Trends in physical health complaints among adolescents from 2014 - 2019: Considering screen time, social media use, and physical activity.

The rising rates of physical and mental health complaints among adolescents observed in many countries have coincided with an increased time spent on screen-based devices, including social media use. We sought to document recent trends in physical health complaints (PHC) and whether co-occurring trends in screen time, social media use, and physical activity may account for these trends. To achieve these aims, we used data from the nationwide Ungdata surveys conducted annually at the municipality level in Norway, comprising 419,934 adolescents aged 13-18 from six survey years (2014-2019). Six items assessed PHC, including neck and shoulder pain, headache, and abdominal pain, during the past month. To account for the nesting structure of Ungdata, and to exploit the variation within and between municipalities, we used multilevel analyses with adolescents nested in municipality-years (n = 669), nested in municipalities (n = 345). We found a small to moderate linear increase in number of PHC among boys and girls from 2014 to 2019. Screen time and social media use moderately attenuated the trend for girls, and to a lesser extent for boys. Screen time and social media use were further positively associated with PHC across the between and within-municipality levels, and social media use was more strongly associated with PHC for girls than boys across all levels of analysis. A similar pattern emerged when considering each symptom individually. The results suggest that the prevalence of PHC rose in tandem with a group-level shift towards higher screen time and social media use. Moreover, the results indicate that higher screen time and social media use may have led to changes in the youth culture with potential consequences for adolescents' well-being.

Psychometric properties of a short self-report measure of rule-breaking behaviour among adolescents: findings from the Ungdata survey.

BACKGROUND: The aim of the present study was to examine the factor structure and reliability of a six-item scale of rule-breaking behaviour, and to test for measurement invariance across gender, age, survey year and geographical location. METHODS: Data were from three yearly cross-sectional and population-based collections of the Ungdata surveys (2017 to 2019) including a total of 297,102 Norwegian adolescents aged approximately 13 to 19 years. Measurements included respondent's rule-breaking behaviour, time, gender, age and geographical location. RESULTS: Confirmatory factor analyses demonstrated that a one-factor solution of the rule-breaking behaviour scale had good fit to data (comparative fit index 0.98; Tucker-Lewis index 0.96; root mean square error of approximation 0.049 (95% confidence interval 0.048, 0.050)), with factor loadings ranging from 0.60 to 0.81 for all items (mean factor loading 0.72). Similar results were found across survey years for both genders. Several multiple group confirmatory factor analyses showed indications of measurement invariance for the scale across gender, age groups, geographical locations and survey years. The ordinal alpha and omega coefficients for internal consistency of the scale were both 0.86. CONCLUSIONS: The six-item scale for self-reported rule-breaking behaviour demonstrated good psychometric properties and appears to constitute a reliable measure of adolescent rule-breaking behaviour for use in population-based surveys in a Norwegian setting.

The Relationship Between Perceived Social Support and PTSD Symptoms After Exposure to Physical Assault: An 8 Years Longitudinal Study.

Consequences of nondomestic violence are known to be multifaceted with high rates of emotional and psychological problems in addition to physical injuries, and victims report many trauma related symptoms. This study explore if perceived social support (PSS) (Social Provisions Scale [SPS]) and post-traumatic stress disorder (PTSD) symptoms (Impact of Event Scale [IES-22]) are interrelated among adult victims at four assessment points up until eight years after the exposure to physical assault; soon after the event (T1), three months after T1 (T2), one year after T1 (T3), and eight years after T1 (T4). One hundred and forty-three subjects participated at T1, 94 at T2, 73 at T3, and 47 accepted a follow-up at T4. At T1, 138 of 143 completed the questionnaires within 16 weeks after the incident. PTSD symptoms were highly correlated across time (p < .001); PSS were significantly correlated only between T1 and T2 (p < .001), T1 and T3 (p < .05), and between T2 and T3 (p < .05). Cross-lagged analyses showed an inverse relationship between prior PSS and later PTSD symptoms across all time points (ps < .05); not proved between prior PTSD symptoms and later PSS (ps > .1). PSS at T1 was an independent predictor of PSS one year and eight years after the incident. We conclude that higher perception of social support protects against the development of PTSD symptoms; diminished perception of social support increases the risk of developing PTSD symptoms. These findings suggest that PSS after experiencing a violent assault should be considered as an important factor in natural recovery in the long run, as well as essential alongside psychiatric treatment. Establishing psychosocial interventions for victims of physical violence in the acute phase may prevent prolonged trauma reactions.

Perfectionism in Adolescence: Associations With Gender, Age, and Socioeconomic Status in a Norwegian Sample.

Background: Perfectionism in adolescence has received increased attention, but few studies have examined this in non-clinical samples. This study investigated perfectionism among adolescents from the general population in relation to demographic factors. Methods: The present study is cross-sectional and draws on the epidemiological youth@hordaland study. The sample consisted of 10.217 adolescents aged 16-19 years (52.9% girls). Self-reported perfectionism was assessed by the EDI-P scale from the Eating Disorder Inventory with two dimensions of perfectionism, namely self-oriented (SOP) and socially prescribed (SPP) perfectionism, and a total score. Perfectionism was analyzed in relation to age, gender, and socioeconomic status (SES) by perceived economic well-being and parental education level. Chi-squared tests, t-tests, and regression analyses were performed. Results: There were few gender differences on the mean scores on perfectionism, with similar levels on the total score of EDI-P and SOP, while girls scored slightly higher on SPP (p < 0.001). The latter gender difference represented a small effect size (Cohen's d = 0.053). Chi-square analyses with perfectionism split at the 90th percentile across gender showed that there were significantly more girls than boys among the high scorers both for EDI-P, EDI-SOP, and EDI-SPP. There were no significant differences between levels of perfectionism between the three age groups. The logistic regression analyses adjusted by age and gender showed that adolescents with a better perceived economic well-being had increased odds of high perfectionism. This was evident for overall EDI-P (OR = 1.760, 95% CI = 1.493-2.076), SOP (OR = 1.543, 95% CI = 1.292-1.843), and SPP (OR = 1.836, 95% CI = 1.559-2.163). Parental education was not significantly associated with perfectionism scores among the adolescents. Conclusions: The levels of perfectionism were relatively similar between the genders in the present study, besides slightly higher SPP among girls than boys. There were also significantly more girls than boys among the high scorers on overall perfectionism, SOP, and SPP, respectively. High perfectionism was related to SES for perceived economic well-being, but not for parental education level. Implications for further research and clinical interventions were suggested.

Past Year Cannabis Use Among Norwegian Adolescents: Time Trends Based on the Ungdata Surveys 2010-2019.

Aims: To describe trends in cannabis use from 2010 to 2019 among Norwegian adolescents and relate these to individual- and municipal-level variables. Design: Data from nationwide repeated cross-sectional surveys collected in 2010-2013 (T1), 2014-2016 (T2), and 2017-2019 (T3) were used to describe secular trends in proportions of adolescent cannabis use. Setting: Cross-sectional surveys in 410 of the total 428 municipalities of Norway. Participants: A total of 628,678 survey responses from adolescents aged ~13-19 years of age, in which 566,912 survey responses were eligible for analyses, representing data from 340 municipalities. Measurements: Respondent's past year cannabis use, time, gender, school grade, municipality, geographical location, and municipality population. Findings: Boys reported overall higher cannabis use, with ~2:1 gender ratio for any past year cannabis use and a 3:1 gender ratio for frequent cannabis use. Adolescents in Eastern Norway reported higher cannabis use compared with other areas in the country, and adolescents from municipalities with a higher population size reported higher rates of cannabis use than smaller municipalities. A gradual increase in cannabis use from T1 to T3 was found in Eastern Norway and in the largest municipalities. More generally, proportions of past year cannabis use showed a marked increase from T2 to T3 across genders, grade/age groups, geographical location, and municipality population, with few exceptions. Conclusions: Our findings indicate that proportions of past year cannabis use have increased among Norwegian adolescents in recent years. Preventive interventions to hinder initiation of cannabis use, as well as measures to address frequent cannabis use among Norwegian adolescents, are needed.

Weekday time in bed and obesity risk in adolescence.

INTRODUCTION: Sleep curtailment is associated with obesity in children, but few studies have investigated this relationship in a longitudinal sample of adolescents. The aim of the present study was to examine the longitudinal association between weekday time in bed (TIB) at age 10-13 and overweight at age 16-19. METHODS: Adolescents and their parents (N = 3025 families), participating in a longitudinal population-based study, completed questionnaires assessing habitual bedtime and wake time on weekdays, weight and height, socioeconomic status (SES), internalizing mental health problems and disturbed eating. Two surveys were administered with a 6-year interval (T1 and T2). A one-way analysis of covariance (ANCOVA) was performed examining the association between TIB and weight category 6 years later, with SES, internalizing problems and disturbed eating at baseline entered as covariates. Hierarchical and logistic regression analyses were used to assess TIB at age 10-13 years to as a predictor of body mass index (BMI) standardized deviation scores (SDS) and overweight status at age 16-19 adjusting for the same confounders and baseline BMI. RESULTS: A linear inverse relationship between TIB at age 10-13 and BMI category at age 16-19 was demonstrated by the ANCOVA, p < 0.001. Shorter TIB was related to higher weight, but the effect size was small (partial eta squared = 0.01). When adjusting for the included baseline confounders in the hierarchical regression model TIB significantly predicted later BMI SDS (ß = -0.039, p = 0.02). The adjusted logistic regression model showed that for each hour reduction of TIB at T1 the odds of being overweight/obese at T2 increased with a factor of 1.6. CONCLUSION: Shorter TIB was found to be a significant, yet modest, independent predictor of later weight gain in adolescence. The findings implicate that establishing healthy sleep habits should be addressed in prevention and treatment strategies for adolescent obesity.

Prevalence of psychiatric disorders in Norwegian 10-14-year-olds: Results from a cross-sectional study.

Youth mental health problems is the leading cause of disability worldwide and a major public health concern. Prevalence rates are needed for planning preventive interventions and health care services. We here report Norwegian prevalence estimates for youth mental disorders based on findings from the Bergen Child Study cohort. A web-based psychiatric interview; the Development and Well-Being Assessment, was completed by parents and teachers of 2,043 10-14-year-olds from the city of Bergen, Norway. Post-stratification weights were used to account for selective participation related to parental educational in the estimation of prevalence rates. Prevalence rates are presented for the whole sample and stratified by gender and age. The overall population weighted estimate suggests that 6.93% (95% CI 5.06-9.41) of the children met DSM-IV diagnostic criteria for one or more psychiatric disorders. There were no robust indications of age- or gender-related differences in the prevalence. 11.4% of the children fulfilled criteria for more than one diagnosis. The most common comorbid conditions were ADHD and disruptive disorders. The prevalence of psychiatric disorders was relatively low among Norwegian 10-14-year-olds, compared to published worldwide prevalence estimates. This is in line with estimates from prior studies from the Nordic countries. These findings raise important questions about the origins of different prevalence rates for psychiatric disorders between societies. The findings also illustrate the importance of locally driven epidemiological studies for planning preventative efforts and appropriately scaling mental health services to meet the need of the population.

Physical inactivity, non-participation in sports and socioeconomic status: a large population-based study among Norwegian adolescents.

BACKGROUND: Physical activity in adolescence is found to promote both immediate and long-term health, as well as school- and work performance. Previous studies suggest that parental socioeconomic status (SES) may influence the level of activity, although the results are inconsistent. The objective of this study was to examine the overall level of low physical activity/sports participation and the associations with parental SES and adolescent school program in a population-based study of older adolescents. METHODS: The youth@hordalandy study, a large population-based study in Hordaland county, Norway, conducted in 2012, included 10,257 adolescents aged 16-19 years (53% girls). Physical activity was examined by self-reported overall activity, and participation in organized team- and individual sports. Predictor variables were parental SES measured by youth self-reports of family economic well-being, parental education and work affiliation and self-reported current high school program (vocational versus general studies). Age, ethnicity, and family structure were included as covariates. RESULTS: Girls who reported lower parental education had small, but significant higher risk for physical inactivity and non-participation in individual sports compared with their counterparts who reported higher family education (RRs ranging from 1.04 to 1.12, p < 0.01). There were some, but inconsistent, evidence of an increased risk for physical inactivity and non-participation in sports among those (and particularly boys) with lower family economic well-being. Parental work status was largely unrelated with physical inactivity/non-participation in sports. Adolescents in vocational studies had a small but significantly increased risk of physical inactivity and non-participation in sports compared with individuals in general studies (RRs ranging from 1.03 to 1.05, all p < 0.05). CONCLUSIONS: We found some evidence of a social gradient for lower physical inactivity and non-participation in sports for adolescents. Although effect sizes were small, vocational studies was the most robust correlate for physical inactivity/non-participation in sports among the SES-variables, while the corresponding associations with parental education and family economic well-being differed by gender.

Measurement Equivalence and Convergent Validity of a Mental Health Rating Scale.

Emotional and behavioral problems among children and adolescents may be studied using the Strengths and Difficulties Questionnaire, containing five subscales, based on ratings by parents, teachers, or adolescents themselves. We investigate two measurement issues using data from a longitudinal sample of 8,806 participants aged 7 to 9 years and 11 to 13 years from the Bergen Child Study in Bergen, Norway. First, convergent validity of parent and teacher ratings is studied using a multitrait-multimethod approach. Second, longitudinal measurement equivalence is studied using confirmatory factor analysis, which requires us to deal with the considerable attrition. The multitrait-multimethod indicates not only good convergent validity but also considerable method variance for parents and teachers. The reliability and validity of some subscales are relatively low. Attrition analysis indicates that attrition is not missing completely at random, but estimation assuming missing at random makes no real difference. We conclude that assuming missing completely at random is acceptable. Comparing ratings by parents and teachers results in partial scalar equivalence. In addition, all subscales exhibit (partial) longitudinal scalar measurement equivalence. We recommend using latent variable modeling and not summated scales for longitudinal modeling using the Strengths and Difficulties Questionnaire.

Complex families and health complaints among adolescents: A population-based cross-sectional study.

Aims: The structure of adolescents' families has become more complex over the last decades in several western countries. In parallel, health complaints among adolescents appear to have risen in the Nordic countries. This study aimed to examine the association between family structure and health complaints among Norwegian adolescents while capturing biological, half-, and stepsiblings (sibship-type) in the families. Methods: Data stem from the youth@hordaland study, an epidemiological study of adolescents aged 16-19 years (N = 10,257; participation rate = 53%) conducted in 2012. This study is based on a subsample of 8808 adolescents who lived with parent(s). The adolescents provided detailed information on sociodemographics, family structure, sibship-type, and common health complaints among youth (headache, dizziness, and abdominal, neck, back, and shoulder pain). Results: Adolescents in nuclear families and joint physical custody (JPC) reported significantly lower levels of health complaints compared to peers in single- or stepparent families. Independent of family structure, biological siblings were associated with lower levels of health complaints, while stepsiblings were associated with higher levels of health complaints, but only among girls. These findings were robust to adjustments of sociodemographic variables. Conclusions: Health complaints are frequent but unequally distributed across family structures. Adolescents in nuclear families and JPC report lower levels of health complaints compared to peers in single- or stepparent families. Considering siblings appears to be relevant, as biological- and stepsiblings were related to adolescents' symptoms, independent of family structure. In combination, knowledge about family structure and sibship-type may aid the identification of adolescents at risk of experiencing health complaints.

The association between sleep problems and academic performance in primary school-aged children: Findings from a Norwegian longitudinal population-based study.

The purpose of this study was to examine the longitudinal association between concurrent, transitory and persistent difficulties initiating and maintaining sleep (DIMS) on academic performance in children in a. longitudinal child-cohort (N = 3986) targeting school-aged children when they were 7-9 years (T1) and 11-13 years (T2) old, whilst controlling for mental health problems. DIMS were parent-reported at T1 and T2 and academic performance teacher-reported at T2. Mental health was based on child self-report at T2 using the Strength and Difficulties Questionnaire (SDQ). In all, 10.6% (n = 423) of the children had poor school performance at T2. These had more symptoms of externalizing and internalizing mental health problems (p. < 001) compared to their peers at T2. A logistic regression analysis showed that both concurrent DIMS (at T2, but not at T1) and persistent DIMS (at both T1 and T2) was associated with elevated risk of poor academic performance. After controlling for mental health problems, only persistent DIMS was associated with increased risk of poor academic performance. Transitory DIMS (DIMS at T1 but not at T2) did not increase the risk of later poor academic performance. A mediation analysis also revealed that the association between DIMS and poor school performance was mediated by mental health problems, in addition to an overall significant direct relative effect of DIMS on poor school performance in the persistent DIMS group. These findings support the notion that sleep problems in children are associated with impaired academic performance, and extends past findings demonstrating that sleep problems may not increase the risk of poor academic performance unless they persist over time. The negative effects of persistent sleep problems suggest that more emphasis should be put on preventive interventions of sleep problems in school-aged children.

The effect of Atlantic salmon consumption on the cognitive performance of preschool children - A randomized controlled trial.

BACKGROUND AND AIMS: Long chain polyunsaturated n-3 fatty acids (LC-PUFA) are of functional and structural importance for brain development. Observational studies have shown positive relations between fatty fish consumption and cognitive performance in children, but Results from intervention studies using supplementary n-3 LC-PUFA are conflicting. Salmon is a good source of n-3 LC-PUFA, including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). We tested the hypothesis that an increased dietary salmon intake results in better cognitive outcomes than a meat based diet. METHODS: Children (n = 205, age 4-6 years) in this trial were individually randomized to eating meals containing farmed Atlantic salmon or meat three times weekly for 16 weeks. Pre- and post-intervention a cognitive test (Wechsler Preschool and Primary Scale of Intelligence, 3rd edition, WPPSI-III) and a fine-motor coordination test (Nine Hole Peg Test, 9-HPT) were performed. Biochemical analyses included glycerophospholipid fatty acid profiles in plasma and cheek cells, serum 25-hydroxyvitamin D, and urinary iodine concentration. Dietary intake before and during the study were determined using food frequency questionnaires. RESULTS: Intakes of EPA, DHA, vitamin D and iodine were higher in the salmon than the meat group, but on biomarker level only EPA and DHA increased significantly in the salmon group compared to the meat group (p < 0.001). In general linear models no significant differences between the intervention groups were found in the scale scores of the WPPSI-III tests and the 9-HPT. In analyses of the raw scores, the salmon group showed significantly better improvement in two of the eight raw scores compared to the meat group (symbol search p = 0.038, picture concepts p = 0.047). CONCLUSIONS: Intake of farmed Atlantic salmon led to a greater increase of the raw scores of the picture concept and symbol search subtests, while in the six other subtests raw scores were not different between the groups. This might indicate a modest positive association of salmon intake with the performance of preschool children in some subtests evaluating fluid intelligence but does not suggest an influence on global IQ development. CLINICAL TRIAL REGISTRY NUMBER AND WEBSITE: ClinicalTrials.gov registration number: NCT01951937.

Little in Norway: a prospective longitudinal community-based cohort from pregnancy to child age 18 months.

PURPOSE: The Little in Norway (LiN) project is a cross-disciplinary prospective longitudinal study starting in pregnancy. It was set up to investigate maternal and paternal mental health functioning in the transition to parenthood, detect pathways to healthy and aberrant child development and generate new knowledge about mechanisms underlying differential child mental health susceptibility. PARTICIPANTS: The LiN cohort is a community-based sample comprising 1036 families (1036 mothers, 884 partners, 1017 children). All pregnant women and their partners receiving routine prenatal care at well-baby clinics at nine geographically selected sites across Norway were invited to participate. Enrolment took place from September 2011 to October 2012. This cohort profile comprises 10 data collection waves spanning from enrolment in pregnancy until child age 18 months. FINDINGS TO DATE: Four types of information have been collected: multi-informant questionnaire reports, direct observation of interaction, test data and biological samples. The most significant findings so far relate to three domains of results. First, when examining risk factors for parental mental health problems, results showed that the parents' own adverse childhood experiences and attachment style were related to anxiety, depression and stress in the perinatal period. The perception of difficult child temperament was also found to contribute to parenting stress in the first year after birth. Second, we studied how parental mental health risk factors were related to later child development and social emotional functioning, for example, linking maternal symptoms to social-emotional outcomes and paternal symptoms to language outcomes. Third, we investigated the relation between maternal nutrition during pregnancy and aspects of early child development. Results showed that mild to moderate maternal iodine deficiency in pregnancy was associated with poorer language skills up to 18 months, but not with reduced cognitive or fine and gross motor skills. FUTURE PLANS: A data collection point at 36 months is completed and currently being analysed. A new data collection wave is planned when the children are 8 years of age. TRIAL REGISTRATION NUMBER: ISRCTN66710572.

Early postpartum discharge: maternal depression, breastfeeding habits and different follow-up strategies.

BACKGROUND: In most maternity wards in Norway, early discharge (<48 hour) is the norm. To monitor newborns' and women's health during the first week after delivery, most maternity wards offer early check-ups, where families return to the hospital (standard care). However, a few municipalities offer home visits by midwives (domiciliary care) to ensure seamless services for the family. AIM: The primary aim of this study was to explore whether different follow-up strategies were differently associated with maternal depression and breastfeeding habits, 6 weeks and 6 months postpartum. The secondary aim was to investigate whether families at risk of postpartum depression were included in the home visiting programme in the municipality that offered both follow-up strategies. METHOD: This study draws on data from the 'Little in Norway' (LIN) study, which followed families from pregnancy until the child was 18 months. This study used data from two different well-baby clinics in two municipalities, where one offered standard care (n = 95) and the other domiciliary (n = 64) and standard care (n = 17). The Edinburg Postnatal Depression Scale (EPDS) was used to measure maternal depression. Breastfeeding habits were measured using a self-report questionnaire. The Life Stress subscale of the Parenting Stress Index (PSI) was used to identify women at risk of postpartum depression. RESULTS: There were no differences in maternal depressive symptoms or breastfeeding habits at neither 6 weeks nor 6 months postpartum between women who received standard or domiciliary care in the two municipalities. Within the municipality that offered both follow-up strategies, a higher number of women scoring high on prenatal life stress were included in domiciliary - compared to standard care. CONCLUSION: Differential follow-up strategies in the first week after birth did not impact on maternal depression or breastfeeding habits. However, domiciliary care seems to be regarded as supportive and nonstigmatising for women at risk of postpartum depression.

Fatty Fish Intake and the Effect on Mental Health and Sleep in Preschool Children in FINS-KIDS, a Randomized Controlled Trial.

Mental health and sleep problems are prevalent in children during preschool years. The aim of the current study was to investigate if increased intake of fatty fish compared with meat improves mental health and sleep in four- to six-year-old children. The children (n = 232) in the two-armed randomized controlled trial, Fish Intervention Studies-KIDS (FINS-KIDS), were randomly assigned to lunch meals with fatty fish (herring/mackerel) or meat (chicken/lamb/beef) three times a week for 16 weeks. The fish and meat were weighed before and after the meals to record the exact consumption in grams (dietary compliance). Mental health problems were assessed by the strengths and difficulties questionnaire (SDQ) and sleep by parent report pre- and post-intervention. There was no significant statistical difference between changes in mental health and sleep for the fish eating group compared with the meat eating group, neither in the crude analysis nor after adjusting for intake of fish or meat (dietary compliance).

Fatty fish, hair mercury and cognitive function in Norwegian preschool children: Results from the randomized controlled trial FINS-KIDS.

BACKGROUND: The toxic effects of prenatal methylmercury (MeHg) include neurological abnormalities and developmental delay of which infants and children are particular susceptible. Studies on the effects of low and moderate exposure show conflicting results. Seafood is the main dietary source of MeHg, but also contributes with nutrients regarded as beneficial for development. OBJECTIVES: To measure the change in total hair mercury concentration (THHg) after an intervention of lunch meals with fatty fish or meat in Norwegian preschool children, and to examine the associations between THHg and cognitive function. METHODS: Children (n = 232) 4-6 years old were randomized to lunch meals with fatty fish (n = 114) or meat (n = 118) three times a week for 16 weeks. THHg was determined using a Direct Mercury Analyzer, and cognitive function was assessed by the Wechsler Preschool and Primary Intelligence Scale-III (WPPSI-III) pre- and post-intervention. Linear mixed effect models were used to analyze changes in THHg and WPPSI-III scores. RESULTS: The mean (SD) THHg pre-intervention was 0.373 (0.204) mg kg-1. Children in the fish group had an increase in THHg (change 0.162, 95% CI 0.111, 0.213 mg kg-1), whereas children in the meat group had decreased THHg (-0.053, 95% CI -0.103, -0.002 mg kg-1). There were no notable associations between THHg and the WPPSI-III raw scores at baseline or after 16 weeks of the fish/meat intervention. CONCLUSIONS: Lunch meals including fatty fish led to a significant increase in THHg, but the values remain below the point of departures used for risk assessment by the EFSA, WHO and US-EPA. We observed no associations between THHg and cognitive function.

Precursors of delayed sleep phase in adolescence: a population-based longitudinal study.

Study Objective: The aim of this study was to assess sleep behavior, sleep problems and mental health in childhood as possible candidate precursors for the development of delayed sleep phase (DSP) during adolescence. Methods: A longitudinal cohort study of 2200 children at age 7-9 (T1), 11-13 (T2), and 16-19 (T3) years. DSP was assessed at T3, and mental health problems by the Strength and Difficulties Questionnaire and time in bed and sleep problems at T1 and T2. Logistic regression analyses were used to examine associations between sleep and mental health at T1 and T2, and subsequent DSP at T3. Estimated marginal means were computed to compare mental health at T1 and T2 in adolescents with and without DSP. Results: Sleeping less than 9 hours per night at age 11-13 was significantly associated with DSP at 16-19 years (adjusted odds ratio = 3.37). Sleep problems at 11-13 years of age were more frequent among those who developed DSP compared to children who did not develop DSP (20% vs. 12%) but the results did not remain significant when controlling for early mental health problems. Sleep problems and mental health at 7-9 years of age was not related to later DSP. In the crude analyses, all Strengths and Difficulties Questionnaire (SDQ) subscales at 11-13 years was significantly associated with later DSP, but in the fully adjusted analysis, only the SDQ total score and hyperactivity subscale remained statistically significant. Conclusion: Children with DSP in adolescence possess identifiable risk indicators in childhood.

Maternal Iodine Status is Associated with Offspring Language Skills in Infancy and Toddlerhood.

Inadequate iodine status affects the synthesis of the thyroid hormones and may impair brain development in fetal life. The aim of this study was to explore the association between maternal iodine status in pregnancy measured by urinary iodine concentration (UIC) and child neurodevelopment at age 6, 12 and 18 months in a population-based cohort. In total, 1036 families from nine locations in Norway were enrolled in the little in Norway cohort. The present study includes n = 851 mother-child pairs with singleton pregnancies, no use of thyroid medication in pregnancy, no severe genetic disorder, data on exposure (UIC) in pregnancy and developmental outcomes (Bayley Scales of Infant and Toddler Development, third edition). Data collection also included general information from questionnaires. We examined associations between UIC (and use of iodine-containing supplements) and repeated measures of developmental outcomes using multivariable mixed models. The median UIC in pregnancy was 78 µg/L (IQR 46⁻130), classified as insufficient iodine intake according to the WHO. Eighteen percent reported use of iodine-containing multisupplements. A UIC below ~100 was associated with reduced receptive (p = 0.025) and expressive language skills (p = 0.002), but not with reduced cognitive or fine- and gross motor skills. Maternal use of iodine-containing supplements was associated with lower gross motor skills (b = -0.18, 95% CI = -0.33, -0.03, p = 0.02), but not with the other outcome measures. In conclusion, an insufficient iodine intake in pregnancy, reflected in a UIC below ~100 µg/L, was associated with lower infant language skills up to 18 months. The use of iodine-containing supplements was not associated with beneficial effects.

Maternal DHA Status during Pregnancy Has a Positive Impact on Infant Problem Solving: A Norwegian Prospective Observation Study.

Docosahexaenoic acid (DHA, 22:6, n-3) is a long-chain polyunsaturated fatty acid necessary for normal brain growth and cognitive development. Seafood and dietary supplements are the primary dietary sources of DHA. This study addresses the associations between DHA status in pregnant women and healthy, term-born infant problem-solving skills assessed using the Ages and Stages Questionnaire. The fatty acid status of maternal red blood cells (RBCs) was assessed in the 28th week of gestation and at three months postpartum. The infants’ fatty acid status (RBC) was assessed at three, six, and twelve months, and problem-solving skills were assessed at six and twelve months. Maternal DHA status in pregnancy was found to be positively associated with infants’ problem-solving skills at 12 months. This association remained significant even after controlling for the level of maternal education, a surrogate for socio-economic status. The infants’ DHA status at three months was associated with the infants’ problem solving at 12 months. The results accentuate the importance for pregnant and lactating women to have a satisfactory DHA status from dietary intake of seafood or other sources rich in DHA.

Fatty fish intake and cognitive function: FINS-KIDS, a randomized controlled trial in preschool children.

BACKGROUND: Marine resources including fatty fish are important sources of n-3 long chain polyunsaturated fatty acids (n-3 LC-PUFAs), which are important for brain development. To our knowledge, this is the first randomized controlled trial (RCT) investigating the impact of fatty fish on cognition in preschool children. The purpose of the trial was to investigate whether an increased intake of fatty fish compared to meat improves cognitive function in children 4-6 years old. METHODS: The children (n = 232) in this two-armed RCT, Fish Intervention Studies-KIDS (FINS-KIDS) were recruited from 13 kindergartens in Bergen, Norway. They were randomly assigned to lunch meals with fatty fish (herring/mackerel) or meat (chicken/lamb/beef) three times a week for 16 weeks. The fish and meat were weighed before and after the meals to record the exact consumption (dietary compliance). The primary outcome was cognitive function measured by the Wechsler Preschool and Primary Scale of Intelligence, 3rd edition (WPPSI-III) and fine-motor coordination measured by the 9-Hole Peg Test (9-HPT) at pre- and post-intervention. Biological samples (blood, urine, hair), and questionnaires to the caregivers were included at both time points. Linear mixed effect models with a random intercept for kindergarten were used to analyze changes from pre- to post-intervention in the primary outcome variables. RESULTS: There were 218 children included in the trial (105 in the fish, and 113 in the meat group). The children consumed a mean (standard deviation) of 2070 (978) g fish or 2675 (850) g meat from the study meals (p < 0.0001). The fish group had a significant increase of red blood cell n-3 LC-PUFAs. The intervention had no effect on the WPPSI-III scores (mean change total raw score; fish group 17.7, 95% confidence interval (CI) 14.8-20.7 vs meat group 17.8, 95% CI 15.0-20.6, p = 0.97) in the main analyses. In the sub-analyses, adjusting for dietary compliance, the fish group showed a higher improvement on total raw score (20.4, 95% CI 17.5-23.3) compared to the meat group (15.2, 95% CI 12.4-18.0, p = 0.0060); docosahexaenoic acid mediated this effect. CONCLUSIONS: There was no beneficial effect of fatty fish compared to meat on cognitive functioning in the preschool children. When considering dietary compliance, we found a beneficial effect of fatty fish on cognitive scores. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02331667 December 17, 2014.