Marit B. Veierød

Infant feeding practices and associated factors in the first six months of life: the Norwegian infant nutrition survey.

Aim: To describe and evaluate infant feeding practices during the first 6 mo of life in relation to recommendations, and to study infant feeding practices in relation to maternal and infant characteristics. Methods: Data from 2383 Norwegian infants aged 6 mo were collected by a self‐administered semi‐quantitative food‐frequency questionnaire measuring feeding practices at 6 mo and feeding practices retrospectively at ≤5.5 mo of age. Results: Only 1% of the infants had never been breastfed. The proportion of breastfed infants was 96% at 1 mo, 85% at 4 mo and 80% at 6 mo. The proportion of exclusively breastfed infants was 90% at 1 mo, 44% at 4 mo and 7% at 6 mo. Twenty‐one percent of the infants were introduced to solid foods before the age of 4 mo. For exclusive breastfeeding at 4 mo, breastfeeding at 6 mo and timely introduction of solid foods (not before 4 mo) significant positive trends were found for maternal age, education and degree of urbanization. Negative associations were found for maternal smoking. Furthermore, exclusive breastfeeding at 4 mo was associated with infant gender and marital status, and the odds of breastfeeding at 6 mo significantly decreased with decreasing infant birthweight. Finally, both the odds of exclusive breastfeeding at 4 mo and of breastfeeding at 6 mo increased with increasing numbers of children.

Meat consumption and the risk of type 2 diabetes: a systematic review and meta-analysis of cohort studies

Aims/hypothesisDiet is thought to play an important role in the aetiology of type 2 diabetes. Previous studies have found positive associations between meat consumption and the risk of type 2 diabetes, but the results have been inconsistent. We conducted a systematic review and meta-analysis of cohort studies of meat consumption and type 2 diabetes risk.MethodsWe searched several databases for cohort studies on meat consumption and type 2 diabetes risk, up to December 2008. Summary relative risks were estimated by use of a random-effects model.ResultsWe identified 12 cohort studies. The estimated summary RR and 95% confidence interval of type 2 diabetes comparing high vs low intake was 1.17 (95% CI 0.92–1.48) for total meat, 1.21 (95% CI 1.07–1.38) for red meat and 1.41 (95% CI 1.25–1.60) for processed meat. There was heterogeneity amongst the studies of total, red and processed meat which, to some degree, was explained by the study characteristics.Conclusions/interpretationThese results suggest that meat consumption increases the risk of type 2 diabetes. However, the possibility that residual confounding could explain this association cannot be excluded.

DIETARY FAT INTAKE AND RISK OF PROSTATE CANCER: A PROSPECTIVE STUDY OF 25,708 NORWEGIAN MEN

The relationship between incidence of prostate cancer and intake of dietary fat and foods rich in fat was studied in 25,708 men aged 16–56 years attending a Norwegian health screening in 1977–1983. Linkage to the Cancer Registry of Norway and the Central Bureau of Statistics of Norway ensured a complete follow‐up until December 31, 1992. Diet was recorded on a semi‐quantitative food‐frequency questionnaire at the time of screening, and 72 cases of prostate cancer were identified during follow‐up. At the end of follow‐up, mean age of the total study sample was 56 years (range 19–68), while mean age at diagnosis of prostate cancer was 60 years (range 47–67). No association was found between energy‐adjusted intake of total fat, saturated fat, mono‐unsaturated fat or poly‐unsaturated fat and the incidence of prostate cancer. Significant positive associations were found for body mass index (BMI) and consumption of hamburgers/meatballs, while no association was found with consumption of frankfurters/sausages and a significant negative association with the weekly number of main meals with meat. A significantly increased risk of prostate cancer was associated with skim milk as compared to whole milk. Milk preference (skim vs. whole) was associated significantly positively with BMI. Our study of a relatively young cohort does not confirm previous case‐control and cohort studies suggesting that dietary fat, especially from animal sources, is associated positively with risk of prostate cancer. Int. J. Cancer 73:634–638, 1997.

Fear-avoidance beliefs and distress in relation to disability in acute and chronic low back pain

&NA; Patients with chronic low back pain (LBP) frequently demonstrate high scores for fear‐avoidance beliefs and distress. We need better knowledge about fear‐avoidance beliefs and distress in early stages of LBP. The objectives of this study were to compare the level of fear‐avoidance beliefs and distress in patients with acute LBP to patients with chronic LBP, and to assess the relationship of fear‐avoidance beliefs and distress to disability in acute and chronic LBP. Two different back pain groups including 123 patients with acute and 233 patients with chronic LBP were studied. Main outcome measures were Oswestry Disability Index and work loss. The scores for fear‐avoidance beliefs and distress in patients with acute LBP were significantly lower than among patients with chronic LBP. The results of the multivariate regression analyses, adjusting for sociodemographic, pain and clinical variables, demonstrated that whereas fear‐avoidance beliefs for physical activity and distress were significantly associated with the Oswestry Disability Index, fear‐avoidance beliefs for work and distress were significantly associated with work loss. The associations showed the same pattern in acute and chronic LBP. In addition, several of the pain and clinical variables were significantly associated with the Oswestry Disability Index and fingertip–floor distance was associated with work loss. In conclusion, fear‐avoidance beliefs and distress influence pain‐related disability both in early acute and long‐term chronic LBP. The results replicate previous reports on the association between pain experience, fear‐avoidance beliefs, distress, and disability in chronic LBP, and extend the findings to patients at an early stage of acute LBP.

The Efficacy of a Treatment Program Focusing on Specific Stabilizing Exercises for Pelvic Girdle Pain After Pregnancy: A Two-year Follow-up of a Randomized Clinical Trial

Study Design. A randomized clinical trial. Objectives. To examine the effects of a treatment program focusing on specific stabilizing exercises after a 2-year follow-up period. Summary of Background Data. An individualized treatment approach with specific stabilizing exercises is shown to be effective for women with pelvic girdle pain 1 year after delivery. No previous study has examined the long-term effects of treatment for women with postpartum pelvic girdle pain. Methods. Eighty-one women with pelvic girdle pain postpartum were assigned randomly to 2 treatment groups for 20 weeks. Patient self-reported questionnaires measuring pain, disability, and health-related quality of life were collected after 20 weeks of treatment and 1 and 2 years postpartum. Results. All 81 women returned the questionnaires for the 2-year follow-up. Sixteen were excluded from the analysis, mainly due to new pregnancies. The significant differences between the groups in functional status, pain, and physical health (SF-36) were maintained 2 years after delivery. Minimal disability was found in 85% of the specific stabilizing exercise group as compared to 47% in the control group. The control group showed significant improvement in functional status with median change score of 6.0 (Q1–Q3 of −12–0). Minimal evening pain was reported by 68% in the specific stabilizing exercise group versus 23% in the control group. However, the group differences disappeared for all measures when controlling for score level 1 year after delivery by regression analysis. Conclusion. The significant differences between the groups persisted with continued low levels of pain and disability in the specific stabilizing exercise group 2 years after delivery. Significant reduction in disability was found within the control group. Those with the highest level of disability and greatest potential for improvements recovered most, regardless of intervention group.

Diet and risk of cutaneous malignant melanoma: A prospective study of 50,757 Norwegian men and women

The relationship between dietary habits and subsequent risk of cutaneous malignant melanoma (CMM) was studied in 25,708 men and 25,049 women aged 16‐56 years attending a Norwegian health screening in 1977‐1983. Linkage to the Cancer Registry of Norway and the Central Bureau of Statistics of Norway ensured a complete follow‐up until December 31, 1992. Diet was recorded through a semi‐quantitative food‐frequency questionnaire at the time of screening, and 108 cases of CMM were identified during follow‐up. Use of cod liver oil supplementation and intake of polyunsaturated fat were associated with significant increased risk and drinking coffee with significant decreased risk of CMM in women. Adjusting for height, body mass index, body surface area, education, smoking or occupational or recreational physical activity did not change the results. No significant association was found between the incidence of CMM and any of the dietary factors in men. Important aspects are residual confounding by sun exposure and social class, as well as concern with multiple comparisons. Int. J. Cancer 71:600‐604, 1997.

A comparison of the effects of cheese and butter on serum lipids, haemostatic variables and homocysteine.

Milk fat contains considerable amounts of saturated fatty acids, known to increase serum cholesterol. Little is known, however, about the relative effect of different milk products on risk factors for CHD. The aim of the present study was to compare the effects of Jarlsberg cheese (a Norwegian variety of Swiss cheese) with butter on serum lipoproteins, haemostatic variables and homocysteine. A controlled dietary study was performed with twenty-two test individuals (nine men and thirteen women) aged 23-54 years. The subjects consumed three isoenergetic test diets, with equal amounts of fat and protein, and containing either cheese (CH diet), butter + calcium caseinate (BC diet) or butter + egg-white protein (BE diet). The study was a randomised cross-over study and the subjects consumed each diet for 3 weeks, with 1 week when they consumed their habitual diet in between. Fasting blood samples were drawn at baseline and at the end of each period. Serum was analysed for lipids and plasma for haemostatic variables and homocysteine. Total cholesterol was significantly lower after the CH diet than after the BC diet (-0.27 mmol/l; P=0.03), while the difference in LDL-cholesterol was found to be below significance level (-0.22 mmol/l; P=0.06). There were no significant differences in HDL-cholesterol, triacylglycerols, apo A-I, apo B or lipoprotein (a), haemostatic variables and homocysteine between the diets. The results indicate that, at equal fat content, cheese may be less cholesterol increasing than butter.

Evaluation of the odd fatty acids 15:0 and 17:0 in serum and adipose tissue as markers of intake of milk and dairy fat.

Background:There is a need for biomarkers of dietary saturated fatty acids, because several diseases have been related to intake of these fatty acids.Objective:To examine the relation between intake of dairy fat and the proportion of pentadecanoic (15:0) and heptadecanoic (17:0) acid in serum and adipose tissue.Design:Healthy men aged 21–55 y provided serum (n=110) and adipose tissue samples (n=107) and completed both 14 days weighed records (WR) and a 180-item food frequency questionnaire (FFQ). The proportions of 15:0 and 17:0 acid in serum and adipose tissue as measured by gas liquid chromatography were evaluated as biomarkers for fat intake from dairy products using Pearsons correlation coefficient and the method of triads.Results:The strongest correlation coefficients were observed between total intake of dairy fat estimated from WR and relative content of 15:0 in adipose tissue (0.52, 95% CI: 0.37, 0.65) and total serum (0.43, 95% CI 0.26, 0.57). A consistent inverse association was observed between the intake of milk fat and relative serum content of 17:0. The validity coefficients observed for the intake of dairy fat estimated from weighed records, the 180-item FFQ and by the relative content of 15:0 in serum and adipose tissue were 0.94 (95% CI: 0.68, 1.00), 0.50 (95% CI: 0.29, 0.67), 0.49 (95% CI: 0.32, 0.67) and 0.56 (95% CI: 0.28, 0.82), respectively.Conclusion:Relative content of 15:0 in serum and adipose tissue may be a useful biomarker for the intake of total dairy fat, whereas FFQs and WRs may provide better estimates of the intake of fat from milk.

Free School Fruit--sustained effect three years later.

BackgroundNorwegian children consume less fruit and vegetables (FV) than recommended. In order to increase the intake, a School Fruit subscription programme is now offered to all Norwegian elementary and junior high schools. This programme has limited effect due to low participation by schools and pupils. However, recent evaluations of the programme offered for free have reported good effects in increasing FV intake. The purpose of the present study is to evaluate the long term effects of the Norwegian School Fruit programme, provided at no-cost to the pupils, three years after it was provided for free.MethodsA total of 1950 (85%) 6th and 7th grade pupils from 38 Norwegian elementary schools participated in the project. Nine schools were selected as intervention schools and participated for free in the Norwegian School Fruit programme for a school year (October 2001 until June 2002). A baseline questionnaire survey was conducted in September 2001, and follow-up surveys were conducted in May 2002 and May 2005. FV intake was assessed by a written 24-h recall (reporting FV intake at school and FV intake all day), and by four food frequency questions (reporting usual FV intake). Data were analysed by a linear mixed model for repeated measures.ResultsThe pupils in the free fruit group increased their FV intake compared to pupils in the control group as a result of the intervention. Some of the effect was sustained three years later. The estimated long-term effects for FV all day were 0.38 and 0.44 portion/day for boys and girls, respectively.ConclusionThe results show long-term effects of a free school fruit programme.

Reproducibility and stability of normalized EMG measurements on musculus trapezius

The reliability of normalized EMGrms (root mean square value of the electromyographic signal) measurements from musculus trapezius were evaluated in a field study. The reproducibility and stability of the method as well as the reproducibility of the results for nine variables were examined. The variables were: static, median and peak values of the ADF (amplitude distribution function) and the total time and number of periods when the muscles load was below 1, 2 and 5% of MVC (maximum voluntary contraction). Twelve data operators, performing entry work, were measured twice with an interval of a week. Coefficients of repeatability were calculated. The coefficient of repeatability for 5 of the variables showed that 95% of the differences between measurements 1 and 2 for each subject were less than two standard deviations from the group mean. The same was true for the other four variables if the result of one of the twelve measurements was removed. The agreement index, twice the standard deviation of the difference between the two measurements divided by the mean of the two measurements was low only for the static value of the ADF and the number of periods below 5% MVC. Six data operators performing entry work were examined six times at weekly intervals. The stability ratio SDmm/SDv was less than 1 for all variables except for time and number of periods when the muscles load was below 5% MVC. SDmm is the standard deviation of the difference between minimum and maximum value for each of the subjects for the six measurements. SDv is the average of the standard deviations of the six measurements at each visit. Two groups, each consisting of 24 VDU operators doing similar work were compared using the results from one EMG measurement on the trapezius. No significant differences were found between the groups for any of the nine variables (0.07 < p < 0.87).