Physical activity and cardiovascular risk factors at menopause: the Nord-Trøndelag health study

BACKGROUND

Lowered physical activity levels may partially explain changes in metabolic risk factors in women after menopause.

OBJECTIVES

To evaluate the association between physical activity and metabolic risk factors at baseline and after 11 years, as well as the change in that association over time in women who were premenopausal and ≥ 40 years at baseline.

METHODS

Subjects in a Norwegian population-based health survey answered questionnaires and had body and serum measurements during 1995-1997 (HUNT 2) and in a follow-up study during 2006-2008 (HUNT 3). Repeated-measures analyses were used to estimate the association between physical activity and metabolic factors, adjusting for age, smoking status, education, alcohol intake, and parity. Adjustment for hormonal treatment and medication was made, as appropriate.

RESULTS

In women remaining premenopausal, a higher physical activity score in HUNT 3 was associated with lower weight (p < 0.01) and waist-hip ratio (p < 0.01) and higher high density lipoprotein (HDL) cholesterol in HUNT 3 (p < 0.01). In women that were postmenopausal by the time of follow-up, a higher physical activity score in HUNT 3 was associated with lower weight (p < 0.01), waist-hip ratio (p < 0.01), triglycerides (p < 0.01), and higher total cholesterol (p < 0.05), HDL cholesterol (p < 0.01), and diastolic blood pressure (p < 0.05) in HUNT 3. The association of total physical activity score with weight and waist-hip ratio was stronger in HUNT 3 than in HUNT 2 (p < 0.01).

CONCLUSION

Increased physical activity may reduce the risk of adverse outcomes and use of pharmacological management in women of menopausal age.

Physical activity and age at menopause: the Nord-Trøndelag population-based health study

BACKGROUND

Age at menopause may affect women's subsequent morbidity and mortality. In contrast to numerous other health outcomes, little is known about the possible effects of physical activity on age at menopause.

OBJECTIVES

To assess the relationship between leisure-time physical activity and age at menopause.

METHODS

Premenopausal women participating in a population-based health survey (HUNT 2) conducted in the county of Nord-Trøndelag, Norway reported their physical activity in the period of 1995-1997. Age at menopause was reported during 2006-2008 (HUNT 3). Cox proportional hazards models were used to estimate hazard ratios for menopause and logistic regression to estimate odds ratios for early menopause, with 95% confidence intervals, adjusting for age at menarche, parity, use of oral contraceptives prior to the 6 months preceding participation in HUNT 2, symptoms of depression, smoking status, and education.

RESULTS

Women aged 40-49 years at baseline had lower hazard ratios for menopause when participating in any light leisure-time physical activity compared with no activity (p < 0.05) and similar results were observed in 19-39-year-olds. In 50-59-year-old women, the results varied greatly and did not reach statistical significance.

CONCLUSIONS

The effects of leisure-time physical activity on age at menopause may be age-dependent. We found indications of earlier menopause for the least active women aged 19-49 years at baseline.

Physical activity and fertility in women: the North-Trøndelag Health Study

BACKGROUND

Changes in the state of energy balance owing to changes in physical activity may affect the reproductive system. We evaluated the association between physical activity (PA) and fertility and parity in healthy women.

METHODS

A population-based health survey (HUNT 1) was conducted during 1984-1986 in Nord-Trøndelag county, Norway, with follow-up from 1995 to 1997 (HUNT 2). The study included 3887 women, <45 years old in HUNT 2. PA was assessed by baseline questionnaire, and fertility and parity by questionnaire at follow-up. Data focused on overall occurrence of infertility in the population (without biological confirmation).

RESULTS

Increased frequency, duration and intensity of PA were associated with increased subfertility, and frequency of PA was associated with voluntary childlessness (P < 0.01). After adjusting for age, parity, smoking, and marital status, women who were active on most days were 3.2 times more likely to have fertility problems than inactive women. Exercising to exhaustion was associated with 2.3 times the odds of fertility problems versus low intensity. Women with highest intensity of PA at baseline had the lowest frequency of continuing nulliparity and highest frequency of having three or more children during follow-up (P < 0.05). Sensitivity analysis including body mass index as confounder did not alter the results. No associations were found between lower activity levels and fertility or parity.

CONCLUSION

Increased risk of infertility was only found for the small group of women reporting the highest levels of intensity and frequency of PA. Awareness of the possible risks of infertility should be highlighted among non-athletic women who exercise vigorously.

Screening of males with eating disorders

The purpose of this study was to evaluate two different questionnaires for screening of eating disorders (ED) in males; the Eating Disorders Inventory (EDI) and the Survey for Eating Disorders (SEDs). The study sample consisted of 1196 Norwegian males serving as compulsory military recruits (mean age 19.9, SD = 1.4). The best predictors for having a SEDs-based diagnosis of ED were the EDI scales Drive for thinness (D7), bulimia (B), ineffectiveness (I) and interpersonal awareness (IA). When we classified men with an EDI sum score of 40 or higher as having an ED, the sensitivity was 47% and the specificity was 91%, compared to the SEDs diagnosis of ED. Our results suggest modest agreement between the ability of the EDI and that of the SEDs to identify men with ED. Our results indicate the need of further studies including clinical samples to validate the EDI against the SEDs.

Assessment of two self-reporting questionnaires for eating disorders in women

OBJECTIVE

The goals of this study were to evaluate how well the Eating Disorder Inventory (EDI) predicted specific eating disorders as identified by the Survey of Eating Disorders (SED), and to identify the most predictive EDI scales. An additional goal was to evaluate the EDI as a screening instrument for eating disorders among a large non-clinical group of women.

METHOD

The community-based study sample consisted of 1245 Norwegian women between age 18 and 50 years (mean 23). Subjects filled out the EDI and the SED.

RESULTS

The strongest predictors of SED-defined eating disorders were the EDI scales bulimia (BN) and drive of thinness (DT) and body mass index (BMI). When we classified women with an EDI sum score of 40 or higher as having an eating disorder (ED), the sensitivity was 38% and the specificity was 90%, compared to the SED diagnosis of ED.

DISCUSSION

Our findings suggest modest agreement between the EDI and the SED, and modest sensitivity and specificity of the EDI. While these instruments, perhaps with some modification, may be adequate for use in selected research applications, they should probably be supplemented with additional information in a clinical or treatment setting.

Prevalence and gender differences in eating attitudes and physical activity among Norwegians

The aim of the study was to examine gender differences in self-reported eating disorder symptoms in relation to the main reasons for participating in physical activity and the amount of weekly training among Norwegian adults. The study sample consisted of 3084 persons. Scores were obtained for the Eating Disorder Inventory (EDI) and from a self-constructed questionnaire concerning physical activity and sociodemographic information. The results showed that women had twice the risk for > 40 EDI scores than men (Odds Ratio = 2.45, 95% Confidence Interval 1.97-3.05). The main predictors for the weekly amount of physical activity were associated with improvement in physical performance. Both sexes with > 40 EDI scores participated in activity that resulted in body weight reduction and improved physical appearance. The results gave reasons to focus further on the narrowing gap between genders concerning eating disorder attitudes. The amount of weekly physical activity was not a predictor for high EDI scores. The pattern and type of activity may be more important in relation to pathological eating attitudes and exercise-related behavior.

The relationship between eating disorders and personality in physically active women

The aim of the study was to examine the relationship between personality factors, self-reported eating disorders, type of physical activity, level of sport competition and hours spent on physical activity each week among physically active non-athletes and athletes. A total of 591 high school women participated in the study. The mean age was 19 during the data collection. Scores were obtained on the Karolinska Scales of Personality (KSP) and a questionnaire concerning eating disorders (1) and physical activity. All diagnoses were based upon the DSM-IV criteria for anorexia nervosa (AN), bulimia nervosa (BN) and eating disorder not otherwise specified (EDNOS). The prevalence of AN was 1.5%, BN 2.0%, AN+BN 0.3% and EDNOS 12.9%. The prevalence of eating disorders (ED) was highest among physically active non-athletes who were members of fitness clubs (odds ratio (OR)= 1.86, 95% CI: 1.08-2.79). However, there was no relationship between the prevalence of eating disorders and the level of sport competition or time spent on physical activity. The results showed that women with eating disorders scored higher in anxiety, hostility and detachment, and lower in socialisation than the women without eating disorders. The results indicated that individuals with certain personality characteristics had a higher risk for being classified with ED, but it does not seem to be related to whether they are physically active or not. The findings in this study may support the hypothesis that participating in physical activity can have some positive psychological effects, but this does not necessarily apply to patients with AN and BN. ED may have a biological/genetic explanation according to Eysenck's personality theory.

Isokinetic muscle strength after anterior cruciate ligament reconstruction

The purpose of the present study was to investigate the isokinetic muscle strength 6 months after reconstruction of the anterior cruciate ligament (ACL). In order to recommend full-load come-back in sport, sufficient muscle strength may be important. Ninety female elite team handball players (mean 24.1 years) were postoperatively tested with Biodex. The operated limb was compared with the contralateral limb: 82.2% had a hamstring strength of a minimum of 49.6 Nm, corresponding to at least 90% of the non-operated limb, while only 12.2% fulfilled the recommended strength of 117.7 Nm for quadriceps femoris. Patients over 26 years showed significantly lower muscle strength in the operated limb than their younger counterparts. Increased focus on quadriceps femoris muscle strength during rehabilitation may improve the knee function faster after ACL reconstruction.

Menstrual dysfunction in Norwegian top athletes

Of 301 Norwegian female top athletes, all members of the national team in 27 different sports, who were approached with a questionnaire about menstrual function, 278 (92.4%) responded. Ninety-nine of the respondents who used oral contraceptives were excluded. Of the remaining 179, 18 (10.1%) reported secondary amenorrhea (greater than 4 months since the last period) and were chosen for further studies. Blood samples were drawn for hormonal analyses between 10 and 12 a.m. and at least 12 hours after the last training session. Their mean age was 20.8 years (range 18-27), mean height 169.8 cm (160-180), mean weight 58.5 kg (51-67), and their mean age at menarche 14.6 years (13-16.5), significantly older than that of the other top athletes: 13.5 years (p less than 0.05). Their mean number of training hours per week was 16.1 (12-24). Hormonal changes were consistent with simple normoprolactinemic hypothalamic suppression, characterized by low values of FSH, estradiol-17 beta and prolactin. The androgen hormones demonstrated high levels of dihydrotestosterone. Testosterone levels were within normal limits, but in the upper part of the range, whereas sex hormone-binding globulin was in the lower normal range.