Objective: To assess the effect of an increased consumption of vegetables and fruit on body weight, risk factors for cardiovascular disease (CVD) and antioxidant defense in obese patients with ...sleep-related breathing disorders (SRBD). Design: Randomized, controlled trial of an intervention to increase the intake of vegetables to 400 g/day and fruit to 300 g/day. Dietary intake was calculated from a food frequency questionnaire. Antioxidant status was assessed with the ferric-reducing/antioxidant power (FRAP) assay. Plasma carotenoids were biomarkers for the intake of vegetables and fruit. Setting: A hospital clinic preventing risk factors for CVD. Subjects: Subjects were 103 men and 35 women with a body mass index of 36.75.8 kg/m2 of which 57 (86%) in the control and 68 (94%) in the intervention group completed the study. Intervention: Group-based behavioral program during 3 months. Results: The mean between group differences in body weight was -2.0% (95% CI -3.6, -0.5), P<0.0001. The mean between group difference in systolic and diastolic blood pressure (BP) was -7.1 mm Hg (95% CI: -11.6, -2.6), P=0.0022 and -3.9 mm Hg (95% CI: -7.0, -0.9), P=0.0120, respectively. The mean change in daily intake of vegetables and fruit was 12 g (95% CI: -33, 57) and -4 g (95% CI: -79, 71) versus 245 g (95% CI: 194, 296) and 248 g (95% CI: 176, 320) in the control and intervention groups, respectively. This was reflected in higher concentrations of -carotene and -carotene. No change in FRAP was seen. In a multiple regression analysis the change in intake of vegetables was a significant contributor (Radj2=0.073 (95% CI: 0.019, 0.214)) to the change in weight. Conclusion: Targeted dietary advice to increase the intake of vegetables and fruit among subjects with SRBD contributed to weight reduction and reduced systolic and diastolic BP, but had no effect on antioxidant defense measured with FRAP.
Background. Although short-term graft survival has improved substantially in renal transplant recipients, long-term graft survival has not improved over the last decades. The lack of knowledge of ...specific causes and risk factors has hampered improvements in long-term allograft survival. There is an uncertainty if inflammation is associated with late graft loss.
Methods. We examined, in a large prospective trial, the inflammation markers high-sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL-6) and their association with chronic graft dysfunction. We collected data from the Assessment of Lescol in Renal Transplant trial, which recruited 2102 maintenance renal transplant recipients.
Results. Baseline values were hsCRP 3.8 ± 6.7 mg/L and IL-6 2.9 ± 1.9 pg/mL. Adjusted for traditional risk factors, hsCRP and IL-6 were independently associated with death-censored graft loss, the composite end points graft loss or death and doubling of serum creatinine, graft loss or death.
Conclusion. The inflammation markers hsCRP and IL-6 are associated with long-term graft outcomes in renal transplant recipients.
The aim of this population‐based study was to assess the association between objectively recorded physical activity (PA) in early gestation and gestational diabetes mellitus (GDM) identified at 28 ...weeks of gestation in a multi‐ethnic cohort of healthy pregnant women in Oslo, Norway. In total, 759 women were included. In early gestation (<20 weeks), light‐, moderate‐, and vigorous‐intensity PA and number of steps were objectively recorded (SenseWear™ Armband Pro3), and self‐reported PA, demographics, and anthropometrics were collected. The 75‐g oral glucose tolerance test was performed at 28 weeks of gestation. Women with GDM had fewer objectively recorded steps (mean 7964 steps/day vs 8879 steps/day, P < 0.001) and minutes of moderate‐to‐vigorous‐intensity PA (median 62 min/day vs 75 min/day, P = 0.004) in early gestation than women without GDM. Additionally, 30% of women with GDM compared with 44% (P < 0.001) of women without GDM self‐reported regular PA before pregnancy. The significant inverse association between objectively recorded steps per day in early gestation and GDM persisted after adjustment for ethnic origin, weeks of gestation, age, parity, pre‐pregnancy BMI, early life socioeconomic position, and self‐reported regular PA before pregnancy. The adjusted odds ratio for GDM decreased 19% per standard deviation (3159 steps) increase in objectively recorded steps per day (P = 0.039). Daily life PA in early gestation measured as steps/day was associated with lower risk of GDM.
The purpose of this study was to compare the ACL injury rate between two different floor types – wooden floors (parquet, generally having lower friction) and artificial floors (generally having ...higher friction). ACL injuries have been recorded prospectively from the three top divisions for men and women in Norwegian team handball during seven seasons (1989–2000). A total of 174 ACL injuries have been recorded, and of these 53 occurred in regular league games. The floor types for all regular games from the same seasons have been determined retrospectively based on match schedules. The matches were divided into two groups: those played on wooden floors and those played on artificial floors. A total of nine injuries occurred among men (incidence: 0.24±0.09 injuries per 1000 player hours) and 44 among women (0.77±0.04 injuries 1000 h−1; OR vs. men: 3.21 (1.56–6.58); P=0.001). Among men, four injuries occurred on wooden floors (0.32±0.13 injuries 1000 h−1) and five injuries occurred on artificial floors (0.20±0.12 injuries 1000 h−1; OR vs. wooden floors: 0.63 (0.17–2.37); ns). Among women, eight injuries occurred on wooden floors (0.41±0.09 injuries 1000 h−1; OR vs. men: 1.29 (0.39–4.28); ns) and 36 on artificial floors (0.96±0.04 injuries 1000 h−1; OR vs. wooden floors: 2.35 (1.09–5.07); P=0.03; OR vs. men: 4.77 (1.87–12.18); P=0.001). These results indicate that the risk of ACL injury for women is higher on artificial floors than on wooden floors.
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The objective of this analysis was to demonstrate the frequency and extent of error that results from using the TC/HDL C ratio rather than the apoB/apoA‐I ratio to estimate the lipoprotein‐related ...risk of vascular disease within 94 667 men and 75 675 women in the Apoprotein‐related Mortality Risk (AMORIS) cohort. The odds ratio (OR) for the risk of fatal myocardial infarction was determined for 1 SD change in the apoB/apoA‐I ratio and all the conventional cholesterol ratios – TC/HDL C ratio, LDL C/HDL C ratio, non‐HDL C/HDL C ratio. In both men and women, the apoB/apoA‐I ratio was significantly greater than any of the cholesterol ratios, which, in fact, differed little. Therefore, the apoB/apoA‐I ratio was taken as the most accurate index of the lipoprotein‐related risk of vascular disease. Using Receiver Operating Characteristic analysis, it was demonstrated that the diagnostic accuracy of the apoB/apoA‐I ratio was significantly greater than any cholesterol ratio in those with an LDL cholesterol <3.6 mmol L−1 compared to those with an LDL cholesterol >3.6 mmol L−1. Indeed, the difference between the apoB/apoA‐I OR compared with the TC/HDL C OR progressively widened as risk increased. This suggests that the advantage of the apoB/apoA‐I ratio is greatest in the population at highest risk. The distribution of subjects by quintiles showed in both genders that whilst agreement was greatest at the extremes, even at these points there was substantial discordance between the TC/HDL C and the apoB/apoA‐I ratios. Within the middle of the distribution, less than 50% of the values were concordant. Finally, when comparing the ORs, the TC/HDL C ratio underestimated risk in 69.4% of male subjects and overestimated risk in 26.1% of male subjects, whereas in the female subjects, the TC/HDL C ratio underestimated risk in 84.9% of the subjects and overestimated risk in 12.0%. Thus, using the conventional cholesterol ratios rather than the apoB/apoA‐I ratio results in frequent and substantial error in the estimation of the lipoprotein‐related risk of vascular disease.
This study was conducted to investigate the prevalence of diabetes and its association with ethnicity and sex, to identify subgroups at special risk.
We performed a population-based cross-sectional ...survey of 30- to 67-year-olds in an area of Oslo with low socio-economic status, and collected data using questionnaires, physical examinations and serum analyses for the 2,513 participants (attendance rate 49.3%).
In the age group 30-59 years, mean BMI was 28.5 (95% CI: 27.5-29.6) for South Asian women, 26.1 (25.9-26.4) for Western women, 26.7 (26.1-27.4) for South Asian men and 27.2 (26.9-27.5) for Western men. The diabetes prevalence rates were 27.5% (18.1-36.9) for South Asian women, 2.9% (1.9-3.4) for Western women, 14.3% (8.0-20.7) for South Asian men and 5.9% (4.2-7.5) for Western men. The age-adjusted odds ratio (OR) for diabetes for women vs men was 1.9 (0.9-4.1) for South Asians, and 0.4 (0.3-0.6) for the Western population (p<0.001). The age-adjusted OR for diabetes for South Asians vs Westerners was 11.0 (5.8-21.1) for women and 3.0 (1.6-5.4) for men, and after adjustment for WHR the ORs were 7.7 (3.9-15.3) for women and 2.6 (1.4-4.9) for men. After additional adjustments for physical activity, education, body height and fertility for women, the OR was 6.0 (2.3-15.4) for women and 1.9 (0.9-4.0) for men.
The alarmingly high prevalence of diabetes among South Asian women in Norway needs further investigation, as it has considerable public health implications. Ethnic differences in OR for diabetes persisted after adjustment for age, adiposity, physical activity and education. These differences were still present for women after additional adjustment for body height and fertility.
Objectives To investigate sources of variability in serial echocardiographic recordings in a core laboratory we assessed the impact of repeated echo recordings, repeated video measurements and ...measurements made by different investigators. Patients, methods Two investigators each recorded and analysed two-dimensional echos in 12 individuals (n=24 in total) three times at one week intervals. Left ventricular end-diastolic and end-systolic volumes were measured using the biplane modified Simpson's rule. Ejection fraction was derived from these volumes and left ventricular mass estimated using the area-length method. The left ventricular spherity index was expressed as the ratio of the short axis area and the long axis area at end-diastole. A video recording from each examination was reexamined twice by both investigators. Results Deviations between repeated echo recordings and repeated video measurements ranged from −5 to +5% between investigators. A three-way repeated analysis of variance indicated a small, but systematic difference between investigators. Reproducibility, measured by coefficients of variation, ranged from 3–9% for different investigators, 3–6% for repeated video measurements and 7–19% for repeated echo recordings across the different variables. The total variability of all three factors should be considered when the smallest detectable significant change in a variable is assessed. These ranged from 16–28% across the five variables studied, when a 10% error of classification was accepted for a one-sided change in a variable. Conclusion Repeated echo recordings were the dominant component of variation. Two-dimensional echo measurements are reproducible and accurate, but the same investigator should follow the same patients.
Fifty-nine Brassica oleracea cultivars, belonging to five botanical varieties, were evaluated for microsatellite (SSR) polymorphisms using 11 database sequence derived primer pairs. The cultivars ...represented 12 broccoli (Brassica oleracea var. italica), ten Brussels sprouts (B. o. var. gemmifera), 21 cabbage (B. o. var. capitata, including the groups white and red cabbage), six savoy cabbage (B. o. var. sabauda), and ten cauliflower (B. o. var. botrytis) cultivars from 13 seed suppliers. The 11 primer pairs amplified in total 47 fragments, and differentiated 51 of the cultivars, whereas the remaining eight cultivars were differentiated from the rest in four inseparable pairs. All SSR markers, except one, produced a polymorphic information content (PIC value) of 0.5 or above. The average diversity for all markers within the tested material was 0.64. There was no major difference in the diversity within botanical varieties and groups. The cluster analysis and the resulting dendrogram showed that the cultivars tended to group within these taxonomic units. The present study substantiates the use of microsatellite markers as a powerful tool for cultivar differentiation and identification in vegetable brassicas.
No controlled trial of treatment of generalised social phobia has been conducted in general practice.
To examine the efficacy of sertraline or exposure therapy, administered alone or in combination ...in this setting.
Study was of a randomised, double-blind design. Patients (n = 387) received sertraline 50-150 mg or placebo for 24 weeks. Patients were additionally randomised to exposure therapy or general medical care.
Sertraline-treated patients were significantly more improved than non-sertraline-treated patients (chi(2)=12.53, P<0.001; odds ratio=0.534; 95% Cl 0.347-0.835). No significant difference was observed between exposure- and non-exposure-treated patients (chi(2)=2.18, P=0.140; odds ratio=0.732; 95% Cl 0.475-1.134). In the pairwise comparisons, combined sertraline and exposure (chi(2)=12.32; P<0.001) and sertraline (chi(2)=10.13; P=0.002) were significantly superior to placebo.
Sertraline is an effective treatment for generalised social phobia. Combined treatment with sertraline and exposure therapy, conducted by the general practitioner, may enhance the treatment efficacy in primary care.
Abstract Background and aim Although many studies report benefits of low glycemic diets, the clinical effects as a whole are mixed. The study aim was to compare a low glycemic load (LGL) diet versus ...a low-fat diet in a trial with a moderately intense dietary intervention in subjects with varying degrees of metabolic syndrome. Methods and results Men and women aged 30–65 years, with a BMI of 28–40 kg/m2 (28–35 for women) and at least one criterion of metabolic syndrome were randomized to the two diets. A total of 202 subjects were included, of which 126 (62%) had metabolic syndrome (≥3 criteria). The completion rate was 81%. At 3 months, weight loss was greater in the LGL group (−4.8 ± 3.9 kg versus −3.8 ± 3.5 kg; P = 0.06) compared to the low-fat group. At 1 year, however, weight loss was similar in both groups (−4.0 ± 5.5 kg versus −4.3 ± 6.2 kg; n.s.), but waist circumference reduction was less in the LGL group (−3.9 ± 5.3 cm versus −5.8 ± 6.8 cm; P = 0.03). In contrast, diastolic blood pressure decreased significantly more in the LGL group (−4.0 ± 8.7 mmHg versus −1.1 ± 8.5 mmHg; P = 0.02). We also observed a significant interaction between the presence of the metabolic syndrome and the effect of the two diets on waist circumference, with a less favorable effect of the LGL diet in subjects without the syndrome ( P = 0.039). Conclusion After 12 months, both diets reduced body weight and the metabolic disturbances similarly, but the LGL diet appeared more suitable for subjects with metabolic syndrome, and was less effective in those without it.
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