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Biomedical subjects

L Lissner

Publications and source records attributed to L Lissner.

At least 19 recordsLinked to original sources
PubMed2006

Health Hunters--an intervention to prevent overweight and obesity in young high-risk women.

AIM: The aim of the study was to develop and implement an obesity and weight gain prevention program targeted to a high-risk group. METHOD: Women, 18-28 years old, with at least one severely obese parent, were randomized to the intervention or control group of the 'Health Hunters' program. During 1 year of follow-up, the intervention group received an individualized behavioral program focusing on food choice, physical activity and other lifestyle factors. Anthropometric measures, DXA-based body composition and fitness levels were measured at baseline and after 1 year. Self-reported changes in obesity-related behaviors were also assessed. RESULTS: Baseline examinations were conducted in 40 women, of whom 30 completed follow-up examinations 1 year later. Pregnancy was the most common reason for failure to complete the study. Compared to the control group (which gained weight), the intervention group displayed significant improvements in body weight, body mass index, waist circumference, waist-to-hip ratio and self-reported physical activity. Changes in body composition, although not significant, suggested that the intervention tended to be associated with improved body composition. Further analysis of changes in diet and fitness in relation to concurrent weight changes indicated that the strongest 'protective' associations were for energy percent protein, fiber density and fitness. CONCLUSION: Pilot data from the Health Hunters obesity prevention program indicates that it is effective in high-risk young women with familial predisposition for obesity.

Adolescent↗
PubMed2005

Obesity in 70-year-old Swedes: secular changes over 30 years.

OBJECTIVE: Secular increases in obesity have been widely reported in middle-aged adults, but less is known about such trends among the elderly. The primary purpose of this paper is to document the most recent wave of the obesity epidemic in population-based samples of 70-y-old men and women from Göteborg. Additionally, we will investigate the influences of physical activity, smoking and education on these secular trends. POPULATIONS AND METHODS: Five population-based samples of 3702 70-y-olds (1669 men and 2033 women) in Göteborg, Sweden, born between 1901 and 1930, were examined in the Gerontological and Geriatric Population Studies (H70) between 1971 and 2000. Cohort differences in anthropometric measures were the main outcomes studied. Physical activity, smoking habits and education were assessed by comparable methods in all cohorts. Subsamples of the women in the latest two cohorts (birth years 1922 and 1930) were also part of the Prospective Population Study of Women in Göteborg. In these women, it was possible to examine body mass index (BMI) and waist-to-hip circumference ratio (WHR) longitudinally since 1968. RESULTS AND CONCLUSIONS: Significant upward trends were found for height, weight, BMI, waist circumference (WC), WHR, prevalence of overweight (BMI> or =25 kg/m(2)) and obesity (BMI> or =30 kg/m(2)) across cohorts in both sexes. In 2000, 20% of the 70-y-old men born in 1930 were obese, and the largest increment (almost doubling) had occurred between the early 1980s and the early 1990s. In 70-y-old women the prevalence of obesity was 24% in 2000, a 50% increase compared to the cohort born 8 y earlier. BMI increased over time in all physical activity, smoking and education groups, with the exception of never-smoking men. Although 70-y-old women in 2000 were heavier than cohorts examined 8 y previously, data from the women studied longitudinally revealed that these differences were already present in earlier adulthood. In conclusion, the elderly population is very much part of the obesity epidemic, although secular trends in BMI were detected slightly earlier in men than in women. The health implications of these secular trends should be focused on in future gerontological research.

Aged↗
PubMed2005

Trends in overweight and obesity from 1985 to 2002 in Göteborg, West Sweden.

OBJECTIVE: To study secular trends in overweight and selected correlates in men and women in Göteborg, Sweden. DESIGN: Cross-sequential population-based surveys. SUBJECTS: A total of 2931 female and 2691 male subjects aged 25-64 y participated in WHO MONICA surveys (1985, 1990, 1995) and the INTERGENE study (2002). MEASUREMENTS: Body mass index (BMI), waist-to-hip ratio (WHR), prevalence of overweight (BMI> or =25 kg/m(2)), and obesity (BMI> or =30 kg/m(2)). RESULTS: Mean body weight increased by 3.3 kg for women and 5 kg for men, with a significant upward trend for BMI in men but not women over the 17-y observation period. The prevalence of overweight and obesity increased significantly in both sexes over the period. The largest increase was observed in men, and in women aged 25-34 y. In 2002, the prevalence of overweight was 38% in women and 58% in men, and the prevalence of obesity was 11% in women and 15% in men. No significant secular trends were observed for WHR, but there was an upward trend in prevalence of WHR>0.85 in women. A decreased prevalence of smoking in both sexes was observed together with an increase in reported leisure time physical activity. No significant secular trends were observed in rates of self-reported diabetes, although the risk of diabetes attributable to obesity was 24%. CONCLUSION: The results indicate that 25-64-y-olds in the recent survey were more overweight and obese than earlier studied MONICA participants. The increase in BMI was more pronounced in men while abdominal obesity increased principally in women. Although obesity and overweight are clearly important risk factors for type 2 diabetes, the number of diabetics remains low and any secular increase is not yet apparent.

Adult↗
PubMed2004

A 24-year follow-up of body mass index and cerebral atrophy.

OBJECTIVE: To investigate the longitudinal relationship between body mass index (BMI), a major vascular risk factor, and cerebral atrophy, a marker of neurodegeneration, in a population-based sample of middle-aged women. METHODS: A representative sample of 290 women born in 1908, 1914, 1918, and 1922 was examined in 1968 to 1969, 1974 to 1975, 1980 to 1981, and 1992 to 1993 as part of the Population Study of Women in Göteborg, Sweden. At each examination, women completed a survey on a variety of health and lifestyle factors and underwent anthropometric, clinical, and neuropsychiatric assessments and blood collection. Atrophy of the temporal, frontal, occipital, and parietal lobes was measured on CT in 1992 when participants were age 70 to 84. Univariate and multivariate regression analyses were used to assess the relationship between BMI and brain measures. RESULTS: Women with atrophy of the temporal lobe were, on average, 1.1 to 1.5 kg/m2 higher in BMI at all examinations than women without temporal atrophy (p < 0.05). Multivariate analyses showed that age and BMI were the only significant predictors of temporal atrophy. Risk of temporal atrophy increased 13 to 16% per 1.0-kg/m2 increase in BMI (p < 0.05). There were no associations between BMI and atrophy measured at three other brain locations. CONCLUSION: Overweight and obesity throughout adult life may contribute to the development of temporal atrophy in women.

Adult↗
PubMed2004

Birth weight is associated with postmenopausal breast cancer risk in Swedish women.

There is some evidence that birth weight is associated with breast cancer. Whether this association differs between premenopausal and postmenopausal ages is still unclear. The results from this study suggest that higher birth weight is a risk factor for postmenopausal breast cancer (OR 1.06, CI 1.00-1.12, per 100 g), independent of selected early-life and adult factors.

Aged↗
PubMed2004

Body composition in the SOS (Swedish Obese Subjects) reference study.

OBJECTIVE: The primary objective was to establish population-based, sex- and age-specific reference data with respect to body composition variables. Secondary objectives were to relate body mass index (BMI) to anthropometric measurements reflecting central adiposity and to body fat (BF). Another objective was to examine if secular changes in adipose tissue distribution occurred during the sampling period, 1994-1999. DESIGN: Sex- and age-specific data on anthropometric measurements and body composition were cross-sectionally collected in the reference study of Swedish Obese Subjects. SUBJECTS: In total, 1135 randomly selected subjects (524 men and 611 women), aged 37-61 y, BMI 17.6-45.4 kg/m(2). MEASUREMENTS: Measures of body fatness and fat distribution (by dual energy X-ray absorptiometry and anthropometry) were collected. RESULTS: At BMI 25 kg/m(2), relative (absolute) BF mass was 24% (19 kg) in men vs 36% (25 kg) in women, waist circumference was 90 vs 85 cm, and sagittal trunk diameter was 21 vs 19 cm. BF and measures of centralized adipose tissue distribution increased with age in both sexes (P<0.01). In women, waist circumference and sagittal diameter increased (P<0.01) over the sampling period while BMI did not. CONCLUSIONS: Sex- and age-specific reference data on body composition are reported from a randomly selected sample of Swedish men and women. At given BMIs, women had more BF but smaller waist circumference than men. Secular increases in indices of central obesity were found in women but not in men.

Absorptiometry, Photon↗
PubMed2004

Secular trends in diet among elderly Swedes -- cohort comparisons over three decades.

OBJECTIVE: The purpose of this study was to compare dietary practices among different birth cohorts of 70-year-old Swedes, who were examined between 1971 and 2000. SETTING: Göteborg, Sweden. DESIGN: Four population-based samples of 1360 70-year-olds, born in 1901, 1911, 1922 and 1930, have undergone health examinations and dietary assessments over a period of almost three decades. One-hour diet history (DH) interviews were conducted in 1971, 1981, 1992 and 2000 with a total of 758 women and 602 women. The formats and contents of the dietary examinations were similar over the years. Statistical analysis of linear trends was conducted, using year of examination as the independent variable, to detect secular trends in food and nutrient intakes across cohorts. RESULTS: At the 2000 examination, the majority of 70-year-olds consumed nutritionally adequate diets. Later-born cohorts consumed more yoghurt, breakfast cereals, fruit, vegetables, chicken, rice and pasta than earlier-born cohorts. Consumption of low-fat spread and milk also increased, along with that of wine, light beer and candy. In contrast, potatoes, cakes and sugar were consumed less in 2000 than in 1971. The ratio of reported energy intake to estimated basal metabolic rate did not show any systematic trend over time in women, but showed a significant upward trend in men. CONCLUSIONS: The diet history method has captured changes in food selections in the elderly without changing in general format over three decades. Dietary quality has improved in a number of ways, and these findings in the elderly are consistent with national food consumption trends in the general population.

Aged↗
PubMed2003

Associations between reproduction and maternal body weight: examining the component parts of a full reproductive cycle.

OBJECTIVE: Many transitional societies currently face both extremes of nutritional status, undernutrition and overnutrition. Women of reproductive age are at high risk of these conditions. The purpose of this review is to consider evidence for relationships between reproduction and nutritional status in women from societies of varying economic development, using body weight or weight-for-height as indicators of maternal nutritional status. DESIGN: The conceptual framework guiding this review is that the duration of the reproductive cycle varies as a function of its component parts, which include (i) pregnancy, (ii) lactation, (iii) the non-pregnant/non-lactating (NP/NL) interval or, possibly, (iv) an overlap between lactation and next pregnancy. All component parts of the complete cycle vary in length and are associated with changes in nutritional status. A variety of factors ('proximal and distal determinants') influence the duration of the component parts of the reproductive cycle. This framework is used to examine current knowledge of changes in maternal nutritional status during each of these parts. RESULTS: Women in affluent societies retain some weight with each pregnancy, beyond that of non-pregnant women. Women in less affluent societies retain less weight with each pregnancy. During lactation, women in both affluent and less affluent societies experience only modest weight loss. During the NP/NL interval, women in affluent societies tend to gain weight, whereas weight of women in less affluent societies is likely to fluctuate. CONCLUSIONS: We conclude that there is a dearth of information on certain parts of the cycle, particularly the periods of overlap of lactation with pregnancy and the NP/NL interval.

Adult↗
PubMed2003

Body composition estimated by bioelectrical impedance in the Swedish elderly. Development of population-based prediction equation and reference values of fat-free mass and body fat for 70- and 75-y olds.

OBJECTIVE: To develop a bioelectrical impedance (BIA) prediction equation for fat-free mass (FFM(BIA)) and present reference values of FFM and body fat (BF) for healthy Swedish elderly from population-based representative samples. SUBJECTS: This study is based on 823 (344 males, 479 females) participants from two systematic samples of birth cohorts in Göteborg aged 70 (cohort H70V, 201 males and 299 females) and 75 (cohort NORA75, 143 males and 180 females). METHODS: Body composition was measured with BIA (BIA-101, RJL system, Detroit) in both cohorts and was estimated by a four-compartment (4C) model from total body water (TBW) and total body potassium (TBK) in a sub-sample of the NORA75 cohort. The FFM(BIA) was validated against the FFM from the 4C model (FFM(4C)). RESULTS: The FFM(BIA) correlated well with FFM(4C) (r=0.95, SEE=2.64 kg). The FFM(BIA) (kg) in 70-y-old males and females were 58.5+/-5.4 and 43.4+/-4.4, and for 75-y-old males and females were 56.1+/-4.7 and 42.5+/-4, respectively. The body fat in kg (FM) among 70-y-old males and females were 25.2+/-8.1 and 25.7+/-8.4, and for 75-y-old males and females were 21.7+/-7.1 and 22.8+7.2, respectively. The percent body fat (BF%) among 70-y-old males and females were 29.5+/-5.8 and 36.3+/-6.4, and for 75-y-old males and females were 27.3+/-6 and 34.1+/-6.1, respectively. CONCLUSION: The FFM, FM and BF% from this study might be used as reference values for Swedish elderly aged 70 and 75 y.

Adipose Tissue↗
PubMed2003

Blood pressure and pulse pressure development in a population sample of women with special reference to basal body mass and distribution of body fat and their changes during 24 years.

OBJECTIVE: To study blood pressure and pulse pressure longitudinally and their association with basal and change of body mass index (BMI) and waist to hip ratio (WHR). DESIGN: A prospective population study of 1462 women in Gothenburg, Sweden, aged 38-60 y at baseline, with a longitudinal follow-up of 24 y. OUTCOME MEASURES: Incidence of hypertension, systolic and diastolic blood pressure, and pulse pressure at baseline and after 12 and 24 y of follow-up. RESULTS: Systolic and diastolic blood pressure as well as pulse pressure increased with age and turned down again at high age. BMI and WHR at baseline were each independently associated with baseline systolic and diastolic blood pressure, but only BMI with pulse pressure. However, baseline BMI and WHR were not associated with change of systolic, diastolic or pulse pressure during 12 or 24 y of follow-up. Increase in BMI during the follow-up period was associated with increase in systolic and diastolic blood pressure but not with increase in pulse pressure. There were no such associations with WHR changes which, were either unrelated or in one analysis inversely related with blood pressure changes. When considering incidence of hypertension during the first 12 y of follow-up, BMI and change in BMI were significant predictors, independent of WHR. CONCLUSION: Age, BMI and increments in BMI seem to be strong predictors for hypertension and increased systolic and diastolic blood pressure in women. In contrast, WHR plays a lesser and uncertain role in the development of hypertension in middle-aged women. Changes in BMI seem not to be accompanied by changes in pulse pressure during a long time follow-up.

Adipose Tissue↗
PubMed2003

Self-reported stress levels predict subsequent breast cancer in a cohort of Swedish women.

The association between stress and breast cancer has been studied, mostly using case-control designs, but rarely examined prospectively. The purpose of this paper is to describe the role of stress as a predictor of subsequent breast cancer. A representative cohort of 1,462 Swedish women aged 38-60 years were followed for 24 years. Stress experience at a baseline examination in 1968-69 was analysed in relation to incidence of breast cancer with proportional hazards regression. Women reporting experience of stress during the five years preceding the first examination displayed a two-fold rate of breast cancer compared with women reporting no stress (age-adjusted relative risk 2.1; 95% CI [1.2-3.7]). This association was independent of potential confounders including reproductive and lifestyle factors. In conclusion, the significant, positive relationship between stress and breast cancer in this prospective study is based on information that is unbiased with respect to knowledge of disease, and can be regarded as more valid than results drawn from case-control studies.

Adult↗
PubMed2002

Meal patterns and obesity in Swedish women-a simple instrument describing usual meal types, frequency and temporal distribution.

OBJECTIVE: To characterize meal patterns in relation to obesity in Swedish women using a simple instrument describing meal frequency, meal types and temporal distribution. DESIGN: Cross-sectional parallel group design. SUBJECTS: Eighty-three obese women from the Swedish Obese Subjects (SOS) study were compared with 94 reference women, randomly recruited from the population. METHOD: A new, simplified and self-instructing questionnaire was used to assess meal patterns. Usual meal pattern was reported as time and meal type for each intake episode during a typical day. RESULTS: The obese women consumed 6.1 meals/day compared with 5.2 meals/day among the reference women (P<0.0001). All types of meals except 'drink meals' were significantly more frequently consumed in the obese group. The obese women also displayed a different meal pattern across the day, consuming a larger number of meals later in the day. As a result a larger fraction of each obese woman's total meals were consumed in the afternoon and in the evening/night. There was no difference in the number of obese vs reference women consuming breakfast. Snack meals were positively associated with total energy intake in both groups. CONCLUSIONS: A new simplified method assessing meal pattern revealed that the number of reported intake occasions across a usual day was higher in obese women compared with controls and the timing was shifted to later in the day. These findings should be considered in the treatment of obesity.

Adult↗
PubMed2002

Acquired preference especially for dietary fat and obesity: a study of weight-discordant monozygotic twin pairs.

OBJECTIVE: To determine the independent associations of dietary preference for fat with obesity without the confounding by genetic effects. DESIGN: Descriptive comparison of the responses of monozygotic twins discordant for obesity to questions concerning current and past preference for dietary fat, current overconsumption of fatty items and recalled food consumption compared to the co-twin. SETTING: The Research and Development Centre of the Social Insurance Institution, Finland. SUBJECTS: Twenty-three healthy monozygotic twin pairs who were discordant for obesity (BMI difference at least 3 kg/m(2)). MAIN OUTCOME MEASURES: Obesity status of the twin, as a function of the current and recalled dietary preferences and selected psychosocial variables. RESULTS: The obese twins reported current preference for fatty foods three times more frequently than the lean co-twin. Moreover, when comparing recalled taste for fat at the time the twins left their parental homes, both the obese and lean co-twins consistently recalled that the obese twin had greater preference for fatty foods in young adulthood, and that the lean twin had less. Psychological characteristics of lean and obese co-twins did not differ. CONCLUSION: Acquired preference for fatty foods is associated with obesity, independent of genetic background. Modification of fat preferences may be an important step in the prevention of obesity in the general population.

Adult↗
PubMed2002

Cholesterol and triglyceride concentration as risk factors for myocardial infarction and death in women, with special reference to influence of age.

OBJECTIVE: To evaluate the importance of serum cholesterol and triglyceride concentrations as predictors of myocardial infarction and death in women of different ages. DESIGN: Prospective observational study, initiated in 1968-69. Setting. Gothenburg, Sweden, with about 430 000 inhabitants. SUBJECTS: A population-based sample of 1462 women aged 38, 46, 50, 54 and 60 years at start of the study, followed up for 24 years. Main outcome measures. Within each age group, myocardial infarction and death were predicted by serum cholesterol and triglyceride concentrations and smoking in a multivariate model. RESULTS: In the total population only serum triglyceride concentration was a strong independent risk factor for both end-points studied. Serum triglyceride concentration measured in 38- and 46-year-old women had no predictive value with respect to 24-year incidence of myocardial infarction or death. In 50-, 54- and 60-year-old women, high serum triglyceride concentration consistently predicted myocardial infarction and total mortality. Serum cholesterol concentration, on the other hand, showed evidence of direct association for 24-year all-cause mortality in the younger premenopausal group. Serum cholesterol had no predictive value for myocardial infarction or mortality in the peri- and postmenopausal ages. CONCLUSIONS: There appears to be age-specificity in association between serum lipids and these end-points in women, serum cholesterol concentration being more important for younger women and serum triglyceride concentration more important for postmenopausal women as risk factors, observations which need further attention.

Adult↗
PubMed2001

Larger hip circumference independently predicts health and longevity in a Swedish female cohort.

OBJECTIVE: The waist circumference is widely viewed as a simple but effective measure for assessing obesity-related health risks, whereas measurement of the hip circumference is not currently prioritized. This study examines health risks associated specifically with hip circumference in a cohort of Swedish women, to determine whether information may be lost by excluding the hip circumference from health surveys. RESEARCH METHODS AND PROCEDURES: The subjects described in this report constitute a population-based sample of 38- to 60-year-old women who underwent anthropometric examinations in 1968. The 24-year incidence rates have been ascertained for myocardial infarction, combined cardiovascular diseases, and diabetes. All-cause, cardiovascular, and myocardial infarction mortality also were evaluated. RESULTS: Hip circumference was a significant independent inverse risk estimator for all endpoints studied. Using Cox regression with adjustment for age, smoking, body mass index, and waist circumference, the remaining variability associated with larger hips was associated with significantly fewer adverse health outcomes. The hip circumference became statistically informative after body mass index adjustment. The strongest protective associations were observed for cardiovascular disease and diabetes endpoints, although significant trends were also seen for total mortality. Considering hip and waist simultaneously, the strength of the inverse association for large hips generally exceeded the positive association for waist. DISCUSSION: Recent interest in the waist circumference as an effective screening tool has taken the focus off of the hip circumference. The present results suggest that collection of hip measurements should not be discontinued in assessment of obesity-related risk status and health promotion.

Adult↗
PubMed2001

Socioeconomic status and mortality in Swedish women: opposing trends for cardiovascular disease and cancer.

We examined relations between socioeconomic status and cardiovascular disease, cancer, and diabetes mellitus in a 24-year prospective study of 1,462 Swedish women. Two socioeconomic indicators were used: the husband's occupational category for married women and a composite indicator combining women's educational level with household income for all women. The husband's occupational category was strongly associated with cardiovascular disease and cancer mortality in opposite directions, independent of age and other potential confounders. Women with husbands of lower occupational categories had an increased risk of cardiovascular disease mortality [relative risk (RR) = 1.60; 95% confidence interval (95% CI) = 1.09-2.33] while experiencing lower rates of all-site cancer mortality (RR = 0.69; 95% CI = 0.50-0.96). A similar relation was seen with the composite variable: women with low socioeconomic status had an increased risk of cardiovascular disease (RR = 1.37; 95% CI = 1.01-1.84) but a somewhat lower risk for cancer of all sites (RR = 0.86; 95% CI = 0.66-1.11). Finally, morbidity data (diabetes mellitus, stroke, and breast cancer) yielded results that were consistent with the mortality trends, and breast cancer appeared to account for a major part of the association between total cancer and high socioeconomic status. In summary, higher socioeconomic status was associated with decreased cardiovascular disease mortality and excess cancer mortality, in such a way that only a weak association was seen for all-cause mortality.

Adult↗
PubMed2001

Evaluation of "Live for Life", a health promotion programme in the County of Skaraborg, Sweden.

STUDY OBJECTIVE: To evaluate a health promotion programme, combining a population and individual based strategy, in the County of Skaraborg, Sweden, with special attention to outcome. DESIGN: The evaluation was subdivided into structure, process and outcome. The evaluation procedure as a total is described here, but the results presented refer only to outcome. In order to study the potential effect of the individually based health examination, 35 year old subjects who had participated five years previously were in 1994-1996 compared with 35 year old subjects who had not participated before, and compared with their own values five years earlier. The results during 1995-1996 were compared with those of 1989-1990 for corresponding ages in order to study the effect of, particularly, the population based strategy. SETTING: The County of Skaraborg in the south western part of Sweden with about 270 000 inhabitants. In addition to population strategy, involving the total county, men and women aged 30 and 35 years were invited to an individually based examination. MAIN RESULTS: Factors related to body weight increased during the study period, while other factors mostly changed in the direction wanted. As a whole the changes were rather modest. There were favourable changes in lifestyle variables, for example, concerning smoking and dietary habits. CONCLUSIONS: There were beneficial effects from the health promotion programme, but there is a need for continuous improvement of methods of intervention referred to lifestyle.

Adult↗