Blood lipids, fatty acids, diet and lifestyle parameters in adolescents from a region in northern Norway with a high mortality from coronary heart disease.

INTRODUCTION: Students aged 13 and 14 y, in a region in northern Norway with high blood cholesterol levels and high mortality from coronary heart disease (CHD) in the adult population, were studied with respect to lifestyle, dietary habits, nutritional intake and blood lipids including fatty acids in serum. The students came from a coastal community with seawater fish as an important part of the traditional diet, and an inland community with meat from reindeer as a major constituent of the diet. OBJECTIVE: To investigate whether the traditional diet was maintained among the adolescents and to evaluate the lifestyle and blood lipids. The study was followed up after 1 y. RESULTS: The adolescents from the coastal region did not maintain the traditional diet. In the inland region the students had a high intake of meat, probably reflecting the traditional food culture. The inland boys had higher mean body mass index (BMI) than the coastal boys, and 12% had BMI>28, as compared to none of the coastal boys. Other findings showed that the students had higher levels of blood cholesterol than in the south of Norway and several other countries (about 25% had total cholesterol >5.2 mmol/l), higher intake of dietary sugar and fat than the national recommendations and little intake of seawater fish with corresponding low levels of n-3 fatty acids. This did not change after 1 y of follow up. Some 10-20% reported daily smoking and 8-13% reported that they rarely or never did physical exercise. About 30% of the students presented no factors negatively related to development of cardiovascular disease. CONCLUSION: The findings demonstrate, in the majority of students at the age of 13 and 14 y, the appearance of factors contributing to development of cardiovascular disease (CHD). SPONSORSHIP: This study was supported by the program 'Medisinsk forskning i Finnmark, University of Tromsø'.

A long-term seal- and cod-liver-oil supplementation in hypercholesterolemic subjects.

In this long-term study, we wanted to explore the effect of dietary supplementation of seal oil (SO) as compared cod-liver oil (CLO) on subjects with moderate hypercholesterolemia. The test parameters included fatty acid composition in serum, blood lipids, platelet aggregation, and the activity of blood monocytes. After a run-in period of 6 mon, 120 clinically healthy hypercholesterolemic (7.0-9.5 mmol/L; 270-366 mg/dL) subjects were randomly selected to consume either 15 mL of SO or CLO daily for 14 mon followed by a 4-mon wash-out period. A third group was not given any dietary supplement (control). Consumption of marine oils (SO and CLO) changed the fatty acid composition of serum significantly. Maximal levels were achieved after 10 mon. No further changes were seen after 14 mon. A wash-out period of 4 mon hardly altered the level of n-3 fatty acids in serum. Addition of SO gave 30% higher level of eicosapentaenoic acid, as compared to CLO. Subjects taking SO or CLO had lower whole-blood platelet aggregation than the control group. Neither SO nor CLO had any effects on the levels of serum total cholesterol, high-density lipoprotein cholesterol, postprandial triacylglycerol, apolipoproteins Al and B100, lipoprotein (a), monocyte function expressed as monocyte-derived tissue factor expression, and tumor necrosis factor.

[Local, central and regional functions. Obsolete concepts?]. / Lokal-, sentral- og regionfunksjoner. Foreldede begreper?

As a consequence of the regionalization of the health services in Norway hospitals were given either local, central or regional responsibility. This system was intended to improve the availability of expertise and costly equipment, and at the same time reduce the growth of expenditures on health care. In the last few years, however, many of the smaller hospitals have improved their technical and medical skills to such an extent that this classification system has become less meaningful. Aker hospital in Oslo carries out local, central and regional functions. In a prospective study at this hospital we found that 88% of 980 consecutive medical admissions could be classified as local hospital admissions. Only 5% of the patients needed service at the central level, and 5% at the regional level. In our opinion it would suffice to have two types of hospital ("treatment levels"), standard hospitals and referral hospitals.

[Internal medicine--limited or wide medical specialty?]. / Indremedisin--snever eller vid spesialitet?

980 consecutive admissions to the medical department of Aker Hospital were analyzed in order to determine the extent to which the department deals with problems not related directly to the field of internal medicine. 709 patients (72%) were admitted for purely medical conditions. These patients occupied 49% of the beds. In 121 cases (12%) the main reason for admission involved other specialities. 209 admissions (21%) involved conditions other than somatic disease. Patients waiting for transferral to permanent nursing homes occupied 16% of the beds. Most patients needed hospital care, and many suffered from complex medical conditions. These factors advocate a liberal admission policy. On the other hand, medical departments should be relieved of responsibility for patients whose primary requirement is long-term care.

[Admissions to the medical wards. Are resources used in accordance to patients' needs?]. / Innleggelser i medisinsk avdeling. Svarer bruken av ressurser til pasientenes behov?

Medical and social data on 980 consecutive admissions to the Medical Department, Aker Hospital, Oslo, were recorded prospectively with emphasis on patients' requirements and the Department's use of available resources. 73% of the admissions were acute, 4% were considered unnecessary. Half were because of chronic illness. Although 88% of the patients' requirements could have been met at a local hospital, 59% were treated in specialized units. 12% were admitted to the day unit at reduced cost for an average stay of three days. 41% of the patients were over 70 years of age, 37% lived alone and 14% needed rehabilitation. A main reason for admission was the patient's inability to take care of him/herself at home, in nearly all cases the main reason being acute illness or deterioration. Therefore many of the patients seemed to need care in an acute geriatric unit. At any one time the reason for 20-25% of the patients being in the department was delay in providing care at home or in a nursing home.