Impact of eating disorders on obstetric outcomes in a large clinical sample: A comparison with the HUNT study.

OBJECTIVE: Current evidence from clinical studies suggests that having an active eating disorder (ED) during pregnancy is associated with unfavorable obstetric outcomes. However, the role of a lifetime diagnosis of ED is not fully understood. Variations in findings suggest a need for additional studies of maternal ED. This study aims to identify associations between a lifetime ED and obstetric outcomes. METHOD: Data from a hospital patient register and a population-based study (The HUNT Study) were linked to the Medical Birth Registry in Norway. Register based information of obstetric complications (preeclampsia, preterm birth, perinatal deaths, small for gestational age (SGA), large for gestational age (LGA), Caesarean sections, and 5-min Apgar score) were acquired for 532 births of women with ED and 43,657 births of non-ED women. Multivariable regression in generalized estimating equations was used to account for clusters within women as they contributed multiple births to the dataset. RESULTS: After adjusting for parity, maternal age, marital status, and year of delivery, lifetime history of anorexia nervosa was associated with increased odds of having offspring who were SGA (Odds ratio (OR) 2.7, 95% Confidence Interval (CI) 1.4-5.2). Women with a lifetime history of bulimia nervosa had higher odds of having a Caesarian section (OR 1.7 95% CI 1.1-2.5). Women with EDNOS/sub-threshold ED had a higher likelihood of having a low Apgar score at 5 min (OR 3.1, 95% CI 1.1-8.8). CONCLUSION: Our study corroborates available evidence on the associations between maternal ED and adverse obstetric outcomes.

Global Lung Function Initiative 2012 reference equations for spirometry in the Norwegian population.

We studied the fit of the Global Lung Function Initiative (GLI) all-age reference values to Norwegians, compared them with currently used references (European Community for Steel and Coal (ECSC) and Zapletal) and estimated the prevalence of obstructive lung disease.Spirometry data collected in 30 239 subjects (51.7% females) aged 12-90 years in three population-based studies were converted to z-scores.We studied healthy non-smokers comprising 2438 adults (57.4% females) aged 20-90 years and 8725 (47.7% female) adolescents aged 12-19 years. The GLI-2012 prediction equations fitted the Norwegian data satisfactorily. Median±sd z-scores were respectively 0.02±1.03, 0.01±1.04 and -0.04±0.91 for forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC in males, and -0.01±1.02, 0.07±0.97 and -0.21±0.82 in females. The ECSC and Zapletal references significantly underestimated FEV1 and FVC. Stricter criteria of obstruction (FEV1/FVC GLI-2012 LLN. Corresponding comparison regarding myocardial infarction showed a four-fold higher risk for women.The GLI-2012 reference values fit the Norwegian data satisfactorily and are recommended for use in Norway. Correspondingly, the FEV1/FVC GLI-2012 LLN identifies higher risk of obstructive characteristics than FEV1/FVC <0.7.

The relationship of anxiety, depression and behavioral problems with recurrent headache in late adolescence ­ a Young-HUNT follow-up study.

BACKGROUND: The comorbidity of headache and psychiatric symptoms is a well-recognized clinical phenomenon, but there are only limited data regarding the temporal relationship between headache and symptoms of anxiety and depression as well as behavioral problems in adolescents. This study investigates the relationship of anxiety and depressive symptoms and behavioral problems at baseline with recurrent headache at follow-up four years later. METHODS: Within the Nord-Trøndelag Health Study (HUNT), including repeated population-based studies conducted in Norway, 2399 adolescents in junior high schools aged 12-16 years (77% of the invited) participated in Young-HUNT1 (1995-1997) and again at follow-up four years later, in Young-HUNT2 (2000-2001). The same comprehensive questionnaire that included assessment of symptoms of anxiety and depression and behavioral problems, i.e. conduct and attention difficulties was completed in both studies. In addition 1665 of the participants were interviewed about their headache complaints in Young-HUNT2. RESULTS: In adjusted multivariate analyses we found that higher scores of anxiety and depressive symptoms at baseline were associated with recurrent headache at follow-up four years later (OR: 1.6, 95% CI: 1.2-2.1, p = 0.001), evident for migraine (OR: 1.8, 95% CI: 1.2-2.7, p = 0.008) and non-classifiable headache (OR: 1.7, 95% CI: 1.0-2.8, p = 0.034), but not statistically significant for tension-type headache (OR: 1.4, 95% CI: 1.0-1.9, p = 0.053). Higher scores of anxiety and depressive symptoms at baseline were significantly associated with more frequent headache at follow-up (monthly vs. no recurrent headache OR: 1.8, 95% CI: 1.3-2.5, p = 0.001, weekly or daily vs. no recurrent headache OR: 1.9, 95% CI: 1.2-2.9, p = 0.005). Among adolescents without recurrent headache at baseline, higher scores for symptoms of anxiety and depression were associated with new onset migraine four years later (OR: 2.6, 95% CI: 1.1-4.8, p = 0.036). Higher scores of attention problems at baseline were associated with non-classifiable headache at follow-up (OR: 2.0, 95% CI: 1.3-3.4, p = 0.017). CONCLUSIONS: Results from the present study showed that symptoms of anxiety and depression in early adolescence were associated with recurrent headache four years later. Recognizing anxiety and depressive symptoms should be considered part of the clinical assessment in young headache patients, as early identification of these associated factors may lead to improved headache management.

Anxiety, depression and behavioral problems among adolescents with recurrent headache: the Young-HUNT study.

BACKGROUND: It is well documented that both anxiety and depression are associated with headache, but there is limited knowledge regarding the relation between recurrent primary headaches and symptoms of anxiety and depression as well as behavioral problems among adolescents. Assessment of co-morbid disorders is important in order to improve the management of adolescents with recurrent headaches. Thus the main purpose of the present study was to assess the relationship of recurrent headache with anxiety and depressive symptoms and behavioral problems in a large population based cross-sectional survey among adolescents in Norway. METHODS: A cross-sectional, population-based study was conducted in Norway from 1995 to 1997 (Young-HUNT1). In Young-HUNT1, 4872 adolescents aged 12 to 17 years were interviewed about their headache complaints and completed a comprehensive questionnaire that included assessment of symptoms of anxiety and depression and behavioral problems, i.e. conduct and attention difficulties. RESULTS: In adjusted multivariate analyses among adolescents aged 12-14 years, recurrent headache was associated with symptoms of anxiety and depression (OR: 2.05, 95% CI: 1.61-2.61, p < 0.001), but not with behavioral problems. A significant association with anxiety and depressive symptoms was evident for all headache categories; i.e. migraine, tension-type headache and non-classifiable headache. Among adolescents aged 15-17 years there was a significant association between recurrent headache and symptoms of anxiety and depression (OR: 1.64, 95% CI: 1.39-1.93, p < 0,001) and attention difficulties (OR: 1.25, 95% CI: 1.09-1.44, p =0.001). For migraine there was a significant association with both anxiety and depressive symptoms and attention difficulties, while tension-type headache was significantly associated only with symptoms of anxiety and depression. Non-classifiable headache was associated with attention difficulties and conduct difficulties, but not with anxiety and depressive symptoms. Headache frequency was significantly associated with increasing symptoms scores for anxiety and depressive symptoms as well as attention difficulties, evident for both age groups. CONCLUSIONS: The results from the present study indicate that both anxiety and depressive symptoms and behavioral problems are associated with recurrent headache, and should accordingly be considered a part of the clinical assessment of children and adolescents with headache. Identification of these associated factors and addressing them in interventions may improve headache management.

Parental alcohol misuse and hazardous drinking among offspring in a general teenage population: gender-specific findings from the Young-HUNT 3 study.

BACKGROUND: Parental alcohol misuse may negatively affect drinking behaviours among offspring, but it is unclear to what extent influences are gender-specific and dependent upon the actual drinking behaviour measured. The aim of this study was to investigate whether hazardous drinking among Norwegian teenage boys (N = 2538) and girls (N = 2494) was associated with paternal and maternal alcohol misuse (CAGE). METHODS: Definitions of hazardous drinking among offspring were based on self-reported alcohol consumption (in litres a year), frequency of drinking, and frequency of drunkenness. Based on this information, two composite measures of hazardous drinking were also constructed. Cross-sectional data from the Norwegian Young-HUNT 3 survey (2006-2008) were linked to information from biological parents who participated in the adult part of the HUNT study. RESULTS: Logistic regression analyses showed that both boys and girls with alcohol misusing fathers were more likely to report high levels of alcohol intake compared to others of the same age and gender. This was contrary to boys with misusing mothers, who reported less alcohol consumption than other boys. Among girls, but not boys, high frequency of drunkenness was associated with maternal as well as paternal misuse. CONCLUSIONS: This study suggests that adolescent hazardous drinking is more prevalent among boys and girls with alcohol misusing parents versus those whose parents do not misuse alcohol. However, findings were gender specific and varied depending on the drinking outcomes under investigation. More evidence-based knowledge in this field is of great importance for better understanding the possible role paternal and maternal alcohol misuse may play in the development of hazardous alcohol drinking patterns among adolescent boys and girls.

Early eczema and the risk of childhood asthma: a prospective, population-based study.

BACKGROUND: Severe eczema in young children is associated with an increased risk of developing asthma and rhino-conjunctivitis. In the general population, however, most cases of eczema are mild to moderate. In an unselected cohort, we studied the risk of current asthma and the co-existence of allergy-related diseases at 6 years of age among children with and without eczema at 2 years of age. METHODS: Questionnaires assessing various environmental exposures and health variables were administered at 2 years of age. An identical health questionnaire was completed at 6 years of age. The clinical investigation of a random subsample ascertained eczema diagnoses, and missing data were handled by multiple imputation analyses. RESULTS: The estimate for the association between eczema at 2 years and current asthma at 6 years was OR=1.80 (95% CI 1.10-2.96). Four of ten children with eczema at 6 years had the onset of eczema after the age of 2 years, but the co-existence of different allergy-related diseases at 6 years was higher among those with the onset of eczema before 2 years of age. CONCLUSIONS: Although most cases of eczema in the general population were mild to moderate, early eczema was associated with an increased risk of developing childhood asthma. These findings support the hypothesis of an atopic march in the general population. TRIAL REGISTRATION: The Prevention of Allergy among Children in Trondheim study has been identified as ISRCTN28090297 in the international Current Controlled Trials database.

Reading and writing difficulties in adolescence and later risk of welfare dependence. A ten year follow-up, the HUNT Study, Norway.

BACKGROUND: Welfare dependence and low work participation among young people have raised concern in many European countries. Reading and writing difficulties (RWD) might make young people vulnerable to work integration problems and welfare dependence through negative influences on education and health. Our main objective of this study was to examine if RWD in adolescence affected the risk of welfare dependence in young adulthood. METHODS: Baseline information on self-reported RWD, health and family was obtained for 8950 school-attending adolescents in Nord-Trøndelag County, Norway, participating in the Young-HUNT1 survey, 1995-97. All individuals were linked to biological parents to identify siblings and parental education from national registers. Welfare dependence was assessed by the reception of social benefits (medical and economic) from the national social insurance database (1998-2007). Only long-term benefits (> 180 days) were included. RESULTS: The adolescents who reported RWD at baseline were more likely to receive medical or social benefits during follow-up compared with those who did not report RWD. In girls with RWD, the adjusted 5-year risk (at age 24 to 28) for receiving medical benefits was 0.20 (95% confidence interval 0.14-0.26), compared with 0.11 (0.09-0.12) in girls without RWD. In boys the corresponding risks were 0.13 (0.09-0.17) and 0.08 (0.07-0.09). CONCLUSIONS: The associations between RWD in adolescence and welfare dependence later in life suggest that increased attention should be paid to these problems when discussing the public health aspects of work integration, since there might be a potential for prevention.

Weight status and hypertension among adolescent girls in Argentina and Norway: data from the ENNyS and HUNT studies.

BACKGROUND: To provide data on overweight, obesity and hypertension among adolescent girls in Norway and Argentina. METHODS: Data was obtained from two population-based, cross-sectional and descriptive studies containing anthropometric and blood pressure measurements of 15 to 18 year old girls. The study included 2,156 adolescent girls from Norway evaluated between 1995 and 1997, and 669 from Argentina evaluated between 2004 and 2005. RESULTS: Around 15% of adolescent girls in Norway and 19% in Argentina are overweight or obese. Body mass index (BMI) distribution in these two countries is similar, with a low percentage (< 1%) of girls classified as thin. Norwegian adolescents show a height mean value 8 cm taller than the Argentinean. Obesity is strongly associated with systolic hypertension in both populations, with odds ratios of 11.4 [1.6; 82.0] and 28.3 [11.8; 67.7] in Argentina and Norway, respectively. No direct association between BMI and systolic hypertension was found, and only extreme BMI values (above 80th - 90th percentile) were associated with hypertension. CONCLUSION: This study confirms a current world health problem by showing the high prevalence of obesity in adolescents and its association with hypertension in two different countries (one developed and one in transition).

Life style related to blood pressure and body weight in adolescence: cross sectional data from the Young-HUNT study, Norway.

BACKGROUND: The associations between physical activity, unhealthy dietary habits and cigarette smoking and blood pressure, overweight and obesity are well established in adulthood. This is not the case for similar associations in adolescence. Thus, the purpose of this study is to examine how physical activity, smoking status and dietary habits were related to overweight, obesity and blood pressure in a population of Norwegian adolescents. METHODS: Weight, height, systolic (SBP) and diastolic blood pressure (DBP) were measured, and body mass index (BMI) was calculated among 8408 adolescents who participated in a population based study in 1995-97 in the county of Nord-Trøndelag. Internationally accepted cut-off values were used to determine if the adolescents were overweight or obese. The adolescents also completed a detailed questionnaire including dietary habits, physical activity and smoking habits. We calculated adjusted mean blood pressures and odds ratios for being overweight or obese for different exposure categories of life style variables. RESULTS: Low levels of physically activity were associated with increased odds of being overweight (odds ratio (OR), 1.4; 95% confidence interval (CI), 1.1-1.8 in girls and OR, 2.0; 95% CI, 1.6-2.5 in boys) or obese (girls: OR, 3.1; 95% CI, 1.6-6.0; boys: OR, 3.7; 95% CI, 2.1-6.4). In addition, the least physically active girls had a 1.5 mmHg higher mean DBP compared with the most active (p-trend <0.001), and among boys this difference was 1.0 mmHg (p-trend < 0.001). Smokers were more likely to be obese (OR, 1.6; 95% CI, 1.1-2.5 in girls and 1.4; 95% CI, 0.9-2.1 in boys) compared with non-smokers. Smokers also had lower mean SBP than non-smokers; however, this finding was restricted to smokers with the lowest smoking exposure. Associations between dietary habits and weight status largely disappeared after adjusting for weight losing behaviour. CONCLUSION: In this population of adolescents low levels of physical activity were associated with higher mean DBP and higher odds of overweight or obesity. Smoking was also associated with higher odds of overweight and obesity. The paradoxical associations between healthy dietary habits and overweight and obesity are most likely an effect of reverse causality.

The Nord-Trøndelag Health Study shows increased prevalence of primary recurrent headaches among adolescents over a four-year period.

Objective Earlier epidemiological studies have shown that headaches are frequent among adolescents, especially girls. In particular, recurrent primary headache disorders such as migraine and tension-type headaches are common complaints in this age group. Headaches are increasingly being recognized as a significant health problem in adolescents and can lead to significant disabilities by affecting their lives, their school performance and their social lives. The aim of this study was to compare the prevalence of primary headaches among adolescents aged 16-20 years in Norway in two periods. Very few replicate studies have re-evaluated the prevalence of primary headaches in this age range and it is uncertain whether the prevalence is increasing. Methods Two cross-sectional, population-based studies were conducted in Norway from 1995 to 1997 (Young-HUNT 1) and from 1999 to 2001 (Young-HUNT 2). In Young-HUNT 1, 2594 adolescents in 2nd and 3rd grade in upper secondary school (aged 16-20 years) completed a comprehensive questionnaire including one question regarding headache during the last 12 months. In addition, 1730 of the students were interviewed about their headache complaints. In Young-HUNT 2, 2373 adolescents aged 16-20 years completed the same questionnaire and 1655 were interviewed in the same way as the earlier survey. The interviews were performed by trained nurses, and respondents were asked if they had experienced recurrent headache during the last year. If so, the headache was classified as migraine (MI), tensiontype headache (TTH) or non-classifiable headache (NCH). Headache frequency during the past year was recorded according to the following categories: Less than 1 day per month (less than monthly), 1-3 days per month (monthly), 1-5 days per week (weekly), or more than 5 days per week (daily). Results The participation rate was 88% in Young-HUNT 1 and 81% in Young-HUNT 2. The overall prevalence of having had headaches during the last 12 months did not change significantly (79.4% versus 77.5%; OR: 0.89, 95%CI: 0.79-1.02, p = 0.09), whereas the prevalence of recurrent headaches increased from 30.3% in Young-HUNT 1 to 35.4% in Young-HUNT 2 (OR: 1.26, 95%CI: 1.09-1.46, p = 0.002). The prevalence of tension-type headache changed significantly from 19.0% to 21.9% (OR: 1.20, 95%CI: 1.02-1.42, p = 0.03). Also the prevalence of migraine tended to increase (7.5% versus 8.7%, OR: 1.18, 95%CI: 0.92-1.52, p = 0.18). The overall frequency of recurrent headache changed towards more monthly and less weekly headache. Conclusions This is the first large-scale population-based study among adolescents in Norway assessing changes in the prevalence of primary headaches over a four-year period of time. The overall prevalence of recurrent headaches increased significantly from Young-HUNT 1 to Young-HUNT 2. An increase was seen in all types of recurrent headaches and was significant for tension-type headache. Implications Earlier follow-up studies have examined changes in prevalence of recurrent headaches in young age, but the results are diverging. Our findings support the impression that the prevalence of recurrent headache among adolescents is increasing, and underlines the need for prospective designed studies with emphasis on prognosis and etiological factors.

Female gender is associated with higher incidence and more stable respiratory symptoms during adolescence.

Childhood asthma and wheeze is more common among boys than girls, while the opposite is found in adults. The main objective was to study the incidence and the course of wheeze and asthma during adolescence with focus on gender differences. In addition, we explored associations between lifestyle factors at baseline and wheeze at follow-up. A total of 2399 adolescents answered validated questionnaires on respiratory symptoms and lifestyle in 1995-1997 (13-15 years) and at follow-up in 2000-2001 (17-19 years). The risk of reporting wheeze and asthma at follow-up was greater in girls compared to boys among subjects reporting no respiratory symptoms at baseline; Relative risk: 1.4 and 2.4, respectively. More girls than boys reported current wheeze at follow-up, both among those with current wheeze (girls 60%, boys 48%) and previous wheeze (girls 33%, boys 28%) at baseline. In girls, development of current wheeze was significantly associated with current smoking (OR=2.8) and stable current wheeze was significantly associated with overweight (OR=2.4). Similar associations were not significant in boys. More girls than boys developed wheeze, had stable wheeze or had relapse of previous symptoms during the four year follow-up. The impact of smoking and overweight may put girls at a higher risk of respiratory symptoms than boys. Awareness of the gender difference in respiratory symptoms is important for diagnosis and preventive strategies during adolescence.

Early sexual maturation, central adiposity and subsequent overweight in late adolescence. a four-year follow-up of 1605 adolescent Norwegian boys and girls: the Young HUNT study.

BACKGROUND: Early sexual maturation has been associated with overweight that may persist after the completion of biological growth and development. We have prospectively examined the influence of early sexual maturation on subsequent overweight in late adolescence and assessed if this association was modified by central adiposity in early adolescence. METHODS: 1605 Norwegian adolescents were followed from early (baseline, mean age 14.2 years) to late adolescence (follow-up, mean age 18.2 years). Maturational timing was assessed by self-reports of pubertal status (PDS) in boys and age at menarche (AAM) in girls. Central adiposity was classified according to waist circumference (waist) measured at baseline, using age and gender specific medians as cut off. Overweight was classified according to International Obesity Task Force (IOTF) standards. RESULTS: At follow-up, early sexual maturation in girls, but not in boys, was associated with overweight. This association, however, was restricted to girls with high waist circumference (> median) at baseline (OR, 2.7, 95% CI 1.5-4.9). Thus, age at menarche was not associated with overweight in girls with low waist (< or = median) at baseline. Central adiposity was, independent of maturational timing, associated with higher BMI at follow-up in both genders, but differences were more pronounced among early matured girls (3.5 kg/m2), than among intermediate (2.7 kg/m2) and late matured girls (1.2 kg/m2). CONCLUSION: In girls, the combination of central adiposity and early age at menarche appears to increase the risk of being overweight in late adolescence.

Cross-sectional associations of total sitting and leisure screen time with cardiometabolic risk in adults. Results from the HUNT Study, Norway.

OBJECTIVES: To examine associations of total sitting time, TV-viewing and leisure-time computer use with cardiometabolic risk biomarkers in adults. DESIGN: Population based cross-sectional study. METHODS: Waist circumference, BMI, total cholesterol, HDL cholesterol, blood pressure, non-fasting glucose, gamma glutamyltransferase (GGT) and triglycerides were measured in 48,882 adults aged 20 years or older from the Nord-Trøndelag Health Study 2006-2008 (HUNT3). Adjusted multiple regression models were used to test for associations between these biomarkers and self-reported total sitting time, TV-viewing and leisure-time computer use in the whole sample and by cardiometabolic disease status sub-groups. RESULTS: In the whole sample, reporting total sitting time ≥10 h/day was associated with poorer BMI, waist circumference, total cholesterol, HDL cholesterol, diastolic blood pressure, systolic blood pressure, non-fasting glucose, GGT and triglyceride levels compared to those reporting total sitting time <4h/day (all p<0.05). TV-viewing ≥4 h/day was associated with poorer BMI, waist circumference, total cholesterol, HDL cholesterol, systolic blood pressure, GGT and triglycerides compared to TV-viewing <1h/day (all p<0.05). Leisure-time computer use ≥1 h/day was associated with poorer BMI, total cholesterol, diastolic blood pressure, GGT and triglycerides compared with those reporting no leisure-time computing. Sub-group analyses by cardiometabolic disease status showed similar patterns in participants free of cardiometabolic disease, while similar albeit non-significant patterns were observed in those with cardiometabolic disease. CONCLUSIONS: Total sitting time, TV-viewing and leisure-time computer use are associated with poorer cardiometabolic risk profiles in adults. Reducing sedentary behaviour throughout the day and limiting TV-viewing and leisure-time computer use may have health benefits.

The influence of behavioural and health problems on alcohol and drug use in late adolescence - a follow up study of 2 399 young Norwegians.

BACKGROUND: Both early alcohol debut, behavioural and health problems are reported to enhance adolescence substance use. This prospective study investigate the influence of behavioural and health problems on adolescents' alcohol and drug use. METHOD: Prospective population based cohort study of 2 399 adolescents attending the Young-HUNT study, aged 13-15 at baseline in 1995/97, and 17-19 at follow-up 4 years later. Exposure variables were self reported conduct problems, attention problems, anxiety and depressive symptoms, and muscular pain and tension. Outcome variables at follow-up were frequent alcohol use and initiation of drug use. Associations were estimated by logistic regression models, influence of gender and drinking status at baseline were controlled for by stratification. RESULTS: At follow-up 19% of the students drank alcohol once a week or more frequently. Baseline conduct problems (OR 2.2, CI 1.7-3.0) and attention problems (OR 1.5, CI 1.2-2.0) increased the risk for frequent alcohol use at follow-up in the total population. Girls who had experienced alcohol-intoxications at baseline showed strong association between baseline problems and frequent alcohol use at follow-up. Conduct problems (OR 2.5, CI 1.3-4.8), attention problems (OR 2.1, CI 1.2-3.4), anxiety/depressive symptoms (OR 1.9, CI 1.1-3.1) and muscular pain and tension (OR 1.7, CI 1.0-2.9) all were associated with frequent alcohol use among early intoxicated girls.14% of the students had tried cannabis or other drugs at follow-up. Conduct problems at baseline increased the odds for drug use (OR 2.6, CI 1.9-3.6). Any alcohol intoxications at baseline, predicted both frequent alcohol use (boys OR 3.6, CI 2.4-5.2; girls OR 2.8, CI 1.9-4.1), and illegal drug use (boys OR 4.7; CI 3.2-7.0, girls OR 7.7, CI 5.2-11.5) within follow-up. CONCLUSIONS: Conduct problems in high-school more than doubles the risk for both frequent alcohol use and initiation of drug use later in adolescence. The combination of health problems and alcohol intoxication in early adolescence was closely associated with more frequent drinking later in adolescence among girls.Overall, early alcohol intoxication was closely associated with both frequent alcohol use and drug use at follow up in both genders.

Adolescents with wheeze have increased risk of additional health problems. The Young-HUNT study, Norway.

OBJECTIVE: To explore the hypothesis of an association between current wheeze and other health problems in adolescence and to investigate any sex differences. METHODS: N=8817 adolescents aged 13-19 years completed a self-administered questionnaire including questions on health and lifestyle in Norway (1995-1997). RESULTS: All subjective health problems were significantly more prevalent in current wheezers compared to non-wheezers (frequent headache: girls 18% vs. 9%, boys 8% vs. 3%; frequent neck and shoulder pain: girls 10% vs. 5%, boys 6% vs. 2%; frequent joint and muscle pain: girls 6% vs. 2%, boys 6% vs. 2%; and frequent abdominal pain: girls 10% vs. 3%, boys 3% vs.1%). In both sexes, adjusted for covariates, current wheezers had statistically significant increased risk of reporting frequent headache (girls OR=2.0, boys OR=2.9), frequent neck and shoulder pain (girls OR=1.9, boys OR=3.3), frequent joint and muscle pain (girls OR=2.7, boys OR=3.5) and frequent abdominal pain (girls OR=2.7, boys OR=2.0). CONCLUSIONS: Current adolescent wheezers reported more additional health problems compared to non-wheezers. Even if girls reported more symptoms in general, the associations were stronger in boys. The findings are important for the clinical approach to teenage wheezers and should increase doctors' awareness of coexistence of other health complaints in these patients.

Perceived pubertal timing, pubertal status and the prevalence of alcohol drinking and cigarette smoking in early and late adolescence: a population based study of 8950 Norwegian boys and girls.

AIM: To study whether perceived pubertal timing is related to the prevalence of alcohol drinking and cigarette smoking among adolescent boys and girls. METHODS: The Young-HUNT study (95-97), conducted in Nord-Trøndelag County in Norway, comprises information from 8950 students, aged 13-19 years. Odds ratios (OR) with 95% confidence intervals (CI) related to alcohol drinking and cigarette smoking were estimated by logistic regression analyses. RESULTS: Boys and girls who perceived themselves as early matured were more likely to report more risky drinking than those who perceived themselves as being on time, both in middle school and high school. A nearly identical pattern was found for smoking. However, boys in middle school, who perceived themselves as late, were more likely to smoke than those who were on time. CONCLUSION: In both genders, perceived early maturation was associated with increased risk behaviour involvement. Perceptions of being early in combination with high pubertal status yielded the highest prevalence of alcohol and tobacco use.

Adolescent adjustment and well-being: effects of parental divorce and distress.

This study investigates the long-term effects of parental divorce on adolescent psychological adjustment and well-being, and to what extent the effects are accounted for by parental psychological distress. Data were collected among 8,984 Norwegian adolescents (13-19 years) and their parents. Outcome variables were symptoms of anxiety and depression, subjective well-being, and three areas of school problems. Parental divorce was found to be associated with both higher mean levels and larger variances in adolescent problems. Divorce and parental distress contributed independently to adolescent distress, supporting the notion of "double exposure" effects. The prevalence of adolescents with substantial distress symptoms was 14% among those with non-distressed non-divorced parents and 30% among those with divorced and distressed parents. In general effects remained when controlling for demographic factors. Long-term effects of divorce on symptoms of anxiety and depression were stronger among girls than among boys.

Combined influence of early sexual maturation and central adiposity on subsequent stature. A four-year follow-up of 1,605 Norwegian boys and girls: the Young-HUNT study.

INTRODUCTION: Shorter adult stature has been attributed to early sexual maturation, as well as early adiposity, but it is not clear if these factors are interrelated. RESULTS AND DISCUSSION: A number of 1,605 Norwegian adolescents were followed from early (baseline) to late adolescence (follow-up). Maturational timing was assessed by self-reports of pubertal status (pubertal development scale, PDS) in boys and age at menarche (AAM) in girls. Height, weight and waist circumference were measured at baseline and at follow-up. Differences in height at follow-up and height gain related to the timing of sexual maturation and the level of central adiposity (i.e. high or low waist circumference) at baseline were estimated using general linear modelling. At follow-up, the median height was 180 cm in boys and 167 cm in girls. Early maturing boys and girls with relatively high central adiposity at baseline were, on average, 5.7 cm (P value<0.001) and 3.6 cm (P value<0.001) taller than early maturing boys and girls with low central adiposity. Differences in stature related to central adiposity were less pronounced for intermediate and late maturing boys and girls. The height was lowest in boys (176.6 cm) and girls (163.8 cm) who had matured early and had low central adiposity at baseline. Height gain during follow-up was independent of the level of central adiposity, but was closely related to the timing of sexual maturation. The association between the early timing of sexual maturation and subsequent height was modified by the level of central adiposity in early adolescence. CONCLUSION: The results suggest that early maturity combined with adiposity yields higher stature than early maturity and leanness.

Sexual maturation in early adolescence and alcohol drinking and cigarette smoking in late adolescence: a prospective study of 2,129 Norwegian girls and boys.

Early sexual maturation has been associated with higher involvement in risk behaviour during early and mid-adolescence. In a prospective study of 2,129 girls and boys, we investigated whether the timing of sexual maturation was associated with cigarette smoking and alcohol drinking in late adolescence and whether this relation differed between boys and girls. Nine hundred and eighty boys and 1,149 girls, who participated in a cross-sectional study in middle school, were included in a follow-up study in high school 4 years later. Self-rating of pubertal status, as registered at baseline in middle school, was used to indicate the timing of sexual maturation. Age-adjusted odds ratios (ORs) with 95% confidence intervals (CIs), estimated by logistic regression, were used to assess the association between sexual maturation and alcohol drinking and daily smoking at follow-up. We found that girls who had matured early (OR 1.7, CI 1.2-2.4) or late (OR, 1.5, CI, 1.1-2.2) were both more likely to report more advanced drinking in late adolescence than were girls who were on time. Boys who had matured late were less likely (OR 0.5, CI 0.3-0.8) than boys who were on time to engage in advanced drinking. In general, daily smoking was more common among girls than boys, and more common among girls who had matured early (OR 1.5, CI 1.1-2.2) than among girls who were on time. Adjustment for social factors, e.g. parental education and marital status and parental drinking and smoking habits, did not substantially influence these results. We concluded that, for girls, but not for boys, early sexual maturation was associated with more advanced drinking and higher frequency of smoking in late adolescence. In boys, late sexual maturation was associated with reduced risk of advanced drinking.