Patterns of sitting and mortality in the Nord-Trøndelag health study (HUNT).

BACKGROUND: Current evidence concerning sedentary behaviour and mortality risk has used single time point assessments of sitting. Little is known about how changes in sitting levels over time affect subsequent mortality risk. AIM: To examine the associations between patterns of sitting time assessed at two time points 11 years apart and risk of all-cause and cardio-metabolic disease mortality. METHODS: Participants were 25,651 adults aged > =20 years old from the Nord-Trøndelag Health Study with self-reported total sitting time in 1995-1997 (HUNT2) and 2006-2008 (HUNT3). Four categories characterised patterns of sitting: (1) low at HUNT2/ low at HUNT3, 'consistently low sitting'; (2) low at HUNT2/high at HUNT3, 'increased sitting'; (3) high at HUNT2/low at HUNT3, 'reduced sitting'; and (4) high at HUNT2 /high at HUNT3, 'consistently high sitting'. Associations of sitting pattern with all-cause and cardio-metabolic disease mortality were analysed using Cox regression adjusted for confounders. RESULTS: Mean follow-up was 6.2 years (158880 person-years); 1212 participants died. Compared to 'consistently low sitting', adjusted hazard ratios for all-cause mortality were 1.51 (95% CI: 1.28-2.78), 1.03 (95% CI: 0.88-1.20), and 1.26 (95% CI: 1.06-1.51) for 'increased sitting', 'reduced sitting' and 'consistently high sitting' respectively. CONCLUSIONS: Examining patterns of sitting over time augments single time-point analyses of risk exposures associated with high sitting time. Whilst sitting habits can be stable over a long period, life events (e.g., changing jobs, retiring or illness) may influence sitting trajectories and therefore sitting-attributable risk. Reducing sitting may yield mortality risks comparable to a stable low-sitting pattern.

Multiple lifestyle behaviours and mortality, findings from a large population-based Norwegian cohort study - The HUNT Study.

BACKGROUND: Lifestyle risk behaviours are responsible for a large proportion of disease burden and premature mortality worldwide. Risk behaviours tend to cluster in populations. We developed a new lifestyle risk index by including emerging risk factors (sleep, sitting time, and social participation) and examine unique risk combinations and their associations with all-cause and cardio-metabolic mortality. METHODS: Data are from a large population-based cohort study in a Norway, the Nord-Trøndelag Health Study (HUNT), with an average follow-up time of 14.1 years. Baseline data from 1995-97 were linked to the Norwegian Causes of Death Registry. The analytic sample comprised 36 911 adults aged 20-69 years. Cox regression models were first fitted for seven risk factors (poor diet, excessive alcohol consumption, current smoking, physical inactivity, excessive sitting, too much/too little sleep, and poor social participation) separately and then adjusted for socio-demographic covariates. Based on these results, a lifestyle risk index was developed. Finally, we explored common combinations of the risk factors in relation to all-cause and cardio-metabolic mortality outcomes. RESULTS: All single risk factors, except for diet, were significantly associated with both mortality outcomes, and were therefore selected to form a lifestyle risk index. Risk of mortality increased as the index score increased. The hazard ratio for all-cause mortality increased from 1.37 (1.15-1.62) to 6.15 (3.56-10.63) as the number of index risk factors increased from one to six respectively. Among the most common risk factor combinations the association with mortality was particularly strong when smoking and/or social participation were included. CONCLUSIONS: This study adds to previous research on multiple risk behaviours by incorporating emerging risk factors. Findings regarding social participation and prolonged sitting suggest new components of healthy lifestyles and potential new directions for population health interventions.

Effects of single genetic variants and polygenic obesity risk scores on disordered eating in adolescents - The HUNT study.

PURPOSE: Improving the understanding of the role of genetic risk on disordered eating (DE). METHODS: A case-control study including 1757 (F: 979, M: 778) adolescents (aged 13-19 years) from the Nord-Trøndelag Health Study (HUNT), an ethnically homogenous Norwegian population based study. Cases and controls were defined using a shortened version of the Eating Attitude Test. Logistic regression was employed to test for associations between DE phenotypes and 24 obesity and eating disorder susceptibility SNPs, and the joint effect of a subset of these in a genetic risk score (GRS). RESULTS: COMT was shown to be associated with poor appetite/undereating (OR: 0.6, CI 95%: 0.43-0.83, p = 0.002). Independent of obesity associations, the weighted GRS was associated to overeating in 13-15 year old females (OR: 2.07, CI 95%: 1.14-3.76, p = 0.017). Additionally, a significant association was observed between the GRS and loss of control over eating in the total sample (OR: 1.62, CI 95%: 1.01-2.61, p = 0.046). CONCLUSIONS: The COMT variant (rs4680) was associated with poor appetite/undereating. Our study further confirms prior findings that obesity risk also confers risk for loss of control over eating; and overeating amongst girls.

Blood pressure changes during 22-year of follow-up in large general population - the HUNT Study, Norway.

BACKGROUND: While hypertension still is a major health problem worldwide, some studies have indicated that the blood pressure level has decreased in some populations. This population based cohort study aims at analysing blood pressure changes in a large Norwegian population over a 22 year period. METHODS: Data is acquired from three comprehensive health surveys of the HUNT Study conducted from 1984-86 to 2006-08. All citizens of Nord-Trøndelag County, Norway, >20 years were invited: 74,549 individuals participated in 1984-86; 64,523 in 1995-97; and 43,905 in 2006-08. RESULTS: Both systolic and diastolic blood pressure levels decreased substantially from mid 1980s to mid 2000s, with the most pronounced decrease from 1995-97 to 2006-08 (from 136.0/78.9 to 128.3/70.9 mmHg in women and from 140.1/82.1 to 133.7/76.5 mmHg in men). Although the use of blood pressure lowering medication increased, there was a considerable decrease even in those who reported never use of medication (mean decrease 6.8/7.2 mmHg in women and 6.3/5.3 mmHg in men), and the decrease was most pronounced in the elderly (mean decrease 16.1/12.4 mmHg in women and 14.7/10.4 mmHg in men aged 80+). Mean heart rate, total cholesterol and daily smoking decreased, self-reported hard physical activity increased, while body weight and the prevalence of diabetes increased during the same period. CONCLUSIONS: The BP decrease might seem paradoxically, as body weight and prevalence of diabetes increased during the same period. Salt consumption might have decreased, but no salt data is available. The parallel decrease in mean heart rate might indicate reduction in the white-coat phenomenon, or increased use of beta blockers or calcium channel blockers for other diagnosis than hypertension. Additionally, the data could support the "healthy obese" hypothesis, i.e., that subgroups in the population can sustain obesity without serious health consequences.

Cultural activity participation and associations with self-perceived health, life-satisfaction and mental health: the Young HUNT Study, Norway.

BACKGROUND: Leisure time activities and culture participation may have health effects and be important in pulic health promotion. More knowledge on how cultural activity participation may influence self-perceived health, life-satisfaction, self-esteem and mental health is needed. METHODS: This article use data from the general population-based Norwegian HUNT Study, using the cross-sectional Young-HUNT3 (2006-08) Survey including 8200 adolescents. Data on cultural activity participation, self-perceived health, life-satisfaction, self-esteem, anxiety and depression were collected by self-reported questionnaires. RESULTS: Both attending meetings or training in an organisation or club, and attending sports events were positively associated with each of the health parameters good self-percieved health, good life-satisfaction, good self-esteem, and low anxiety and depression symptoms. We found differences according to gender and age (13-15 years versus 16-19 years old) for several culture activities, where girls aged 16-19 years seemed to benefit most from being culturally active. The extent of participation seemed to matter. Those who had frequent participation in cultural activities reported better health outcomes compared to inactive adolecents. CONCLUSIONS: The results from this study indicate that participation in cultural activities may be positively associated with health, life-satisfaction and self-esteem in adolescents and thus important in public health promotion. Possible sex and age differences should be taken into account.

Sedentary behaviour and risk of mortality from all-causes and cardiometabolic diseases in adults: evidence from the HUNT3 population cohort.

BACKGROUND: Sedentary behaviour is a potential risk factor for chronic-ill health and mortality, that is, independent of health-enhancing physical activity. Few studies have investigated the risk of mortality associated with multiple contexts of sedentary behaviour. OBJECTIVE: To examine the prospective associations of total sitting time, TV-viewing time and occupational sitting with mortality from all causes and cardiometabolic diseases. METHODS: Data from 50,817 adults aged ≥20 years from the Nord-Trøndelag Health Study 3 (HUNT3) in 2006-2008 were linked to the Norwegian Cause of Death Registry up to 31 December 2010. Cox proportional hazards models examined all-cause and cardiometabolic disease-related mortality associated with total sitting time, TV-viewing and occupational sitting, adjusting for multiple potential confounders including physical activity. RESULTS: After mean follow-up of 3.3 years (137,315.8 person-years), 1068 deaths were recorded of which 388 were related to cardiometabolic diseases. HRs for all-cause mortality associated with total sitting time were 1.12 (95% CI 0.89 to 1.42), 1.18 (95% CI 0.90 to 1.57) and 1.65 (95% CI 1.24 to 2.21) for total sitting time 4-<7, 7-<10 and ≥10 h/day, respectively, relative to <4 h/day after adjusting for confounders (p-trend=0.001). A similar pattern of associations was observed between total sitting time and mortality from cardiometabolic diseases, but TV-viewing time and occupational sitting showed no or borderline significant associations with all-cause or cardiometabolic disease-related mortality over the same follow-up period. CONCLUSIONS: Total sitting time is associated with all-cause and cardiometabolic disease-related mortality in the short term. However, prolonged sitting in specific contexts (ie, watching TV, at work) do not adversely impact health in the same timeframe. These findings suggest that adults should be encouraged to sit less throughout the day to reduce their daily total sitting time.

Intergenerational Hazardous Alcohol Use and Area Factors: The HUNT Study, Norway.

BACKGROUND: Alcohol use among adolescents has been found to be associated with parental alcohol abuse, but it's relation to more prevalent forms of hazardous drinking patterns among parents has been less explored. Few studies have included area factors when investigating alcohol use across generations. OBJECTIVES: The aims of this study were to investigate whether adolescent intoxication was associated with parental heavy episodic drinking (HED) and intoxication, area-level socioeconomic status (SES), and rates of area-level HED. METHODS: General Estimation Equations (GEE) was applied to analyze data from the Nord-Trøndelag Health Study (2006-08) including 2,306 adolescents. Adolescent alcohol use was defined by self-reported frequency of intoxication. Parental alcohol use was defined by parental self-reports of drinking five glasses of alcohol at one occasion (HED), whether they had been strongly intoxicated, and adolescent reports of seeing parents intoxicated. Area-level SES and HED were based on data from HUNT3 and Statistics Norway. RESULTS: Parental and offspring alcohol use were associated, although this varied to some extent with gender and exposures. The strongest associations were found between offspring intoxication and offspring reports of seeing their parent intoxicated (girls: OR 3.3, 95% CI 2.3-4.7; boys: OR 3.4, 95% CI 2.4-4.7). Intoxication was more common among girls, who lived in areas with a higher level of adult HED. Living in areas with higher SES was associated with less intoxication among adolescents. CONCLUSION: Intoxication in adolescence was associated with factors at both family and area level, which emphasize the need of both population and high risk preventive approaches.

The prevalence of metabolic syndrome and metabolically healthy obesity in Europe: a collaborative analysis of ten large cohort studies.

BACKGROUND: Not all obese subjects have an adverse metabolic profile predisposing them to developing type 2 diabetes or cardiovascular disease. The BioSHaRE-EU Healthy Obese Project aims to gain insights into the consequences of (healthy) obesity using data on risk factors and phenotypes across several large-scale cohort studies. Aim of this study was to describe the prevalence of obesity, metabolic syndrome (MetS) and metabolically healthy obesity (MHO) in ten participating studies. METHODS: Ten different cohorts in seven countries were combined, using data transformed into a harmonized format. All participants were of European origin, with age 18-80 years. They had participated in a clinical examination for anthropometric and blood pressure measurements. Blood samples had been drawn for analysis of lipids and glucose. Presence of MetS was assessed in those with obesity (BMI ≥ 30 kg/m2) based on the 2001 NCEP ATP III criteria, as well as an adapted set of less strict criteria. MHO was defined as obesity, having none of the MetS components, and no previous diagnosis of cardiovascular disease. RESULTS: Data for 163,517 individuals were available; 17% were obese (11,465 men and 16,612 women). The prevalence of obesity varied from 11.6% in the Italian CHRIS cohort to 26.3% in the German KORA cohort. The age-standardized percentage of obese subjects with MetS ranged in women from 24% in CHRIS to 65% in the Finnish Health2000 cohort, and in men from 43% in CHRIS to 78% in the Finnish DILGOM cohort, with elevated blood pressure the most frequently occurring factor contributing to the prevalence of the metabolic syndrome. The age-standardized prevalence of MHO varied in women from 7% in Health2000 to 28% in NCDS, and in men from 2% in DILGOM to 19% in CHRIS. MHO was more prevalent in women than in men, and decreased with age in both sexes. CONCLUSIONS: Through a rigorous harmonization process, the BioSHaRE-EU consortium was able to compare key characteristics defining the metabolically healthy obese phenotype across ten cohort studies. There is considerable variability in the prevalence of healthy obesity across the different European populations studied, even when unified criteria were used to classify this phenotype.

General, but not abdominal, overweight increases odds of asthma among Norwegian adolescents: the Young-HUNT study.

AIM: The aim of this analysis was to examine the association between asthma and general and abdominal weight status, defined by age- and sex-specific cut-offs for body mass index (BMI) and waist circumference (WC) in adolescents. METHODS: Participants aged 12-19 years in the Young-HUNT (YH) Study (YH1 1995-1997: n = 8222; YH3 2006-2008: n = 7403) completed self-administered questionnaires in school as part of a series of cross-sectional, population-based studies conducted in Nord-Trøndelag, Norway. Weight, height and WC were measured. Adjusted odds ratios (ORs) and 95% Confidence Intervals (CI) for asthma, defined by self-reported physician diagnosis, were calculated. Potential effect modifiers evaluated included sex and pubertal development status (PDS). RESULTS: Asthma was reported by 11.8% of the adolescents in YH1 and 17.0% in YH3. Asthma odds significantly increased for adolescents with general (OR = 1.33; 95%CI: 1.13, 1.56), but not abdominal, overweight and increased for adolescents with general (OR = 1.34; 95%CI: 1.02, 1.75) or abdominal obesity (OR = 1.36; 95%CI: 1.16, 1.60). Underweight had no association with asthma regardless of weight assessment type, and PDS did not meaningfully influence the associations between asthma and weight. CONCLUSION: Overweight and obesity both increased the odds of asthma in 12-19 year-old Norwegians. WC did not add further information to that already provided by BMI to improve our understanding of the association between asthma and weight.

Smoking, alcohol consumption, and drug use among adolescents with psychiatric disorders compared with a population based sample.

This study investigated frequencies of smoking, alcohol use, and illicit drug use by diagnostic category in 566 adolescent psychiatric patients, comparing this sample with 8173 adolescents from the general population in Norway who completed the Young-HUNT 3 survey. Frequencies of current alcohol use were high in both samples but were lower among psychiatric patients. Compared with adolescents in the general population, adolescents in the clinical sample had a higher prevalence of current smoking and over four times higher odds of having tried illicit drugs. In the clinical sample, those with mood disorders reported the highest frequencies of smoking, alcohol use, and illicit drug use, whereas those with autism spectrum disorders reported the lowest frequencies. Our results show an increased prevalence of risky health behaviors among adolescents with psychiatric disorders compared with the general population. The awareness of disorder-specific patterns of smoking and substance use may guide preventive measures.

Medical benefits in young Norwegians and their parents, and the contribution of family health and socioeconomic status. The HUNT Study, Norway.

AIMS: Family and intergenerational perspectives might contribute to a better understanding of why young people in many European countries experience work impairment and end up being dependent on public benefits for life sustenance. The aim of this cohort study was to explore the relationship between the receipt of medical benefits in parents and their young adult offspring and the contributions of family health and family socioeconomic status. METHODS: Baseline information on the health of 7597 adolescents and their parents who participated in the HUNT Study 1995-1997 was linked to national registers to identify long-term receipt of medical benefits for parents (1992-1997) and adolescents as they entered adulthood (1998-2008). We used logistic regression to explore the association between parent and offspring receipt of medical benefits, adjusting for family health and socioeconomic status. RESULTS: Among adolescents, 13% received medical benefits from age 20-29. Adolescents whose parents had received medical benefits (26%) were more likely to receive such benefits themselves from age 20-29 compared with adolescents without benefit-receiving parents (age- and sex-adjusted odds ratio (OR) 2.16, 95 % confidence interval (CI) 1.86-2.49). Adjustment for family health reduced this estimate considerably (to OR 1.66, 95% CI 1.38-1.99), whereas adjustment for family socioeconomic status had less impact. CONCLUSIONS: Adolescents whose parents receive medical benefits enter adult working life with an elevated risk of health-related work exclusion. Family health vulnerability appears to be a key to understanding this association, suggesting that more attention to intergenerational continuities of health could be a way to prevent welfare dependence in future generations.

High school dropout and long-term sickness and disability in young adulthood: a prospective propensity score stratified cohort study (the Young-HUNT study).

BACKGROUND: High school dropout and long-term sickness absence/disability pension in young adulthood are strongly associated. We investigated whether common risk factors in adolescence may confound this association. METHODS: Data from 6612 school-attending adolescents (13-20 years old) participating in the Norwegian Young-HUNT1 Survey (1995-1997) was linked to long-term sickness absence or disability pension from age 24-29 years old, recorded in the Norwegian Labour and Welfare Organisation registers (1998-2008). We used logistic regression to estimate risk differences of sickness or disability for school dropouts versus completers, adjusting for health, health-related behaviours, psychosocial factors, school problems, and parental socioeconomic position. In addition, we stratified the regression models of sickness and disability following dropout across the quintiles of the propensity score for high school dropout. RESULTS: The crude absolute risk difference for long-term sickness or disability for a school dropout compared to a completer was 0.21% or 21% points (95% confidence interval (CI), 17 to 24). The adjusted risk difference was reduced to 15% points (95% CI, 12 to 19). Overall, high school dropout increased the risk for sickness or disability regardless of the risk factor level present for high school dropout. CONCLUSION: High school dropouts have a strongly increased risk for sickness and disability in young adulthood across all quintiles of the propensity score for dropout, i.e. independent of own health, family and socioeconomic factors in adolescence. These findings reveal the importance of early prevention of dropout where possible, combined with increased attention to labour market integration and targeted support for those who fail to complete school.

Social and spatial patterns of obesity diffusion over three decades in a Norwegian county population: the HUNT Study.

BACKGROUND: In order to develop effective preventive strategies, knowledge of trends in socioeconomic and geographical differences in risk factor levels is important. The objective of this study was to examine social and spatial patterns of obesity diffusion in a Norwegian population during three decades. METHODS: Data on adults aged 30-69 years from three cross-sectional health surveys eleven years apart in the Nord-Trøndelag Health Study, Norway, HUNT1 (1984-1986), HUNT2 (1995-1997) and HUNT3 (2006-2008) were utilized. Body mass index (BMI) was used as a measure of obesity. Height and weight were measured clinically. Age standardized prevalences, absolute prevalence differences and ratios, prevalence odds ratios for BMI and the Relative Index of Inequality (RII) were calculated. Multilevel statistical models were fitted for analysing geographical patterns. RESULTS: The prevalence of obesity was systematically higher in groups with lower socio-economic status and increased successively in all groups in the population during the three decades. The relative socioeconomic inequalities in obesity measured by level of education did not change substantially in the period. In HUNT1 (1984-86) obesity was most prevalent among low educated women (14.1%) and in HUNT3 (2006-08) among low educated men (30.4%). The RII for men changed from 2.60 to 1.91 and 2.36 in HUNT1, HUNT2 and HUNT3. In women the RIIs were 1.71, 2.28 and 2.30 correspondingly. However, the absolute obesity prevalence inequalities increased, and a geographical diffusion from central to distal districts was observed from HUNT2 to HUNT3. CONCLUSIONS: The prevalence of obesity increased in all socioeconomic groups in this Norwegian adult county population from the 1980ies up to present time. The data did not suggest increasing relative inequalities, but increasing absolute socioeconomic differences and a geographical diffusion towards rural districts. Public health preventive strategies should be oriented to counteract the obesity epidemic in the population.

Is physical activity maintenance from adolescence to young adulthood associated with reduced CVD risk factors, improved mental health and satisfaction with life: the HUNT Study, Norway.

BACKGROUND: Little is known about the effect maintaining physical activity throughout adolescence has on cardiovascular risk factors and health status in early adulthood. This ten-year prospective longitudinal study investigated whether differences in physical activity patterns from adolescence to young-adulthood showed different associations with subsequent cardio-metabolic risk factors and mental health in young-adulthood. METHODS: Based on the second and third Norwegian Nord-Trøndelag Health Surveys (HUNT2 and 3), we included 1869 individuals (838 males) participating in Young-HUNT (1995-97), aged 13-19 years and followed-up at HUNT3 (2006-08), aged 23-31. Self-reported physical activity (PA), mental health and perceived health were recorded, along with measurements of body mass index (BMI), waist circumference (WC), total cholesterol (TC), HDL cholesterol, glucose, triglycerides, resting heart rate (HR) and blood pressure. We used separate linear regressions models to investigate associations between physical activity and each CVD risk factor, and logistic regression analysis to examine PA patterns and subsequent mental health. Physically active maintainers were compared to inactive maintainers. Adopters (inactive as adolescents and physically active as young adults) were compared to inactive maintainers and to those who discontinued activity (relapsers). RESULTS: Active maintainers had significantly lower HR, compared to all other PA patterns. Active maintaining men had significantly lower WC than relapsers and inactive maintainers. When adjusted for age and gender, WC, BMI, HR, diastolic blood pressure and HDL-C showed significant differences comparing active maintaining to other PA patterns. Comparing inactive maintainers against adopters, only HR was significantly lower. Male adopters did not differ significantly in CVD risk compared to inactive maintainers and relapsers. Among females adopting was associated with lower HR and TC compared to inactive maintainers. Active maintainers showed better mental health than inactive maintainers. Active maintaining males had an increased likelihood of good mental health compared to adopters. Active maintaining females reported greater satisfaction with life compared to adopters. CONCLUSIONS: Those who maintained their physical activity from adolescence to young adulthood demonstrated a significantly lower CVD risk and better mental health, compared to inactive maintainers. Compared to inactivity maintainers and relapsers, adopting physical activity was not significantly associated with lowered CVD risk. Adopting physical activity between adolescence and young adulthood may not necessarily protect against mental distress.

Leisure time activities in adolescence in the presence of susceptibility genes for obesity: risk or resilience against overweight in adulthood? The HUNT study.

BACKGROUND: Environment, health behavior, and genetic background are important in the development of obesity. Adolescents spend substantial part of daily leisure time on cultural and social activities, but knowledge about the effects of participation in such activities on weight is limited. METHODS: A number of 1450 adolescents from the Norwegian HUNT study (1995-97) were followed-up in 2006-08 as young adults. Phenotypic data on lifestyle and anthropometric measures were assessed using questionnaires and standardized clinical examinations. Genotypic information on 12 established obesity-susceptibility loci were available for analyses. Generalized estimating equations were used to examine the associations between cultural and social activities in adolescence and adiposity measures in young adulthood. In addition, interaction effects of a genetic predisposition score by leisure time activities were tested. RESULTS: In girls, participation in cultural activities was negatively associated with waist circumference (WC) (B = -0.04, 95%CI: -0.08 to -0.00) and with waist-hip ratio (WHR) (B = -0.058, 95%CI: -0.11 to -0.01). However, participation in social activities was positively associated with WC (B = 0.040, CI: 0.00 to 0.08) in girls and with BMI (B = 0.027, CI: 0.00 to 0.05) in boys. The effect of the obesity-susceptibility genetic variants on anthropometric measures was lower in adolescents with high participation in cultural activities compared to adolescents with low participation. CONCLUSION: This study suggests that the effects of cultural activities on body fat are different from the effects of participation in social activities. The protective influence of cultural activities in female adolescents against overweight in adulthood and their moderating effect on obesity-susceptibility genes suggest that even cultural activities may be useful in public health strategies against obesity.

Psychological factors and weight problems in adolescents. The role of eating problems, emotional problems, and personality traits: the Young-HUNT study.

BACKGROUND: The associations between psychological factors and weight problems in adolescents are not conclusive. We studied associations between psychological factors, including personality and weight problems, in an adolescent population. In addition, we examined the same psychological factors as predictors for change in weight categories during adolescence. METHOD: From 1995 to 1997, 8,090 adolescents, aged 13-18 years, participated in the Young-HUNT-I study; of those, 1,619 also participated in a follow-up study in 2000-2001. They completed a questionnaire monitoring eating problems, self-esteem, personality, anxiety, and depression, and had their height and weight measured. Weight problems were defined using the international age-and sex-specific BMI-cut-offs defining underweight, overweight, and obesity. Psychological factors at baseline were studied both in relation to weight categories at baseline, and as predictors for weight change between baseline and the follow-up. RESULTS: Significant sex differences in mean values were found in all psychological factors, with higher scores in girls compared with boys. In the cross-sectional design, eating problems were associated with weight problems, and the two factors of oral control (EAT-A) and food preoccupation (EAT-B) showed an inverse association. Oral control was associated with underweight, while food preoccupation was associated with overweight and obesity in both sexes. Low self-esteem was associated with overweight and obesity in both sexes, but no association was found between emotional problems or personality traits, and weight problems. During the follow-up, oral control was a clear predictor of weight change during adolescence in both sexes. Oral control protected against unhealthy weight gain but also predicted unhealthy weight reduction in both sexes. CONCLUSIONS: Girls scored higher on all psychological factors compared with boys, but no sex differences were found with regard to the association between psychological factors and weight problems. Eating problems showed the strongest association with weight problems at baseline and were also the strongest predictor of weight change during adolescence.

Association between blood pressure measures and recurrent headache in adolescents: cross-sectional data from the HUNT-Youth study.

The relationship between blood pressure and headache in youth has not been explored and the objective of the present study was to provide data on this association in an adolescent population. Cross-sectional data from a large population-based survey, the Young-HUNT study, on 5,847 adolescents were used to evaluate the association between blood pressure (systolic, diastolic, mean arterial and pulse pressure) and recurrent headache, including migraine and tension-type headache. Increasing pulse pressure was inversely related to recurrent headache prevalence, and both tension-type headache and migraine. For systolic blood pressure such an inverse relationship was present for recurrent headache and tension-type headache prevalence. For migraine, the results were not significant, although there was a tendency in the same direction (p = 0.05). High-pulse pressure has previously been found to be inversely related to the prevalence of migraine and tension-type headache in an adult population. This inverse relationship has now been demonstrated to be present among adolescents also, supporting the results from a previous study in adults, that blood pressure regulation may be linked to the pathophysiology of headache.

Intergenerational polygenic obesity risk throughout adolescence in a cross-sectional study design: The HUNT study, Norway.

OBJECTIVE: This study examined the relationship between parental obesity polygenic risk and children's BMI throughout adolescence. Additionally, from a smaller subsample, the objective was to assess whether parental polygenic risk score (PRS) may act as a proxy for offspring PRS in studies lacking offspring genetic data. METHODS: A total of 8,561 parent-offspring (age 13-19 years) trios from the Trøndelag Health Study (the HUNT Study) were included, of which, 1,286 adolescents had available genetic data. Weighted parental PRSs from 900 single-nucleotide polymorphisms robustly associated with adult BMI were constructed and applied in linear mixed-effects models. RESULTS: A positive association between parental PRS and offspring sex- and age-adjusted BMI (iso-BMI) throughout adolescence was identified. The estimated marginal effects per standard deviation increase in parental PRS were 0.26 (95% CI: 0.18-0.33), 0.36 (95% CI: 0.29-0.43), and 0.62 kg/m2 (95% CI: 0.51-0.72) for maternal, paternal, and combined parental PRS, respectively. In subsample analyses, the magnitude of association of the parental PRS versus offspring PRS with iso-BMI in adolescents was similar. CONCLUSIONS: Parental PRS was consistently associated with offspring iso-BMI throughout adolescence. Results from subsample analyses support the use of parental PRS of obesity as a proxy for adolescent PRS in the absence of offspring genetic data.

Spirometric phenotypes from early childhood to young adulthood: a Chronic Airway Disease Early Stratification study.

BACKGROUND: The prevalences of obstructive and restrictive spirometric phenotypes, and their relation to early-life risk factors from childhood to young adulthood remain poorly understood. The aim was to explore these phenotypes and associations with well-known respiratory risk factors across ages and populations in European cohorts. METHODS: We studied 49 334 participants from 14 population-based cohorts in different age groups (≤10, >10-15, >15-20, >20-25 years, and overall, 5-25 years). The obstructive phenotype was defined as forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) z-score less than the lower limit of normal (LLN), whereas the restrictive phenotype was defined as FEV1/FVC z-score ≥LLN, and FVC z-score

Allergy related disorders among 2-yrs olds in a general population. The PACT Study.

Allergic disorders represent a major health problem in most developed countries, but few population-based studies have focused on these disorders in early childhood. The aims of the present study were to investigate the prevalence, gender differences and distribution of allergy related disorders and their association to sensitization among unselected children, 2 yrs of age, in a general population. A population-based study with parental self reported questionnaire data involving allergy related symptoms and results from allergy tests from 4783 two-yr-old children was conducted, and skin prick tests (SPT) of a randomly selected sample comprising 390 children were performed. In the total population the prevalence of reported wheeze was 26%, doctor diagnosed asthma (DDAsthma) 7.0%, atopic dermatitis (AD) 17% and allergic rhinoconjunctivitis (ARC) 3%. Of the 1008 (21%) allergy tested children 59% reported a positive test, but of the randomly selected children only 8% had a positive SPT. Children with AD were most frequently sensitized and children with ARC were most likely to have other allergy related disorders (70%). More boys than girls had an allergy related disorder or a positive allergy test. In conclusion, two in five had an allergy related disorder, but less than 10% had a positive SPT. Having one allergic disorder, especially ARC, increased substantially the risk of having another, and having AD was most strongly associated to a positive allergy test. Moreover, boys were more likely than girls to have an allergy related disorder or a positive SPT indicating a gender difference in the natural history of allergy related disorders.