Showing papers by "Calle Bengtsson published in 1994"
Journal Article•
TL;DR: Familial predisposition did not relate to most aspects of current medical risk, however, later-onset obesity tended to be associated with greater cardiovascular risk, while prior weight loss was predictive of an improved risk factor profile.
Abstract: The natural history of obesity was examined in a nation-wide sample of 1,084 obese men and 1,367 obese women aged 37-59 years who were recruited into a registry of potential subjects for an intervention trial. The registry and intervention studies are jointly referred to as SOS ('Swedish Obese Subjects'). In the registry, the mean body mass index was 37.7 kg/m2 in men and 40.9 kg/m2 in women. Descriptive information on subjects' weight histories and the relative weights of their biological parents was collected by means of a self-administered questionnaire. At a physical examination shortly thereafter, weights, heights and selected cardiovascular risk factors were measured in the fasting state. Virtually all subjects reported weight loss attempts in the past, men and women reported having gained weight during adulthood at a considerably higher rate than that observed in population-based samples. Significant correlations were observed between relative weights of obese males and both of their biological parents, but not between obese women and either of their parents. Indices of medical risk were then examined in relation to individual weight histories. Familial predisposition did not relate to most aspects of current medical risk. However, later-onset obesity tended to be associated with greater cardiovascular risk, while prior weight loss was predictive of an improved risk factor profile. These latter associations were not dependent on a subject's current degree of obesity and were particularly consistent with respect to fasting insulin level.
33 citations
TL;DR: An intervention study of men living in the Community of Habo in southwestern Sweden has been carried out, and a health profile was worked out comprising 11 different potential risk factors for coronary heart disease.
Abstract: An intervention study of men living in the Community of Habo in southwestern Sweden has been carried out. All men aged 33-42 and living in the community were invited. Altogether 652 men participated. The study included a questionnaire, an interview made by a nurse, anthropometric measurements, blood pressure measurements, measurements of respiratory function and work performance capacity, and blood sampling for chemical analyses. The participation rate was high, 86.1%, after one mail invitation even considering the fact that two reminders were sent. Most of the non-participants had recently been in contact with the health care organisation, either because they were high-consumers of health care, or because they had attended a health examination at work. A health profile was worked out comprising 11 different potential risk factors for coronary heart disease. This health profile turned out to be a useful educational tool when discussing the results of the examination with the participants. Risk points were given according to certain predetermined criteria. The distribution of risk factors was similar in the different ages studied. Most of the participants had at least one risk factor as defined, but many of them had two or more risk factors.
31 citations
TL;DR: The results indicate that abdominal distribution of body fat in women independently of general obesity is closely associated with metabolic risk factors including elevated blood pressure, a metabolic syndrome with increased risk for cardiovascular disease and non-insulin dependent diabetes mellitus.
Abstract: Abdominal obesity is closely associated with the presence of metabolic risk factors and elevated blood pressure in selected materials. This has, however, never been analyzed quantitatively in a non-selected cohort. Therefore, in a population-based study of 1462 Swedish women, four selected risk factors for non-insulin dependent diabetes mellitus (NIDDM) and cardiovascular disease (CVD), serum triglycerides, blood glucose and systolic blood pressure and also serum insulin in a subsample, were examined in relation to regional and overall obesity. This was performed by subdividing the age adjusted sample into quintiles of waist to hip circumference ratio (WHR) or body mass index (BMI) as indicators of abdominal distribution of body fat and overall obesity, respectively. The risk factors serum triglycerides, blood glucose, blood pressure and serum insulin were defined as being elevated when the value of the risk factor was higher than the mean plus one or two standard deviations of the total age-adjusted cohort. The percentage of women with elevated risk factors according to this definition was then calculated in each of these quintiles. Having a risk factor which was elevated according to the definition was significantly correlated to WHR and BMI (p<0.0001) independent of age. The presence of one or several of these elevated risk factors was clearly higher than expected in the fifth quintile of WHR, and to a lesser extent in the fifth quintile of BMI while this was not the case in the lower quintiles of WHR and BMI. When studying the combination of the WHR and BMI, the presence of risk factors higher than the mean plus two standard deviations increased gradually with WHR in all five quintiles of BMI. A significant association was observed between WHR and presence of risk factors independent of BMI (p<0.0001) but BMI did not remain significantly correlated to presence of risk factors when controlling for WHR (p=0.09). These results indicate that abdominal distribution of body fat in women independently of general obesity is closely associated with metabolic risk factors including elevated blood pressure, a metabolic syndrome with increased risk for cardiovascular disease and non-insulin dependent diabetes mellitus.
28 citations
TL;DR: It may be concluded that the accuracy of the population study registration as well as that of the Cancer Registry at that time were very high, which enables us to draw relatively safe conclusions from the authors' own material when testing for risk factors.
Abstract: A longitudinal study of altogether 1462 women aged 38 to 60 years started in Gothenburg, Sweden in 1968-69. Based on information from the population study and from the Swedish Cancer Registry 35 women had a history of malignant disease when initially examined in 1968-69. During a 12-year follow-up period a total of 79 malignant tumours developed in 73 women. A comparison was made between the 1988 Cancer Registry listing and the observations made in the population study. All but one out of 103 cases (99%) were registered in the Cancer Registry and all but one (99%) in the population study. It may be concluded that the accuracy of the population study registration as well as that of the Cancer Registry at that time were very high. This enables us to draw relatively safe conclusions from our own material when testing for risk factors.
26 citations
25 citations
TL;DR: In self-help groups layman support is the most effective kind of support, but the results indicate that health professionals also have an important role to play.
Abstract: Experiences of social support among participants in self-help groups related to coronary heart disease
23 citations
Journal Article•
22 citations
TL;DR: The high mortality emphasizes the importance of an early diagnosis and the general practitioners are very important in the diagnostic process and the role of the general practitioner.
Abstract: Objective — To study the incidence of pulmonary cancer in a community with special reference to the diagnostic process and the role of the general practitioner.Design — Study of the records of all patients within the community with pulmonary cancer reported to the Swedish Cancer Registry during the years 1980–1984.Setting — The community of Kungsbacka in southwestern Sweden with about 48,000 inhabitants.Participants — 40 subjects with pulmonary cancer.Outcome measures — Incidence, main symptoms, level of care, doctor delay, survival rate.Results — The incidence was 16 per 100 000 per year. Most patients first visited a general practitioner. Most common initial symptom was cough. Mean doctor delay was 12.5 weeks. The five-year mortality rate was 95%.Conclusion — The high mortality emphasizes the importance of an early diagnosis. The general practitioners are very important in the diagnostic process.
12 citations
TL;DR: The referrals from primary health care to different medical specialists worked adequately, but it was concluded that it may be further improved.
Abstract: Objective — To study what proportion of clinical visits to a general practitioner working at a Swedish health centre leads to a referral to a specialist, the adequacy of the reason for the referral, the quality of the referral notes, and the quality of the answers by the specialists to whom the patients had been referred.Design -A referee committee representing the different medical specialists and the general practitioners studied all referral notes dealing with internal medicine, surgery, orthopaedics, and otorhinolaryngology during a defined period from two health centres as to adequacy of the reason for referral, the quality of the referral notes, and the quality of the answers to the referrals.Setting and participants — Altogether 188 consecutive referral notes and 171 answers to these referrals from two Swedish health centres were evaluated.Results — Of the visits to a general practitioner, 7–8% resulted in a referral to a hospital specialist, and 90% of these were answered by letter. The referee co...
8 citations
TL;DR: The combination of overweight and impaired glucose tolerance is already common at a rather young age in men and is often combined with impairment of arterial blood pressure and serum lipids, indicating that it is urgent to start preventive measures early in life.
Abstract: Objective – To study the prevalence of family history of diabetes, overweight, and glucose intolerance in a defined general population, and the associations between these variables and others involved in the so-called metabolic syndrome (blood pressure, obesity, serum lipids).Design – An oral glucose tolerance test (OGTT) was done on all participants in a population study who reported a family history of diabetes or had a body mass index (BMI) ≥27.Setting and participants – A population study of men aged 33–42 was carried out at Habo in southwestern Sweden (participation rate 86.1%). An OGTT was done on 170 men who fulfilled the criteria stated above.Results – Overweight was a risk factor for impaired glucose tolerance and was more strongly associated with this state than was a family history of diabetes. Glucose intolerance was also associated with increased blood glucose concentration during the OGTT and with other metabolic disturbances such as increased serum lipids, increased blood pressure, and phys...
5 citations
TL;DR: There were significant correlations between the life-style factors (physical inactivity, smoking, alcohol intake, self-experienced mental stress) and probable biological markers of life- Style factors such as anthropometric data, blood pressure and serum lipids and of the biological markers studied, the waist to hip circumference ratio was most strongly associated with life- style factors.
Abstract: A population study was carried out in the community of Habo in southwestern Sweden, to which all men living in the community aged 33–42 years were invited. Altogether 652 participated, the participation rate being 86.1%. Special reference was given to potential risk factors for coronary heart disease. There were significant correlations between the life-style factors (physical inactivity, smoking, alcohol intake, self-experienced mental stress) and probable biological markers of life-style factors such as anthropometric data, blood pressure and serum lipids. Physical inactivity was the life-style factor which was most strongly associated with anthropometric measurements and to a lower degree with serum lipid concentrations and arterial blood pressure. Of the biological markers studied, the waist to hip circumference ratio was most strongly associated with life-style factors. The observations further emphasize the need for a murtifactorial view on risk factors.
TL;DR: The pedagogics of the intervention program described in this paper are shown to be of value when addressed to middle-aged women with risk factors for cardiovascular disease.
Abstract: A primary health care community intervention program was offered to the middle-aged female population in a Swedish community aiming at reducing risk factors for cardiovascular disease. Around 30% of women with risk factors took active part in an intervention course program inspiring to lifestyle changes. Analysis showed few background differences between the group of women who participated and who did not participate in the intervention program. Most women with risk factors benefited from lifestyle changes, those with multiple risk factors to as large an extent as those with few risk factors for cardiovascular disease. Also women with risk factors who did not take part in the intervention course program changed their lifestyle habits to some extent.The pedagogics of the intervention program described in this paper are shown to be of value when addressed to middle-aged women with risk factors for cardiovascular disease.