Koenraad Cuypers

Patterns of receptive and creative cultural activities and their association with perceived health, anxiety, depression and satisfaction with life among adults: the HUNT study, Norway

Background Cultural participation has been used both in governmental health policies and as medical therapy, based on the assumption that cultural activities will improve health. Previous population studies and a human intervention study have shown that religious, social and cultural activities predict increased survival rate. The aim of this study was to analyse the association between cultural activity and perceived health, anxiety, depression and satisfaction with life in both genders. Methods The study is based on the third population-based Nord-Trøndelag Health Study (2006–2008), including 50 797 adult participants from Nord-Trøndelag County, Norway. Data on cultural activities, both receptive and creative, perceived health, anxiety, depression and satisfaction with life were collected by comprehensive questionnaires. Results The logistic regression models, adjusted for relevant cofactors, show that participation in receptive and creative cultural activities was significantly associated with good health, good satisfaction with life, low anxiety and depression scores in both genders. Especially in men, attending receptive, rather than creative, cultural activities was more strongly associated with all health-related outcomes. Statistically significant associations between several single receptive, creative cultural activities and the health-related outcome variables were revealed. Conclusion This population-based study suggests gender-dependent associations between cultural participation and perceived health, anxiety, depression and satisfaction with life. The results support hypotheses on the effect of cultural activities in health promotion and healthcare, but further longitudinal and experimental studies are warranted to establish a reliable cause–effect relationship.

Being Normal Weight but Feeling Overweight in Adolescence May Affect Weight Development into Young Adulthood—An 11-Year Followup: The HUNT Study, Norway

Objectives. To explore if self-perceived overweight in normal weight adolescents influence their weight development into young adulthood and if so, whether physical activity moderates this association. Methods. A longitudinal study of 1196 normal weight adolescents (13–19 yrs) who were followed up as young adults (24–30 yrs) in the HUNT study. Lifestyle and health issues were assessed employing questionnaires, and standardized anthropometric measurements were taken. Chi square calculations and regression analyses were performed to investigate the associations between self-perceived overweight and change in BMI or waist circumference (WC) adjusted for age, age squared, sex, and other relevant cofactors. Results. Adolescents, defined as being normal weight, but who perceived themselves as overweight had a larger weight gain into young adulthood than adolescents who perceived themselves as normal weight (difference in BMI: 0.66 units [CI95%: 0.1, 1.2] and in WC: 3.46 cm [CI95%: 1.8, 5.1]). Level of physical activity was not found to moderate this association. Conclusions. This study reveals that self-perceived overweight during adolescence may affect development of weight from adolescence into young adulthood. This highlights the importance of also focusing on body image in public health interventions against obesity, favouring a “healthy” body weight taking into account natural differences in body shapes.

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

BackgroundHigh 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.MethodsData 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.ResultsThe 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.ConclusionHigh 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.

Cultural activities and public health: research in Norway and Sweden. An overview

In Norway and Sweden, the governments see a potential for establishing a policy for cultural participation, based on the assumption that cultural activities will improve health and well-being. Aim: The aim was to survey the scientific literature in Norway and Sweden concerning cultural interventions for increased well-being and health. All applications of cultural activities in medical and leisure time field were included. Methods: Medline, Cinahl, Cochrane, Psycinfo, Proquest, Sportdiscus, PsiTri, Norart, ERIC, www.helsedirektoratet.no, www.folk2.no, www.nakuhel.no, www.ssd.gu.se, www.scb.se were browsed. Additionally, grey literature such as books, reports, as well as White and Green Papers has been searched. Studies published from 1995 to 2009 were included. Results: Mostly effects of cultural participation in clinical settings were studied, focusing on small groups. Very few studies have been published regarding public health aspects. The few epidemiological studies were for the most part carried out in Sweden. In Norway the prime issue has been music therapy. Conclusions: More epidemiological and longitudinal studies addressing cause–effect relations and intermediary mechanisms are warranted as well as public health intervention studies.

Obesity-Susceptibility Loci and Their Influence on Adiposity-Related Traits in Transition from Adolescence to Adulthood - The HUNT Study

Introduction Obesity-susceptibility loci have been related to adiposity traits in adults and may affect body fat estimates in adolescence. There are indications that different sets of obesity-susceptibility loci influence level of and change in obesity-related traits from adolescence to adulthood. Objectives To investigate whether previously reported obesity-susceptible loci in adults influence adiposity traits in adolescence and change in BMI and waist circumference (WC) from adolescence into young adulthood. We also examined whether physical activity modifies the effects of these genetic loci on adiposity-related traits. Methods Nine obesity-susceptibility variants were genotyped in 1 643 adolescents (13–19 years old) from the HUNT study, Norway, who were followed-up into young adulthood. Lifestyle was assessed using questionnaires and anthropometric measurements were taken. The effects of genetic variants individually and combined in a genetic predisposition score (GPS) on obesity-related traits were studied cross-sectionally and longitudinally. A modifying effect of physical activity was tested. Results The GPS was significantly associated to BMI (B: 0.046 SD/allele [0.020, 0.073], p = 0.001) in adolescence and in young adulthood (B: 0.041 SD/allele [0.015, 0.067], p = 0.002) as it was to waist circumference (WC). The GPS was not associated to change in BMI (p = 0.762) or WC (p = 0.726). We found no significant interaction effect between the GPS and physical activity. Conclusions Our observations suggest that obesity-susceptibility loci established in adults affect BMI and WC already in adolescence. However, an association with change in adiposity-related traits from adolescence to adulthood could not be verified for these loci. Neither could an attenuating effect of physical activity on the association between the obesity-susceptibility genes and body fat estimates be revealed.

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

BackgroundEnvironment, 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.MethodsA 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.ResultsIn 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.ConclusionThis 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.

Do current fortification and supplementation programs assure adequate intake of fat-soluble vitamins in Belgian infants, toddlers, pregnant women, and lactating women?

Adequate intakes of fat-soluble vitamins are essential to support the growth and development of the foetus, the neonate, and the young child. By means of an online self-administered frequency questionnaire, this study aimed to evaluate the intake of vitamins A, D, E, and K in Belgian infants (n = 455), toddlers (n = 265), pregnant women (n = 161), and lactating women (n = 165). The contribution of foods, fortified foods, and supplements on the total intake was quantified. 5% of toddlers, 16% of pregnant women, and 35% of lactating women had an inadequate vitamin A intake. Conversely, excessive vitamin A intakes were associated with consumption of liver (products). Furthermore, 22% of infants were at risk for inadequate vitamin D intake due to the lack of prophylaxis, while consumption of highly dosed supplements posed a risk for excessive intakes in 6%–26% of infants. Vitamin D intake in pregnant women and lactating women was inadequate (median of 51%, respectively, 60% of the adequate intake). In all groups, the risk for inadequate intake of vitamin E and K was low. Contribution of fortified foods to vitamin A, D, E, and K intake was minor, except in toddlers. National fortification strategies should be investigated as an alternative or additional strategy to prevent vitamin D and A deficiency. There is a need to revise and set uniform supplement recommendations. Finally, non-users of vitamin D prophylaxis need to be identified for targeted treatment.

Musik, Kultur und Gesundheitsforschung vom Individuum zur Bevölkerung

Die Tendenz zur Integrativen Medizin, die auf Grundlage evidenzbasierter Verfahren eine ubergreifende schul- und alternativmedizinische Ausrichtung propagiert, geht teilweise auf Ansatze in der epidemiologischen Forschung zuruck. Beispielhaft hierfur steht die Suche nach Zusammenhangen zwischen kultureller Teilhabe und Gesundheit auf der Ebene ganzer Bevolkerungen. Die HUNT-Studie aus Norwegen reprasentiert eine Entwicklung hin zu stetig detaillierteren Erkenntnissen uber die Bedeutung kultureller Aktivitaten fur psychisches und korperliches Wohlbefinden. Die Annahme, dass kulturelle Techniken einschlieslich musikalischer Praktiken signifikant zur Bevolkerungsgesundheit beitragen, kann gegenwartig weder als bestatigt noch als widerlegt gelten. Gleichwohl lassen die vorliegenden Anfangsbefunde wenig Zweifel daran erkennen, dass es sich auch und gerade bei der menschlichen Musikalitat um eine universelle und interkulturelle Ressource mit hohem gesundheitlichem Potenzial handelt.

Patterns of Passive and Active Cultural Activities among 13- 18 Year Old Norwegian High School Students

Several studies illuminate positive relations between health and passive versus active cultural activities. However, current knowledge on the patterns of participation in cultural activities of adolescents in a humanistic health perspective is limited. Aims: the aim of the study was to investigate the patterns of participation in passive versus active cultural activities among adolescents out of a humanistic health perspective. Methods: junior high and high school students from two municipalities in the county of Nord-Trondelag, Norway, aged 13-18 year (n=71) completed a self-administered questionnaire. Results: five passive cultural activities ranked highest among adolescents. Active cultural activities were ranked sixth on the list. Junior high school students gave priority to the active cultural activities. High school students preferred passive cultural activities. Conclusions: out of a humanistic point of view both passive and active cultural activities should be aimed in health promotion programs.