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- Borud, Einar Kristian, et al.
(author)
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The Acupuncture on Hot Flushes Among Menopausal Women (ACUFLASH) study, a randomized controlled trial
- 2009
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In: MENOPAUSE-THE JOURNAL OF THE NORTH AMERICAN MENOPAUSE SOCIETY. - : Ovid Technologies (Wolters Kluwer Health). - 1072-3714. ; 16:3, s. 484-493
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Journal article (peer-reviewed)abstract
- Objective: This study compared the effectiveness of individualized acupuncture plus self-care versus self-care alone on hot flashes and health-related quality of life in postmenopausal women. Methods: This study involved a multicenter, pragmatic, randomized, controlled trial with two parallel arms. Participants were postmenopausal women experiencing, on average, seven or more hot flashes per 24 hours during seven consecutive days. The acupuncture group received 10 acupuncture treatment sessions and advice on self-care, and the control group received advice on self-care only. The frequency and severity (0-10 scale) of hot flashes were registered in a diary. Urine excretion of calcitonin gene-related peptide was assessed at baseline and after 12 weeks. The primary endpoint was change in mean hot flash frequency from baseline to 12 weeks. The secondary endpoint was change in health-related quality of life measured by the Womens Health Questionnaire. Results: Hot flash frequency decreased by 5.8 per 24 hours in the acupuncture group (n = 134) and 3.7 per 24 hours in the control group (n = 133), a difference of 2.1 (P < 0.001). Hot flash intensity decreased by 3.2 units in the acupuncture group and 1.8 units in the control group, a difference of 1.4 (P < 0.001). The acupuncture group experienced statistically significant improvements in the vasomotor, sleep, and somatic symptoms dimensions of the Womens Health Questionnaire compared with the control group. Urine calcitonin gene-related peptide excretion remained unchanged from baseline to week 12. Conclusions: Acupuncture plus self-care can contribute to a clinically relevant reduction in hot flashes and increased health-related quality of life in postmenopausal women.
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2. |
- Di Castelnuovo, Augusto, et al.
(author)
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Drinking alcohol in moderation is associated with lower rate of all-cause mortality in individuals with higher rather than lower educational level : findings from the MORGAM project
- 2023
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In: European Journal of Epidemiology. - : Springer Nature. - 0393-2990 .- 1573-7284. ; 38:8, s. 869-881
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Journal article (peer-reviewed)abstract
- The association between socioeconomic status (SES) and alcohol-related diseases has been widely explored. Less is known, however, on whether the association of moderate drinking with all-cause mortality is modified by educational level (EL). Using harmonized data from 16 cohorts in the MORGAM Project (N = 142,066) the association of pattern of alcohol intake with hazard of all-cause mortality across EL (lower = primary-school; middle = secondary-school; higher = university/college degree) was assessed using multivariable Cox-regression and spline curves. A total of 16,695 deaths occurred in 11.8 years (median). In comparison with life-long abstainers, participants drinking 0.1–10 g/d of ethanol had 13% (HR = 0.87; 95%CI: 0.74–1.02), 11% (HR = 0.89; 0.84–0.95) and 5% (HR = 0.95; 0.89–1.02) lower rate of death in higher, middle and lower EL, respectively. Conversely, drinkers > 20 g/d had 1% (HR = 1.01; 0.82–1.25), 10% (HR = 1.10; 1.02–1.19) and 17% (HR = 1.17; 1.09–1.26) higher rate of death. The association of alcohol consumption with all-cause mortality was nonlinear, with a different J-shape by EL levels. It was consistent across both sexes and in various approaches of measuring alcohol consumption, including combining quantity and frequency and it was more evident when the beverage of preference was wine. We observed that drinking in moderation (≤ 10 g/d) is associated with lower mortality rate more evidently in individuals with higher EL than in people with lower EL, while heavy drinking is associated with higher mortality rate more evidently in individuals with lower EL than in people with higher EL, suggesting that advice on reducing alcohol intake should especially target individuals of low EL.
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3. |
- Mikkelsen, Mari, et al.
(author)
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Associations between postprandial triglyceride concentrations and sex, age, and body mass index : cross-sectional analyses from the Tromso study 2015-2016
- 2023
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In: Frontiers in Nutrition. - : Frontiers Media S.A.. - 2296-861X. ; 10
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Journal article (peer-reviewed)abstract
- Introduction: Elevated serum triglyceride concentrations increase the risk of developing atherosclerosis, the leading cause of cardiovascular disease. Postprandial triglyceride concentrations have shown to be a stronger predictor of cardiovascular disease compared to fasting triglycerides. It is therefore clinically relevant to study patterns of postprandial triglyceride concentrations in a general adult population.Aims: The aim of this cross-sectional analysis was to examine postprandial triglyceride concentrations in women and men, and the association with age, body mass index and menopausal status.Methods: Non-fasting blood samples from 20,963 women and men aged 40 years and older, attending the seventh survey of the Tromso Study (2015-2016), were analyzed for postprandial triglyceride concentrations using descriptive statistics and linear regression models. Self-reported time since last meal before blood sampling was categorized into 1-h intervals with 7+ hours considered fasting.Results: Men had higher triglyceride concentrations compared to women. The pattern of postprandial triglyceride concentrations differed between the sexes. In women, the highest triglyceride concentration (19% higher compared to fasting level, p < 0.001) was found 3-4 h postprandially compared to 1-3 h in men (30% higher compared to fasting level, p < 0.001). In women, all subgroups of age and BMI had higher triglyceride concentrations than the reference group (age 40-49 years and BMI < 25 kg/m(2)), but no linear trend for age was observed. In men, triglyceride concentrations were inversely associated with age. Body mass index was positively associated with triglyceride concentration in both women (p < 0.001) and men (p < 0.001), although this association was somewhat modified by age in women. Postmenopausal women had significantly higher triglyceride concentrations compared to premenopausal women (p < 0.05).Conclusion: Postprandial triglyceride concentrations differed in groups of sex, age, body mass index, and menopausal status.
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4. |
- Reinikainen, Jaakko, et al.
(author)
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Regional and temporal differences in the associations between cardiovascular disease and its classic risk factors : an analysis of 49 cohorts from 11 European countries
- 2024
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In: European Journal of Preventive Cardiology. - : Oxford University Press. - 2047-4873 .- 2047-4881. ; 31:5, s. 569-577
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Journal article (peer-reviewed)abstract
- Aims: The regional and temporal differences in the associations between cardiovascular disease (CVD) and its classic risk factors are unknown. The current study examined these associations in different European regions over a 30-year period.Methods and results: The study sample comprised 553 818 individuals from 49 cohorts in 11 European countries (baseline: 1982-2012) who were followed up for a maximum of 10 years. Risk factors [sex, smoking, diabetes, non-HDL cholesterol, systolic blood pressure (BP), and body mass index (BMI)] and CVD events (coronary heart disease or stroke) were harmonized across cohorts. Risk factor-outcome associations were analysed using multivariable-adjusted Cox regression models, and differences in associations were assessed using meta-regression. The differences in the risk factor-CVD associations between central Europe, northern Europe, southern Europe, and the UK were generally small. Men had a slightly higher hazard ratio (HR) in southern Europe (P = 0.043 for overall difference), and those with diabetes had a slightly lower HR in central Europe (P = 0.022 for overall difference) compared with the other regions. Of the six CVD risk factors, minor HR decreases per decade were observed for non-HDL cholesterol [7% per mmol/L; 95% confidence interval (CI), 3-10%] and systolic BP (4% per 20 mmHg; 95% CI, 1-8%), while a minor HR increase per decade was observed for BMI (7% per 10 kg/m2; 95% CI, 1-13%).Conclusion: The results demonstrate that all classic CVD risk factors are still relevant in Europe, irrespective of regional area. Preventive strategies should focus on risk factors with the greatest population attributable risk.
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5. |
- Rosberg, Victoria, et al.
(author)
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Simple cardiovascular risk stratification by replacing total serum cholesterol with anthropometric measures : The MORGAM prospective cohort project
- 2022
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In: Preventive Medicine Reports. - : Elsevier. - 2211-3355. ; 26
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Journal article (peer-reviewed)abstract
- To assess whether anthropometric measures (body mass index [BMI], waist-hip ratio [WHR], and estimated fat mass [EFM]) are independently associated with major adverse cardiovascular events (MACE), and to assess their added prognostic value compared with serum total-cholesterol. The study population comprised 109,509 individuals (53% men) from the MORGAM-Project, aged 19–97 years, without established cardiovascular disease, and not on antihypertensive treatment. While BMI was reported in all, WHR and EFM were reported in ∼52,000 participants. Prognostic importance of anthropometric measurements and total-cholesterol was evaluated using adjusted Cox proportional-hazards regression, logistic regression, area under the receiver-operating-characteristic curve (AUCROC), and net reclassification improvement (NRI). The primary endpoint was MACE, a composite of stroke, myocardial infarction, or death from coronary heart disease. Age interacted significantly with anthropometric measures and total-cholesterol on MACE (P ≤ 0.003), and therefore age-stratified analyses (<50 versus ≥ 50 years) were performed. BMI, WHR, EFM, and total-cholesterol were independently associated with MACE (P ≤ 0.003) and resulted in significantly positive NRI when added to age, sex, smoking status, and systolic blood pressure. Only total-cholesterol increased discrimination ability (AUCROC difference; P < 0.001). In subjects < 50 years, the prediction model with total-cholesterol was superior to the model including BMI, but not superior to models containing WHR or EFM, while in those ≥ 50 years, the model with total-cholesterol was superior to all models containing anthropometric variables, whether assessed individually or combined. We found a potential role for replacing total-cholesterol with anthropometric measures for MACE-prediction among individuals < 50 years when laboratory measurements are unavailable, but not among those ≥ 50 years.
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7. |
- Sagelv, Edvard H., et al.
(author)
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Physical activity levels in adults and elderly from triaxial and uniaxial accelerometry. The Tromsø Study
- 2019
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In: PLOS ONE. - : PLOS. - 1932-6203. ; 14:12
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Journal article (peer-reviewed)abstract
- Introduction: Surveillance of physical activity at the population level increases the knowledge on levels and trends of physical activity, which may support public health initiatives to promote physical activity. Physical activity assessed by accelerometry is challenged by varying data processing procedures, which influences the outcome. We aimed to describe the levels and prevalence estimates of physical activity, and to examine how triaxial and uniaxial accelerometry data influences these estimates, in a large population-based cohort of Norwegian adults.Methods: This cross-sectional study included 5918 women and men aged 40–84 years who participated in the seventh wave of the Tromsø Study (2015–16). The participants wore an ActiGraph wGT3X-BT accelerometer attached to the hip for 24 hours per day over seven consecutive days. Accelerometry variables were expressed as volume (counts·minute-1 and steps·day-1) and as minutes per day in sedentary, light physical activity and moderate and vigorous physical activity (MVPA).Results: From triaxial accelerometry data, 22% (95% confidence interval (CI): 21–23%) of the participants fulfilled the current global recommendations for physical activity (≥150 minutes of MVPA per week in ≥10-minute bouts), while 70% (95% CI: 69–71%) accumulated ≥150 minutes of non-bouted MVPA per week. When analysing uniaxial data, 18% fulfilled the current recommendations (i.e. 20% difference compared with triaxial data), and 55% (95% CI: 53–56%) accumulated ≥150 minutes of non-bouted MVPA per week. We observed approximately 100 less minutes of sedentary time and 90 minutes more of light physical activity from triaxial data compared with uniaxial data (p<0.001).Conclusion: The prevalence estimates of sufficiently active adults and elderly are more than three times higher (22% vs. 70%) when comparing triaxial bouted and non-bouted MVPA. Physical activity estimates are highly dependent on accelerometry data processing criteria and on different definitions of physical activity recommendations, which may influence prevalence estimates and tracking of physical activity patterns over time.
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9. |
- Tiwari, Sweta, et al.
(author)
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Lifestyle factors as mediators of area-level socioeconomic differentials in mental health and cognitive function: The Tromsø Study
- 2024
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In: Journal of Epidemiology and Community Health. - 0143-005X .- 1470-2738. ; 78:2, s. 88-97
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Journal article (peer-reviewed)abstract
- Introduction: Low socioeconomic status (SES) is associated with poor mental health and cognitive function. Individual-level SES and area-level SES (ASES) may affect mental health and cognitive function through lifestyle. We aimed to quantify the associations of ASES with mental health and cognitive function and examine the mediating role of lifestyle behaviours independent of individual-level SES in a Norwegian population. Methods: In this cross-sectional study, we included 7211 participants (54% women) from the seventh survey of the Tromsø Study (2015-2016) (Tromsø7). The exposure variable ASES was created by aggregating individual-level SES variables (education, income, housing ownership) from Statistics Norway at the geographical subdivision level. Tromsø7 data were used as mediators (smoking, snuff, alcohol, physical activity, diet) and outcomes (cognitive function, anxiety, depression, insomnia). Mediation and mediated moderation analysis were performed with age as a moderator, stratified by sex. Results: Higher ASES was associated with better cognitive function and fewer depression and insomnia symptoms, independent of individual-level SES. These associations were mediated by smoking and physical activity. Alcohol was a mediator for depression and cognitive function in women. Age was a significant moderator of the association between ASES and global cognitive function in women. The largest total indirect effect of ASES was found for depression, with the joint effect of the mediators accounting for 36% of the total effect. Conclusions: People living in areas with lower ASES are at higher risk of poor mental health, such as depression and insomnia, and have lower cognitive function possibly due to unhealthy lifestyle (smoking, alcohol and physical inactivity).
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10. |
- Vishram-Nielsen, Julie K.K., et al.
(author)
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Predictive importance of blood pressure characteristics with increasing age in healthy men and women : The MORGAM Project
- 2021
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In: Hypertension. - : Lippincott Williams & Wilkins. - 0194-911X .- 1524-4563. ; 77:4, s. 1076-1085
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Journal article (peer-reviewed)abstract
- It remains unclear which blood pressure (BP) characteristics best predict cardiovascular risk in different age groups and between sexes. We leveraged data from the MORGAM (MONICA [Monitoring of Trends and Determinants in Cardiovascular Disease], Risk, Genetics, Archiving and Monograph) Project to investigate determinants of BP characteristics and their prognostic importance, in younger and older (
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