BACKGROUND: It is controversial whether the association between back pain, and other types of chronic pain, and smoking is causal or not. AIM: To examine the relationship between frequent pain and smoking, and between frequent pain and exposure to environmental tobacco smoke (ETS) in smokers and non-smokers. METHODS: A randomised population-based study, Inter99 (1999-2006), Denmark. Subjects in the intervention groups (N=6784; participation rate=52.5%) completed self-report questionnaires. Cross-sectional data from baseline were analysed in adjusted logistic regression analyses to investigate the relationship between active and passive smoking and frequent pain in the back, abdomen, joints and head. RESULTS: Daily smokers reported significantly more frequent pain in every of the six locations, and in several, minimum three, locations (OR=1.98 (95%CI=1.6-2.4)) than never smokers. We found a dose-response relationship between frequent pain and intensity of both active and passive smoking (test-for-trend p
To examine the effects on consumption and risk of ischemic heart disease (IHD) of the Danish fat tax, effective from October 2011 to January 2013.
We used comprehensive retail outlet data on the sale of twelve foodstuff categories targeted by the fat tax. Data covered January 2010 to July 2013. IHD risk was assessed by modelling first the effect of changes in intake of monounsaturated, polyunsaturated and saturated fat and dietary cholesterol on serum cholesterol and subsequently modelling the resulting changes in risk of IHD using two different methods.
The total sale of the included foodstuffs decreased by 0.9%. The fat tax was associated with marginal changes in population risk of IHD. One estimate suggests an increased population risk of IHD by 0.2% and the other estimate suggests that the risk of IHD decreased by 0.3%.
The Danish fat tax had a marginal effect on population consumption of fat and risk of IHD. Fat taxes have to be carefully designed to prevent possible adverse effects from outweighing its beneficial effects on health outcomes. Policymakers must therefore be more ambitious in relation to food taxes, e.g. by implementing more comprehensive tax-subsidy schemes.
School lunch programmes are one strategy to promote healthier dietary habits in children, but better evaluation tools for assessing the dietary quality of such programmes are needed. The aim of the present study was to develop and validate a simple index to assess the dietary quality of school lunches for children aged 7-13 years.
A Meal Index of dietary Quality (Meal IQ) was developed to consist of seven components (nutrients and food groups) based on dietary issues for children aged 7-13 years, which were identified in a national dietary survey. The Meal IQ was validated against calculated nutrient contents of school lunches both provided by the school and brought from home.
At eight public schools from all over Denmark, data were collected on 191 individual lunches brought from home (which is most common in Denmark) and thirty-one lunches provided as part of a school food programme. In addition thirty-two lunches provided at eighteen other public schools were included.
A total of 254 school lunches.
A higher Meal IQ score was associated with a higher overall dietary quality, including lower contents of fat, saturated fat and added sugars, higher contents of fibre, various vitamins and minerals, and more fruits, vegetables and fish.
The Meal IQ is a valid and useful evaluation tool for assessing the dietary quality of lunches provided by schools or brought to school from home.
The prevalence of overweight and obesity has increased markedly the past decades. However, recent studies have indicated that the development differ between different socio-economic groups and different geographic regions. The aim of this study was to assess the development in prevalence of overweight and obesity from 2006/2007 to 2010 by age, gender, socio-economic factors and geographical regions.
Two cross-sectional surveys in three regions in Denmark (The Capital Region of Denmark, The Central Denmark Region and The North Denmark Region) were performed in 2006/2007 and 2010. A random sample of citizens aged more than or equal to 25 years was invited to participate. The overall response rate was 57.5% (n = 177 076). Data from questionnaire and central registers were included.
In 2006/2007, the prevalence of overweight, including obesity, was 54.3% and 36.8% among men and women, respectively. Of the overweight men 12.8% were obese and 11.8% women were obese. The prevalence was highest in the Northern region and among those who were older, had short education, was outside labour market, had low income and residents in rural areas. In 2010, the prevalence of overweight had increased to 56.3% and 39.6% in men and women, respectively (P
Cross-sectional data suggests that a low level of plasma ascorbic acid positively associates with both Body Mass Index (BMI) and Waist Circumference (WC). This leads to questions about a possible relationship between dietary intake of ascorbic acid and subsequent changes in anthropometry, and whether such associations may depend on genetic predisposition to obesity. Hence, we examined whether dietary ascorbic acid, possibly in interaction with the genetic predisposition to a high BMI, WC or waist-hip ratio adjusted for BMI (WHR), associates with subsequent annual changes in weight (?BW) and waist circumference (?WC).
A total of 7,569 participants' from MONICA, the Diet Cancer and Health study and the INTER99 study were included in the study. We combined 50 obesity associated single nucleotide polymorphisms (SNPs) in four genetic scores: a score of all SNPs and a score for each of the traits (BMI, WC and WHR) with which the SNPs associate. Linear regression was used to examine the association between ascorbic acid intake and ?BW or ?WC. SNP-score?×?ascorbic acid interactions were examined by adding product terms to the models.
We found no significant associations between dietary ascorbic acid and ?BW or ?WC. Regarding SNP-score?×?ascorbic acid interactions, each additional risk allele of the 14 WHR associated SNPs associated with a ?WC of 0.039?cm/year (P?=?0.02, 95% CI: 0.005 to 0.073) per 100?mg/day higher ascorbic acid intake. However, the association to ?WC only remained borderline significant after adjustment for ?BW.
In general, our study does not support an association between dietary ascorbic acid and ?BW or ?WC, but a diet with a high content of ascorbic acid may be weakly associated to higher WC gain among people who are genetically predisposed to a high WHR. However, given the quite limited association any public health relevance is questionable.
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We examined whether the adherence to major dietary patterns at baseline of 5824 nondiabetic Danes (30-60 y) enrolled in the nonpharmacological Inter99 intervention predicted changes in fasting plasma glucose (FPG) and postchallenge 2-h plasma glucose (2h-PG) concentrations during a 5 y period and whether a potential association was dependent on baseline glucose tolerance status. Through principal component analysis, a score for a traditional dietary pattern (characterized by higher intakes of high-fat sandwich spreads, red meat, potatoes, butter and lard, low-fat fish, sandwich meat, and sauces) and a score for a modern dietary pattern (characterized by higher intakes of vegetables, fruit, vegetable oil/vinegar dressing, poultry, pasta, rice, and cereals) were estimated for each person at baseline. Random effect models adjusting for relevant confounders were used to estimate changes in repetitive measures of FPG and 2h-PG. A higher modern score (of 1 SD) predicted an annual decrease in 2h-PG of 0.015 mmol/L (P
To investigate whether the effect of an individualised multi-factorial lifestyle intervention on dietary habits differs across socioeconomic groups.
The study was an individualised multi-factorial lifestyle intervention study with a control group, Inter99 (1999-2006), Copenhagen, Denmark. Participants in the intervention group (n=6 091) received lifestyle intervention during a five-year period. The control group (n=3 324) was followed by questionnaires. Multilevel regression analyses were used, including interaction term between intervention effect and socioeconomic position (SEP) and analysed separately for men and women. SEP was measured as length of education and employment status and dietary habits were measured by a validated food frequency questionnaire.
Men with a short education improved their dietary habits more (net-change [95% confidence interval]) (0.25 points [-0.01;0.52]) than men with longer education (0.02 points [-0.09;0.14]), (interaction: p=0.02). Furthermore, unemployed women improved their dietary intake more (0.33 points [0.05;0.61]) than employed women (0.01 points [-0.10;0.11]), (interaction: p=0.03). Similar results were found for fruit intake, whereas no significant interactions were found for fish, fat and vegetable intake.
Individualised dietary interventions do not increase and may even decrease or hinder further widening of the social inequalities in health due to unhealthy dietary habits among socially disadvantaged individuals.
Excessive salt intake causes increased blood pressure which is considered the leading risk for premature death. One major challenge when evaluating associations between daily salt intake and markers of non-communicable diseases is that a high daily salt intake correlates with obesity, which is also a well described risk factor for poor cardiometabolic outcome. The aim of this study was to evaluate the relationship of estimated daily salt intake with blood pressure and blood lipids and to investigate the effect of taking different measures of obesity into account.
We included 3294 men and women aged 18-69 years from a general population based study in Copenhagen, Denmark. Estimated 24-hour sodium excretion was calculated by measurements of creatinine and sodium concentration in spot urine in combination with information of sex, age, height and weight. The relations of estimated 24-hour sodium excretion with blood pressure and blood lipids were evaluated by linear regression models.
The daily mean estimated intake of salt was 10.80?g and 7.52?g among men and women, respectively. Daily salt intake was significantly associated with blood pressure (ß-estimates 1.18?mm Hg/g salt (systolic) and 0.74?mm Hg/g salt (diastolic), p?
A simple and valid alternative for 24-hour urine collection to estimate populational 24-hour urinary sodium excretion would be desirable for monitoring sodium intake in populations.
To assess the validity of the predicted 24-hour urinary sodium excretion using spot urine and two different prediction methods in a Danish population.
Overall, 473 Danish individuals provided a para-aminobenzoic acid-validated complete 24-hour urine collection and a spot urine sample. Data were collected in the DanThyr study (248 women aged 25-30 years and 60-65 years) and the Inter99 study (102 men and 113 women aged 30-60 years), respectively. The measured 24-hour urine sodium excretion was compared with the predicted 24-hour sodium excretion from a causal urine specimen, using both the Tanaka prediction method and a prediction model developed in a Danish population.
The measured 24-hour sodium excretion (median, 5th to 95th percentile) was men 195 (110 to 360) and women 139 (61 to 258), whereas the predicted 24-hour sodium excretion for the Tanaka model was men 171 (117 to 222) and women 153 (92 to 228) and for the Danish model was men 207 (146 to 258); women 134 (103 to 163). The Spearman correlation between predicted and measured 24-hour sodium excretion was 0.39 and 0.49 for the Tanaka and the Danish model, respectively. For both prediction models, the proportion of individuals classified in the same or adjacent quintile was 74% for men and 64% for women.
Both prediction models gave a reasonable classification of individuals according to their sodium excretion. However, the median daily sodium intake was estimated more precisely by the Danish model, especially among men.