model to stimulate learning in those academically weakest schoolchildren.

Effects of dalcetrapib in patients with a recent acute coronary syndrome.

BACKGROUND: In observational analyses, higher levels of high-density lipoprotein (HDL) cholesterol have been associated with a lower risk of coronary heart disease events. However, whether raising HDL cholesterol levels therapeutically reduces cardiovascular risk remains uncertain. Inhibition of cholesteryl ester transfer protein (CETP) raises HDL cholesterol levels and might therefore improve cardiovascular outcomes. METHODS: We randomly assigned 15,871 patients who had had a recent acute coronary syndrome to receive the CETP inhibitor dalcetrapib, at a dose of 600 mg daily, or placebo, in addition to the best available evidence-based care. The primary efficacy end point was a composite of death from coronary heart disease, nonfatal myocardial infarction, ischemic stroke, unstable angina, or cardiac arrest with resuscitation. RESULTS: At the time of randomization, the mean HDL cholesterol level was 42 mg per deciliter (1.1 mmol per liter), and the mean low-density lipoprotein (LDL) cholesterol level was 76 mg per deciliter (2.0 mmol per liter). Over the course of the trial, HDL cholesterol levels increased from baseline by 4 to 11% in the placebo group and by 31 to 40% in the dalcetrapib group. Dalcetrapib had a minimal effect on LDL cholesterol levels. Patients were followed for a median of 31 months. At a prespecified interim analysis that included 1135 primary end-point events (71% of the projected total number), the independent data and safety monitoring board recommended termination of the trial for futility. As compared with placebo, dalcetrapib did not alter the risk of the primary end point (cumulative event rate, 8.0% and 8.3%, respectively; hazard ratio with dalcetrapib, 1.04; 95% confidence interval, 0.93 to 1.16; P=0.52) and did not have a significant effect on any component of the primary end point or total mortality. The median C-reactive protein level was 0.2 mg per liter higher and the mean systolic blood pressure was 0.6 mm Hg higher with dalcetrapib as compared with placebo (P<0.001 for both comparisons). CONCLUSIONS: In patients who had had a recent acute coronary syndrome, dalcetrapib increased HDL cholesterol levels but did not reduce the risk of recurrent cardiovascular events. (Funded by F. Hoffmann-La Roche; dal-OUTCOMES ClinicalTrials.gov number, NCT00658515.).

The effect of kiwifruit consumption on blood pressure in subjects with moderately elevated blood pressure: a randomized, controlled study.

BACKGROUND AND AIMS: Kiwifruit contains bioactive substances that may lower blood pressure (BP) and improve endothelial function. We examined the effects of adding kiwifruit to the usual diet on 24-h ambulatory BP, office BP and endothelial function. METHODS: In a parallel-groups study, 118 subjects with high normal BP or stage 1 hypertension (systolic BP 130-159 mmHg and/or diastolic BP 85-99 mmHg) were randomized to intake of three kiwifruits (intervention) or one apple (control) a day for 8 weeks. Office and 24-h ambulatory BP was measured along with biomarkers of endothelial function including metabolites of nitric oxide (NO) formation and finger photo-plethysmography. RESULTS: At randomization, mean 24-h ambulatory systolic/diastolic BP was 133 ± 13/82 ± 9 mmHg (n = 106). After 8 weeks, BP was lower in the group assigned to kiwifruit versus apple intake (between group difference, - 3.6 mmHg [95% CI - 6.5 to - 0.7], p = 0.017 and - 1.9 mmHg [95% CI - 3.6 to - 0.3]; p = 0.040, for systolic and diastolic BP, respectively). Changes in office BP and endothelial function did not differ between the groups. CONCLUSIONS: Among men and women with moderately elevated BP, intake of three kiwifruits was associated with lower systolic and diastolic 24-h BP compared with one apple a day. The effect may be regulated by mechanisms other than improvement of endothelial function.

Maternal life course socio-economic position and offspring body composition at birth in a multi-ethnic population.

BACKGROUND: Size and body composition at birth may affect long-term health. Mean birthweight and body composition differ between ethnic groups living in Europe. We wanted to explore if this relates to differences in socio-economic conditions in country of origin and over the maternal life course. METHODS: This is a population-based cohort study of healthy pregnant women living in Oslo, Norway. Data on maternal early life and present socio-economic position (SEP) were collected in early gestation, and SEP scores were extracted through two separate principal components analyses. The associations between maternal present SEP and four different offspring anthropometric measures at birth were assessed separately, stratified by maternal early life SEP (dichotomised score) and Human Development Index (HDI, a country-level socio-economic indicator) in the country of origin [high HDI (Reference), n = 287 and low HDI, n = 250]. RESULTS: A strong positive association between maternal present SEP and offspring birthweight was observed if maternal early life SEP was high, but not if maternal early life SEP was low (P < 0.001 for the interaction term). This interactional effect was observed in both HDI groups. Maternal life course SEP affected offspring birthweight mainly through an effect on length and sum of skin folds. Offspring of mothers with origin from low HDI countries had smaller abdominal circumference, possibly indicating less fat-free mass, regardless of maternal life course SEP. CONCLUSION: Our results suggest that there are transgenerational effects of maternal past socio-economic conditions on offspring size and body composition at birth that modify the associations with present socio-economic factors.

Anthropometrics, body composition, and aerobic fitness in Norwegian home guard personnel.

The Norwegian Home Guard (HG) consists of soldiers and officers who primarily live a civilian life but are typically called in for military training a few days per year. Although full-time soldiers and officers are monitored annually on physical fitness, no such assessments are performed on regular HG personnel. Data on physical fitness of similar forces from other nations are also scarce. Thus, the main aim of this study was to collect reference data on physical fitness in HG personnel. A total of 799 male soldiers and officers from the regular and the rapid reaction HG force participated in this study. Between 13 and 19% of the subjects were obese, according to measured body mass index, waist circumference and estimations of body fat. The mean (95% confidence interval) estimated peak oxygen uptake from the 20-m shuttle run test was 50.1 (49.7-50.6) mL·kg·minute. Personnel from the rapid reaction force had a more favorable body composition compared with the regular HG personnel, whereas no differences were found for peak oxygen uptake. The physical demands on HG personnel are not well defined, but we believe that the majority of Norwegian HG soldiers and officers have a sufficient aerobic fitness level to fulfill their planned HG tasks. The gathered data can be used by military leaders to review the ability of the HG to perform expected military tasks, to serve as a future reference material for secular changes in HG fitness level, and for comparison purposes among similar international reserve forces.

Rationale and design of the dal-OUTCOMES trial: efficacy and safety of dalcetrapib in patients with recent acute coronary syndrome.

BACKGROUND: Despite contemporary therapies for acute coronary syndrome (ACS), morbidity and mortality remain high. Low levels of high-density lipoprotein (HDL) cholesterol are common among patients with ACS and may contribute to ongoing risk. Strategies that raise levels of HDL cholesterol, such as inhibition of cholesterol ester transfer protein (CETP), might reduce risk after ACS. Dal-OUTCOMES is a multicenter, randomized, double-blind, placebo-controlled trial designed to test the hypothesis that CETP inhibition with dalcetrapib reduces cardiovascular morbidity and mortality in patients with recent ACS. DESIGN: The study will randomize approximately 15,600 patients to receive daily doses of dalcetrapib 600 mg or matching placebo, beginning 4 to 12 weeks after an index ACS event. There are no prespecified boundaries for HDL cholesterol levels at entry. Other elements of care, including management of low-density lipoprotein cholesterol, are to follow best evidence-based practice. The primary efficacy measure is time to first occurrence of coronary heart disease death, nonfatal acute myocardial infarction, unstable angina requiring hospital admission, resuscitated cardiac arrest, or atherothrombotic stroke. The trial will continue until 1,600 primary end point events have occurred, all evaluable subjects have been followed for at least 2 years, and 80% of evaluable subjects have been followed for at least 2.5 years. SUMMARY: Dal-OUTCOMES will determine whether CETP inhibition with dalcetrapib, added to current evidence-based care, reduces cardiovascular morbidity and mortality after ACS.

An adapted version of the long International Physical Activity Questionnaire (IPAQ-L): construct validity in a low-income, multiethnic population study from Oslo, Norway.

BACKGROUND: The aim was to assess the construct validity characteristics of an adapted version of the long International Physical Activity Questionnaire (IPAQ-L) and report seasonal variations in physical activity (PA). METHODS: In two multiethnic suburbs of Oslo, Norway, all men and women aged 31-67 years (N = 6140) were invited to a survey in 2000, and participants (N = 2950) were re-invited in 2003. Complete IPAQ-L forms were delivered by 2274 baseline participants. We used the first IPAQ-L version, which asks for PA in a usual week with separate answering alternatives for summer and winter. Baseline energy expenditure calculated from IPAQ-L was compared with anthropometrical and biological measurements including maximal aerobic power in a subgroup, and individual changes in PA were compared with changes in these measurements. RESULTS: Vigorous PA within all domains, leisure-time PA (LPA), total PA, and in men occupational PA correlated with waist-to-hip ratio (rho around -0.1, p < 0.05). For vigorous PA and LPA similar correlations were found with triglycerides and high-density lipoprotein-cholesterol (rho 0.1, p < 0.05). LPA was correlated with maximal aerobic power in both sexes with rho 0.2 for total LPA and 0.4 for vigorous LPA (p < 0.01). In men, similar correlations were found for changes in total vigorous PA. The overall energy expenditure reported was 18% higher in summer than in winter. The amount of total and commuting PA in the two seasons were highly correlated with rho values of 0.9 and 0.7, respectively (p < 0.01). CONCLUSION: Weak, but consistent correlations with baseline biological and anthropometrical measurements were found in both sexes, but for changes in PA such a pattern was seen in men only. The total energy expenditure in summer and winter were highly correlated although the absolute volume was higher in summer than in winter.

Objectively Measured Physical Activity in Home Guard Soldiers During Military Service and Civilian Life.

Soldiers are encouraged to be physically active, and thereby maintain or increase their fitness level to meet job-related physical demands. However, studies on objectively measured physical activity (PA) in soldiers are scarce, particular for reserve soldiers. Hence, the aim of this study was to present PA data on Norwegian Home Guard (HG) soldiers. A total of 411 HG soldiers produced acceptable PA measurements (SenseWear Armband Pro2) during civilian life, of which 299 soldiers also produced acceptable data during HG military training. Reference data on total energy expenditure, metabolic equivalents, steps per day, and minutes of PA in three different metabolic equivalent categories are presented. The HG soldiers produced more minutes of moderate PA during HG military training compared to civilian life, but less vigorous and very vigorous PA. Furthermore, HG soldiers were more physically active during civilian week days compared to weekend days. The presented reference data can be used for comparisons against other groups of soldiers. Our data indicate that aerobic demands during HG military training were not very high. Promoting PA and exercise could still be important to ensure HG soldiers are physically prepared for more unforeseen job tasks.

Long-Term Correlates of Objectively Measured Physical Activity and Sedentary Time in Norwegian Men and Women.

BACKGROUND: Sex, age, body mass index (BMI), perceived health and health behavior are correlates known to affect physical activity and sedentary time. However, studies have often been cross-sectional, and less is known about long-term correlates. Thus, the aims were to investigate 1) the associations between a set of characteristics (demographic, biological, psychological, and behavioral) and objectively measured physical activity and sedentary time at 13-year follow-up, and 2) the association between changes in these characteristics over time and physical activity and sedentary time. METHODS: Baseline characteristics were collected in 40-year-olds in 1996, and follow-up data on objectively measured physical activity and sedentary time were obtained in 2009 (n = 240). Data were analyzed by multiple linear regressions. RESULTS: Self-reported physical activity (P < .001) and improved perceived health (P = .046) were positively associated with moderate-to-vigorous physical activity (MVPA) whereas BMI (P = .034) and increased BMI (P = .014) were negatively associated with MVPA at follow-up. Women spent less time being sedentary than men (P = .019). Education (P < .001) was positively associated and improved perceived health (P = .010) was negatively associated with sedentary time at follow-up. CONCLUSIONS: MVPA and sedentary time at follow-up were associated with behavioral, biological and demographic correlates. However, the nature of our analyses prevents us from inferring causality.

Comparison of self-reported versus accelerometer-measured physical activity.

INTRODUCTION: The International Physical Activity Questionnaire (IPAQ) is one of the most widely used questionnaires to assess physical activity (PA). Validation studies for the IPAQ have been executed, but still there is a need for studies comparing absolute values between IPAQ and accelerometer in large population studies. PURPOSE: To compare PA and sedentary time from the self-administered, short version of the IPAQ with data from ActiGraph accelerometer in a large national sample. METHODS: A total of 1751 adults (19-84 yr) wore an accelerometer (ActiGraph GT1M) for seven consecutive days and completed the IPAQ-Short Form. Sedentary time, total PA, and time spent in moderate to vigorous activity were compared in relation to sex, age, and education. RESULTS: Men and women reported, on average, 131 min·d (SE = 4 min·d) less sedentary time compared with the accelerometer measurements. The difference between self-reported and measured sedentary time and vigorous-intensity PA was greatest among men with a lower education level and for men 65 yr and older. Although men reported 47% more moderate to vigorous physical activity (MVPA) compared with women, there were no differences between sexes in accelerometer-determined MVPA. Accelerometer-determined moderate PA was reduced from 110 to 42 min·d (62%) when analyzed in blocks of 10 min (P < 0.0001) compared with 1-min blocks. The main correlation coefficients between self-reported variables and accelerometer measures of physical activity were between 0.20 and 0.46. CONCLUSIONS: The participants report through IPAQ-Short Form more vigorous PA and less sedentary time compared with the accelerometer. The difference between self-reported and accelerometer-measured MVPA increased with higher activity and intensity levels. Associations between the methods were affected by sex, age, and education, but not body mass index.

Ethnic differences in neonatal body composition in a multi-ethnic population and the impact of parental factors: a population-based cohort study.

BACKGROUND: Neonates from low and middle income countries (LAMIC) tend to have lower birth weight compared with Western European (WE) neonates. Parental height, BMI and maternal parity, age and educational level often differ according to ethnic background, and are associated with offspring birth weight. Less is known about how these factors affect ethnic differences in neonatal body composition. OBJECTIVES: To explore differences in neonatal body composition in a multi-ethnic population, and the impact of key parental factors on these differences. METHODS: A population-based cohort study of pregnant mothers, fathers and their offspring, living in Oslo, Norway. Gender- and gestational-specific z-scores were calculated for several anthropometric measurements, with the neonates of WE ethnic origin as reference. Mean z-scores for neonates with LAMIC origin, and their parents, are presented as outcome variables. RESULTS: 537 singleton, term neonates and their parents were included. All anthropometric measurements were smaller in neonates with LAMIC origin. Abdominal circumference and ponderal index differed the most from WE (mean z-score: -0.57 (95% CI:-0.69 to -0.44) and -0.54 (-0.66 to -0.44), and remained so after adjusting for parental size. Head circumference and skin folds differed less, and length the least (-0.21 (-0.35 to -0.07)). These measures became comparable to WEs when adjusted for parental factors. CONCLUSIONS: LAMIC origin neonates were relatively "thin-fat", as indicated by reduced AC and ponderal index and relatively preserved length and skin folds, compared with neonates with WE origin. This phenotype may predispose to type 2 diabetes.