Does the "stages of change" construct predict cross-sectional and temporal variations in dietary behavior and selected indicators of diabetes risk among Norwegian-Pakistani women?

UNLABELLED: The aim of this study is to explore the association between motivational "stage" and intake of selected foods, and risk factors for diabetes; and what degree of attendance in an intervention that was necessary to show movements across the motivational "stages of change". Participants (n = 198, aged 25-62 years) were randomly assigned into intervention and control. DATA COLLECTION: Interviews with a structured questionnaire, anthropometric and biochemical assessments. Intake of several food items and blood parameters at baseline differed according to motivational stage. Those who participated in at least four group sessions in the intervention were more likely to show a positive move through the "stages of change". Those in low motivational stages at baseline had benefitted just as much from the intervention as those in higher stages. Intake of several food items corresponded to the motivational "stage". High attendance in the intervention was necessary for a positive move through "stages of change".

High sugar consumption and poor nutrient intake among drug addicts in Oslo, Norway.

Poor dietary habits among drug addicts represent health hazards. However, very few studies have focused on dietary intake as an independent health risk factor in relation to this group. The objective of the present study was to examine the dietary habits of drug addicts living on the fringes of an affluent society. The study focused on food access, food preferences, intake of energy and nutrients, and related nutrient blood concentrations. The respondent group consisted of 123 male and seventy-two female drug addicts, who participated in a cross-sectional study that included a 24 h dietary recall, blood samples, anthropometrical measurements and a semi-structured interview concerning food access and preferences. Daily energy intake varied from 0 to 37 MJ. Food received from charitable sources and friends/family had a higher nutrient density than food bought by the respondents. Added sugar accounted for 30 % of the energy intake, which was mirrored in biomarkers. Sugar and sugar-sweetened food items were preferred by 61 % of the respondents. Of the respondents, 32 % had a TAG concentration above the reference values, while 35 % had a cholesterol concentration beneath the reference values. An elevated serum Cu concentration indicated inflammation among the respondents. Further research on problems related to the diets of drug addicts should focus on dietary habits and aim to uncover connections that may reinforce inebriation and addiction.

Intention to change dietary habits, and weight loss among Norwegian-Pakistani women participating in a culturally adapted intervention.

The aim was to explore the relationships between degree of participation in a culturally adapted lifestyle intervention and stages of change for healthy eating and weight loss among Pakistani immigrant women in Norway. The intervention lasted 7 months and included 198 women, randomized into control and intervention groups. The odds of losing weight from baseline to follow-up, and being in action stages of change (compared to pre-action stages) with regard to intake of amount and type of fat, sugar and white flour at follow-up, increased significantly with number of group sessions attended. Those in action stage of reducing intake of fat and increasing intake of vegetables, as well as of reducing weight, were significantly more likely than others to have experienced weight loss at follow-up. Participation in the culturally adapted intervention was related to increase in intentions to change dietary behaviours and to weight loss.

Associations between food patterns, socioeconomic position and working situation among adult, working women and men in Oslo.

BACKGROUND/OBJECTIVES: Socioeconomic disparities in diet are well documented, but the relative importance of different indicators of socioeconomic position (SEP) is not well known. The aim of this study was to explore relationships between food patterns, SEP (occupation, education and income) and degree of work control. SUBJECTS/METHODS: A cross-sectional population-based study 2000-2001, using three self-administered questionnaires including food frequency questions (FFQs). Factor analysis was used to explore food patterns. Participants include 9762 working Oslo citizens, 30-60 years of age, having answered the questionnaires with <20% of the FFQ missing. RESULTS: Four food patterns were found: Western, prudent, traditional and sweet. In multivariate analyses, the likelihood of having a high intake of the Western pattern was lowest in the two highest educational groups (women: odds ratio (OR)=0.54/OR=0.75; men: OR=0.51/OR=0.76), and in the two highest occupational groups for men (OR=0.73/OR=0.78). The odds of having a high intake of the prudent pattern was highest in the two highest educational groups (women: OR=2.50/OR=1.84; men: OR=2.23/OR=1.37), and among the self-employed (women OR=1.61, men OR=1.68), as well as in the highest occupational group for men (OR=1.33). Women always having work control were least likely to have high intake of the Western pattern (OR=0.78) and most likely to have high intake of the prudent pattern (OR=1.39). CONCLUSIONS: The SEP indicators were in different ways related to the food patterns, but the effect of occupation and income was partly explained by education, especially among women. Women's work control and men's occupation were important for their eating habits.

Living as a drug addict in Oslo, Norway--a study focusing on nutrition and health.

OBJECTIVES: To investigate nutritional status and related living conditions among drug addicts in Oslo. DESIGN: A cross-sectional study of nutritional status evaluated by anthropometric and biochemical measurements; a structured interview concerning education, living conditions, income source, drug history and sex practice; and biochemical testing of sexually transmitted infections. SETTING: The present study was conducted between November 2001 and April 2003 in locations where the drug addicts reside in Oslo. SUBJECTS: A total of 123 male and seventy-two female addicts using drugs by injections regularly. RESULTS: We found that 20 % of the women were moderately underweight (BMI in kg/m2) (16.5 < BMI < 18.5), 7 % were severely underweight (BMI < or = 16.5) and 3 % of the men were moderately underweight (16.5 < BMI < 18.5). BMI was positively correlated with days institutionalised and number of eating events per day. Respondents sleeping rough had significantly reduced BMI compared to those in hostels and shelters. The concentrations of Hb, serum ferritin and albumin supported a higher prevalence of malnutrition among the women. Hepatitis C was found in 85 %, active hepatitis B in 6 % and less than 2 % were HIV positive. Also, 84 % received public financial support, 38 % of the women had prostitution as a significant income source, while burglary was most prevalent among the men; 20 % were pushing drugs. CONCLUSION: Malnutrition among the drug addicts varied from 5 % to 30 %, independent of drug history, education and income. Moderate and severe underweight was most prevalent among the women. Being previously institutionalised and having increased number of eating events increased BMI. Sleeping rough correlated with reduced body weight. Hepatitis C infection was common; hepatitis B and HIV were rare.

Assessing social differences in overweight among 15- to 16-year-old ethnic Norwegians from Oslo by register data and adolescent self-reported measures of socio-economic status.

OBJECTIVE: To determine to what extent self-reported and objective data on socio-economic status (SES) are associated with overweight/obesity among 15 to 16-year-old ethnic Norwegians. DESIGN: A cross-sectional questionnaire study on health and health-related behaviors. SUBJECTS: All school children aged 15-16 years old in 2000 and 2001 in Oslo, Norway. Response rate 88% (n=7343). This article is based on the data from the 5498 ethnic Norwegians. MEASUREMENTS: Self-reported height and weight were used to measure overweight (including obesity) as defined by the International Obesity Task Force cutoffs at the nearest half-year intervals. SES was determined by register data from Statistics Norway on residential area, parental education and income and by adolescent self-reported measures on parental occupation and adolescents' educational plans. RESULTS: The prevalence of overweight/obesity was low, but higher among boys (11%) than among girls (6%). Parental education (four levels) showed the clearest inverse gradients with overweight/obesity (boys: 18, 13, 10 and 7%; girls: 11, 6, 6 and 4%). Parental education remained significantly associated with overweight/obesity when adding occupation and income to the model for the boys, whereas there were no significant associations in the final model for the girls. Overweight/obesity was associated with a lower odds ratio of planning for higher education (college/university) among boys only. CONCLUSION: For the boys, parental education was most strongly associated with overweight/obesity, and the association between overweight/obesity and educational plans appears to imply downward social mobility. The relationships between the various SES measures and overweight/obesity appeared more interrelated for the girls.

Ethnic differences in obesity among immigrants from developing countries, in Oslo, Norway.

OBJECTIVES: To compare ethnic and gender differences in generalized and central obesity and to investigate whether these differences persisted after adjusting for socio-demographic and lifestyle factors. DESIGN: In 2002, the population-based cross-sectional, Oslo Immigrant Health study was conducted. SUBJECTS: A total of 7890 Oslo residents, born between 1942 and 1971 in Turkey, Iran, Pakistan, Sri Lanka and Vietnam, were invited and 3019 attended. MEASUREMENTS: Participants completed a health questionnaire and attended a clinical screening that included height, weight, waist and hip measurements. RESULTS: Generalized obesity (BMI> or =30 kg/m2) was greatest among women from Turkey (51.0%) and least among men from Vietnam (2.7%). The highest proportions of central obesity (waist hip ratio (WHR)>or =0.85) were observed among women from Sri Lanka (54.3%) and Pakistan (52.4%). For any given value of BMI, Sri Lankans and Pakistanis had higher WHR compared to the other groups. Despite a high mean BMI, Turkish men (27.9 kg/m2) and women (30.7 kg/m2) did not have a corresponding high WHR. Ethnic differences in BMI, waist circumference and WHR persisted despite adjusting for socio-demographic and lifestyle factors. CONCLUSION: We found large differences in generalized and central obesity between immigrant groups from developing countries. Our data find high proportions of overweight and obese subjects from Pakistan and Turkey, but low proportions among those from Vietnam. Subjects from Sri Lanka and Pakistan had the highest WHR for any given value of BMI. Our findings, in light of the burgeoning obesity epidemic, warrant close monitoring of these groups.

Ethnic differences in body mass index and associated factors of adolescents from minorities in Oslo, Norway: a cross-sectional study.

OBJECTIVES: To examine ethnic differences in body mass index (BMI), food habits and physical activity, and determine the factors contributing to differences in BMI. DESIGN AND METHOD: In 2000-2001, 7343 (response rate 88%) 15- and 16-year-old students, enrolled in lower secondary schools in Oslo, participated in the cross-sectional Oslo Health Study. Of these participants, 1719 were defined as ethnic minorities. RESULTS: Significant gender and ethnic differences in mean BMI were observed. Of the ethnic minority adolescents, 5.8% were underweight (<5th percentile of the US Centers for Disease Control and Prevention (CDC)/National Center for Health Statistics (NCHS) reference distribution) and 9.1% were overweight (>85th percentile of the US CDC/NCHS reference distribution). BMI was not significantly associated with either socio-economic factors or physical activity. Food habits and physical activity differed with ethnicity but not with socio-economic factors. An ordinal regression showed that girls from East Asia (odds ratio (OR) 0.4) and boys from sub-Saharan Africa (OR 0.4) had lower BMI than the Western group. Among girls, higher BMI was associated with less frequent consumption of chocolates and sweets, full-fat milk and breakfast (OR 2.4, 1.7 and 1.7, respectively). Higher BMI, for both boys and girls, was associated with current and past dieting (OR 3.7 and 4.2, respectively). CONCLUSIONS: Adolescent food habits and physical activity varied by gender and ethnicity but not with socio-economic factors. BMI was associated with ethnicity, gender and food habits, but no significant relationship was observed with socio-economic factors or physical activity. Ethnicity, in addition to gender, should be taken into consideration when studying BMI and associated factors among adolescents.

Changes in potato consumption in different stages of life in Norway.

The aim of this study is to contribute to a better understanding of factors promoting the decline in potato consumption in Norway from the mid-1970s to mid-l990s, as well as with what foods the potatoes have been replaced. The article is based on three surveys, all of them carried out on nation-wide representative samples of the Norwegian population: records of household consumption from 1976 to 1995, N=1000-1500 each year; questionnaire surveys of food frequency from 1986 to 1996, N=3000 every other year; and telephone interviews of yesterday's eating events in 1997, N=1177. The results indicated that it was particularly the young people who lived alone who had dropped eating boiled potatoes. The use frequency increased when there was a partner and it increased even more when there where children in the household. Furthermore, higher socio-economic groups were particularly prone to drop using boiled potatoes, and they had a distinctly different use pattern of alternative staple foods than the others. The data indicated that the potato is more commonly used together with certain foods (fish, carrots and broccoli) than others. Therefore, omitting the potato from the meal may signify other dietary changes than the exchange of staple foods.

Gender differences in opinions and practices with regard to a "healthy diet".

Socio-cultural theories about gender differences with regard to food and health constitute the point of departure for this paper, which is based on data from two representative surveys in the Norwegian population. Both were carried out in the autumn of 1994; the first with 1050, the second with 13 200 respondents above 15 years of age. The surveys included questions on: (1) opinions on food and health related issues; (2) self reported dietary changes during the last 3 years prior to the study; (3) frequency of consumption of selected foods. Gender differences are analysed and related to various socio-economic variables. Such differences, although not as pronounced as expected, were found for most of the aspects studied. The responses from women were less related to socio-economic variables than those of men, both concerning opinions on what constitutes a healthy diet, and frequency of consumption of some foods (vegetables, fruits and dairy products). Gender differences were more pronounced between than within socio-economic groups. In line with theories about women's higher health consciousness, women in general reported dietary changes corresponding to the dietary recommendations, and may also have learned more about health than men through their choice of information sources.

Dietary intake of fruits and vegetables in Norway: influence of life phase and socio-economic factors.

The aim of the study was to contribute to a better understanding of factors influencing the consumption of fruits, vegetables and potatoes among consumers in Norway. It is built on data from two consumer surveys; one including 1103 persons and the other including 13,857 persons. The data indicate that a considerable proportion of the consumers had a very low frequency of consumption when compared to present recommendations of intake; 31% consumed vegetables, and 24% fruits twice a week or less. Data from multivariate analyses (logistic regression) showed that age, sex, income and household structure were important determinants for the consumption of fruits. These factors, as well as education and place of living were important determinants of the consumption of vegetables and potatoes. Consumers who were very interested in health issues, were more likely to have a high consumption of fruits and vegetables, whereas those who had a preference for quickly prepared food tended to have a low consumption of vegetables. These results are discussed in relation to the consumers own perception of important limitations for consumption of these products.

[Iron status and weaning practices among healthy 1-year old infants]. / Jernstatus og kostholdsutvikling hos friske ettåringer.

Iron status and weaning practices were studied in healthy one-year-old Norwegian and immigrant children (from developing countries) attending Fjell Health centre, Drammen. None of the Norwegian children (n = 33) had empty iron stores (serum ferritin < 10 micrograms/l) or iron deficiency anaemia (serum ferritin < 15 micrograms/l and haemoglobin < 11 g/100 ml). Among the immigrant children (n = 37) the prevalences were 14 and 11% respectively. The immigrant children were given infant formula earlier than the Norwegian and drank cow's milk for a longer period of the first year. There were no differences between the groups as regards introduction of infant cereals or other types of foods (vegetables, meat, fish).

Nutrition-related diseases and dietary change among Third World immigrants in northern Europe.

Immigrants from the third world are more prone to acquire nutritional deficiency diseases, such as rickets, osteomalacia and iron deficiency anemia than the rest of the population in the recipient countries. Lately, evidence is also emerging that some immigrant groups are particularly susceptible to diseases related to overnutrition, such as coronary heart disease and non-insulin dependent diabetes. The purpose of this review article is to give a holistic view of the nutrition related diseases and disorders among immigrants. It deals with the prevalence of these diseases among immigrants in Northern European countries, and looks into some of the hypotheses, which have been put forward to explain why immigrant groups are more prone to acquire these diseases than the rest of the population. The focus of this part of the paper is the process of dietary change after migration. The practical implications of the findings from the literature review are then discussed.

Women's work in agriculture and child nutrition in Tanzania.

This paper examines the food related work that women are doing, and the possible effect on child feeding and nutritional status. Women's participation in food production may have positive as well as negative consequences for child nutrition. On the one hand, it may augment the total amount of food procured, while on the other, it may give women less time for child care and feeding. The data show that women are using less time in cooking and children are fed less often during the peak labour seasons. However, a profound and conclusive negative effect of mother's agricultural work on child nutritional status could not be shown. This finding is explained by various compensatory mechanisms employed by the mothers which may buffer the negative effect of the women's time constraints. The norm of feeding children at the maximum only three times a day was seen as the major contributing factor to child malnutrition. According to the women, this feeding frequency was seen as the maximum possible taking into account their heavy work in agricultural production.

Vitamin E deficiency in phrynoderma cases from Sri Lanka.

Phrynoderma cases were identified in a village close to Colombo in Sri Lanka. The alpha-tocopherol level in plasma was 3.3 +/- 0.6 mumol/L among the phrynoderma patients (n = 11) and 13.0 +/- 2.3 mumol/L among the control subjects (p less than 0.002). A test on glutathione reductase activity in erythrocytes revealed a stronger riboflavin deficiency among patients than among control subjects (p less than 0.005). No significant differences were found between the groups with regard to plasma levels of retinol, retinol-binding protein, vitamin B-12, folic acid, thiamin, selenium, zinc, or essential fatty acid pattern. Primary malnutrition may partly explain the deficiency of alpha-tocopherol and riboflavin observed in phrynoderma cases.

Intracellular transport and degradation of 125I-Labelled denatured serum albumin in isolated nonparenchymal rat liver cells.

The intracellular movement, following uptake of 125I-labelled denatured serum albumin into nonparenchymal liver cells, was followed by means of subcellular fractionation. Isolated nonparenchymal rat liver cells were prepared by means of differential centrifugation. The cells were homogenized in a sonifier and the cytoplasmic extract subjected to isopycnic centrifugation in a sucrose gradient. The intracellular movement of the labelled albumin was followed by comparing the distribution profile of radioactivity in the sucrose gradient with those of marker enzymes for plasma membrane and lysosomes. The distribution profiles for radioactivity after the cells had been exposed to the labelled denatured albumin for different time periods indicated that the radioactivity was first associated with subcellular fractions of lower modal densities than the lysosomes. With time of incubation the radioactivity moved towards higher densities. After prolonged incubations in the absence of extracellular labelled denatured albumin the radioactivity peak coincided with that of the lysosomal marker beta-acetylglucosaminidase. When the cells were treated with the lysosomal inhibitor leupeptin, degradation of the labelled albumin was decreased, resulting in a massive intracellular accumulation of radioactivity. The radioactivity peak coincided with the peak of activity for the lysosomal marker beta-acetylglucosaminidase, suggesting lysosomal degradation.

Binding, uptake, and degradation of 125I-labelled high-density lipoproteins in isolated non-parenchymal rat liver cells.

Binding, uptake, and degradation of 125I-labelled HDL were measured in isolated rat non-parenchymal cells in vitro. The binding exhibited saturation kinetics and was inhibited to various degrees with other unlabelled lipoproteins such as VLDL, LDL, and HDL, but the uptake was not reduced by heat and formaldehyde-denatured albumin. The binding could be reduced by pronase treatment of the cells. Acetylated 125I-labelled HDL were more effectively taken up and degraded by non-parenchymal cells than unmodified 125I-labelled HDL. The Kupffer cells were able to take up two to three times as much HDL per cell as the endothelial cells. 125I-labelled HDL bind to the plasma cell membrane and can be dissociated by addition of unlabelled HDL. Relatively more labelled HDL dissociate at 4 degrees C than at 37 degrees C. The non-parenchymal cells also internalize 125I-labelled HDL at 37 degrees C, and the lysosomotropic drug chloroquine inhibits partly the degradation of accumulated 125I-labelled HDL.