Association between sweet drink intake and adiposity in Danish children participating in a long-term intervention study.

BACKGROUND: In some previous studies direct associations between intake of soft drinks, sugar-sweetened beverages and adiposity have been reported. The majority of these studies were, however, conducted in the USA and it is uncertain if the results are applicable to non-US countries. OBJECTIVE: To assess the association between sweet drink intake at age 6 and 9 years and the subsequent 3- to 7-year changes in body mass index (BMI) and sum of four skin-folds (Σ4SF). METHODS: Information on sweet drink intake (7 days food record) and physical activity (accelerometer) was obtained at age 6 years (n = 366) [Correction made here after initial online publication.] and 9 years (n = 269). Weight, height and Σ4SF were measured at age 6, 9 and 13 years. Additional information on socio-economic status, maternal BMI and pubertal status was obtained. RESULTS: No associations were observed between sweet drink intake at age 6 years and change in BMI or logΣ4SF from age 6 to 9 years or 6 to 13 years. Also, no associations were observed between change in sweet drink intake from age 6 to 9 years and subsequent change in BMI or logΣ4SF from age 9 to 13 years. A weak direct association was observed between sweet drink intake at age 9 years and change in logΣ4SF from age 9 to 13 years (per 100 g ∼ 3.38 fl oz) (ß: 0.014, 95% confidence interval [CI]: -0.001 to 0.029, P = 0.06), while no association was seen for BMI. In supplementary analyses a similar association was observed for soft drinks (ß: 0.087, 95% CI: 0.048 to 0.126, P = 0.001) but only in the intervention group. CONCLUSION: We observed associations between intake of sweet drinks and soft drinks and change in skin-fold thickness in a group of Danish children. However, as the associations did not remain significant when multiple testing was considered or was only significant among children from the intervention group, the results do not confirm or refute the direct association reported in previous studies.

Effects of ß-hydroxy ß-methyl butyrate supplementation to sows in late gestation on absorption and hepatic metabolism of glucose and amino acids during transition.

A multicatheter sow model was established to study the effects of dietary ß-hydroxy ß-methyl butyrate (HMB) supplementation on net portal flux (NPF) and net hepatic flux (NHF) of HMB, glucose, and the AA Ala, Gly, Ile, Leu, Phe, Tyr, and Val. Eight second parity sows were fitted with permanent indwelling catheters in an artery and in the portal, hepatic, and mesenteric veins. Eight hourly sets of blood samples were taken starting 30 min before the morning meal on day -3 and day 3 relative to parturition. Four control (CON) sows were fed a standard lactation diet from day -15 and throughout the experiment, and 4 HMB sows were fed the control diet supplemented with 15 mg Ca(HMB)(2)/kg BW mixed in one third of the morning meal from day -10 until parturition. Net portal flux of HMB was affected by treatment (Trt; P < 0.01) and peaked in the HMB sows at 6.9 mmol/h 30 min after the morning meal and then decreased towards preprandial level (0.0 mmol/h) 3.5 h after the meal, revealing that dietary HMB was rapidly absorbed from the intestine. The NHF of HMB tended to be affected by Trt (P = 0.06) showing a small hepatic uptake of HMB (1.1 mmol/h) in HMB sows. Net portal flux of glucose and all measured AA, except for Gly and Tyr, were affected the Trt × time interaction (P < 0.01). The NPF was positive for all nutrients, indicating absorption from the intestine to the portal blood. Absorption rates appeared to be more stable for HMB than for CON sows. Net hepatic flux of glucose was not affected by Trt. It was negative from 1.5 to 2.5 h after the meal, indicating hepatic uptake, but positive before and after, indicating net hepatic release of glucose. Net hepatic fluxes of AA were negative and were not affected by Trt (P > 0.10), except for Phe (P < 0.05). In conclusion, HMB reduced the variation in net portal flux of glucose and AA during 8 h of blood sampling and suggest that the improved sow productivity observed by others may be due to a more uniform nutrient absorption pattern into portal blood.

Prediction of fat-free body mass from bioelectrical impedance among 9- to 11-year-old Swedish children.

AIM: Predictive equations for estimating body composition from bioelectrical impedance analysis (BIA) among Scandinavian children are lacking. In the present study, equations for estimation of fat-free body mass (FFM) and lean tissue mass (LTM) were developed and cross-validated from BIA using dual-energy X-ray absorptiometry (DXA) as the reference measurement of body composition. METHODS: The study population consisted of 49 girls and 52 boys aged 9-11 years from Malmö, Sweden. Bioelectrical impedance was measured between hand and foot at 50 kHz. Predictive equations were developed by multiple linear regression and cross-validated against DXA measurements of body composition. RESULTS: FFM was predicted from BIA and anthropometric variables with an adjusted R(2)= 0.95 and root mean square error (RMSE) = 0.84 kg, and LTM was predicted with an adjusted R(2)= 0.95 and RMSE = 0.87 kg. Cross-validation revealed a mean RMSE = 0.95 kg FFM and a mean RMSE = 0.96 kg LTM. Prediction of body composition from equations developed in previous literature was mixed when applied to the present cohort of children. CONCLUSIONS: FFM and LTM are predicted with sufficient accuracy at the population level. We recommend that the predictive equations developed in the present study are used in prepubescent European children aged 9-11 years only in order to minimize confounding of results because of possible differences in population samples.

High purity bright single photon source.

Using cavity-enhanced non-degenerate parametric down-conversion, we have built a frequency tunable source of heralded single photons with a narrow bandwidth of 8 MHz, making it compatible with atomic quantum memories. The photon state is 70% pure single photon as characterized by a tomographic measurement and reconstruction of the quantum state, revealing a clearly negative Wigner function. Furthermore, it has a spectral brightness of ~1,500 photons/s per MHz bandwidth, making it one of the brightest single photon sources available. We also investigate the correlation function of the down-converted fields using a combination of two very distinct detection methods; photon counting and homodyne measurement.

A comparison of fluoxetine and imipramine in the treatment of outpatients with major depressive disorder.

A double-blind clinical trial was undertaken to evaluate the clinical efficacy and safety of fluoxetine compared with imipramine in the treatment of 59 outpatients suffering from major depressive disorder. The mean scores of all depression rating scales showed that the drugs had comparable efficacy. The side effect profile of imipramine was found to be mainly anticholinergic, which was not the case for fluoxetine, where it was mainly found to be gastrointestinal, such as nausea and diarrhoea. In both groups the total number of adverse events reported were the same. Fluoxetine treatment resulted in weight loss, whereas imipramine treatment resulted in a slight but significant weight increase.

Agreement in psychiatric assessment.

In 103 schizophrenic patients we investigated the extent of practice needed in the use of the Brief Psychiatric Rating Scale (BPRS) to enable its reliability to be assessed. The agreement level of the 7 raters was analysed. Generally, the lowest mean agreement found was for the negative symptoms of the BPRS schizophrenia subscale. A high degree of agreement was attained both for the positive symptoms of the BPRS schizophrenia subscale and for the symptoms of the depression--and of the mania subscale. The degree of disagreement observed was due to both individual differences in assessment ability and the rating procedure. These results indicate that it is necessary to state the degree of agreement achieved in studies in which several raters are taking part.

Quantifying depressive symptomatology: inter-rater reliability and inter-item correlations.

In this study an evaluation of the inter-rater reliability of the Hamilton Depression Rating Scale, the Melancholia Scale and the Montgomery-Asberg Depression Rating Scale has been carried out. Furthermore, the inter-item correlations of these scales have been investigated in relation to diagnostic ratings. It was found that the quantitative scales had satisfactory inter-rater relationship. Only low agreement was found between the quantitative and diagnostic scales, as expected, while there was high agreement between the quantitative scales. The relevance of introducing new scales and the definition of major depression are discussed.

Ophthalmoplegic migraine: diagnostic criteria, incidence of hospitalization and possible etiology.

Charts from patients admitted from April 1976 to March 1986 to the departments of neurology, neurosurgery, ophthalmology and pediatrics serving a population of 615,000 inhabitants in Copenhagen County were surveyed. We then examined patients with coexisting headache and ophthalmoplegia at follow-up. Many diseases may mimic a single attack of ophthalmoplegic migraine. We found 4 cases of ophthalmoplegic migraine, i.e. an annual incidence of 0.7 per million inhabitants. We added another 4 cases from the same area, but diagnosed before or after the study period. Only in 2 of the 8 cases did the ophthalmoplegic episodes fulfil criteria for pain and associated symptoms required for migraine without aura (common migraine). In contrast, the clinical characteristics of the attacks are typical of the Tolosa-Hunt syndrome. When this inflammatory disease strikes a migraineur it is likely to elicit headache with migrainous features. We postulate that such cases have been diagnosed as ophthalmoplegic migraine, whereas the proper diagnosis of Tolosa-Hunt syndrome has been made in non-migraineurs.

The Brief Psychiatric Rating Scale. Dimension of schizophrenia--reliability and construct validity.

This study has focussed on a 10-item Brief Psychiatric Rating Scale (BPRS) subscale for the quantification of schizophrenic states. Seven psychiatrists interviewed jointly patients who all fulfilled the DSM-III criteria of schizophrenia, and in a subsequent pencil-and-paper procedure a judgment analysis was performed. The reliability analysis showed that less experienced BPRS raters made less consistent judgments implying the cautionary statement that the proper use of a scale for schizophrenia requires specialized training with the scale. The validity analysis showed that the BPRS items had an additive relationship implying that the sum of these items is a sufficient statistic for the measurement of severity of schizophrenic states. Finally, the results seem to indicate, that the underlying dimension defined by the 10-items BPRS subscale includes hierarchically the negative and positive symptoms of schizophrenia.

An ethological description of depression.

During the last 20 years ethological psychiatric research has developed a working method for the systematic and quantitative recording and analysis of the nonverbal behaviour of psychiatric patients in their actual hospital environment. In this study this method was used to follow changes in the behaviour pattern of 5 depressed, hospitalized patients during their entire hospital stay. Parallel to ethological recording, patients were rated according to Hamilton twice a week. The patients who were most depressed at admission showed the greatest behavioural changes; the changes were most conspicuous in the behavioural elements representing social contact and communication. One patient who obviously developed a new depression during the observation period without this being recognized by the Hamilton rating or the clinical control, seemed to have been better described by the behaviour recording. This study shows that ethological psychiatric methods are very suitable for obtaining a better basis for the observations of the staff in the ward environment.

An ethological analysis of depression: comparison between ethological recording and Hamilton rating of five endogenously depressed patients.

Five patients who had all been diagnosed as endogenously depressed at admission were rated twice a week and observed ethologically for 4 h/week during the entire hospitalization (4-11 weeks). Observations were carried out in the actual social environment of the ward. Data were analysed based on the parameters of behaviour diversity, behaviour activity, and marker elements. Depression was scored as low values of diversity and activity; improvement corresponded to higher values of these parameters. As possible markers of improvement, 8 behavioural elements have been singled out. One patient constituted a special case: at discharge she was rated as completely recovered; however, the ethological data indicated a serious aggravation. The day after discharge the patient attempted to commit suicide. It is concluded that ethological psychiatric research may be able to supplement traditional psychiatry with decisive information in the areas of diagnosis and treatment assessment.

Altered balance in the autonomic nervous system in schizophrenic patients.

The aim of the present study was to evaluate the autonomic nervous function in schizophrenic patients. Twenty-eight patients (29 +/- 6 years) diagnosed as schizophrenics and in stable medication were included, together with ten schizophrenic patients (25 +/- 5 years) who were unmedicated. Eleven healthy subjects (32 +/- 7 years) served as controls. Immediate heart-rate responses to a single deep inspiration was used as a measure of parasympathetic function. Heart-rate response to standing was used as a measure of sympathetic function. Supine blood pressure, heart-rate and orthostatic changes in blood pressure did not differ between groups. Heart-rate response to standing was greater in both medicated and non-medicated schizophrenics compared to normal subjects (P less than 0.01). Heart-rate response to standing was greater in non-medicated compared to medicated schizophrenics (P less than 0.05). Heart-rate response to inspiration was greater in non-medicated schizophrenics compared to normal subjects (P less than 0.05), whereas no difference was found between medicated and non-medicated schizophrenics. The results show that the balance in the autonomic nervous system is altered in schizophrenic patients with a hyperexcitability in both the sympathetic and the parasympathetic division. Our study has thus indicated a dysfunction in the autonomic nervous system per se and the previous interpretations of attentional orienting responses in schizophrenia is questioned. Medication with neuroleptics seems to partly normalize the autonomic reactivity rather than being the cause of autonomic dysfunction.

Left ventricular performance in alcoholic patients without chronic liver disease.

Left ventricular performance was studied non-invasively in 24 chronic alcoholics without liver disease. Twelve patients who had abstained from drinking for at least one month (group A) and 12 sex and age matched patients who had ceased drinking during the preceding 24 hours (group B) were studied at rest and during 50% submaximal exercise. Cardiac output and stroke volume were measured by first passage and left ventricular ejection fraction by multigated radionuclide cardiography. Twelve healthy sex and age matched controls were also studied. Haemodynamic variables were similar in group A and the controls, except that in group A left ventricular end systolic volume index did not decrease during exercise. In group B the heart rate was increased both at rest and during exercise and plasma noradrenaline concentrations were increased. The stroke volume index did not increase significantly during exercise in group B. In addition, the increase in left ventricular ejection fraction was smaller in group B than in controls. End systolic contraction was reduced in group B patients and diastolic blood pressure was increased. These results suggest that cardiac abnormalities in chronic alcoholics may be reversed after cessation of drinking if no chronic liver disease is present. Recent alcohol consumption increases sympathetic nervous activity, impairs cardiac contractility, and increases afterload during physical stress.

Personality in unipolar and bipolar manic-malancholic patients.

By use of standardized case-recording criteria (MULTI-CLAD) manic-melancholic patients were classified as unipolar (n = 13) and bipolar (n = 23). Personality patterns are evaluated when patients were in neutral mood (defined by low symptom rating scale scores). Results showed that the similarities in the personality patterns of unipolars and bipolars were much pronounced than the differences. In general, the score patterns of the various scales in both groups of patients were found to be within the normal score range. However, this was indirectly expressed by high Lie (or denial) score levels on the Eysenck scale. The dynamic explanations of this form of symptom-denial are discussed. Moreover, our findings are discussed in connection with lithium treatment which was the main therapy the patients had received.