The global increase in obesity parallels the increase in PCa incidence, but the role of excess weight and weight change throughout adult life and their implications for PCa risk and prognosis are still under debate. We studied whether pre-diagnostic body mass index (BMI) and weight change is linked to PCa risk and prognosis. A total of 16 879 healthy men were included to study PCa risk and prognosis in the Prostate Cancer Study throughout life (PROCA-life), based on those who participated in the prospective cohort Tromsø Study (1994-2016). Pre-diagnostic BMI and weight change (relative weight change in percent of baseline weight between two waves of the Tromsø study) during follow-up were measured. Detailed information from histopathological and clinical medical records for PCa cases were obtained. Cox proportional hazard and logistic regression models were used to estimate hazard ratios (HRs) and odds ratios (ORs) for the associations between pre-diagnostic measurements of BMI and weight change during follow-up, and PCa risk and overall and PCa specific mortality. Regression models were used to evaluate incidence rate ratios (IRR). Overall, the participants had a median age at study entry of 44 years, 46.0% were overweight and 13.8% were obese. In total 904 men developed PCa during follow-up, with a median age at diagnosis of 68 years. The incidence rates for PCa increased from 1995 to 2019 (overall IRR 2.27, 95% CI 1.82-2.83). We observed that men with a pre-diagnostic BMI ≥ 30kg/m2 at study entry, and who had a weight gain > 5% during follow-up, had a three-fold increased risk for incident PCa (HR 2.94, 95% CI 1.36-6.36). Overweight was associated with lower Gleason grade (OR 0.64, 95% CI 0.43-0.96) and lower Prostate Specific Antigen (OR 0.69, 95% CI 0.48-0.99). Overall, 311 PCa cases died, of whom 154 was PCa related deaths (17%). Pre-diagnostic obesity was associated with PCa-specific death (HR 1.73, 95% CI 1.03-2.91). Our observation that weight gain in adult pre-diagnostic obese men was associated with increased risk for incident PCa, and that pre-diagnostic obesity increased the risk of PCa-mortality, support the importance to combat excess weight gain in the general population.

Abstract Funding Acknowledgements Type of funding sources: None. Background Although the use of guidelines in clinical practice is emphasised, large multi-center studies of patients with cardiovascular disease have shown secondary prevention to be suboptimal, which increase the risk of recurrent events. Purpose To examine ESC guideline treatment target achievement after myocardial infarction for cardiovascular risk factors, medication use and a broad range of lifestyle factors in women and men from a Norwegian general population. Methods In a population-based study conducted 2015-2016 (65% attendance), 637 participants 40-95 years (23% women, 70% ≥65 years) had validated myocardial infarction. Cross-sectionally, we investigated target achievement for blood pressure (<140/90 mmHg, <130/80 mmHg if diabetes), LDL cholesterol (<1.8 mmol/L), HbA1c (<7.0% if diabetes), weight (body mass index (BMI) <25 kg/m2, waist circumference (women <80 cm, men <94 cm)), smoking (non-smoking), physical activity (self-reported >sedentary, accelerometer-measured moderate-to-vigorous ≥150 min/week), diet (intake of fruits ≥200 g/day, vegetables ≥200 g/day, fish ≥200 g/week, saturated fat <10E%, fiber ≥30g/day, and alcohol (women ≤10 g/day, men ≤20 g/day)), and medication use (antihypertensives, lipid-lowering drugs, antithrombotics, antidiabetics) using regression models. Results Proportion of target achievement was for blood pressure 55.8%, LDL cholesterol 9.3%, HbA1c 42.7%, BMI 19.5%, waist circumference 15.6%, non-smoking 86.2%, self-reported physical activity 79.5%, objectively measured physical activity 9.1%, intake of fruits 66.7%, vegetables 38.4%, fish 96.8%, saturated fat 25.4%, fiber 29.5%, and alcohol 78.5%, use of antidiabetics 84.3%, lipid-lowering drugs 86.8%, antihypertensives 78.5% and antithrombotics 77.9%. In total, 0.8% achieved all cardiovascular risk factor targets (blood pressure, LDL cholesterol, BMI and waist circumference combined). Compared to men, a lower proportion of women achieved the target for waist circumference (6.9% vs 18.1%, p = 0.002). Compared to participants 65 years or older, a higher proportion of those 40-64 years achieved the target for blood pressure (71.2% vs 49.0%, p < 0.001), and a lower proportion achieved the target for BMI (15.3 vs 21.4, p = 0.007). Conclusion Secondary prevention after myocardial infarction was suboptimal in both women and men. A negligible proportion achieved the treatment target for all risk factors. Improvement in follow-up care after myocardial infarction is needed.

Abstract Backgound: Obesity and related metabolic imbalances, including increased activity of free fatty acids, may promote tumor growth and metastasis. Fatty acids are mainly stored as triacylglycerols. Yet, the role of serum-triglycerides on breast cancer prognosis is still undefined. Methods: A population based survival study among 575 breast cancer patients identified within the Tromsø study during 1979-2008, was conducted. Pre-diagnostic serum triglycerides, high density lipoprotein-cholesterol, total cholesterol, height and weight were measured. Histopathological and clinical data were obtained from medical records, and hormone receptor, HER2 status, and Ki-67 were re-analyzed on tissue microarray blocks. Multivariate Cox proportional Hazard regression models were used to study the associations between patient characteristics including s-triglycerides, and breast cancer survival. Results: Among 575 women with invasive breast cancer (stage 1-3), a total of 87 women were diagnosed with triple negative breast cancer (TNBC). Patients diagnosed with TNBC, compared to non-TNBC, were likely to be younger at diagnosis (55.3 vs 57.9 years, p=0.061), they had larger tumors (29.7 mm vs 22.5 mm, p=0.001), and higher Ki-67 (31.1% vs 15.9%, p<0.001). After a mean follow-up of 8.4 years, TNBC patients with above median levels of s-triglycerides (> 0.98mmol/L) compared to TNBC patients with below median levels of s-triglycerides (≤ 0.98mmol/L) had 3.0 times higher risk for breast cancer recurrence or breast cancer specific death (HR 3.02, 95% CI 1.21-7.55), and 3.4 times higher overall mortality risk (HR 3.41, 95% CI 1.38-8.45). Among the TNBC patients, women with above median s-triglycerides had 15% lower 5-year disease-free survival (76% vs 91%) and 18% lower 5-year overall survival (74% vs 92%) compared to women with below median s-triglycerides. Conclusions: Our results strongly support s-triglycerides as an important biomarker for breast cancer outcomes among triple negative breast cancer patients. Table 1: Multivariable adjusted Hazard Ratios (HRs) for incidence breast cancer recurrence or breast cancer specific death, and incidence overall mortality by pre-diagnostic serum-triglycerides among non-triple negative breast cancer (TNBC) and TNBC patients Non-TNBC, n=488 TNBC, n=87 Recurrence or breast cancer specific death (n=90)Overall mortality (n=104) Recurrence or breast cancer specific death (n=24)Overall mortality (n=33) nHR (95% CI)HR (95% CI)nHR (95% CI)HR (95% CI)s-Triglycerides Median ≤ 0.98 mmol/l2571.001.00431.001.00> 0.98 mmol/l2310.87 (0.56-1.35)1.06 (0.70-1.62)443.02 (1.21-7.55)3.41 (1.38-8.45) Tertiles ≤ 0.82 mmol/l1731.001.00261.001.000.83 – 1.22 mmol/l1660.74 (0.44-1.23)0.81 (0.49-1.36)311.37 (0.38-4.98)0.98 (0.31-3.08)≥ 1.23 mmol/l1490.88 (0.50-1.54)1.17 (0.66-1.96)306.63 (1.64-19.3)3.87 (1.52-12.0)p-trend 0.4950.357 0.0050.007 Multivariate Cox proportional Hazard regression model. Adjusted for BMI and age at attendance (continuous), age at diagnosis (continuous), breast cancer stage at diagnosis (categorical), and current smoking (categorical). Abbreviation: CI, confidence interval; n, number of cases; TNBC, triple negative breast cancer Citation Format: Lofterød T, Mortensen ES, Nalwoga H, Wilsgaard T, Frydenberg H, Risberg T, Eggen AE, McTiernan A, Aziz S, Wist EA, Reitan JB, Akslen LA, Thune I. Serum-triglycerides among triple negative breast cancer patients as a biomarker of poor outcome [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-12-02.

Background: Obesity is both an independent risk factor, and a prognostic factor of postmenopausal breast cancer. In contrast, the association between premenopausal obesity/leanness, and subsequent weight gain and breast cancer outcomes, is still unclear. Furthermore, the association between adult weight gain, weight and age at diagnosis, and tumor characteristics is less studied. Methods: During 1979-2007, a total of 18 990 women, aged 18-87 years, answered questionnaires and underwent clinical examination at a total of five repeated health surveys (attendance rate 68-82%). Height and weight were measured at each survey, and before surgery, among those women diagnosed with breast cancer during follow-up. Careful review of the respective medical records, including histopathological workup, was performed. Multivariate Cox Proportional Hazard models were used to study the importance of Body Mass Index (BMI kg/m 2 ) and weight change on breast cancer risk, and to evaluate variation in breast tumor characteristics. Results: During a median follow-up of 23.3 years, 579 women with invasive breast cancer were identified, and the cases were histologically verified. These breast cancer cases had a mean age at diagnosis of 56.3 years, and mean BMI at diagnosis of 25.3 kg/m 2 . Most (67 %) of the breast cancer patients had estrogen receptor (ER) positive tumors, 48 % had progesterone receptor (PgR) positive tumors, and 41 % had lymph node positive disease. We divided all participating women in three groups of weight change ( 15 kg). When we compared women with less than 5 kg weight gain, to women with weight gain 5-15 kg, and to women with weight gain above u003e15kg, we observed a RR of 1.43 (95% CI 1.07-1.90) and a RR of 1.86 (95% CI 1.30-2.68), respectively, for postmenopausal breast cancer. We divided women by quartiles of BMI (kg/m 2 ) at entry, and observed that women in the lowest quartile of BMI (≤ 21.45 kg/m 2 ), who had a subsequent weight gain u003e15 kg, had a RR of 2.40 (95% CI 1.07-5.38) for postmenopausal breast cancer compared to women with the same BMI at entry, but who remained stabile in weight. We observed a 6 year difference in age at diagnosis for women diagnosed with breast cancer, who at study entry were in the same BMI group ( 2 ), but subsequently either experienced a large weight gain (u003e15 kg), or remained stabile in weight (59.5 years vs. 64.4 years, p=0.007). Furthermore, we observed a 15 year difference in age at diagnosis for women diagnosed with breast cancer, who at study entry were in the same BMI group (≥ 25kg m 2 ), but subsequently either experienced a large weight gain (u003e 15 kg), or remained stabile in weight (60.3 years vs. 74.9 years, p=0.007). Conclusion: Avoiding large weight gain during pre- and postmenopausal years may both protect against, and delay onset of postmenopausal breast cancer. Our findings support the importance of weight gain as a modifiable lifestyle factor for early onset of breast cancer. Citation Format: Lofterod T, Frydenberg H, Flote VG, Risberg T, Eggen AE, McTiernan A, Mortensen E, Wist EA, Akslen LA, Reitan JB, Wilsgaard T, Thune I. Weight gain during pre- and postmenopausal years results in earlier onset of breast cancer. The Tromso cohort study. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-07-06.

Abstract Background: Obesity is both an independent risk factor, and a prognostic factor of postmenopausal breast cancer. In contrast, the association between premenopausal obesity/leanness, and subsequent weight gain and breast cancer outcomes, is still unclear. Furthermore, the association between adult weight gain, weight and age at diagnosis, and tumor characteristics is less studied. Methods: During 1979-2007, a total of 18 990 women, aged 18-87 years, answered questionnaires and underwent clinical examination at a total of five repeated health surveys (attendance rate 68-82%). Height and weight were measured at each survey, and before surgery, among those women diagnosed with breast cancer during follow-up. Careful review of the respective medical records, including histopathological workup, was performed. Multivariate Cox Proportional Hazard models were used to study the importance of Body Mass Index (BMI kg/m2) and weight change on breast cancer risk, and to evaluate variation in breast tumor characteristics. Results: During a median follow-up of 23.3 years, 579 women with invasive breast cancer were identified, and the cases were histologically verified. These breast cancer cases had a mean age at diagnosis of 56.3 years, and mean BMI at diagnosis of 25.3 kg/m2. Most (67 %) of the breast cancer patients had estrogen receptor (ER) positive tumors, 48 % had progesterone receptor (PgR) positive tumors, and 41 % had lymph node positive disease. We divided all participating women in three groups of weight change (< 5kg, 5-15 kg, >15 kg). When we compared women with less than 5 kg weight gain, to women with weight gain 5-15 kg, and to women with weight gain above >15kg, we observed a RR of 1.43 (95% CI 1.07-1.90) and a RR of 1.86 (95% CI 1.30-2.68), respectively, for postmenopausal breast cancer. We divided women by quartiles of BMI (kg/m2) at entry, and observed that women in the lowest quartile of BMI (≤ 21.45 kg/m2), who had a subsequent weight gain >15 kg, had a RR of 2.40 (95% CI 1.07-5.38) for postmenopausal breast cancer compared to women with the same BMI at entry, but who remained stabile in weight. We observed a 6 year difference in age at diagnosis for women diagnosed with breast cancer, who at study entry were in the same BMI group (< 25kg/m2), but subsequently either experienced a large weight gain (>15 kg), or remained stabile in weight (59.5 years vs. 64.4 years, p=0.007). Furthermore, we observed a 15 year difference in age at diagnosis for women diagnosed with breast cancer, who at study entry were in the same BMI group (≥ 25kg m2), but subsequently either experienced a large weight gain (> 15 kg), or remained stabile in weight (60.3 years vs. 74.9 years, p=0.007). Conclusion: Avoiding large weight gain during pre- and postmenopausal years may both protect against, and delay onset of postmenopausal breast cancer. Our findings support the importance of weight gain as a modifiable lifestyle factor for early onset of breast cancer. Citation Format: Lofterød T, Frydenberg H, Flote VG, Risberg T, Eggen AE, McTiernan A, Mortensen E, Wist EA, Akslen LA, Reitan JB, Wilsgaard T, Thune I. Weight gain during pre- and postmenopausal years results in earlier onset of breast cancer. The Tromsø cohort study. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-07-06.

Inflammation may initiate and promote breast cancer development, and be associated with elevated circulating levels of inflammation markers. A total of eight 130 initially healthy women, participated in the population-based Tromsø study (1994–2008). Pre-diagnostic high-sensitivity C-reactive protein (hs-CRP) was assessed. During 14.6 years of follow-up, a total of 192 women developed invasive breast cancer. These cases were followed for additional 7.2 years. Detailed medical records were obtained. We observed an overall positive dose–response relationship between pre-diagnostic hs-CRP and breast cancer risk (hazard ratio (HR) = 1.06, 95 % CI 1.01–1.11). Postmenopausal women with above median levels of hs-CRP (>1.2 mg/l) had a 1.42 (95 % CI 1.01–2.00) higher breast cancer risk compared to postmenopausal women with hs-CRP below median. Postmenopausal women, who were hormone replacement therapy non-users, and were in the middle tertile (0.8–1.9 mg/l), or highest tertile of hs-CRP (>1.9 mg/l), had a 2.31 (95 % CI 1.31–4.03) and 2.08 (95 % CI 1.16–3.76) higher breast cancer risk, respectively, compared with women in the lowest tertile. For each unit increase in pre-diagnostic hs-CRP levels (mg/l), we observed an 18 % increase in disease-free interval (95 % CI 0.70–0.97), and a 22 % reduction in overall mortality (95 % CI 0.62–0.98). Our study supports a positive association between pre-diagnostic hs-CRP and breast cancer risk. In contrast, increased pre-diagnostic hs-CRP was associated with improved overall mortality, but our findings are based on a small sample size, and should be interpreted with caution.

Department of Dermatology, Neuro and Orthopaedic Clinic, University Hospital of North Norway, Tromsø, Norway Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway Department of Rheumatology, Dermatology and Infectious Diseases, The Olafia Clinic, Oslo University Hospital, Oslo, Norway Institute of Clinical Medicine, University of Oslo, Oslo, Norway Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA Department of Public Health, Division of Biostatistics and Epidemiology, Weill Cornell Medical College, NY, NY, USA

Background Questions remain concerning to what extent age and sex may modify the suggested association between psoriasis and the metabolic syndrome in the general population.Objectives To investigate the association between psoriasis and the metabolic syndrome within a large population-based cohort by age and sex.Methods A cross-sectional study including 10 521 participants aged 30-79 years from the Tromso Study cohort was performed; 1137 participants reported lifetime psoriasis of a mainly mild character. The new harmonized definition of metabolic syndrome was used in the multivariable logistic regression analysis.Results There was a uniformly higher prevalence of metabolic syndrome in men and women with psoriasis compared with those without across all age groups. In women, psoriasis was associated with a 3.8-times higher odds of metabolic syndrome at age 30 years (95% confidence interval 1.5-9.7), with a decreasing odds ratio with increasing age. In men, psoriasis was associated with a stable 1.35-times higher odds of metabolic syndrome (95% confidence interval 1.1-1.6) at all ages. Abdominal obesity was the most frequent metabolic syndrome component in women in this study, and there was indication of a dose-response relationship between psoriasis severity, indicated through treatment, and having a high waistline in women.Conclusions This study suggests age and sex variations in the risk of metabolic syndrome among individuals with psoriasis. Given the high prevalence of psoriasis and the significantly elevated burden of metabolic syndrome in this patient group, there may be a benefit from targeted screening of metabolic syndrome among individuals with psoriasis regardless of age and disease severity.

Objective: To investigate changes in age-specific mean systolic (SBP) and diastolic blood (DBP) pressures in women and men over a 28 year-period. Design and Methods: Subjects were men and women born between 1920 and 1970 who participated in a large population-based study with five repeated surveys conducted between 1979 and 2008. Altogether 35,675 adults (51 % women) aged 20–89 years participated from one and up till five times. Blood pressure was measured twice with an ERCA device (first survey) or three times with a Dinamap automatic device (four last surveys) after 2 min rest in sitting position. Mean of reading 2 and 3 was used in the analyses, with adjustment for systematic difference between ERCA and Dinamap. Results: A secular decrease in mean SBP from 1979 to 2008 was observed in all age groups. The decrease in age group 40–44 years was 5.2 mmHg in men and 11.8 mmHg in women. Similar trends were observed for DBP. Mean life-time SBP increased by age in subjects born 1925–1954 in both genders. By contrast, in the youngest birth cohorts a decrease or flattening of the curve was observed. In men born 1935–39, mean SBP at age 42 increased from 132.8 to 143.5 at age 70. In men born 1960–64, mean SBP at age 22 decreased from 131.2 to 130.1 after 22 years. In women, mean SBP in the two corresponding age cohorts were 130.1 to 151.9 and 119.9 to 119.1. In men, there was a curvilinear relationship between mean DBP and age, peaking at 50–55 years. In women, the increase in mean DBP was lower, with a flattening of the curve at approximately 50 years. Conclusion: A secular decrease in SBP was observed in all age groups, most pronounced in women. Life-time SBP increased by age in the oldest birth cohorts, whereas no change or decrease was observed in those born 1955–1969.

AIMS:To study the implications of European guidelines on the use of antihypertensives and/or lipid-lowering drugs (LLDs) for primary prevention in a Norwegian population.METHODS AND RESULTS:The Tromsø study is a population-based study in the municipality Tromsø, Norway (from 1974 to till now). This analysis includes 45-79-year-old participants in 2001 (n = 6362, attendance rate 86%). From the age of 60 years in men and 70 years in women, almost all participants were defined as high-risk individuals according to the European guidelines, with established cardiovascular disease, diabetes, or a 10-year risk score of > or =5%. In the primary prevention subgroup of the 45-64-year-olds, recommended antihypertensive and/or LLD use would be higher in men only, 42% compared with 12% on current medication. Among the 65-79-year-olds, >90% would be eligible for antihypertensives and/or LLDs in both sexes when compared with current treatment rates of <30%. In total, 40% of all participants aged 45-79 would be candidates for primary prevention, compared with 15% on current medication.CONCLUSION:The implementation of the European guidelines could imply a doubling of the numbers of Norwegian adults on cardiovascular medication for primary prevention. Contributors to the increase would be more frequent drug use in men and elderly people, particularly for LLD use.

This study investigated the relationship between self reported body weight and health perceptions and choice of seafood in a region with a traditionally high-level of fish consumption. A random sample of women aged 45–69 years who live in northern Norway answered a self-administrated questionnaire about eating habits, socioeconomic factors and questions related to health sent to them by mail; 7556 women answered the questionnaire (56.1% response rate) which was analyzed by logistic regression methods in which odds ratios (OR) were calculated. The mean frequency of consumption of seafood was 15 times a month. Some 46% of the respondents were overweight, 77% agreed that food is important for health and 55% had a desire to reduce weight. Overweight women consumed less lean fish than normal weight women (OR=0.8). Fish consumption was not associated with the desire to reduce weight. Fat and lean fish, but not processed fish, consumption are associated with the perception that food is important for health. A generally healthy food consumption pattern was strongly associated with weekly fish consumption, with normal weight and with the desire to reduce weight. Very high family income was associated with higher fat fish consumption (OR=1.9) normal body weight and for the desire to reduce weight (OR=2.1). High fish consumption in childhood and the belief that food is important for health were strongly associated with high fish consumption (OR=2.1 and 1.4 respectively for lean fish). Kids <7 years in the household are associated with processed fish consumption (OR=2.9) but not with the belief that food is important for health, that association is made by teenagers in the household (OR=1.4). Education is associated with high fat fish consumption, while increasing age is strong associated with high lean fish consumption (OR=1.88 for >60 years compared with 45–49 years). It is concluded that the desire to reduce weight does not influence fish consumption, but overweight women consume less lean fish than women of normal weight. Normal body weight and the desire to reduce overweight are associated with a broader healthy lifestyle pattern, in which seafood has a role in the diet. Higher fish consumption is associated with increasing consumers’ belief and behavior according to food's importance to health, high fish consumption in childhood and a higher level of education and income.

Main research question: the aim of the study was to investigate how perception about diet and health, eating habits and socioeconomic pattern influence choice of seafood. Materials and methods: a randomly drawn sample of Norwegian women aged 45–69 years answered a self-administrated mail questionnaire about eating habits, socioeconomic status, and questions related to health. There were 9407 women answered the questionnaire (response rate 52.5%). Findings: the mean level of seafood consumption was 2.7 times a week. Seafood consumption increased with (1) increasing belief in the idea that diet is important for health (2) using medicine for cardiovascular disease (3) other healthy eating habits (4) increasing age, (5) increasing household size, (6) decreasing family income, and (7) having residence in coastal areas. The growing consumption of fat fish is greater in central eastern Norway, while lean fish consumption is related to traditional food consumption. Processed fish consumption is related to consumption of other fast food. Conclusions and implications. seafood consumption is strongly related to consumption of three food groups: healthy food, fast food, and traditional food. The marginal benefit is high for health information and the marketing of seafood as healthy food, which fits into the current food lifestyle of consumption in all three food segments. Marketing implications are outlined.

This study aimed to characterize constraints on consumption of fish perceived by consumers in Norway. A random sample of Norwegian women aged 45–69 years answered a self-administered mail questionnaire in 1996 about eating habits, perceived barriers to fish consumption, socioeconomic status, and questions related to health. Altogether, 9407 women answered the questionnaire (response rate: 52.5%). Data were analyzed by means of logistic regression. Limited supply of fish products that satisfy children's wishes reduce at-home fish consumption. People with health problems and those who wish to lose weight are dissatisfied with the range of products offered in the marketplace. Satisfaction with quality and availability of wild lean codfish, especially in inland regions, is lower than for aqua-cultured fat salmon. Neither income nor education or health factors were significantly associated with consumption levels among those who would like to eat more fish. Higher education and income were associated with increased dissatisfaction about fish consumption, but also with reduced perception of most barriers. It is concluded that improvements in the supply of high-quality fresh and processed fish products that satisfy (a) children's wishes, (b) health-oriented family members, and (c) convenience-oriented consumers, will significantly increase at-home consumption of fish.

OBJECTIVES:The authors examined patterns of benzodiazepine use in older adults. Specifically, they describe prevalence and incidence of benzodiazepine use during the index year, describe persistence and intensity of benzodiazepine use over a 4-year period; and examine factors associated with benzodiazepine use in the upcoming year.METHODS:Authors performed a secondary analysis of data collected as part of a health promotion intervention trial conducted from 1986 to 1992 in older health maintenance organization enrollees (N=1,505). Benzodiazepine use was ascertained from computerized pharmacy records. Demographic characteristics, health status, and health behaviors were ascertained from mailed questionnaires.RESULTS:During the index year, the prevalence and incidence of benzodiazepine use was 12.3% and 6.6%, respectively. Of those using during the index year, 16% of new users and 63% of previous users continued to use for the following 3 years. The factors significantly associated with benzodiazepine use in the following year were female gender, high school education, higher chronic disease score, higher levels of self-reported pain and stress, low-to-normal body mass index (BMI), and self-reported nervous disorder.CONCLUSIONS:New users had low intensity of use and a low probability of continuing use over the following 3 years. A very small percentage of this sample had evidence of daily use for 4 years. Of concern, benzodiazepines were used by the segment of the sample that were at greatest risk for hip fractures (women with normal/low BMI). Clinicians should assess the need for continued benzodiazepine use at regular intervals.

Objectives: To assess the prevalence of hormone replacement therapy (HRT) among Norwegian women and examine factors related to use. Materials and methods: A random sample of 18,199 Norwegian women aged 45–64 years responded to a postal questionnaire in 1996–1997. The questionnaire included questions about menstruation status and fertility, oral contraceptives (OC) and HRT use, lifestyle, health and socio-economic status. The response rate was 60%. Results: Overall prevalence of ever using systemic or local HRT was 43.9%. Current use was reported by 31.9% of the women. The highest prevalence was in the age group of 55–59 years where 57.4% reported ever use, and 43.1% current use. Mean duration of use among current users was 4.6 years. More than 60% of the women were classified as postmenopausal, two-thirds of them naturally postmenopausal. The prevalence of ever using HRT was 51.8%. Prevalence of use was higher among earlier OC users, smokers, lean women and in households with high income. Among older women, users had a higher educational level than non-users, while this difference disappeared among the youngest of the women. Fixed combinations of estradiol and noretisteroneacetate either cyclic or continuous, are used by six out of ten users. Conclusions: Our results confirm the increasing trend in sales of estrogens in Norway and suggest that user patterns are changing. More than four out of ten women aged 45–64 years reported ever use of HRT, and one out of three reported current use. Socio-economic differences between users and non-users seem to disappear among women under 55 years of age, but persist in the older age groups. Short time use still dominates.

Data from the Norwegian Health Survey, a national cross-sectional study, were collected through interviews with a randomly drawn sample of members of private households, including 5454 women and 5122 men (0-80+ years) in 1985. The response rate was 78.7%. They were interviewed at home and asked questions regarding health conditions and drug use in the preceding 14 days due to diseases, illnesses or injuries. Drug use decreased with age in childhood, but the overall age trend showed an increase with age. The gender differences were observed through the childbearing years (15-49 years) and above 70 years of age. Higher medicine use in women compared with men was due to a higher frequency of diagnoses of diseases/illnesses/injuries and a higher medicine use among those women with a diagnosis. Higher medicine use among women due to women's reproductory role can only be a part of the explanation. The gender difference in medicine use was also distinct after the menopause. Use of both prescribed and non-prescribed medicines was sporadic, and self-medication decreased in both sexes when obtaining medicines from the doctor. The regional variations in self-reported medicine use were mainly due to variation in the frequency of self-reported diseases/illnesses/injuries. (C) 1997 by John Wiley & Sons, Ltd.

The use of controlled analgesics (codeine, buprenorphine and pentazocine preparations) was studied through drugs dispensed (prescriptions) over a one-year period in the municipality of Tromsø, Norway. Drug use was linked to information from the Tromsø Health Survey, a cross-sectional survey where the population was invited to a health screening. The study sample comprised 9640 women and 9141 men between 15 and 59 years of age. About 9% of the population had obtained one or more prescriptions. Combined codeine preparations dominated, and the average amount purchased was 25 defined daily doses/year. The use was mainly sporadic, but regular use did occur. Low self-evaluated health, headache suffering and former use of analgesics and psychotropics were the most significant predictors. However, daily smoking and low education level were also significant predictors. Drug use increased significantly with age, but only a minor gender difference was observed. After adjustment for differences in health problems the gender difference became insignificant.