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Study Objectives To examine the longitudinal and bidirectional association between nighttime sleep duration and emotional and behavioral problems (EBPs) over 15 months among preschool children. Methods Data of children aged 2 to 6 years from the control group of the Danish Healthy Start Study, a 15-month obesity prevention intervention, were used. Nighttime sleep duration was measured using a 7-day sleep record. EBPs were assessed by the Strengths and Difficulties Questionnaire Total Difficulties (SDQ-TD) score and Prosocial Behavior (SDQ-PSB) score. Multivariable regression models were conducted to examine the bidirectional associations between changes in nighttime sleep duration and SDQ scores. Results With adjustment for child, family factors, and parental stress level, every hour extra nighttime sleep at baseline was associated with a 1.02 decrease in SDQ-TD score and 77% lower odds of having an abnormal SDQ-TD score (≥90th percentile) at the follow-up (p = 0.01). Children who increased their nighttime sleep duration over the 15-month demonstrated a similar concurrent reduction in SDQ-TD score (β = −1.28, p = 0.02) compared with those who decreased or had no change in nighttime sleep duration. After additional adjustment for sleep problem and habit variables, the significant associations remained. No associations were found between nighttime sleep duration and SDQ-PSB scores. Examination of SDQ scores as predictors of subsequent changes in nighttime sleep duration showed no significant associations. Conclusions Among preschool children, longer nighttime sleep duration was associated with a decline in EBPs, but not vice versa. Our study provides new longitudinal evidence to support sleep interventions to improve EBPs in early childhood. Clinical trials: The Healthy Start Study: https://clinicaltrials.gov/ct2/show/NCT01583335 Trial registration: ID NCT01583335

Introduction Few studies have examined the role of maternal diet in relation to development of autoimmune diseases such as coeliac disease (CD). In Denmark, cancellation of mandatory vitamin D fortification of margarine in June 1985 provides this opportunity. This study examined if prenatal exposure to extra vitamin D from food fortification or season of birth were associated with a decreased risk of developing CD later in life. If low prenatal vitamin D levels are a risk factor, there are immediate, cheap and easy public health implications. Methods This register based study has a partially ecologic design. The two entire cohorts were created using information available from the Danish birth registry and development of CD (ICD-8 269 ICD-10 K90) over 30 years was retrieved from the Danish National Patient Register. Logistic regression analysis was used to generate odds ratios and 95% confidence intervals. Results There was a lower odds ratio of developing CD (OR: 0.811 95% CI 0.655; 1.003) from the exposed birth cohort adjusting for sex and season of birth. There was a significant season effect particularly for children born in autumn (OR 1.6 95% CI 1.16; 2.21) and born summer (OR 1.5 95% CI 1.1;2.1) when compared to children born in winter. Conclusions The results indicate a potential protective effect of a small extra intake of vitamin D from food fortification by pregnant women in relation to the risk of their offspring developing CD. This conclusion is further supported by the results showing that summer born children, where first half of gestation occurred during the dark winter season, had a higher risk of CD. This research lends support for the reconsideration of vitamin-D food fortification in Denmark. Key messages Exposure to even a small amount of vitamin D prenatally may protect against developing coeliac disease later in life. Association between season and CD indicates that vitamin D may play an important role in relation to fetal programming.

High glycemic index (GI) and glycemic load (GL) have been proposed to be associated with increased risk of lifestyle diseases. Since protein intake varies little in humans, adherence to the common recommendation to reduce fat intake probably leads to increases in carbohydrate intake, which emphasizes the need to investigate the effects of carbohydrate on diet-related conditions and diseases. This review examines the epidemiological literature linking GI and GL to heart disease, insulin sensitivity, type 2 diabetes, dyslipidemia, and obesity among initially healthy people. The evidence for associations between GI and particularly GL and health among free-living populations is mixed. Only the positive association between GI and development of type 2 diabetes was consistent across cross-sectional and longitudinal studies for both sexes. Low GI/GL may protect against heart disease in women, and cross-sectional studies indicate low GI/GL may reduce high-density-lipoprotein cholesterol and triacylglycerol levels in both sexes. Based on the evidence found in this review, it seems premature to include GI/GL in dietary recommendations.

Introduction Proportion of populations that are overweight and obese are on the rise and generally affecting more than 50% of the adult Western male population. It is, therefore, of interest to look at possible associations between obesity and sexual function in a homogeneous population. Aim To examine a possible association between sexual disorders (erectile dysfunction, ejaculatory disorders, and sexual desire disorders) and obesity among younger men born and living in Denmark. Methods A community-based cross-sectional study of sexual health among Danish younger men. Questionnaires were mailed to 3,300 men, aged 20–45 years and divided into six 5-year age cohorts. Odds ratios were calculated using logistic regression modeling. In total, 863 men (26%) responded anonymously. A similar set of data from 600 older men aged 50–75 years and from same community was used for comparison. Main Outcome Measures The associations between self-reported erectile, ejaculatory and desire disorders, and body mass index (BMI) were examined, stratified by age group and smoking status. Results The material was found to be generally representative of the Danish population of men of similar age in regard to height, weight, smoking status, and alcohol consumption. Erectile dysfunction (ED) was more prevalent among these younger and older men with higher BMI, but only significant among men 20–45 years old, with an odds ratio of 2.74 (95% confidence interval 1.1–6.8). The prevalence of ED was higher among the younger obese nonsmokers than obese smokers. Premature ejaculation, retarded ejaculation, and sexual desire disorders were all unrelated to overweight or obesity. Conclusion Obesity (BMI ≥ 30 kg/m 2 ) seems associated with ED among younger men aged 20–45 years. Health programs directed toward preventing obesity in younger men may benefit from informing about an almost three-fold occurrence of erectile dysfunction associated with obesity. Andersen I, Heitman B, and Wagner G. Obesity and sexual dysfunction in younger Danish men. J Sex Med 2008;5:2053–2060.

Most prospective observational studies suggest that weight loss increases the risk of premature death among obese individuals. This is surprising because clinical studies show that weight loss generally leads to overall improvements in cardiovascular risk factors. It is sometimes argued that the increased mortality observed with weight loss must depend on confounding or poor study designs. This review was conducted to summarize results from studies on intentional weight loss and mortality among healthy individuals, while carefully considering the designs and problems in these studies. Evaluation criteria with a rating scale were developed. Of the studies evaluated, two found decreased mortality with intentional weight loss, three found increased mortality, and four found no significant associations between intentional weight loss and total mortality. Thus, it is still not possible for health authorities to make secure recommendations on intentional weight loss. More studies designed to specifically address this issue are warranted.

BACKGROUND: Studies have shown a positive association between trans fatty acids (TFA) intake and risk of coronary heart disease (CHD), primarily accounted for by industrially produced TFA. Some of these studies indicate an inverse association between ruminant TFA (R-TFA) intake and CHD implying that R-TFA intake is innocuous or even protective against CHD. The aim of this study was to describe the association between R-TFA intake and risk of CHD evaluating both the absolute and the energy-adjusted intake. METHODS: The study was an 18-year follow-up study of 3686 Danes, aged 30-71 years, at baseline without previous CHD. RESULTS: There were no overall associations between absolute or energy-adjusted R-TFA intakes and risk of CHD. However, among women, indications of inverse associations between R-TFA intake and risk of CHD were found: hazard ratio (HR) per 0.5 g increase in absolute R-TFA intake = 0.84 [95% confidence interval (CI): 0.70, 1.01] and HR per 0.5 g increase in energy-adjusted R-TFA intake = 0.77 (95% CI: 0.55, 1.09). No associations between absolute or energy-adjusted R-TFA intakes and CHD were found among men. CONCLUSIONS: This study suggests that R-TFA intake is not associated with a higher risk of CHD. Whether R-TFA intake is even protective against CHD among women cannot be concluded from this study. Udgivelsesdato: 2008-Feb

Udgivelsesdato: 2008-Jan AIMS: To determine the combined influence of leisure-time physical activity and weekly alcohol intake on the risk of subsequent fatal ischaemic heart disease (IHD) and all-cause mortality. METHODS AND RESULTS: Prospective cohort study of 11 914 Danes aged 20 years or older and without pre-existing IHD. During approximately 20 years of follow-up, 1242 cases of fatal IHD occurred and 5901 died from all causes. Within both genders, being physically active was associated with lower hazard ratios (HR) of both fatal IHD and all-cause mortality than being physically inactive. Further, weekly alcohol intake was inversely associated with fatal IHD and had a U-shaped association with all-cause mortality. Within level of physical activity, non-drinkers had the highest HR of fatal IHD, whereas both non-drinkers and heavy drinkers had the highest HR of all-cause mortality. Further, the physically inactive had the highest HR of both fatal IHD and all-cause mortality within each category of weekly alcohol intake. Thus, the HR of both fatal IHD and all-cause mortality were low among the physically active who had a moderate alcohol intake. Conclusion Leisure-time physical activity and a moderate weekly alcohol intake are both important to lower the risk of fatal IHD and all-cause mortality.

Objective To evaluate the health outcomes of a manualized intervention program based on social cognitive therapy and motivational interviewing. The program was embedded in Swedish child health services and started when eligible children were 9–10 months of age and ended at four years of age. …

Background According to Karasek's Demand/Control Model, workload can be conceptualized as job strain, a combination of psychological job demands and control in the job. High job strain may result from high job demands combined with low job control. Aim To give an overview of the literature on the association between obesity and psychological workload. Method We carried out a review of the associations between psychological workload and body weight in men and women. In total, 10 cross-sectional studies were identified. Results The review showed little evidence of a general association between psychological workload and body mass index. Only weak positive associations were found, and only between elements of psychological workload and overall body weight. For body fat distribution, two out of three studies showed a positive association in men, but the associations became insignificant after adjustment for education. For women, there was no evidence of a consistent association. Conclusion The reviewed articles were not supportive of any associations between psychological workload and either general or abdominal obesity. Future epidemiological studies in this field should be prospective or experimental, and should examine how chronic work stress affects eating and to what extent initial body weight is a predictor for individual differences in perceived psychological workload.

We thank Dr Viktor Culic for his interest in our article ‘The combined influence of leisure-time physical activity and weekly alcohol intake on fatal ischaemic …