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Biomedical subjects

Knut-Inge Klepp

Publications and source records attributed to Knut-Inge Klepp.

At least 37 records · Page 2Linked to original sources
PubMed2005

The stability of soft drinks intake from adolescence to adult age and the association between long-term consumption of soft drinks and lifestyle factors and body weight.

OBJECTIVES: To investigate the tracking of sugar-sweetened, carbonated soft drinks intake from age 15 to 33 years and the association between this intake and lifestyle factors and body weight. DESIGN: A longitudinal study with 18-20 years of follow-up. Data about diet, physical activity, smoking and dieting were collected in 1981/1979, 1991 and 1999. Body weight and height were measured in 1981/1979 and self-reported in 1999. SETTING: Oslo, Norway. SUBJECTS: Four hundred and twenty-two men and women. RESULTS: Tracking of soft drinks intake from adolescence into early adulthood (age 25 years) and from early adulthood into later adulthood (33 years) was moderate to high, while tracking from adolescence into later adulthood was low. Comparing those reporting a high intake of soft drinks in both 1991 and 1999 with those reporting a low intake at both times, male long-term high consumers were more likely to smoke (48 vs. 21%, P=0.002) and reported higher intakes of energy (12.2 vs. 10.2 MJ day(-1), P=0.005) and sugar (142 vs. 50 g day(-1), P<0.001) in 1999 than did long-term low consumers. Women high consumers were less likely to be physically active (14 vs. 42%, P=0.03) and had higher sugar intake (87 vs. 41 g day(-1), P<0.001) in 1999 than did women low consumers. There were no differences in body mass index, overweight or obesity in 1999 between long-term high and low consumers. CONCLUSION: In this study, stability of soft drinks intake from age 15 to 25 years and from age 25 to 33 years was moderate to high, while from age 15 to 33 years it was low. Soft drinks intake from age 25 to 33 years was associated with smoking and physical inactivity, but not with body weight.

Adolescent↗
PubMed2005

Overweight and obesity among Norwegian schoolchildren: changes from 1993 to 2000.

AIM: The aim of the present study was to investigate the prevalence rate of overweight and obesity in a nationwide survey of fourth- and eighth-grade Norwegian schoolchildren, the changes in overweight rates among eighth graders from 1993 to 2000, and to investigate factors associated with overweight. METHODS: Cross-sectional dietary surveys were conducted on nationally representative samples of eighth graders in 1993, and among fourth and eighth graders in 2000. Self-reported weight and height was available from 1,650 eighth graders in 1993, and from 664 fourth and 825 eighth graders in 2000. Data on dietary pattern, social class, and physical activity were also available. RESULTS: In 2000 the prevalence of overweight and obesity among the fourth graders was 18.5% and 3.6%, respectively, and among the eighth graders 11.5% and 1.8%, respectively. A marked increase in overweight and obesity among Norwegian eighth graders from 1993 to 2000 was observed; the prevalence of overweight and obesity increased by 4 and 0.9 percentage points, respectively. Social class, time spent watching TV or in front of a computer, and breakfast frequency were associated with the odds of being overweight. An inverse relation between intake of sweets and overweight was observed. Validation studies demonstrated a high correlation between self-reported and measured height and weight in both age groups. CONCLUSION: The present study demonstrates a high prevalence of overweight and obesity among schoolchildren, especially among fourth graders in Norway. Moreover, the proportion of overweight and obese children has increased greatly among eighth graders during the last decade.

Adolescent↗
PubMed2005

Self-reported and observed female genital cutting in rural Tanzania: associated demographic factors, HIV and sexually transmitted infections.

OBJECTIVES: To determine (i) the prevalence and type of female genital cutting (FGC) in a rural multi-ethnic village in Tanzania, (ii) its associated demographic factors, (iii) its possible associations with HIV, sexually transmitted infections (STIs) and infertility and (iv) to assess the consistency between self-reported and clinically observed FGC. METHOD: The study was part of a larger community-based, cross-sectional survey with an eligible female population of 1993. All were human immunodeficiency virus (HIV)-tested and asked whether they were circumcised (n = 1678; 84.2%). Participants aged 15-44 years were interviewed (n = 636; 79.7%), and 399 (50.0%) were gynaecologically examined to screen for STIs and determine the FGC status. RESULTS: At a mean age of 9.6 years, 45.2% reported being circumcised. In the age-group 15-44 years, 65.5% reported being cut, while FGC was observed in 72.5% and categorized as clitoridectomy or excision. The strongest predictors of FGC were ethnicity and religion, i.e. being a Protestant or a Muslim. FGC was not associated with HIV infection, other STIs or infertility. A positive, non-significant association between FGC and bacterial vaginosis was found with a crude odds ratio of 4.6. There was a significant decline of FGC over the last generation. An inconsistency between self-reported and clinically determined FGC status was observed in more than one-fifth of the women. CONCLUSION: The data indicate that both women and clinicians might incorrectly report women's circumcision status. This reveals methodological problems in determining women's circumcision status in populations practising the most common type of FGC. The positive association between FGC and bacterial vaginosis warrants further investigation.

Adolescent↗
PubMed2005

Clinicians' perspective of a training programme in syndromic management of sexually transmitted infections in Northern Tanzania.

This process evaluation study was designed to investigate clinicians' perception of a training programme on syndromic management of sexually transmitted infections (STIs) and their experiences in applying the skills learnt during the course. Out of 136 eligible course participants from Arusha and Kilimanjaro regions, Tanzania, 47 were invited to take part in the study and 40 agreed to participate (85%). The research instruments consisted of a structured interview including open- and close-ended questions, a self-administered questionnaire, and an observation checklist. While the clinicians reported to be satisfied with the course itself, the results revealed insufficient practical training. The clinicians reported problems with condom promotion and partner notification, and frequent shortage of equipment and drugs in the clinics was observed. Future courses on syndromic management of STI should focus on skills training related to health education and counselling, and have a stronger emphasis on practical, clinical work. There is need to address barriers to condom promotion and partner referral.

Health Education↗
PubMed2004

[From a hypothesis to dietary advice--roads, short cuts and dead-end roads].

Few scientific fields receive more public attention than food and nutrition and few have more self-proclaimed experts. Many are confused by the jungle of dietary advice, sometimes widely differing, with the media often giving broad attention to isolated results without assessing them in the context of the total body of knowledge within a field. A new hypothesis may be received with enthusiasm by lay people and professionals alike, but the road to a well-documented conclusion on which to build general advice, is most often long. A finding must be seen in the context of other findings and judged in relation to the whole body of theory within a field before conclusions can be drawn. Work is carried out both nationally and internationally in order to reach a shared understanding of the minimum requirements of documentation before advice can be given. Traditional guidelines for evidence-based medicine can be applied to some but not all aspects of the science of nutrition. This article presents the process leading to official dietary guidelines in Norway.

Dietary Services↗
PubMed2004

Reliability of parental and self-reported determinants of fruit and vegetable intake among 6th graders.

OBJECTIVE: To assess the reliability of newly developed questionnaires measuring theoretical constructs believed to predict fruit and vegetable consumption among 6th-grade pupils. DESIGN: Participating pupils and parents completed questionnaires twice, 14 days apart. SETTING: One hundred and twenty-nine pupils from 6th-grade classes (average age: 11.9 years) at two schools in Norway and their parents were invited to participate. RESULTS: The test-retest reliability was found to be good or very good for scales reported both by the pupils and their parents. All scales showed acceptable to strong correlations between time 1 and time 2, and only one scale had significant different mean values at the two times. The internal consistency reliability of the scales was acceptable to good. CONCLUSIONS: Sixth graders and their parents are able to provide reliable reports on theoretical determinants of the pupil's fruit and vegetable consumption.

Adolescent↗
PubMed2004

Are infant feeding options that are recommended for mothers with HIV acceptable, feasible, affordable, sustainable and safe? Pregnant women's perspectives.

OBJECTIVE: To investigate pregnant women's views on infant feeding options recommended for HIV-infected women. DESIGN: A structured interview survey complemented with focus group discussions. SETTING: Antenatal clinics in Moshi urban and rural districts of Tanzania. SUBJECTS: Five hundred pregnant women participated in the interview survey and 46 pregnant women participated in six focus group discussions. RESULTS: Participating women reported that they would change to an alternative infant feeding method if they were found to be HIV-infected and were advised to do so. Cow's milk was regarded as the most feasible infant feeding method for local HIV-infected mothers. Infant feeding formula was regarded as too costly, but if recommended by health workers and distributed free of charge, the majority of the women (82%) were confident that they would then choose this option. In the focus group discussions, women were less optimistic and expressed great concern for the social consequences of not breast-feeding. The safety of exclusive breast-feeding was questioned. Less common infant feeding methods, such as expressed heat-treated breast milk and wet-nursing, were not regarded as viable options. Several social barriers to replacement feeding were identified in the focus group discussions, including possible lack of support from partner and potential negative reactions from the community. CONCLUSION: Future research on infant feeding options should include the broader cultural context and the psychological stress that HIV-infected women face when choosing infant feeding methods.

Adolescent↗
PubMed2004

Correlates of fruit and vegetable intake among Norwegian schoolchildren: parental and self-reports.

OBJECTIVES: To identify correlates of 6th and 7th graders' (age 10-12 years) fruit and vegetable intake, to investigate parent-child correlations of fruit and vegetable intake, and to compare parents' and children's reports of children's accessibility, skills and preferences with respect to fruit and vegetables. DESIGN: The results presented are based on the baseline survey of the 'Fruits and Vegetables Make the Marks Project', where 38 schools participated. SETTING: Fruit and vegetable intake was measured by food frequency questions. Theoretical factors, based on Social Cognitive Theory, potentially correlated to intake were measured, including behavioural skills, accessibility, modelling, intention, preferences, self-efficacy and awareness of 5-a-day recommendations. SUBJECTS: In total, 1950 (participation rate 85%) 6th and 7th graders and 1647 of their parents participated. RESULTS: Overall, 34% of the variance in the pupils' reported fruit and vegetable intake was explained by the measured factors. The strongest correlates to fruit and vegetable intake were preferences and accessibility. The correlation between the children's and their parents' fruit and vegetable intake was 0.23. The parents perceived their children's accessibility to be better than what was reported by the children (P<0.01), while the children reported their skills to be better than what was perceived by their parents (P<0.01). CONCLUSION: The results from this study clearly point to a need for nutrition interventions aimed at parents. An important next step will be to investigate whether the identified correlates predict future fruit and vegetable intake, and whether they mediate any changes in intake in an intervention study.

Child↗
PubMed2003

Predictors and tracking of body mass index from adolescence into adulthood: follow-up of 18 to 20 years in the Oslo Youth Study.

OBJECTIVES: To examine tracking of body mass index (BMI) (weight in kilograms divided by the square of height in meters) from age 15 to 33 years, to examine the effect of adolescent and adult health-related behavior and parents' BMI and education on adult BMI; and to examine changes in lifestyle factors as predictors of adult overweight and obesity. METHODS: A longitudinal study with 18 to 20 years of follow-up in a cohort from Oslo, Norway (N = 485); mean age was 15 years at baseline. Weight, height, physical fitness, leisure time physical activity (LTPA), smoking, and education were assessed at baseline and follow-up. Parents' height, weight, and education were assessed at baseline. RESULTS: Tracking of BMI from age 15 to 33 years was high (r = 0.54). Adolescent BMI, father's BMI, the subject's own LTPA, adult smoking, and sex explained 44.1% of the variation in adult BMI. The odds ratio (95% confidence interval) of having a BMI of 25 or more as an adult was 0.07 (0.03-0.14) for lowest vs highest quartile of adolescent BMI. The corresponding odds ratio of having a BMI of 30 or more was 0.02 (0.002-0.14). Those who increased their LTPA level between adolescence and adulthood had a lower risk of adult overweight than those with a stable low LTPA level. CONCLUSIONS: Tracking of BMI from adolescence into adulthood was substantial. Changes in LTPA between adolescence and adulthood predicted the risk of adult overweight, suggesting that the foundation for adult body weight is laid during adolescence. Implications of this would be to emphasize physical activity among youths.

Adolescent↗
PubMed2003

Frequency and perceived credibility of reported sources of reproductive health information among primary school adolescents in Arusha, Tanzania.

AIMS: To describe adolescents' sources of reproductive health information and perceived credibility of these sources. METHODS: A questionnaire survey was conducted among 1247 seventh grade pupils in Arusha district; enquiring their sources of reproductive health information and perceived credibility of these sources. Mean scores were computed for each type of information in relation to frequency of source and credibility, and scales for reproductive health information sources and credibility constructed. Analysis of covariance was used to compare mean scores by demographic and sexual behaviour variables. RESULTS: Mass media ranked first as sources of reproductive health information, followed by teachers and health workers. Health workers ranked first in credibility followed by parents, while credibility rating for media was low. Religious leaders and respondents' friends played a rather minor role as sources of reproductive health information, and their credibility ratings were also low. CONCLUSION: Mass media were the most frequent sources of reproductive health information for primary school adolescents, but parents and health workers were regarded as more credible sources. Programmes seeking to promote reproductive health of young people should take into account the diverse arenas through which young people currently obtain reproductive health information, and strive to tap into and strengthen the full range of these arenas. Increased involvement of parents and health workers in providing reproductive health information to young people seem indispensable.

Adolescent↗
PubMed2002

[Dieting among girls from Hordaland].

BACKGROUND: Dieting is highly prevalent among girls and women. The purpose of this article is to study the stability of dieting in a cohort of young females from age 13 until age 21, and to relate their dieting behaviour to their body mass index. MATERIAL AND METHODS: Participants took part in the Norwegian Longitudinal Health Behaviour Study. In 1990, a representative sample of 13-year-old school children from Hordaland County were invited to participate. A total of 414 girls participated at baseline, and 253 (61%) also participated at ages 15, 18 and 21 years. Height, weight and attempts to loose weight were collected through self-reports. RESULTS: At age 14, 40% reported dieting during the past year; the proportion stayed stable with increasing age. Dieting at later ages was much more prevalent in girls who had dieted at age 14 than in those who had not. In the 13 to 21 year cohort, 18% reported dieting on all the three main measuring points. While these girls had a higher body mass index than their non-dieting peers, only 30% of them could be characterised as overweight. INTERPRETATION: Dieting is highly prevalent among adolescent girls and a stable feature in the life of many of them.

Adolescent↗
PubMed2002

[Rooming-in in the maternity ward--are mothers satisfied?].

BACKGROUND: 24-hour rooming-in in Norwegian maternity wards has been introduced as one of the "10 steps to successful breastfeeding", the basis for WHO/UNICEF Baby-Friendly Hospital Initiative. This step, optimal in order to get lactation off to a flying start, has lead to some worry about maternal fatigue. MATERIALS AND METHODS: Self-administrated questionnaires to health care personnel as well as to mothers in all Norwegian maternity wards were used to evaluate the impact of the Baby-Friendly Hospital Initiative. The same mothers were interviewed again 15 months later. RESULTS: Many (52%) felt tired after giving birth, but most (85%) were content with the care received. There was no difference in tiredness between mothers who chose to keep their babies with them and those who did not. Only 3.3% cited this at a main reason for tiredness. INTERPRETATION: Most mothers felt positive about keeping their infants with them at night. This demonstrates that Norwegian maternity wards generally have been able to implement 24 hour rooming-in in a caring way. Staff should offer to look after fussy babies without mothers demanding it and give the new mothers care and support in all possible ways.

Breast Feeding↗
PubMed2002

[Stability of body mass index from adolescence to adulthood].

BACKGROUND: The purpose of this study was to track the development of body mass index from adolescence into adulthood and to study the association between parental and offspring's body mass index. MATERIAL AND METHODS: From 1979, 506 children participated in a twenty-years follow-up study. Mean age in 1979 was 13 years. Participants' weight and height were measured in 1979, 1981 and 1991, and self-reported in 1999. Weight and height of parents were reported in 1979 and in 1981. The cohort in this paper was followed up until 1999. RESULTS: In 1999, 26% of women and 53% of men had body mass index (BMI: weight in kg/height in meters2) > or = 25, and 7% of women and 11% of men had BMI > or = 30. Participants in the highest quartile of BMI in 1981 had significantly higher BMI in 1999 compared to those in the lowest 1981 quartile (mean and 95% confidence interval was 27.7 (27.0-28.3) kg/m2 versus 22.0 (21.3-22.7) kg/m2). The highest 1981 quartile also had a higher proportion of overweight and obese participants in 1999 than those in the lowest quartile; 64.8% overweight and 27% obese versus 18.8% overweight and 0.9% obese. Participants whose both parents were in the normal weight range in 1981 had lower mean body mass index in 1999 than those with one parent overweight, and a smaller proportion of them were overweight than among participants with both parents overweight. INTERPRETATION: The probability of overweight in adulthood is predicted by both one's own relative weight during adolescence and by parental relative weight 18 years earlier.

Adolescent↗
PubMed2002

Counsellors' perspectives on antenatal HIV testing and infant feeding dilemmas facing women with HIV in northern Tanzania.

This study investigated the infant feeding advice that counsellors were giving HIV-infected pregnant women in Moshi, Tanzania, the factors they thought had an impact on women's infant feeding choices and their role in influencing these decisions. The data are drawn from in-depth interviews with 16 nurses working as counsellors in their spare time in an antenatal trial of prevention of mother-to-child transmission, five local HIV/AIDS counsellors and two medical doctors, whose counselling experience ranged from less than six months to nine years. Informed choice of infant feeding method by HIV-infected women, as recommended by UNAIDS/WHO/UNICEF Guidelines, was seriously compromised by the actual advice given, directive counselling, lack of time to cope with a positive HIV test result, and lack of follow-up support, regardless of socio-economic status. Infant feeding options were not always accurately explained, but counsellors believed most women had little choice but to breastfeed and were unlikely to exclusively breastfeed, despite advice. It was apparent that the risks and benefits of the options open to HIV-infected women were complicated for the counsellors, not only the women. Counsellors needed additional training in non-directive counselling and infant feeding options to ensure a better quality of advice-giving and support to follow-up women at home.

Adult↗
PubMed2002

Exploring predictors of eating behaviour among adolescents by gender and socio-economic status.

OBJECTIVE: Guided by theory, this study explored cross-sectional differences in factors influencing adolescent eating behaviour including gender and socio-economic status (SES), and subsequently tested the longitudinal predictive power of the models. DESIGN/SETTING/SUBJECTS: Data were collected by questionnaires in a longitudinal study of adolescents (age 13 years at baseline) and their parents from Hordaland County, Norway. Association of personal and environmental variables (family, friends, school/society) with the consumption of fruit and vegetables (FV) and selected sources of fat and of sugar were assessed at age 15 The final cross-sectional models were subsequently employed in groups stratified by gender/SES and to predict consumption at age 21 RESULTS: The model explained more of the variation in the sugar score (21%) and the FV score (13.5%) than in the fat score (5%). SES was associated with both the sugar and FV scores. The strongest associations with the sugar score and FV were for antisocial behaviour and evaluation of own diet, respectively. The former association was significant in all gender/SES groups, whereas the latter association was only significant in the low SES groups. For all three types of food, the strongest significant predictors in the longitudinal models were frequency of consumption at age 15. CONCLUSION: The model's ability to explain variation in eating behaviours differed by food type, and possibly by gender/SES, but previous eating behaviour was an important predictor for all three foods. Prospective studies should carefully operationalize theoretical constructs when further investigating the influences of and interrelationships between these factors and gender/SES on the development of eating behaviours.

Adolescent↗
PubMed2002

A review of studies of sexual behaviour of school students in sub-Saharan Africa.

AIMS: This is a review of articles on sexual behaviour of school students in sub-Saharan Africa published between 1987 and 1999. The objective was to describe what is known in this regard and identify gaps in knowledge. METHODS: Literature search using electronic databases and a thumb search of relevant journals identified 47 articles reporting sexual behaviours of school-based young persons aged between 14 and 24 years. RESULTS: The findings indicate a relatively low number of articles when one considers the scope of the problems related to adolescent sexual behaviour in the region; high prevalence rates of sexual intercourse; infrequent use of condoms and other contraceptives; and significant proportions of adolescents who have two or more lifetime sexual partners. More data are needed on the extent to which adolescents engage in non-penetrative sexual behaviour and penetrative sex other than heterosexual vaginal intercourse; characteristics of the sexual partners of adolescents; and proximal psychosocial antecedents of sexual behaviour and consistent risk-reduction behaviours. CONCLUSIONS: Cultural influences on sexual behaviour, the sensitivity of such research in adolescent populations, and the opportunity afforded by school systems for intervention suggest a need for additional exploratory and methodological studies. Placing such information firmly within sociocultural contexts in which young people are raised will better inform effective interventions that both delay the onset of sexual intercourse and encourage use of risk reduction strategies.

Adolescent↗