Alcohol policy in the Nordic countries.
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Alcohol Drinking↗
Biomedical subjects
M Osler
Publications and source records attributed to M Osler.
Multiple induced abortions: Danish experience.
Experience with 50 first time aborters, 50 second time aborters, and 50 third time aborters residing in an urban area of Copenhagen suggests that women having a repeat abortion are more similar than dissimilar to women having a first induced abortion. There were no differences in socioeconomic status, educational level, or stated reasons for choosing abortion (usually socioeconomic and family considerations). Though similar to first and second time aborters in their life situations and greater contraceptive risk-taking, third timers seemed to become pregnant more readily. They were also less willing to be interviewed. Related studies and suggestions for postabortion counseling are discussed.
Abortion, Induced↗
Food patterns associated with intakes of fat, carbohydrate and dietary fibre in a cohort of Danish adults followed for six years.
OBJECTIVE: To examine associations between food consumption patterns, measured by a short food frequency questionnaire (FFQ), and the intakes of fat, carbohydrates and fibre over time, and in relation to recommended guidelines. DESIGN: The same 329 individuals had their diet intake measured by a short FFQ and a thorough diet history interview, first in 1987/88, and again six years later in 1993/94. SETTING: The County of Copenhagen, Denmark. SUBJECTS: Three hundred and twenty-nine men and women, aged 35-65 y selected randomly from a large population sample. RESULTS: At both examinations fat energy displayed the strongest positive associations with the intake of animal fats and negative correlations with the vegetables. These food items explained most of the total explained variation in fat intake. In general the associations between food items and intakes of carbohydrates and fibre were similar but inverse, to those found for fat. During the study period median fat energy decreased from 41-38%. A less frequent intake of animal fats over time predicted an increase in fat energy both among men and women, while a more frequent intake of fruit and pasta, and a less frequent intake of cakes was associated with an increase in dietary fibre. CONCLUSIONS: Food items like animal fats, vegetables and certain high starch foods can predict compliance to dietary guidelines for fat and carbohydrates. The study also shows that the food pattern of this Danish cohort has changed in the direction of a more healthy diet during the six years of follow-up. SPONSORSHIP: This study was granted by the Danish Agricultural and Veterinary and Danish Medical Councils and the Danish Health Insurance foundation.
Adult↗
Ten year trends in the dietary habits of Danish men and women. Cohort and cross-sectional data.
OBJECTIVE: To describe 10 year trends and individual changes in food habits of Danish men and women in relation to dietary recommendations using data from both a cohort and a repeated cross-sectional study, and to examine whether the two sampling methods give similar results. DESIGN: Baseline data were collected in 1982-1984 and respectively repeated measurements for cohort and cross-sectional changes in food habits. SETTING: The County of Copenhagen, Denmark. SUBJECTS: Men and women aged 30-70y in 1982-1984, 1986-1988 and 1992-1994. The trend analyses included 3785 subjects for cohort and 7316 for cross-sectional study, respectively. Longitudinal changes were studied among 2430 individuals with food data from all three examinations. METHODS: Food intakes were estimated using a short food frequency questionnaire. RESULTS: During the study period both men and women reported a decreased intake frequency of animal and vegetable fats, milk, eggs, meat products, white bread and potatoes, while they had increased intakes of low-fat margarine, fruit, raw vegetables, coarse breads, oatmeal, pasta, rice, cakes and candy. In both men and women the decrease in the consumption frequency of, white bread and potatoes, and the increase in pasta, and candy, were higher in the younger than in the older age group. In contrast, the increased consumption frequency of coarse breads, and oatmeal were most pronounced in the older age groups. For most foods the cohort and the repeated cross-sectional surveys gave similar results. CONCLUSIONS: From 1982 through 1994 the food habits of middle-aged Danish men and women changed in the direction of a more healthy diet as recommended by health authorities. With the limitation of a possible reporting bias both the cohort and repeated cross-sectional study designs may be used for monitoring changes in food intake.
Adult↗
Diet and mortality in a cohort of elderly people in a north European community.
BACKGROUND: In studies from Italy and Greece a Mediterranean dietary pattern predicts overall survival. Despite an increase in the movement of food around the world, there is still a wide spectrum of dietary patterns and the aim of the present study was to examine the association between a Mediterranean dietary pattern and mortality in a cohort of elderly people living in a North European Community. METHODS: Diet and nutritional status was studied among 202 men and women born 1914-1918 and living in a Danish Municipality (Roskilde) in 1988. They were followed for 6 years. RESULTS: A diet score, with seven dietary characteristics of the Mediterranean diet, was associated with a significant reduction in overall mortality. A one unit increase in the diet score predicted a 21% (95% confidence interval 2-36%) reduction in mortality. Subjects with high diet scores (> or = 4) had significantly higher plasma carotene levels than those with a low score and plasma carotene was negatively associated with mortality. CONCLUSION: A Mediterranean diet score predicts survival in a North European population. Plasma carotene may serve as an intermediate factor in this association.
Aged↗
Has risk associated with smoking increased? Results from the Copenhagen Center for Prospective Population Studies.
BACKGROUND: Two recent much cited publications have raised the concern that risk associated with cigarette smoking has so far been underestimated. In this study we wish to determine whether excess all-cause mortality associated with smoking has increased during the last 20-30 years in a study population representative of the general Danish population and whether any such changes relate to changes in smoking behaviour. METHODS: Pooled data from three prospective population studies conducted in Copenhagen with detailed information on smoking habits. A total of 31,194 subjects, 17,669 males and 13,525 females, initially examined between 1964 and 1992 with examinations repeated at intervals from 1-10 years, were followed until 1995 for all-cause mortality. Relative mortality risk in smokers versus never-smokers was calculated within periods of five calendar years and compared throughout the study period. RESULTS: Male smokers' exposure did not change during the study period whereas female smokers' exposure to tobacco increased in terms of age at smoking onset, quantity smoked and depth of inhalation. During follow-up 5744 males and 2900 females died. In males, death rate ratios (comparing continuous smokers with never-smokers) did not change in the study period. In females, ratios increased from 1964-1978 to 1979-1994 by a factor of 1.3 (95% confidence interval 1.0-1.8). CONCLUSIONS: In agreement with the observed changes in smoking habits, excess mortality in male smokers did not increase whereas excess mortality in female smokers increased slightly.
Adolescent↗
[Life style and prevention of heart disease in Denmark. Changes in knowledge and behavior of the population from 1982 to 1992].
Changes during the period 1982 to 1992 in lifestyle and knowledge of risk factors for ischaemic heart disease (IHD) in Danish adults were assessed by comparing questionnaire data collected in two independent cross-sectional studies. In 1982 the participation rate was 79% among 4807 randomly selected men and women aged 30, 40, 50 and 60 years. In 1992 it was 73% among 2226 randomly selected men and women of similar ages. From 1982 to 1992 the proportion of participants stating that exercise, eating a low-fat diet, avoiding overweight and not smoking reduces the risk of IHD increased. During the same period, the proportion of smokers of men who did not eat vegetables daily, and of men and women who had butter, fat or margarine daily decreased. The changes were seen predominantly among salaried employees and those with a vocational education and social differences were enhanced. The changes in knowledge and lifestyle reflect the topics or which the general educational effort has focussed and are in accordance with results from comparable studies in the USA. Apparently, however, only in the higher social classes is the acquired knowledge associated with change of lifestyle.
Adult↗
[Smoking cessation in general practice].
In May 1995 73% of a random sample of 1000 Danish general practitioners (GPs) participated in a survey by anonymously filling in a mailed questionnaire concerning their smoking counselling practice and attitudes to smoking prevention. Among the participating GPs, there were 65% who every week had contact with one or more patients, who wished to quit smoking. Earlier smoking cessation practices such as giving information about the health consequences of smoking were often used. However, few GPs' advice included helping patients set quit dates or making follow-up appointments and most GPs did not think these two techniques effective. More than 90% of GPs reported that they brought up the subject of smoking if their patient were pregnant or had a smoking-related disease. In order to improve smoking counselling in general practice it is suggested that Danish GPs are introduced to the newest recommended smoking cessation programmes.
Adult↗
[Smoking as social heritage. Children whose mothers are smokers are more likely to become smokers as adults].
Effective prevention of smoking depends on the identification of factors that determine smoking onset. We examined the influence of family factors during childhood (household income, parent education and smoking behaviour) on the subsequent risk of smoking in young adults. In 1979, 1300 children aged 6-18 years, whose parents were randomly selected for participation in the Copenhagen City Heart Study were invited to a health examination. Information about health and smoking behaviour was obtained from 73% of the children. A random sample of 579 of the children were invited to a follow-up examination 13 years later. Four hundred and eighty-six (84%) participated in the follow-up. The influence of household income, parent smoking behaviour and education on the child's risk of becoming a smoker in young adulthood was estimated. Household income and parent education did not significantly affect the risk of adult smoking. Maternal smoking during childhood increased the risk in comparison with the mother being a non-smoker (Adjusted Odds Ratio 1.95 (95% CI 1.07-3.58). Maternal smoking during childhood increases children's risk of becoming young adult smokers, independent of age and smoking behaviour in childhood, gender and social background. In Denmark 28% of smoking in young adults could be attributed to maternal smoking.
Adolescent↗
The validity of a short food frequency questionnaire and its ability to measure changes in food intake: a longitudinal study.
BACKGROUND: In studies of health behaviour exploring factors associated with differences and changes in eating patterns of populations, diet is often measured with short food frequency questionnaires (FFQ). This study examines the validity of a short FFQ by comparing frequencies of food intake from the FFQ to information on food intake obtained by a diet history interview. METHODS: Food intake was measured at two separate occasions in the same 329 individuals, first in 1987-1988 and 6 years later in 1993-1994. RESULTS: In 1987-1988 the Spearman correlation coefficients were around r = 0.50 for most foods, with white and dark ryebread and light bread as extremes on the one hand (r = 0.10, r = 0.23 and r = 0.27, respectively) and coarse bread, fruit and cakes as extremes on the other (r = 0.61, r = 0.60, r = 0.60, respectively). In general, the correlations were higher at the second data collection in 1993-1994. At both data collections, the mean food intake from the diet history interview increased with increasing frequency category, indicating that the questionnaire was able to identify levels of food intake correctly. In general, when individual changes in food intake were assessed during the study period, those who reported a less frequent intake by the FFQ in 1993-1994 compared with 1987-1988 also had a lower mean daily intake according to the diet history information. CONCLUSION: The short FFQ can quantify food intakes and, is also responsive to changes in food intake over time. Thus the short FFQ can be used to monitor changes in food patterns at a group level.
Adult↗
Trends in mortality, incidence and case fatality of ischaemic heart disease in Denmark, 1982-1992.
BACKGROUND: In Denmark, as in many other Western countries, a decline in mortality from ischaemic heart disease (IHD) has been observed. The present study assesses whether the decline in IHD mortality is due to a decrease in incidence and/or case-fatality, and whether parallel changes occurred in the various manifestations of IHD requiring hospitalization. METHODS: The National Patient Register of hospital discharges and the Causes-of-Death Register were linked and all cases of first admission for IHD including AMI and fatal first manifestations of IHD since 1977 in the entire Danish population were identified. Cases of AMI and IHD were considered as incident cases if no admission for these diagnoses had occurred during the preceding 5 years. Sex-specific, age-standardized annual mortality, incidence and case-fatality rates of AMI (ICD8 code 410), narrowly defined IHD (NIHD, ICD8 codes 410-4) and broadly defined IHD (BIHD, ICD8 codes 410-4, 427 and 795-6) were calculated for the period 1982-1992. RESULTS: During the entire period the age-standardized mortality of AMI, NIHD and BIHD decreased in both men and women. The incidence of AMI and NIHD decreased, while the incidence of BIHD remained constant. Case fatality of AMI decreased in both men and women, while case fatality of NIHD and BIHD decreased in men and in women aged 0-64 years only. CONCLUSION: The declining mortality from IHD in Denmark may be partly due to declining incidence as well as declining case fatality, but changes in disease manifestation or diagnostic drift may also contribute because more broadly defined diagnostic groups showed less or no decline in incidence.
Adolescent↗
Changing life expectancy in the 1980s: why was Denmark different from Sweden?
OBJECTIVE: To identify the contribution from specific causes of death to the changes in life expectancy at birth in Denmark relative to Sweden in different age groups during the 1980s and to compare the difference in life expectancy between the two countries in 1990. DESIGN: Mortality data from WHO mortality tapes grouped in smaller series of clinically meaningful categories were used to calculate the contribution of each of these categories at each 10 year age group to the difference in life expectancy at birth in each country between 1979 and 1990 and between the two countries. SETTING: Denmark and Sweden. RESULTS: Between 1979 and 1990 life expectancy increased in both Denmark and Sweden. However, the increase in Sweden was more than two years while that in Denmark was less than one year. In both countries a decrease in cardiovascular disease mortality contributed most to the increase in life expectancy in males as well as females. In both sexes the smaller increase in life expectancy in Denmark was a result of differences in mortality trends in cardiovascular diseases and respiratory and non-respiratory cancers. CONCLUSION: Over a short time two Nordic countries experienced remarkable but different changes in mortality. These findings suggest that mortality rates are sensitive to even minor differences in social and cultural factors across countries and over short time periods.
Adolescent↗
Determinants of smoking behaviour in random samples of Greenlandic and Danish women 20-39 years of age.
BACKGROUND: The prevalence of smoking among young women is of particular concern in most countries as it does not decline as in men. We studied smoking behaviour in Greenlandic and Danish women over a 2 year period to provide information on the social and behavioural determinants of smoking in women. METHODS: In 1986, samples of 800 women aged 20-39 years were drawn at random from Nuuk/Godthåb (Greenland) and Nykøbing Falster (Denmark). A total of 586 and 661 women were interviewed in Greenland and Denmark, respectively. In 1988, new random samples of 150 women were drawn from the same areas. Totally, 129 Greenlandic and 126 Danish women were included in this study. In 1987, a sample of 732 women aged 20-49 years from Copenhagen was randomly drawn from the computerized Central Population Register. Of these, 623 women completed a questionnaire. RESULTS: Smoking behaviour was almost the same among women in Nykøbing Falster and Copenhagen (54% smoked) while a significantly higher percentage of smokers was observed among women in Greenland (88% smoked). Heavy smoking was most prevalent among Danish women and associated with early debut of smoking. Among Danish women, smoking was associated with use of oral contraceptives, early age at first intercourse, and multiple sexual partners. In Greenland, smoking was associated with early sexual debut and multiple sexual partners. In an extended analysis on a subgroup of Danish women, smoking was also associated with low education and infrequent intake of vegetables. The study showed no development in smoking behaviour in any age group over the two year period between the two studies, neither in Nykøbing Falster nor in Nuuk. CONCLUSION: The high prevalence of moderate smoking among women in Greenland suggests that broad anti-smoking initiatives are urgently needed. The high prevalence of heavy smoking and a social gradient among Danish women may indicate that a strategy focusing on restrictions of smoking may be more relevant than merely continuing a pure anti-smoking information strategy.
Adult↗
[Gynecologic examination--up to date?].
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Attitude to Health↗
Smoking behaviour in Danish adults from 1982 to 1992.
The present study describes changes during the period 1982 to 1992 in smoking prevalence, knowledge of the health consequences of smoking and analysis factors predicting quitting smoking among Danish adults. Data were collected by questionnaire in two independent cross-sectional studies in the western part of the County of Copenhagen. In 1982 the participation rate was 79% among 4807 randomly selected men and women aged 30, 40, 50 and 60 years. In 1992 it was 73% among 2226 randomly selected men and women of similar ages. Five years later 2987 of the participants from the study in 1982 were re-examined. From 1982 to 1992 the proportion of participants stating that smoking increases the risk of bronchitis, asthma, lung cancer, cancer of mouth and throat, thrombosis and hypertension increased. Knowledge was independent of smoking status. In 1982 men and women with a vocational education were more knowledgeable than those who were uneducated. This difference equalized in men during the study period. During the same period, the prevalence of smoking decreased from 62% to 52% in men and from 54% to 49% in women, but the declining prevalence was found in those with a vocational education only and an existing educational difference in smoking behaviours was enhanced. The decline in smoking in Denmark in the last decade has been associated with a narrowed gender difference and widened social difference. Knowledge of the health consequences of smoking has increased independently of these changes in smoking behaviour.
Adult↗
Maternal smoking during childhood and increased risk of smoking in young adulthood.
BACKGROUND: Effective prevention of smoking depends on the identification of factors that determine smoking onset. We examined the influence of family factors during childhood (household income, parents' education and smoking behaviour) on the subsequent risk of smoking in young adults. METHODS: In 1979, 1300 children aged 6-18 years, whose parents were randomly selected for participation in the Copenhagen City Heart Study were invited to a health examination. Information about health and smoking behaviour was obtained from 73% of the children. A random sample of 579 of the children were invited to a follow-up examination 13 years later. In all, 486 (84%) participated in the follow-up. RESULTS: The influence of household income, parents' smoking behaviour and education on the child's risk of becoming a smoker in young adulthood was estimated. Household income and parents' education did not significantly affect the risk of adult smoking. Maternal smoking during childhood increased the risk in comparison with the mother being a non-smoker (adjusted odds ratio = 1.95; 95% confidence interval: 1.07-3.58). CONCLUSION: Maternal smoking during childhood increases children's risk of becoming young adult smokers, independent of age and smoking behaviour in childhood, gender and social background. In Denmark 28% of smoking in young adults could be attributed to maternal smoking.
Adolescent↗
Social network and lifestyle in Danish adults.
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Asthma↗
[Down with abortion--live with double Danish protection].
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Abortion, Legal↗