| 51. |
- Lindqvist, Peter, 1945, et al.
(författare)
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Concurrent and separate effects of body mass index and waist-to-hip ratio on 24-year mortality in the Population Study of Women in Gothenburg: evidence of age-dependency
- 2006
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Ingår i: European Journal of Epidemiology. ; 21, s. 789-794
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Tidskriftsartikel (refereegranskat)abstract
- Department of Public Health and Community Medicine/Primary Health Care, The Sahlgrenska Academy at Göteborg University, P.O. Box 454, SE 405 30, Göteborg, Sweden. peter.lindqvist@allmed.gu.se Obesity is generally assumed to be an important risk factor for death and morbidity. However, the association between excess body weight and all-cause mortality among younger and older women and the impact of body mass index (BMI) and waist-to-hip ratio (WHR) concurrently is not fully understood. In 1968-1969 we initiated a prospective study comprising a population sample of 1,462 women from Gothenburg, Sweden. During a 24 year period, until 1992-1993, 265 women had died. A multivariable Cox Proportional Hazards Regression model was used to estimate the relative risk of death in relation to BMI and WHR, with age and other covariates of age-specific interest as smoking, physical activity at work and leisure time and serum triglyceride concentration, at start of the study. BMI and WHR were analyzed as independent variables. Younger women (38 and 46 years at baseline) presented a statistically significant non-linear (U-shaped) relation between BMI and mortality. Among older women (50, 54 and 60 years at baseline), a significant negative linear relationship with decreasing mortality in relation to increasing BMI values was seen. For all women a higher WHR was related to an increased risk of death. The lowest risk of death among younger women corresponded to a low WHR and a BMI within the middle range. For older women the highest survival was observed for those with lowest WHR and highest BMI. Thus, in older women a high BMI seems not to be an increased risk as long as adiposity is not centrally located. PMID: 17111249 [PubMed - indexed for MEDLINE]
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| 52. |
- Lissner, Lauren, 1956, et al.
(författare)
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Diet, obesity and obesogenic trends in two generations of Swedish women.
- 2008
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Ingår i: European Journal of Nutrition. - : Springer Science and Business Media LLC. - 1436-6207 .- 1436-6215. ; 48:8, s. 424-431
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Secular trends in obesity and related lifestyle factors are reported in two generations of 38- and 50-year old Swedish women. Specifically, we describe changes in obesity and fat patterning, while examining concurrent shifts in factors that are proposed to be causally related to the modern obesity epidemic. METHODS: A total of 1,270 women aged 38 or 50 were selected from population registries and examined in 1968/69 (born 1930 or 1918) or 2004/05 (born 1966 or 1954). Anthropometric methods and lifestyle questions were unchanged between earlier and later surveys. Dietary comparisons were based on 24-h recall, with additional questions about usual alcohol and salt consumption patterns. In subgroups, 24-h urinary sodium was determined. RESULTS: Weight, height, waist circumference, waist-hip ratio, triceps and subscapular skinfold measures were all significantly higher in later-born cohorts, although BMI and obesity were not significantly changed. Higher sodium excretion was observed among later-born sub-groups, consistent with reports of increasing salt preference. Lower proportions of energy as fat and sucrose, but higher carbohydrate, protein and fiber concentrations were reported by later-born cohorts. There were shifts towards increased frequency of wine and liquor consumption, but decreased beer. Leisure time physical activity and perceived stress levels both increased significantly over 36 years. CONCLUSIONS: A number of anthropometric and lifestyle differences between two generations of Swedish women were observed. Increases in subcutaneous and abdominal fatness were detected without significantly increasing BMI. While some aspects of diet showed improvement, increases in salt preference and sodium excretion are cause for concern.
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| 53. |
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| 54. |
- Lissner, Lauren, 1956, et al.
(författare)
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Participation bias in longitudinal studies: experience from the Population Study of Women in Gothenburg, Sweden
- 2003
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Ingår i: Scandinavian Journal of Primary Health Care. ; 21, s. 242-247
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Tidskriftsartikel (refereegranskat)abstract
- Department of Primary Health Care, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden. lauren.lissner@medfak.gu.se OBJECTIVE: To describe a cohort study of women receiving a series of comprehensive health examinations over 32 years. DESIGN: Longitudinal population study based on a randomised sample of the female population from defined age cohorts. SETTING: City of Göteborg, Sweden. SUBJECTS: Subjects were 38, 46, 50, 54 or 60 years old at the start of the study in 1968. Re-examinations were performed in 1974, 1982 and 1992. Non-participants in the most recent examination, initiated in 2000, were offered home visits. MAIN OUTCOME MEASURES: Participation, anthropometric and blood pressure changes. RESULTS: At the end of the 32-year follow-up, 64% of the original participants were alive, and low participation among survivors was a problem. An acceptable participation rate (71% of those alive) was obtained after home visits were offered. Surviving non-participants already had elevated cardiovascular risk factors at onset of the study in 1968, along with lower educational level and lower socioeconomic status. Home visited subjects were similar to non-participants with regard to anthropometry and blood pressure, but did not differ from participants with regard to social indicators. Thirty-two-year longitudinal data demonstrate clear ageing effects for several important variables, which should, however, be considered in the context of documented differences with non-participants at the baseline examination. CONCLUSIONS: Longitudinal studies in elderly populations provide important data on changes during the ageing process. However, participation rates decline for a number of reasons and generalisations should be made with care. Moreover, including home visits in the protocol can both increase participation and reduce participation bias in elderly cohorts. PMID: 14695076 [PubMed - indexed for MEDLINE]
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| 55. |
- Lissner, Lauren, 1956, et al.
(författare)
-
Physical activity levels and changes in relation to longevity. A prospective study of Swedish women
- 1996
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Ingår i: American Journal of Epidemiology. ; 143, s. 54-62
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Tidskriftsartikel (refereegranskat)abstract
- Department of Primary Health Care, Göteborg University, Sweden. In 1968-1969, a population-based sample of Swedish women aged 38-60 years was recruited for a health survey, and 20-year survival was later ascertained from national registries. Occupational and leisure-time physical activity data from the baseline and 6-year follow-up examinations were evaluated in relation to all-cause mortality among 1,405 women who were initially free of major diseases. In comparison with being inactive, the mortality relative risk associated with being somewhat active was 0.28 (95% confidence interval 0.17-0.46) for occupational activity and 0.56 (95% confidence interval 0.39-0.82) for leisure-time activity. Being in the most active occupational or leisure activity category further decreased mortality risk to a minor extent. A within-subject decrease in leisure activity over 6 years was also a significant risk factor for all-cause mortality (relative risk = 2.07, relative to no change), although there was no evidence of a benefit from increasing physical activity levels. Since exclusion of early endpoints did not affect the associations in any significant way, underlying illness is unlikely to have played a major role in these analyses. It is concluded that decreases in physical activity as well as low initial levels are strong risk factors for mortality in women, and that their predictive value persists for many years. PMID: 8533747 [PubMed - indexed for MEDLINE]
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| 56. |
- Lissner, Lauren, 1956, et al.
(författare)
-
Secular increases in waist-hip ratio among Swedish women
- 1998
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Ingår i: International Journal of Obesity. ; 22, s. 1116-1120
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Tidskriftsartikel (refereegranskat)abstract
- Department of Internal Medicine, Sahlgrenska University Hospital, Göteborg University, Sweden. INTRODUCTION: Secular increases in obesity have been documented in numerous populations. However, little is known about trends in fat distribution. Because men and women with elevated waist-hip ratios (WHR) constitute a high cardiovascular risk group, it is relevant to document secular changes in WHR. This paper compares WHR in three cohorts of women, one cohort recruited in the late 1960s and the others after 12 y and 24 y intervals. SUBJECTS AND METHODS: In 1968-1969, a randomly selected sample of women aged of 38 y and 50 y, was given anthropometric examinations (n = 761, total). The same measurements were taken on representative cohorts aged 38 y and 50 y in 1980-1981 (n = 677) and 1992-1993 (n = 167). All analyses of trends in WHR as a function of time are age-specific and body mass index (BMI)-adjusted. RESULTS: An interesting feature of this population is that BMI was stable from 1968-1969 to 1992-1993. However, WHR increased significantly in those aged 38 y and 50 y, independent of BMI (P = 0.001, both ages). The source of these changes in WHR was a combination of increasing waist circumferences and decreasing hip circumferences. Skinfold measurements, taken only at the first two examinations, also increased significantly. CONCLUSIONS: This female population appears to have experienced some changes in body shape and composition. However, we cannot explain the increasingly centralized fat patterning by changes in BMI, subcutaneous skinfold thickness or those obesity-related aspects of the modern lifestyle that we were able to measure. PMID: 9822951 [PubMed - indexed for MEDLINE]
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| 57. |
- Lissner, Lauren, 1956, et al.
(författare)
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Smoking initiation and cessation in relation to body fat distribution based on data from a study of Swedish women
- 1992
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Ingår i: American Journal of Public Health. ; 82, s. 273-275
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Tidskriftsartikel (refereegranskat)abstract
- Department of Primary Health Care, University of Gothenburg, Sweden. In a representative sample of Swedish women, smokers were significantly less obese than nonsmokers. However, a smoker was likely to have significantly more upper-body fat than a nonsmoker of similar body mass index. Women who quit smoking experienced less upper-body fat deposition than would be expected by their accompanying weight gain, suggesting that weight gained as a consequence of smoking cessation is not preferentially deposited in the region associated with increased cardiovascular risk. PMID: 1739163 [PubMed - indexed for MEDLINE]
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| 58. |
- Mehlig, Kirsten, 1964, et al.
(författare)
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Alcoholic beverages and incidence of dementia: 34-year follow-up of the prospective population study of women in Goteborg.
- 2008
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Ingår i: American journal of epidemiology. - : Oxford University Press (OUP). - 1476-6256 .- 0002-9262. ; 167:6, s. 684-91
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to assess the association between different types of alcoholic beverages and 34-year incidence of dementia. Among a random sample of 1,462 women aged 38-60 years and living in Göteborg, Sweden, in 1968-1969, 164 cases of dementia were diagnosed by 2002. At baseline as well as in 1974-1975, 1980-1981, and 1992-1993, the frequency of alcohol intake, as well as other lifestyle and health factors, was recorded and related to dementia with Cox proportional hazard regression, by use of both baseline and updated covariates. Wine was protective for dementia (hazard ratio (HR) = 0.6, 95% confidence interval (CI): 0.4, 0.8) in the updated model, and the association was strongest among women who consumed wine only (HR = 0.3, 95% CI: 0.1, 0.8). After stratification by smoking, the protective association of wine was stronger among smokers. In contrast, consumption of spirits at baseline was associated with slightly increased risk of dementia (HR = 1.5, 95% CI: 1.0, 2.2). Results show that wine and spirits displayed opposing associations with dementia. Because a protective effect was not seen for the other beverages, at least part of the association for wine may be explained by components other than ethanol.
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| 59. |
- Mehlig, Kirsten, 1964, et al.
(författare)
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Associations between alcohol and liver enzymes are modified by coffee, cigarettes, and overweight in a Swedish female population.
- 2022
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Ingår i: Scandinavian journal of gastroenterology. - : Informa UK Limited. - 1502-7708 .- 0036-5521. ; 57:3, s. 319-324
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Tidskriftsartikel (refereegranskat)abstract
- To examine whether positive associations between alcohol and liver enzymes were modified by coffee consumption, smoking, or weight status in a female population. Regular consumption of beer, wine, and spirits was assessed in a representative cohort of 1462 Swedish women aged 38-60 in 1968, and re-assessed in 1974. In 1980, gamma-glutamyltransferase (GGT) and aspartase transaminase (AST) were measured in 1130 women. Exposures were averaged over values obtained in 1968 and 1974. Multivariable linear regression linked total ethanol intake to log-transformed enzyme values, including interactions by coffee, smoking, and overweight in mutually adjusted models.Coffee consumption significantly modified the association between ethanol intake and liver enzymes. One g/day higher ethanol intake was associated with 5.5 (3.5, 7.5)% higher values of GGT, and 1.2 (0.4, 2.1)% higher values of AST in women consuming 0-1 cups of coffee per day, while smaller or no effects were observed in women consuming ≥2 cups/day. Synergistic interactions were observed for ethanol and smoking, and for ethanol and overweight. Average alcohol-related effects on GGT in smokers and non-smokers were given by 3.8 (2.7, 4.9)% and 2.1 (0.9, 3.2)% per g ethanol/day, and by 0.9 (0.4, 1.4)% and 0.2 (-0.3, 0.7)% for AST. Similarly, in overweight women, 1 g/day higher ethanol intake was associated with 4.3 (3.0, 5.6)% higher GGT compared to 1.6 (0.7, 2.5)% in non-overweight women.The results suggest that coffee consumption reduces the enzyme-raising effect of ethanol in the presence of synergistic interactions with smoking and overweight, specifically in women.
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| 60. |
- Mehlig, Kirsten, 1964, et al.
(författare)
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Low fasting serum insulin and dementia in nondiabetic women followed for 34 years.
- 2018
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Ingår i: Neurology. - 1526-632X. ; 91:5, s. e427-e435
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Tidskriftsartikel (refereegranskat)abstract
- In a representative population of women followed over 34 years, we investigated the prospective association between fasting serum insulin and dementia, taking into account the incidence of diabetes mellitus.Fasting values for serum insulin and blood glucose were obtained in 1,212 nondiabetic women 38 to 60 years of age at the 1968 baseline. Risk of dementia was assessed by Cox proportional hazard regression with adjustment for insulin, glucose, and other covariates and, in a second model, after censoring for incident cases of diabetes mellitus. Incident diabetes mellitus was considered as a third endpoint for comparison with dementia.Over 34 years, we observed 142 incident cases of dementia. The low tertile of insulin displayed excess risk for dementia (hazard ratio [HR] 2.34, 95% confidence interval [CI] 1.52-3.58) compared to the medium tertile, but the high tertile of insulin did not (HR 1.28, 95% CI 0.81-2.03). These associations were also seen for dementia without diabetes comorbidity. In contrast, high but not low insulin predicted incident diabetes mellitus (115 cases) (HR 1.70, 95% CI 1.08-2.68 and HR 0.76, 95% CI 0.43-1.37, respectively).A previous study reported a U-shaped association between fasting insulin and dementia in a 5-year follow-up of elderly men. Our results confirmed a nonlinear association in a female population, with high risk at low insulin values that was not attributable to preclinical dementia or impaired insulin secretion. This condition suggests a new pathway to dementia, which differs from the metabolic pathway involving diabetes mellitus.
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