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- Eriksson, Margareta K., 1955-, et al.
(författare)
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A randomized trial of lifestyle intervention in primary health care for the modification of cardiovascular risk factors
- 2006
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Ingår i: Scandinavian Journal of Public Health. - : Taylor & Francis. - 1403-4948 .- 1651-1905. ; 34:5, s. 453-61
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To evaluate the effects of a lifestyle intervention programme in primary healthcare, targeted to patients with moderate to high risk of cardiovascular disease in terms of cardiovascular risk factors, physical activity, and quality of life. METHOD: Randomized controlled trial with one-year follow-up, carried out in a primary healthcare centre in Northern Sweden. A total of 151 middle-aged men and women, with hypertension, dyslipidemia, type 2 diabetes, or obesity were enrolled. The subjects were randomized to either the intervention (n = 75) or the control group (n = 76). A total of 123 subjects completed the one-year follow-up. Interventions: Exercise: supervised endurance and circuit training in groups three times a week for three months. Diet: five group sessions of diet counselling with a dietitian. Follow- up meetings with a physiotherapist were conducted monthly thereafter. Primary outcomes were changes in anthropometry, maximal oxygen uptake, health-related quality of life, and self-reported physical activity. The secondary outcomes were changes in blood pressure and metabolic variables. RESULTS: After one year the intervention group significantly increased maximal oxygen uptake, physical activity, and quality of life and significantly decreased body weight, waist and hip circumference, body mass index, waist-hip ratio, systolic and diastolic blood pressure, triglycerides, and glycosylated haemoglobin. There were significant differences between groups, mean changes (and their 95% confidence intervals, CI) in waist circumference -1.9 cm (-2.80 to -0.90; p<0.001), in waist-hip ratio -0.01 (-.02 to -0.004; p<0.01) and in diastolic blood pressure -2.3 mmHg (-4.04 to -0.51; p<0.05). CONCLUSION: A prevention programme in primary healthcare with a focus on physical activity and diet counselling followed by structured follow-up meetings can favourably influence several risk factors for cardiovascular diseases and quality of life in high-risk subjects for at least one year.
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- Haglund, B, et al.
(författare)
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Is moist snuff use associated with excess risk of IHD or stroke? A longitudinal follow-up of snuff users in Sweden
- 2007
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 35:6, s. 618-622
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Tidskriftsartikel (refereegranskat)abstract
- Background: The potential risks of Swedish moist snuff (snus) are debated and studies have shown diverging results. Aims: The aim of this study is to investigate whether there is any excess risk of ischaemic heart disease (IHD) and stroke from snuff use. Methods: The Swedish Survey of Living Conditions from 1988—89 was record-linked to the Swedish Cause of Death Register and the Swedish Hospital Discharge Register to investigate excess mortality and hospitalization from IHD and stroke. A Poisson regression model was used and incidence rate ratios (IRRs) for snuff and smoking were calculated controlling for age, physical activity, self-reported health, number of longstanding illnesses, residential area, and socioeconomic position. Results: Among snuff users there were no excess risks of mortality or hospitalization from IHD (IRR 0.8; 0.5—1.2,) or stroke (IRR 1.1; 0.7—1.8), but, as expected, clear excess risks were found for smokers (IRR 1.7; 1.4—2.1 for IHD, and IRR 1.4; 1.0—1.9 for stroke). Conclusions: This study has not shown any excess risk among users of snuff for IHD or stroke. If there is a risk associated with snuff it is evidently much lower than those associated with smoking.
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- Krachler, Benno, et al.
(författare)
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Population-wide changes in reported lifestyle are associated with redistribution of adipose tissue.
- 2009
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 37:5, s. 545-553
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The Northern Sweden MONICA project 1986—2004 demonstrated a marked increase in average body mass, an unchanged prevalence of diabetes, and a decrease in myocardial infarctions and lately also in stroke. This study estimates the relative importance of time-trends in lifestyle on average waist and hip circumference on a population level. Methods: From a series of independent cross-sectional surveys, a study population of 2,831 men and 2,976 women was formed. Associations between lifestyle factors and waist and hip circumference were estimated. Partial regression coefficients for every level of the lifestyle factors were multiplied by the differences in the proportion of the population reporting the corresponding levels of the respective lifestyle factors in 1986 and 2004. The sum of the product terms for each item represents the respective estimated impact of change in waist and hip circumference. Results: Lifestyle trends associated with changes in hip circumference were (women/men): higher education level (+4.0 mm/+2.4 mm), fewer smokers (+0.4 mm/+0.9 mm), a slight increase in alcohol consumption (+0.4 mm/+0.3 mm), and more saturated fat from meat in women (-0.9 mm) and more fibre from grains in men (+0.6 mm). Average waist circumference was influenced by increased levels of physical activity (-2.2 mm/-4.6 mm), fewer female smokers (-0.3 mm), and a higher intake of saturated fatty acids from meat among men (+1.8 mm). Conclusions: We identified physical activity and the intake of meat and whole-grain products as prime candidates for lifestyle interventions in northern Sweden.
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- Ringbäck Weitoft, Gunilla, et al.
(författare)
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Underweight, overweight and obesity as risk factors for mortality and hospitalization.
- 2008
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 36:2, s. 169-76
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: The prevalence of overweight and obesity is increasing in many countries. We aimed to investigate differences in mortality and severe morbidity between underweight people (body mass index (BMI)<18.5), overweight people (BMI 25 to <30), obese people (BMI> or =30), and those with normal weights (BMI 18.5 to <25). METHODS: Random samples of the Swedish population aged 16-74 years in 1980-81 and 1988-89 were followed for 12 years with regard to all-cause mortality and mortality from circulatory diseases, all inpatient care, and inpatient care for circulatory and musculoskeletal diseases. Relative risks (RRs) for different levels of BMI were adjusted for age, longstanding illness, smoking, and educational level at baseline. In addition, analyses were made with delayed entry until the fourth-year after interview. RESULTS: Obesity and underweight, but not overweight, was associated with higher all-cause mortality. Among underweight men, the adjusted RR for all-cause mortality was 2.4 (95% confidence interval 1.6-3.6), and among underweight women it was 2.0 (1.5-2.7), but population attributable risks (PARs) were small, at 1.2% and 2.7%, respectively. Overweight was associated with increased risks for inpatient care for circulatory diseases, with PARs being 13.4% among men and 8.1% among women, and musculoskeletal diseases (PARs were 12.7% and 12.9%, respectively). Obese men and women had about 50% higher risks of all-cause mortality than normal-weight people, PARs being 3.2% and 3.8% respectively. CONCLUSIONS: This study supports the findings of other studies, in that overweight seems to be an exaggerated risk factor for all-cause mortality, but is related to other chronic disease. Underweight and obesity generally implies greater increases of RRs, but avoidance of overweight may have greater effect on the population level with regard to reduced cardiovascular and locomotor disease.
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- Rodu, Brad, et al.
(författare)
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The low prevalence of smoking in the Northern Sweden MONICA study, 2009
- 2013
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 41:8, s. 808-811
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The purpose of this study was to describe tobacco use in the 2009 Northern Sweden cohort of the World Health Organization Multinational Monitoring of Trends and Determinants in Cardiovascular Diseases (MONICA) study. Methods: Subjects (N = 1698) were randomly selected from population registers, stratified for age (25-74 years old) and gender, in the two northernmost Swedish counties of Norrbotten and Västerbotten. Responses from tobacco-related questions were used to develop three mutually exclusive categories of snus use: past, current, or never use; and three comparable categories of smoking that were consistent with previous studies. Results: Among men, the prevalence of smoking (9%) and dual use (2%) remain unchanged from 2004, although the prevalence of snus use declined from 27% in 2004 to 24% in 2009. Among women, the prevalence of all forms of tobacco use declined between 2004 and 2009; smoking dropped from 16% to 11%, dual use from 2% to less than 1%, and snus use from 9% to 8%. Although overall prevalence of tobacco use was similar for younger versus older men and younger versus older women, there were notable differences in specific snus and smoking rates. Conclusions: This study confirms that use of snus was a significant factor in the low prevalence of smoking, especially among younger men and women in Northern Sweden. Furthermore, it documents that tobacco harm reduction is entirely compatible with a population-level decline in overall tobacco use.
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| 9. |
- Stegmayr, Birgitta, et al.
(författare)
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The decline of smoking in northern Sweden.
- 2005
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Ingår i: Scand J Public Health. - : SAGE Publications. - 1403-4948. ; 33:4, s. 321-4; discussion 243
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Tidskriftsartikel (refereegranskat)abstract
- For decades men in Sweden have smoked at far lower rates than those in comparable countries. Previous studies showed that snus use played a major role in low smoking rates among men in northern Sweden; daily smoking declined from 19% (95% CI 16—22%) in 1986 to 11% (CI 8.9—14%) in 1999. The prevalence of smoking among all men is now 9% (CI 7.0— 11%) and only 3% (CI 0.1—5.4%) among men age 25—34 years; the prevalence of exclusive snus use is 27% (CI 24—30%) and 34% (CI 27—42%) respectively. Combined smoking and snus use, an unstable and transient category, was under 5% in all surveys and was 2.2% (CI 1.4—3.4%) by 2004. For the first time snus use is also associated with a decrease in smoking prevalence among women. These patterns of tobacco use have implications for all smoking-dominated societies.
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