Milk intake and hip fracture incidence in community-dwelling old Icelandic adults.

Milk and milk products have been known as important for bone health. Can ingestion of milk and milk products lower hip fracture risk for older adults? In this study, older Icelandic adults who were ingesting higher milk had a lower risk of hip fractures. INTRODUCTION: This study describes associations between milk intake and hip fracture risk in older Icelanders. The data indicate that no/low milk consumption is related to greater hip fracture risk. Hip fracture can have a severe effect on the life of older adults. Health authorities recommend milk intake for better bone health. However, previous studies addressing this association have been divergent. METHODS: This prospective study included 4614 subjects (mean age 76 years) recruited between 2002 and 2006 into the Age, Gene/Environment Susceptibility-Reykjavik (AGES-Reykjavik) study. Information on hip fractures occurring between recruitment and end of follow-up in 2012 was extracted from hospital records. RESULTS: A total of 14% of participants reported milk intake < 0.5 times/day (the lowest category) and 22% of the participants consumed at least milk two times/day (highest category). Milk consumption was positively related to the volumetric bone mineral density at baseline with a sex- and age-adjusted difference of 8.95 ± 2.5 mg/cm3 between the highest compared to lowest milk intake categories (P < 0.001). During the follow-up, 7.4% of participants had a hip fracture, and we observed a decreased risk of incident hip fractures in the highest compared to the lowest milk intake category with a hazard ratio of 0.69 (95% CI: 0.47-0.99) in adjusted model. Further analysis indicated a linear relationship between milk intake and fracture risk (P-value for linear trend < 0.001). CONCLUSION: Milk intake is associated with a lower risk of incident hip fracture in a linear way in Icelandic community-dwelling older adults.

Growth Rate in Childhood and Adolescence and the Risk of Breast and Prostate Cancer: A Population-Based Study.

Growth rate is regulated by hormonal pathways that might affect early cancer development. We explored the association between rate of growth in height from ages 8 to 13 years (childhood) and from age 13 to attainment of adult height (adolescence), as measured at study entry, and the risk of breast or prostate cancer. Participants were 2,037 Icelanders born during 1915-1935, who took part in the Reykjavik Study, established in 1967. Height measurements were obtained from school records and at study entry. We used multivariable Cox regression models to calculate hazard ratios with 95% confidence intervals of breast and prostate cancer by rates of growth in tertiles. During a mean follow-up of 66 years (women) and 64 years (men), 117 women were diagnosed with breast cancer and 118 men with prostate cancer (45 with advanced disease). Women in the highest growth-rate tertile in adolescence had a higher risk of breast cancer (hazard ratio = 2.4, 95% confidence interval: 1.3, 4.3) compared with women in the lowest tertile. A suggestive inverse association was observed for highest adolescent growth rate in men and advanced prostate cancer: hazard ratio = 0.4, 95% confidence interval: 0.2, 1.0. Rapid growth, particularly in adolescence may affect cancer risk later in life.

Dietary patterns in adolescence and risk of colorectal cancer: a population-based study.

PURPOSE: To study whether dietary patterns in adolescence are associated with risk of colorectal cancer (CRC). METHODS: Food frequency data were obtained from the AGES-Reykjavik study, conducted between 2002 and 2006, which included 5,078 (58% women) participants with mean age of 77 (± 5.8) years. Principal component analysis was used to identify dietary patterns. Participants were followed through linkage to the Icelandic Cancer Registry. Multivariable Cox models were used to calculate hazard ratios (HR) of CRC and 95% confidence interval (CI) by dietary patterns. RESULTS: During the follow-up period (mean 8.2 years), 136 participants (75 women and 61 men) were diagnosed with CRC. The main dietary pattern in adolescence was characterized by high intake of traditional food items consumed in the earlier half of the twentieth century, namely, salted or smoked meat and fish, milk, offal, rye bread, and oatmeal. Compared to the lowest tertile, the middle tertile of this pattern was associated with increased risk of CRC (HR 1.63, 95% CI 1.04-2.57), while the highest tertile was not statistically associated with CRC (HR 1.48, 95% CI 0.93-2.37), except among women (HR 2.06, 95% CI 1.11-3.84). CONCLUSION: These data suggest that strong adherence to a traditional Icelandic diet in adolescence might increase the risk of CRC, particularly among women. More research is need on the association between food items and dietary patterns of relevance to CRC at different points in the life cycle.

Serum 25-Hydroxy-Vitamin D Status and Incident Hip Fractures in Elderly Adults: Looking Beyond Bone Mineral Density.

Observational studies have consistently reported a higher risk of fractures among those with low levels of serum 25-hydroxyvitamin D (25(OH)D). Emerging evidence suggests that low serum 25(OH)D levels may increase the rate of falls through impaired physical function. Examine to what extent baseline measures of volumetric bone mineral density (vBMD), absolute bone mineral content (BMC), and markers of physical function may explain incident hip fractures in older adults with different serum levels of 25(OH)D. A prospective study of 4309 subjects (≥66 years) recruited between 2002 and 2006 into the Age, Gene/Environment Susceptibility-Reykjavik (AGES-Reykjavik) study. Hip fractures occurring until the end of 2012 were extracted from hospital records. Prevalence of serum 25(OH)D deficiency (<30 nmol/L), inadequacy (30-<50 nmol/L), and sufficiency (≥50 nmol/L) was 6%, 23%, and 71% for males; and 11%, 28%, and 53% for females, respectively. Female participants had ~30% lower absolute BMC compared to males. Serum 25(OH)D concentrations were positively associated with vBMD and BMC of the femoral neck and markers of physical function, including leg strength and balance. Those who had deficient compared to sufficient status at baseline had a higher age-adjusted risk of incidence hipfractures with hazard ratios (HRs) of 3.1 (95% confidence interval [CI], 1.9-5.2) and 1.8 (95% CI, 1.3-2.5) among males and females, respectively. When adjusting for vBMD and measures of physical function, the association was attenuated and became nonsignificant for males (1.3; 95% CI, 0.6-2.5) but remained significant for females (1.7; 95% CI, 1.1-2.4). Deficient compared to sufficient serum 25(OH)D status was associated with a higher risk of incident hip fractures. This association was explained by poorer vBMD and physical function for males but to a lesser extent for females. Lower absolute BMC among females due to smaller bone volume may account for these sex-specific differences. © 2021 American Society for Bone and Mineral Research (ASBMR).

Pre-diagnostic 25-hydroxyvitamin D levels and survival in cancer patients.

PURPOSE: Our main aim was to explore whether pre-diagnostic circulating levels of 25-hydroxyvitamin D (25(OH)D) among older individuals with cancer were associated with overall and cancer-specific survival after diagnosis. DESIGN: We used data from the Reykjavik-AGES Study on participants (n = 4,619) without cancer at entry, when blood samples were taken for 25(OH)D standardized measurements. The association with cancer risk, all-cause- and cancer-specific mortality was assessed among those later diagnosed with cancer, comparing four 25(OH)D categories, using 50-69.9 nmol/L as the reference category. RESULTS: Cancer was diagnosed in 919 participants on average 8.3 years after blood draw. No association was observed between the reference group and other 25(OH)D groups and total cancer incidence. Mean age at diagnosis was 80.9 (± 5.7) years. Of those diagnosed, 552 died during follow-up, 67% from cancer. Low pre-diagnostic levels of 25(OH)D < 30 nmol/L were significantly associated with increased total mortality (HR: 1.39, 95% CI 1.03, 1.88) and non-significantly with cancer-specific mortality (HR: 1.33, 95% CI 0.93, 1.90). Among patients surviving more than 2 years after diagnosis, higher pre-diagnostic 25(OH)D levels (≥ 70 nmol/L) were associated with lower risk of overall (HR: 0.68, 95% CI 0.46, 0.99) and cancer-specific mortality (HR: 0.47, 95% CI 0.26, 0.99). CONCLUSIONS: Among elderly cancer patients, low pre-diagnostic serum 25(OH)D levels (< 30 nmol/L) were associated with increased overall mortality.

Dietary intake is associated with risk of multiple myeloma and its precursor disease.

The etiology of monoclonal gammopathy of undetermined significance (MGUS), the precursor state of multiple myeloma (MM), is mostly unknown and no studies have been conducted on the effect of diet on MGUS or progression from MGUS to MM. We aimed to explore the association between common foods and MGUS and progression to MM. Data from the population-based AGES Study (N = 5,764) were utilized. Food frequency questionnaire was used to assess dietary intake during adolescence, midlife, and late life. Serum protein electrophoresis and serum free light-chain assay was performed to identify MGUS (n = 300) and LC-MGUS cases (n = 275). We cross linked our data with the Icelandic Cancer Registry to find cases of MM in the study group. We found that intake of fruit at least three times per week during adolescence was associated with lower risk of MGUS when compared to lower fruit consumption (OR = 0.62, 95% CI 0.41-0.95). We additionally found that intake of fruit at least three times per week during the late life period was associated with decreased risk of progressing from MGUS to MM (HR = 0.34, 95% CI 0.13-0.89) when compared to lower intake. Adolescent intake of fruit may reduce risk of MGUS, whereas fruit intake after MGUS onset may reduce risk of progressing to MM. Our findings suggest that diet might alter the risk of developing MGUS and progression to MM.

Correction: Dietary habits in adolescence and midlife and risk of breast cancer in older women.

[This corrects the article DOI: 10.1371/journal.pone.0198017.].

Dietary habits in adolescence and midlife and risk of breast cancer in older women.

Recent studies indicate that lifestyle factors in early life affect breast cancer risk. We therefore explored the association of high consumption of meat, milk, and whole grain products in adolescence and midlife, on breast cancer risk. We used data from the population based AGES-Reykjavik cohort (2002-2006), where 3,326 women with a mean age of 77 years (SD 6.0) participated. For food items and principal component derived dietary patterns we used Cox proportional models to calculate multivariate hazard ratios (HR) with 95% confidence intervals (95% CI). During a mean follow-up of 8.8 years, 97 women were diagnosed with breast cancer. For both adolescence and midlife, daily consumption of rye bread was positively associated with breast cancer (HR 1.7, 95% CI 1.1-2.6 and HR 1.8, 95% CI 1.1-2.9, respectively). In contrast, persistent high consumption of oatmeal was negatively associated with breast cancer (0.4, 95% CI 0.2-0.9). No association was found for other food items or dietary patterns that included rye bread. High rye bread consumption in adolescence and midlife may increase risk of late-life breast cancer whilst persistent consumption of oatmeal may reduce the risk.

Midlife metabolic factors and prostate cancer risk in later life.

Metabolic syndrome is associated with several cancers, but evidence for aggressive prostate cancer is sparse. We prospectively investigated the influence of metabolic syndrome and its components on risk of total prostate cancer and measures of aggressive disease in a cohort of Icelandic men. Men in the Reykjavik Study (n = 9,097, enrolled 1967-1987) were followed for incident (n = 1,084 total; n = 378 advanced; n = 148 high-grade) and fatal (n = 340) prostate cancer until 2014. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for (1) measured metabolic factors at cohort entry (body mass index (BMI), blood pressure, triglycerides, fasting blood glucose) and (2) a metabolic syndrome score (range 0-4) combining the risk factors: BMI ≥30 kg/m2 ; systolic blood pressure (SBP) ≥130 or diastolic blood pressure (DBP) ≥85 mm Hg or taking antihypertensives; triglycerides ≥150 mg/dl; fasting blood glucose ≥100 mg/dl or self-reported type 2 diabetes. Hypertension and type 2 diabetes were associated with a higher risk of total, advanced, high-grade, and fatal prostate cancer, independent of BMI. Neither BMI nor triglycerides were associated with prostate cancer risk. Higher metabolic syndrome score (3-4 vs 0) was associated with a higher risk of fatal prostate cancer (HR 1.55; 95% CI: 0.89, 2.69; p trend = 0.08), although this finding was not statistically significant. Our findings suggest a positive association between midlife hypertension and diabetes and risk of total and aggressive prostate cancer. Further, metabolic syndrome as a combination of factors was associated with an increased risk of fatal prostate cancer.

[Dietary intake of young Icelanders with psychotic disorders and weight development over an 8-12 months period].

INTRODUCTION: The prevalence of lifestyle related diseases is higher among people with psychotic disorders than the general population. The aim was to assess dietary intake of young people with psychotic disorders for the first time in Iceland. MATERIAL AND METHODS: Subjects were young people (n=48, age 18-30y) with psychotic disorders. Dietary intake was assessed by a 24-hour recall in July-August 2016, and compared with official recommendations and intake of the general public (n=250, age 18-30y). Body weight in the past eight to 12 months, was retrieved from medical records. RESULTS: Consumption of fruits, fish, dairy products, vegetable and fish oil was significantly lower among subjects when compared with the general public, while their soft drink and sweets consumption was higher (p<0.001). Furthermore, the contribution of added sugar was higher (15E% vs. 12E%) and protein intake lower (16E% vs. 18E%). Consumption of omega-3 fatty acids and vitamin D was lower among subjects than the general public and lower than recommended (0.04±0.3% omega-3 of total energy vs. 1.2±0.6%, p<0.001 and 3.1±4.2 µg vitamin D/day vs. 5.6±6.5 µg/day, p<0.001). Almost 40% of the subjects had gained >5% of their initial body weight in the past 8-2 months. CONCLUSION: Diet of young people with psychotic disorders is not consistent with recommendations and is worse than the diet of their peers in the general population. It is important to find ways to improve the diet and thereby nutrient intake of the group. Key words: psychotic disorders, schizophrenia, recommended dietary allowances, fatty acids, omega-3, vitamin D. Correspondence: Ingibjorg Gunnarsdottir, ingigun@landspitali.is.

Early Life Residence, Fish Consumption, and Risk of Breast Cancer.

Background: Little is known about fish intake throughout the life course and the risk of breast cancer.Methods: We used data on the first residence of 9,340 women born 1908 to 1935 in the Reykjavik Study as well as food frequency data for different periods of life from a subgroup of the cohort entering the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study (n = 2,882).Results: During a mean follow-up of 27.3 years, 744 women were diagnosed with breast cancer in the Reykjavik Study. An inverse association of breast cancer was observed among women who lived through the puberty period in coastal villages, compared with women residing in the capital area [HR, 0.78; 95% confidence interval (CI), 0.61-0.99]. In the subgroup analysis of this Icelandic population, generally characterized by high fish intake, we found an indication of lower risk of breast cancer among women with high fish consumption (more than 4 portions per week) in adolescence (HR, 0.71; 95% CI, 0.44-1.13) and midlife (HR, 0.46; 95% CI, 0.22-0.97), compared with low consumers (2 portions per week or less). No association was found for fish liver oil consumption in any time period, which could be due to lack of a reference group with low omega-3 fatty acids intake in the study group.Conclusions: Our findings suggest that very high fish consumption in early to midlife may be associated with a reduced risk of breast cancer.Impact: Very high fish consumption in early adulthood to midlife may be associated with decreased risk of breast cancer. Cancer Epidemiol Biomarkers Prev; 26(3); 346-54. ©2016 AACR.

[Attitudes to food and eating in an Icelandic cohort].

INTRODUCTION: Few studies exist on eating attitudes and well-being of adults in Iceland. In most Western societies great emphasis is placed on a lean and fit body, nevertheless the number of people gaining weigt keeps increasing. Such circumstances may cause discomfort related to food and food choice. The aim of this study was to examine attitudes towards food and eating among Icelandic adults. MATERIAL AND METHODS: We used data from the Icelandic national health survey of 5,861 adults, age 18-79, conducted in 2007. A numerical assessment tool for measuring eating attitude was established, based on answers to questions on eating attitude. We used binary regression models to estimate odds ratios (ORs) for unhealthy eating attitude according to different demographic factors. RESULTS: The prevalence of unhealthy eating attitude according to the measurement tool used in the study was 17% among participants, 22% for women and 11% for men. Unhealthy eating attitude was most prevalent in the age-group 18-29 years (36% of women, 15% of men), among those dissatisfied with their body weight (35% of women, 22% of men) and among those defined as obese (38% of women, 23% of men). CONCLUSION: Our data show that women are more prone to express unhealthy eating attitude compared to men. Those of younger age, with weight dissatisfaction and with high body mass index are positively associated with unhealthy eating attitude, irrespective of gender. KEY WORDS: Diet, Dietary restraint, Public Health, Eating attitude, Body weight satisfaction. Correspondence: Laufey Steingrimsdottir, laufey@hi.is.

Vitamin D Intake and Status in 6-Year-Old Icelandic Children Followed up from Infancy.

High serum 25-hydroxyvitamin D (25(OH)D) levels have been observed in infants in Nordic countries, likely due to vitamin D supplement use. Internationally, little is known about tracking vitamin D status from infancy to childhood. Following up 1-year-old infants in our national longitudinal cohort, our aims were to study vitamin D intake and status in healthy 6-year-old Icelandic children (n = 139) and to track vitamin D status from one year of age. At six years, the mean 25(OH)D level was 56.5 nmol/L (SD 17.9) and 64% of children were vitamin D sufficient (25(OH)D ≥ 50 nmol/L). A logistic regression model adjusted for gender and breastfeeding showed that higher total vitamin D intake (Odds ratio (OR) = 1.27, 95% confidence interval (CI) = 1.08-1.49), blood samples collected in summer (OR = 8.88, 95% CI = 1.83-43.23) or autumn (OR = 5.64, 95% CI = 1.16-27.32) compared to winter/spring, and 25(OH)D at age one (OR = 1.02, 95% CI = 1.002-1.04) were independently associated with vitamin D sufficiency at age six. The correlation between 25(OH)D at age one and six was 0.34 (p = 0.003). Our findings suggest that vitamin D status in infancy, current vitamin D intake and season are predictors of vitamin D status in early school age children. Our finding of vitamin D status tracking from infancy to childhood provides motivation for further studies on tracking and its clinical significance.

Fish and fish-liver oil consumption in adolescence and midlife and risk of CHD in older women.

OBJECTIVE: To study the association of fish and fish-liver oil consumption across the lifespan with CHD later in life among Icelandic women, with special emphasis on the effects of consumption in adolescence. DESIGN: Prevalence association study. Logistic regression was used to estimate odds ratios and 95 % confidence intervals of CHD according to fish or fish-liver oil exposure. Models were adjusted for age, education, concurrent diet and other known risk factors. SETTING: The study was nested within the AGES-Reykjavik Study, conducted in Reykjavik, Iceland. SUBJECTS: Participants were 3326 women aged 66-96 years, with available information on CHD status at entry to the study and information on fish and fish-liver oil consumption during midlife and adolescence. Dietary habits were assessed retrospectively using a validated FFQ. RESULTS: CHD was identified in 234 (7·9 %) women. Compared with women with no intake of fish-liver oil in adolescence or midlife, women who consumed fish-liver oil at least three times weekly in adolescence or in midlife had a decreased risk of CHD (OR=0·62; 95 % CI 0·45, 0·85 and OR=0·68; 95 % CI 0·50, 0·94, respectively). No associations were observed between fish intake (>2 portions/week v. ≤2 portions/week) in adolescence or midlife and CHD in this population with high fish intake. CONCLUSIONS: Fish-liver oil consumption, from early life, may reduce the risk of CHD in older women. Lifelong nutrition may be of importance in the prevention of CHD in older women.

Depression and serum 25-hydroxyvitamin D in older adults living at northern latitudes - AGES-Reykjavik Study.

Low vitamin D status may be associated with depression. Few studies have examined vitamin D and depression in older adults living at northern latitudes. The present study cross-sectionally investigated serum 25-hydroxyvitamin D (25(OH)D) status and depression among 5006 community-dwelling older persons (66-96 years) living in Iceland (latitudes 64-66°N). Depressive symptoms were measured by the fifteen-item Geriatric Depression Scale (GDS-15). Current major depressive disorder was assessed according to Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria. Serum 25(OH)D was analysed using chemiluminescence immunoassay and categorised into three groups: deficient (<30 nmol/l); inadequate (30-49·9 nmol/l); and adequate (≥50 nmol/l). There were twenty-eight (2 %) men and fifty (1 %) women with current major depressive disorder. Mean GDS-15 scores for men and women with adequate vitamin D concentrations were 2·1 and 2·2, respectively. Men and women with deficient v. adequate vitamin D status had more depressive symptoms (higher GDS-15 scores) (difference 0·7 (95 % CI 0·4, 0·9) and 0·4 (95 % CI 0·1, 0·6), respectively). Furthermore, men with deficient vitamin D status were more likely to have current major depressive disorder (adjusted OR 2·51; 95 % CI 1·03, 6·13) compared with men with adequate vitamin D status. Associations among women were not significant. In this older population living at northern latitudes, deficient vitamin D status may be associated with depression. Further investigations are warranted to evaluate the pathways that may be associated with risk of depression among older adults.

Cod liver oil consumption at different periods of life and bone mineral density in old age.

Cod liver oil is a traditional source of vitamin D in Iceland, and regular intake is recommended partly for the sake of bone health. However, the association between lifelong consumption of cod liver oil and bone mineral density (BMD) in old age is unclear. The present study attempted to assess the associations between intake of cod liver oil in adolescence, midlife, and old age, and hip BMD in old age, as well as associations between cod liver oil intake in old age and serum 25-hydroxyvitamin D (25(OH)D) concentration. Participants of the Age, Gene/Environment Susceptibility-Reykjavik Study (age 66-96 years; n 4798), reported retrospectively cod liver oil intake during adolescence and midlife, as well as the one now in old age, using a validated FFQ. BMD of femoral neck and trochanteric region was measured by volumetric quantitative computed tomography, and serum 25(OH)D concentration was measured by means of a direct, competitive chemiluminescence immunoassay. Associations were assessed using linear regression models. No significant association was seen between retrospective cod liver oil intake and hip BMD in old age. Current intake of aged men was also not associated with hip BMD, while aged women with daily intakes had z-scores on average 0.1 higher, compared with those with an intake of < once/week. Although significant, this difference is small, and its clinical relevance is questionable. Intake of aged participants was positively associated with serum 25(OH)D: individuals with intakes of < once/week, one to six time(s)/week and daily intake had concentrations of approximately 40, 50 and 60 nmol/l respectively (P for trend < 0.001).

Plasma phospholipid fatty acids and fish-oil consumption in relation to osteoporotic fracture risk in older adults: the Age, Gene/Environment Susceptibility Study.

BACKGROUND: Polyunsaturated fatty acids (PUFAs) may play a role in fracture, but studies have been largely confined to estimates of dietary intake. OBJECTIVE: We aimed to examine associations between fatty acids measured in late life and fish-oil consumption in early life, midlife, and late life with osteoporotic fracture risk. DESIGN: Osteoporotic fractures were determined from medical records over 5-9 y of follow-up in men and women aged 66-96 y. Data were analyzed from 1438 participants including 898 participants who were randomly selected from the Age, Gene/Environment Susceptibility Study, which is an observational study, and 540 participants with incident fracture. Plasma phospholipid fatty acids were assessed by using gas chromatography. Fish-oil consumption was assessed by using validated questionnaires as never (referent), less than daily, or daily. HRs and 95% CIs adjusted for age, education, height, weight, diabetes, physical activity, and medications were estimated by using Cox regression. RESULTS: In men, the highest tertile of PUFAs, n-3 (ω-3), and eicosapentaenoic acid were associated with decreased fracture risk [HRs (95% CIs): 0.60 (95% CI: 0.41, 0.89), 0.66 (0.45, 0.95), and 0.59 (0.41, 0.86), respectively]. In women, PUFAs tended to be inversely associated with fracture risk (P-trend = 0.06), but tertiles 2 and 3 were not independently associated with risk. Tertile 2 of n-6 and arachidonic acid was associated with fracture risk in women [HRs (95% CIs): 1.43 (1.10, 1.85) and 1.42 (1.09, 1.85), respectively]. Daily fish-oil consumption in late life was associated with lower fracture risk in men (HR: 0.64; 95% CI: 0.45, 0.91). Daily fish-oil consumption in midlife was associated with lower fracture risk in women (HR: 0.75; 95% CI: 0.58, 0.98). CONCLUSIONS: Greater PUFA concentrations may be associated with lower osteoporotic fracture risk in older adults, particularly in men. Critical time periods for n-3 fatty acid consumption may differ by sex.

[Urban-rural differences in diet, BMI and education of men and women in Iceland]. / Áhrif búsetu og menntunar á mataræði og líkamsthyngdarstuðul kvenna og karla.

INTRODUCTION: Previous Icelandic studies have reported higher prevalence of obesity among women residing outside the capital area but no comparable information is available for men. The aim of this study was to assess diet and body mass index (BMI) of adult men and women residing within and outside the capital area. MATERIAL AND METHODS: Participants were 1312 men and women,18-80 years, from a random sample of the national registry, response rate 68.6%. Diet was assessed during years 2010 to 2011 using repeated 24-hour recall, weight and height self-reported. OR of BMI≥25 kg/m2 was calculated according to residence and education. RESULTS: Women≥46 years within the capital area had lower BMI, or 25.7 kg/m2 vs 28.4 kg/m2 p=0.007, and were less likely to have BMI>25 kg/m2, OR=0.64; CI 0.41-1.0 than those outside the area. No difference was found between the areas among men or younger women. Diets outside the capital had higher percentage of total fat compared than inside the capital. Saturated fatty acid (SFA) were 15.7E% vs 13.9E% for men, p<0.001 and 14.8E% vs 14.0E%, p=0.007 for women and trans fatty acids (TFA) were 0.9E% vs 0.7E% p%lt;0.001 and 0.8E% vs 0.7E% p=0.001 for men and women respectively. CONCLUSIONS: Women's BMI is less associated with residence than in former Icelandic studies. Men's BMI is not associated with residence. Diets within the capital area are closer to recommended intake compared with diets outside the area.

[National nutrition surveys and dietary changes in Iceland. Economic differences in healthy eating]. / Kannanir á mataræði og næringargildi fæðunnar á Íslandi.

INTRODUCTION: Here we compare results on food and nutrient intake from the two most recent Icelandic national nutrition surveys from 2010/11 and 2002 and compare intake of energy giving nutrients from 1990. Finally we assess associations beween a healthy diet and difficulties people have in making ends meet. MATERIALS AND METHODS: Participants were selected by a random sample from the national register. Final sample was 1912 individuals in 2010/11 and 1934 in 2002, response rate 68.6% and 70.6% respectively. Diet was assessed by 24-hour recall. Results from the surveys were calculated using t-test and sssociations between a healthy diet and difficulties making ends meet by linear regression. RESULTS: Consumption of bread, bisquits, cakes and cookies, margarine, highly processed meat products, chips, sugared soft drinks and whole milk was lower in 2010/11 than in 2002 while consumption of whole grain bread, oat meal, fruits, vegetables, meat and cod liver oil was higher. Fish intake was unchanged. Fat intake decreased from 1990 to 2010/11, from 41E% to 35E%, saturated fatty acids from 20.0E% to 14.5E% and trans-fatty acids from 2.0E% to 0.8E%. Most of the changes occurred between 1990 and 2002. People having difficulties making ends meet consumed less fruits, vegetables and whole grain bread but more soft drinks in 2010/11 than those not having difficulties. CONCLUSION: Dietary changes in Iceland from 2002 have mostly been toward recommended intake. Between 1990 and 2002 fat consumption decreased considerably, while less significant changes occurred from 2002 til 2010/11. Economic status is associated with healthy diet in Iceland.

Hip fractures and bone mineral density in the elderly--importance of serum 25-hydroxyvitamin D.

BACKGROUND: The significance of serum 25-hydroxyvitamin D [25(OH)D] concentrations for hip fracture risk of the elderly is still uncertain. Difficulties reaching both frail and healthy elderly people in randomized controlled trials or large cohort studies may in part explain discordant findings. We determined hazard ratios for hip fractures of elderly men and women related to serum 25(OH)D, including both the frail and the healthy segment of the elderly population. METHODS: The AGES-Reykjavik Study is a prospective study of 5764 men and women, age 66-96 years, based on a representative sample of the population of Reykjavik, Iceland. Participation was 71.8%. Hazard ratios of incident hip fractures and baseline bone mineral density were determined according to serum concentrations of 25(OH)D at baseline. RESULTS: Mean follow-up was 5.4 years. Compared with referent values (50-75 nmol/L), hazard ratios for hip fractures were 2.24 (95% CI 1.63, 3.09) for serum 25(OH)D <30 nmol/L, adjusting for age, sex, body mass index, height, smoking, alcohol intake and season, and 2.08 (95% CI 1.51, 2.87), adjusting additionally for physical activity. No difference in risk was associated with 30-50 nmol/L or ≥75 nmol/L in either model compared with referent. Analyzing the sexes separately, hazard ratios were 2.61 (95% CI 1.47, 4.64) in men and 1.93 (95% CI 1.31, 2.84) in women. Values <30 nmol/L were associated with significantly lower bone mineral density of femoral neck compared with referent, z-scores -0.14 (95% CI -0.27, -0.00) in men and -0.11 (95% CI -0.22, -0.01) in women. CONCLUSIONS: Our results lend support to the overarching importance of maintaining serum 25(OH)D above 30 nmol/L for bone health of elderly people while potential benefits of having much higher levels could not be detected.