[Why and where for family practice?].
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Family Practice↗
Biomedical subjects
C Bengtsson
Publications and source records attributed to C Bengtsson.
[New height and weight standards for the middle aged and aged. Weight increases more than height].
This article presents new weight and height data collected during three large surveys of representative middle-aged and elderly men and women from Gothenburg in 1990-93. Based on these data, weight and height tables are provided as an aid in clinical evaluation. Additionally, weights and heights collected during previous examinations in the 1970s (Läkartidningen 1981; 78: 3152-4) make it possible to describe secular changes nearly two decades later. These comparative data suggest that height and weight have increased in both men and women. However, body weight has increased more than height, resulting in an increase in mean body mass index (RMI) in most groups, with the exception of 75-year old women.
Aged↗
Low-fat diets may prevent weight gain in sedentary women: prospective observations from the population study of women in Gothenburg, Sweden.
The Population Study of Women in Gothenburg, Sweden is an ongoing prospective study of female residents who were recruited from the local registry in 1968-1969 when they were 38-60 years old. The data presented here were collected from 361 healthy women who underwent a baseline physical examination including a supplementary dietary history interview and returned for a second general health examination 6 years later. This report identifies a subgroup of 57 women who were sedentary during their leisure time and appear to have been particularly susceptible to gaining weight as a function of the fat content of their diets. Specifically, longitudinal analysis of body weights in the whole sample revealed a statistical interaction between leisure-time physical activity and habitual dietary fat intake (energy%), as reported at the baseline examination, in the prediction of subsequent weight change. Further stratified analysis suggested that weight changes were significantly dependent on dietary fat intake among the sedentary women only. High energy intake also predicted weight gain in the sedentary group, although the predictive value for a high-fat diet was of marginal significance after adjusting for total energy consumption. These results suggest that sedentary recreational activity plus a low-fat diet may have a combined contribution to weight change that is not equivalent to the sum of the separate effects. Such a synergy between two modifiable lifestyle factors seems highly relevant for prevention of obesity.
Adult↗
Physical activity levels and changes in relation to longevity. A prospective study of Swedish women.
In 1968-1969, a population-based sample of Swedish women aged 38-60 years was recruited for a health survey, and 20-year survival was later ascertained from national registries. Occupational and leisure-time physical activity data from the baseline and 6-year follow-up examinations were evaluated in relation to all-cause mortality among 1,405 women who were initially free of major diseases. In comparison with being inactive, the mortality relative risk associated with being somewhat active was 0.28 (95% confidence interval 0.17-0.46) for occupational activity and 0.56 (95% confidence interval 0.39-0.82) for leisure-time activity. Being in the most active occupational or leisure activity category further decreased mortality risk to a minor extent. A within-subject decrease in leisure activity over 6 years was also a significant risk factor for all-cause mortality (relative risk = 2.07, relative to no change), although there was no evidence of a benefit from increasing physical activity levels. Since exclusion of early endpoints did not affect the associations in any significant way, underlying illness is unlikely to have played a major role in these analyses. It is concluded that decreases in physical activity as well as low initial levels are strong risk factors for mortality in women, and that their predictive value persists for many years.
Adult↗
Subjectively experienced symptoms in relation to socio-economic factors in women.
As observed in a cross-sectional population study of 1,302 women, aged 44-66 years and representative of middle-aged women living in a Swedish city, symptoms and complaints were found to be unevenly distributed in the female population. Factors such as foreign origin, low education, different kinds of isolation such as not working outside of the home, being divorced or widowed seemed to be factors which increased the risk of experiencing different symptoms and complaints. When meeting a patient with a complaint it is important to take all possible causes into consideration including socio-economic factors.
Adult↗
Effects of a health examination programme on quality of life and subjective well-being.
The effects on quality of life and psychological well-being of a health examination programme in a branch of Swedish industry were studied by means of questionnaires in 124 white-collar workers. They were asked to answer two questionnaires, one before and the other one month after the examination (the Nottingham Health Profile (NHP) and the Psychological General Well-being Schedule (PGWB)). Both are well-known and well-documented standard questionnaires used for estimating quality of life and degree of subjective well-being. The answers were compared with those of a control group comprising other white-collar workers in the same industry, of the same sex and age but who did not participate in the health examination and who were asked to complete the same questionnaires twice. The group that had participated in the health examination did not differ generally from the control group with respect to intra-individual differences as studied in the questionnaires on the two occasions. This indicates that no deterioration of quality of life or of psychological well-being was experienced by the participants in the health examination.
Adult↗
Results from an intervention programme dealing with cardiovascular risk factors. Experiences from a study of men aged 33-42 in Habo, Sweden.
OBJECTIVE: To evaluate the long-term effect of a health examination and intervention programme in a Swedish community. DESIGN: A health examination was carried out with the purpose of improving cardiovascular risk factors. A health profile was created as an educational tool, by means of which a nurse discussed the results of the health examination with the participants. Follow-up studies were carried out after 1 year and after 3-6 years. PARTICIPANTS: All men aged 33-42 living in a Swedish community (Habo) were invited to the health examination. Altogether 652 participated, corresponding to a participation rate of 86.1%. MAIN RESULTS: In the 1-year follow-up study, improvement with respect to cardiovascular risk factors was seen in a high-risk group (n = 161) for systolic blood pressure and lifestyle factors such as alcohol consumption, smoking, mental stress, mental health, and for the sum of risk points according to the health profile. Corresponding improvement was not seen in other men of similar age in the same community who had not participated in the health survey. In the 3-6 year follow-up only minor improvements remained, mainly for blood pressure and sum of risk points. CONCLUSION: Even if the results are rather promising in the short run, it seems urgent to make the methods for improving cardiovascular risk factors better, especially with regard to long-term results.
Adult↗
Reproductive history in relation to relative weight and fat distribution.
OBJECTIVE: To investigate the relationship between reproductive history and body composition. DESIGN: Prospective population study in Sweden. SUBJECTS: 1462 randomly selected women representing five separate age cohorts (38, 46, 50, 54 and 60 at the 1968-1969 baseline examination) have been followed longitudinally. MEASUREMENTS: Relative weight, fat distribution, and fat cellularity were related to menarche, parity, lactation, menopause and oestrogen medication. RESULTS: Age of menarche did not show any association with subsequent fat distribution, nor did length of lactation time. On the other hand parity was positively associated to total as well as central obesity, and lactation time was positively associated to abdominal fat cell diameter. Premenopausal women showed higher mean body weight and hip circumference than postmenopausal women of the same age. Change from pre- to postmenopausal status was associated with increase of waist circumference as well as reduction of hip circumference, resulting in an increased waist-hip ratio (WHR). Oestrogen replacement suggested some postponement of this increase. CONCLUSION: Parity and menopause are the reproductive factors most associated with gradual changes in body fat distribution. Oestrogen medication seems to play an additional role in diminishing waist circumference increase and could thus contribute to decreased cardiovascular morbidity in women.
Adipose Tissue↗
Dietary fat intake and weight gain in women genetically predisposed for obesity.
The influence of dietary fat intake on subsequent change in body mass index (BMI) of adult women was examined while taking into account predisposition for obesity. A representative population sample of 361 Swedish women aged 38-60 y was first examined in 1968-1969 and followed up 6 y later. Dietary intake was estimated by diet history interview, and parental fatness was assessed by questionnaire. Women already overweight with > or = 1 obese parent were considered predisposed to obesity. When total energy intake, smoking habits, physical activity, and menopausal status were controlled for in regression analysis, high dietary fat intake was significantly associated with a 6-y gain in BMI only the predisposed women (P = 0.003), but not among obese women with lean parents, or lean women with or without obese parents. High dietary fat intake may have an obesity-promoting effect in women with a genetic predisposition.
Adult↗
Interrelation between risk factors for cardiovascular disease in men aged 33-42. A study from Habo in Skaraborg County, Sweden.
OBJECTIVES: The main purpose was to study associations between different risk factors for coronary heart disease in order to find out whether such associations already exist during the fourth decade of life. SETTING: A study carried out by the primary healthcare staff in the community of Habo in Skaraborg County in south-western Sweden. SUBJECTS: All men living in Habo aged 33-42 years who were willing to participate in the study--in total 652 men (participation rate 86%). MAIN OUTCOME MEASURES: Risk factors for coronary heart disease considered as markers of lifestyle: body-mass index as a measure of general obesity, waist-to-hip circumference ratio as a measure of central obesity, arterial blood pressure, serum cholesterol concentration and serum triglyceride concentration. RESULTS: There were statistically significant correlations between all the factors analysed including anthropometric data, blood pressure and serum lipids. CONCLUSIONS: The results indicate associations between different risk factors at an early age and emphasises the need for a multifactorial view on risk as early as at the ages which were the focus of this study.
Adult↗
Concentrations of blood, serum and urine components in relation to number of amalgam tooth fillings in Swedish women.
Altogether 1462 women aged 38, 46, 50, 54 and 60 yr were examined in 1968/69 in a combined medical and dental population study in Gothenburg, Sweden. Number of tooth surfaces restored with amalgam fillings was assessed. The examination was repeated in 1980/81 including a new dental examination. The results from a number of biochemical analyses of blood, serum and urine were analyzed for a possible statistical relationship to number of dental amalgam fillings. As emphasis has been put in the literature on special influence from amalgam on kidney function and on the immunological system, special attention was paid to variables which might reflect these functions in our analyses. When potential confounders were taken into consideration, no significant correlations remained which seemed to be of clinical importance. Specifically, amalgam fillings were not found to be associated with impairment of the kidney function or the immunological status.
Adult↗
Medical audit used for estimation of optimum level of outpatient care.
OBJECTIVE: To create a model for determining the optimum level of outpatient medical care and to determine this level. DESIGN: Expert committees were established comprising one or two hospital physicians and two general practitioners who checked medical records for all outpatient visits to doctors made by a defined population during a defined period of time. The determination of optimum level was made blindly by each member of the expert committee. SETTING AND PARTICIPANTS: The study comprised all visits to physicians during 10 weeks, in total more than 4,000, made by the people in a Swedish community, of which 2,084 were randomized. RESULTS: Total agreement between the members of the committee was initially reached for 84% of the visits and, after a common discussion between the committee members, for 99%. A general practitioner was considered to be the optimum level of care for 76% of the patients in the total series, in the upper ages (above 80) for about 85%. CONCLUSION: This method seemed suitable for determining the optimum level of care in a population and may be of value when planning for an optimum health care service. Based on the results from our study it seems reasonable to assume that general practitioners whose training corresponds to that of Swedish ones are competent to treat about 75% of all consultations.
Adolescent↗
Differences in cancer incidence between parts with different socio-economic structure within a Swedish big-city area.
Two subareas with different socio-economic structure in the same big-city area were compared with respect to cancer incidence. Pulmonary cancer was overrepresented in the low socio-economic area. Smoking was more common in the same area, which may be a main contributory factor for the increased incidence of pulmonary cancer in that area. The results indicate that useful information, to be used as a base for local preventive measures, can be obtained from cancer statistics on the community level.
Adult↗
Iron balance in menstruating women.
OBJECTIVES: To study factors determining iron balance in menstruating women by examining the relationships between total iron requirements, based on menstrual iron losses and basal iron losses, and serum ferritin concentration, transferrin saturation, blood haemoglobin concentration, bone marrow haemosiderin and absorption of iron from a test dose of ferrous sulphate (0.56 mg Fe). SUBJECTS: The study was made in 203 women all aged 38 years, randomly selected from the census register of Göteborg. The study was originally made in 1968-69. Serum ferritin in frozen sera was first analysed in 1978. Reanalyses, calibrated to the International Standard 80/602, and studies on the effect of storage of sera, were made in 1992. This allowed a complete re-examination of the importance of different determinants of iron balance in women. RESULTS: With increasing iron requirements there was an increase in iron absorption, and a decrease in serum ferritin concentration and transferrin saturation. Above a certain level of iron requirement there was a rather sudden decrease in haemoglobin concentration and in stainable iron in bone marrow smears, indicating the critical level of iron requirements in these women that could be balanced by an increased iron absorption from the present diet. This level represents the maximal adaptation to maintain iron balance in an iron-replete state that can be achieved with this diet and corresponds to a prevalence of iron deficiency of about 25%. CONCLUSIONS: The continuous regulation of iron absorption from iron deficiency to iron repletion has a critical balance point determined by the properties of the diet.
Absorption↗
Detection in blood and urine of recombinant erythropoietin administered to healthy men.
A method for the detection of administered recombinant human erythropoietin (rhEpo) in the blood and urine of healthy individuals was evaluated. The method is based upon the observation that the electric charge of the rhEpo molecule is less negative than that of endogenous Epo. Fifteen healthy males were treated with subcutaneous injections of 20 IU rhEpo per kg body weight three times a week for 7-9 wk. The charge of Epo in blood and concentrates of urine was determined by electrophoresis in 0.10% agarose suspension expressed as electrophoretic mobility. rhEpo was detected in serum at 24 h after injection in all 15 individuals, at 48 h in 18 of 20 samples from 11 individuals, and at 72 h in 7 of 9 individuals. In urine the rhEpo was detected in all 22 samples taken from 11 individuals up to 24 h after injection and in 9 of 12 samples from 3 individuals at 48 h after injection. rhEpo was not detected in serum or urine at 1-3 wk after the last injection. The charge of both rhEpo and endogenous Epo in urine was more negative (P < 0.001; P < 0.01) than in the paired serum samples. It is suggested that the principle of this method should be further evaluated for use in doping control.
Electrophoresis, Agar Gel↗
[Myocardial infarction among women. Is it possible to prevent?].
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Female↗
[Blood pressure, antihypertensive agents and diabetes. Obese patients with hypertension are a high-risk group].
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Antihypertensive Agents↗
Experiences of social support among participants in self-help groups related to coronary heart disease.
Self-help groups for coronary heart disease (CHD) patients were initiated by the Swedish National Association for Heart and Lung Patients in co-operation with Halland University College of Caring Science. Professional support was given in the form of a guidebook with health advice to be used at group meetings. The aims of this study were to describe the experiences of social support and the effects of health advice among people suffering from CHD and their next-of-kin participating in self-help groups. A questionnaire was developed containing three scales with questions about social support in connection with group participation and the effects of health advice shared during the programme. The results showed that 84% of participants knew about risk factors; all group members had changed their attitudes in some way concerning their life-style and 65% thought that they had changed their daily life activities as a consequence of the group participation. Most participants had experienced social support, through both support received (82%) and their own ability to provide support (7.1, scale range 0-10). In self-help groups layman support is the most effective kind of support, but the results indicate that health professionals also have an important role to play. In future research and clinical planning of rehabilitation of people with CHD, self-help groups, both from a human and economic point of view are well worth considering.
Aged↗