RESUMEN
The border area between Germany, Belgium, and The Netherlands includes a substantial number of cooperative forms in the urgent medical assistance sector. Collaboration usually takes place in densely populated areas with cities or villages situated on or in proximity to the border. In some regions, definitive borders are not apparent to the extent that inhabitants often times are unaware of their existence. The border may pass directly through a built-up area with intense cross-border activity due to population residency, place of work, shopping, and recreational pursuits. To obtain a deeper insight into cross-border Urgent Medical Assistance (UMA), the Ministry of the Interior and Kingdom Relations (IKR) and the Ministry for Health, Welfare, and Sports (HWS) in The Netherlands commissioned research into cross-border UMA impediments and solutions at administrative, judicial, and operational level. The following central questions were presented for research: (1) What opportunities and impediments are presented in the area of cross-border, urgent medical assistance at administrative, legal, operational, and equipment employable level?; and (2) Which solutions may be submitted to tackle existing impediments? Two techniques were employed to answer the research questions. First, relevant documents were studied from extensive file and literature searches. File and literature search findings subsequently were tested in practice through interviews with relevant experts. Dutch ambulance services provide support to both their Belgian and German counterparts and vice versa. In the instance of cross-border ambulance deployment, relevant assistance services are subject to due observance of various legislations and regulations. Such regulations may restrict effective and efficient deployment of personnel and equipment at critical moments, because regulation discrepancies may arise over ambulance personnel's authorities, ambulance content, and deployment sequence. Discrepencies also may exist in the area of financial compensation concerning ambulance deployment and hospital admission. Gaining knowledge on their disparate systems and the opportunity to utilize the medical provisions of a neighboring country potentially in closer proximity to those in the victim's own country serves the best interests of the patient. Survival chances of a traumatized patient increase with the expedited arrival of medical assistance and increased speed of transportation to an appropriate hospital.
Asunto(s)
Servicios Médicos de Urgencia/organización & administración , Cooperación Internacional , Bélgica , Sistemas de Comunicación entre Servicios de Urgencia , Alemania , Humanos , Países Bajos , Admisión del Paciente , Grupo de Atención al Paciente , Transporte de PacientesRESUMEN
In the Amsterdam Growth and Health Longitudinal Study (AGAHLS) biological risk factors for chronic diseases were measured on eight separate occasions over a period of 20 years in a group of apparently healthy males and females (n = 164). Data were first collected from participants at 13 years of age. At each of the eight measurements, a medical checkup was performed and participants were given information about their current health status based on their personal biological risk factor profile (cholesterol, blood pressure, body composition, and physical fitness). A comparable group (n = 113) was measured on two occasions only: at age 13 and again at age 33. It was hypothesized that the group with eight measurements would present a more favorable 20-year development of the risk factors than the group with only two measurements. In the present article the six additional measurements with personal feedback of one's health status were perceived as an "intervention," even though the AGAHLS never intended to improve the lifestyle or health of its subjects. The intervention appeared to have had a positive effect on body fat distribution and, in men, on systolic blood pressure. However, it was expected that these significant results were not true effects of the intervention, but that they were type-I errors. For the other variables, total cholesterol, high-density lipoprotein cholesterol, and the ratio between these two, for the sum of four skinfolds, diastolic blood pressure, neuromotor fitness, and for maximal oxygen uptake, the 20-year development did not differ between the two groups. Thus, the effects of a 20-year health measurement and information intervention begun in youth on biologic risk factors for chronic diseases were limited. The absence of clear significant findings may be due to the low contrast between the two groups, as only six intervention measurements were conducted over a period of 20 years. Another reason may be that the young and relatively healthy population under study here was not amenable to changing their fitness and health.
Asunto(s)
Enfermedad Crónica/epidemiología , Educación en Salud/organización & administración , Indicadores de Salud , Difusión de la Información , Adolescente , Adulto , Femenino , Conductas Relacionadas con la Salud , Humanos , Estudios Longitudinales , Masculino , Países Bajos/epidemiología , Aptitud Física , Prevención Primaria , Factores de RiesgoRESUMEN
In the Amsterdam Growth and Health Longitudinal Study (AGAHLS), a group of apparently healthy males and females (n = 200) were interviewed about their physical activities on eight separate occasions over a period of 20 years between 13 and 33 years of age (multi-measured group: MM). Information about their health was given based on their personally measured lifestyle (activity, diet, smoking) and biological risk characteristics for chronic diseases (medical check-ups). A comparable group of boys and girls (n = 200) was only measured on two occasions (bi-measured group: BM): at 13 and 33 years. Physical activity was estimated with a structured interview. Total physical activity and sports activity were estimated in three intensity levels (light, moderate, and heavy). It was hypothesized that the eight repeated medical check-ups with health information in the MM group would result in a healthier lifestyle with respect to the determinants and levels of habitual physical activity compared to the BM group. Contrary to the hypothesis, males and females in the BM group showed a significantly higher increase or a lower decrease in physical activities compared to the MM group. This negative effect on the physical activity pattern at 33 years in the MM group may have been caused by more underreporting of physical activities than in the BM group. In conclusion, there does not appear to be a significant effect of long-term (multi-measured) health information with medical check-ups during adolescence and young adulthood on level of physical activity in males and females at 33 years of age.
Asunto(s)
Ejercicio Físico , Conductas Relacionadas con la Salud , Educación en Salud/organización & administración , Adolescente , Adulto , Femenino , Humanos , Entrevistas como Asunto , Estudios Longitudinales , Masculino , Motivación , Países Bajos , Encuestas y CuestionariosRESUMEN
BACKGROUND: The Amsterdam Growth and Health Longitudinal Study (AGAHLS) is a 20 y observational study concerning biological, psychological and lifestyle risk factors for cardiovascular disease and osteoporosis. In the AGAHLS two cohorts can be distinguished: the so-called Multi-Measurement Group (MMG), which received eight repeated measurements, and a Bi-Measurement Group (BMG), which received two measurements, one at the beginning and one at the end of the 20 y period. OBJECTIVE: In health-related longitudinal research, the outcomes of the study may be influenced by the measurements themselves and the health information provided. It was hypothesized that the repeated measurements and the health information given to the MMG would result in a more healthy dietary intake in comparison to the BMG. DESIGN: The MMG consisted of 164 subjects and the BMG consisted of 90 subjects. At the start of the study, subjects were teenagers of 13-y-old. The hypothesis was tested with use of regression analysis, analysing group differences in mean individual change scores. RESULTS: Only the MMG showed a significantly larger decrease in the intake of mono- and disaccharides compared to the BMG. CONCLUSIONS: The effect of the repeated measurements and the health information provided on dietary intake was relatively small, since it was only one out of the 14 nutrients that differed between the MMG and the BMG.
Asunto(s)
Dieta , Carbohidratos de la Dieta/administración & dosificación , Conducta Alimentaria/psicología , Promoción de la Salud , Adolescente , Adulto , Envejecimiento/fisiología , Estudios de Cohortes , Encuestas sobre Dietas , Grasas de la Dieta/administración & dosificación , Proteínas en la Dieta/administración & dosificación , Ingestión de Energía , Femenino , Humanos , Estudios Longitudinales , Masculino , Micronutrientes/administración & dosificación , Países BajosRESUMEN
The purpose of this paper is to test the hypothesis that daily physical activity over a period of 15 years has been beneficial to aerobic fitness in young male and female participants (13-27 years) in the Amsterdam Growth and Health Longitudinal Study. Only subjects with the maximal data of six sets of measurements were included (83 male and 98 female participants). Daily physical activity was assessed using a standardized interview on activity and expressed as a weighted activity score. Aerobic fitness was assessed using a maximal running test on a treadmill and measuring the maximal oxygen uptake (VO2max) and the maximal slope of the track (Smax). To assess the longitudinal relationship between daily physical activity and aerobic fitness a real longitudinal analysis was carried out with generalized estimating equations, adjusting for differences in initial aerobic fitness at age 13, and for other lifestyle (dietary intake, smoking and alcohol consumption) and biological parameters (biological age, body fat, blood pressure and concentration of serum cholesterol). A significant relationship (P < 0.01) was observed between daily physical activity and both VO2max and Smax. It can be concluded that the development of aerobic fitness between the age of 13 and 27 years is independently and positively related to daily physical activity in this group of male and female participants in the study. The functional implications, however, are small: a relatively high increase in the weighted physical activity score of 30% over a period of 15 years results in a 2%-5% increase in aerobic fitness.
Asunto(s)
Ejercicio Físico/fisiología , Consumo de Oxígeno , Aptitud Física , Adolescente , Adulto , Niño , Femenino , Humanos , Estilo de Vida , Estudios Longitudinales , Masculino , CarreraRESUMEN
PURPOSE: The purpose of this study was to investigate whether or not clustering of biological coronary heart disease (CHD) risk factors exists and to investigate the longitudinal relationship between lifestyle parameters (dietary intake, daily physical activity, smoking behaviour, alcohol consumption) and a biological CHD risk factor clustering score. This was defined as belonging to one or more gender specific 'high risk' quartiles for the following CHD risk factors: ratio between total serum cholesterol and high density lipoprotein cholesterol (TC:HDL), mean arterial blood pressure (MABP), body fatness [sum of skinfolds (SSF)], and cardiopulmonary fitness (VO2-max). METHODS: The data were derived from the Amsterdam Growth and Health Study, an observational longitudinal study in which six repeated measurements were carried out over a period of 15 years covering adolescence and young adulthood. The longitudinal relationships were analysed with generalized estimating equations. RESULTS: The results showed significant clustering for the TC:HDL ratio, SSF, and VO(2)-max. MABP was not significantly associated with the other CHD risk factors. Daily physical activity and alcohol consumption (only for males) were both inversely related to the clustering score. None of the other lifestyle parameters showed significant relationships with the clustering score. CONCLUSIONS: Based on this small longitudinal study, it can be stated that during adolescence and young adulthood both daily physical activity and alcohol consumption were related to a healthy CHD risk profile.
Asunto(s)
Enfermedad Coronaria/epidemiología , Conductas Relacionadas con la Salud , Estilo de Vida , Adolescente , Adulto , Consumo de Bebidas Alcohólicas , Presión Sanguínea/fisiología , Colesterol/sangre , HDL-Colesterol/sangre , Análisis por Conglomerados , Dieta , Femenino , Estudios de Seguimiento , Humanos , Estudios Longitudinales , Masculino , Países Bajos/epidemiología , Aptitud Física , Factores de Riesgo , FumarRESUMEN
When studying long-term effects of alcohol consumption on health, the stability of alcohol consumption should be known. In this paper the development and stability of alcohol consumption were investigated. Seven measurements of alcohol consumption were carried out over a period of 20 years, starting at age 13 years, in a cohort of 65 men and 85 women. Effects of age, gender, and type of beverage on the stability of drinking as a dichotomous variable (drink or abstain) and on the stability of relative amounts of alcohol consumption were analyzed. The stability of the drink/abstain dichotomy was high (odds ratios>4) and increased with age. The stability of relative amounts of alcohol consumption was moderate (rS<0.6), and no effect of age was found. No sex effects were found, while the consumption of beer often showed higher stability than that of wine and spirits.
Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Adolescente , Adulto , Bebidas Alcohólicas , Estudios Transversales , Femenino , Humanos , Incidencia , Estudios Longitudinales , Masculino , Países Bajos/epidemiología , Templanza/estadística & datos numéricosRESUMEN
Although positive effects of physical activity are often reported, there are still uncertainties about the type, intensity, duration, and frequency of these activities that are most effective for (re)modeling bone mass during youth. In the Amsterdam Growth and Health Longitudinal Study, daily physical activity and fitness were monitored from age 13 to 29 years in a group of 182 males and females. At a mean age of 28 years, bone mineral density (BMD) was measured at three sites with dual X-ray absorptiometry (DXA): in the lumbar region (lumbar BMD), the femoral neck (hip BMD), and the distal radius (wrist BMD). Physical activity (PA) was estimated from a cross-check activity interview taking in consideration all daily physical activities during the last 3 months; PA was scored in two different ways: (1) metabolic physical activity score (METPA) by weighting the intensity (multiples of basic metabolic rate [METs]) and duration (minutes per week); and (2) mechanic physical activity score (MECHPA) by weighting the peak strain (ground reaction forces as multiples of body mass) irrespective of frequency and duration of the physical activities. Physical fitness was measured with a neuromotor fitness test (composite of six strength, flexibility, and speed tests) and as cardiopulmonary fitness (maximal oxygen uptake). The physical activity and fitness scores were calculated over two age periods: during adolescence (13-16 years) and during adulthood (21-27 years). The standardized regression coefficients (corrected for gender, biological age, body composition, and calcium intake) show that weight, physical activity (both METPA and MECHPA), and neuromotor fitness during adolescence and in young adulthood are significantly and positively related with the lumbar BMD (beta = 0. 11-0.40) and hip BMD (beta = 0.18-0.26), measured at the mean age of 28 years. This was not the case for cardiorespiratory fitness. No significant correlations at all are found with wrist BMD, a bone site that is less involved in physical activity and fitness. It can be concluded that daily physical activity during adolescence and in the young adult period is significantly related to the BMD at the lumbar spine and femoral neck at age 28 of males and females. Only neuromotor fitness and not cardiopulmonary fitness during adolescence and young adulthood is related to the BMD of males and females at age 28 years.
Asunto(s)
Densidad Ósea/fisiología , Huesos/fisiología , Aptitud Física/fisiología , Adolescente , Adulto , Factores de Edad , Composición Corporal , Femenino , Humanos , Modelos Lineales , Estudios Longitudinales , Masculino , Países Bajos , Factores SexualesRESUMEN
PURPOSE: To describe the natural development of habitual physical activity behavior (HPA) of young Dutch male and female subjects between the ages of 13 and 27, using data from the Amsterdam Longitudinal Growth and Health Study. METHODS: HPA was measured by means of a structured interview at ages 13, 14, 15, 16, 21, and 27 and concerned all activities (at work, school, during leisure, organized and nonorganized sports, and active transportation) exceeding a level of intensity of 4 METs. Complete longitudinal data concern 98 female and 83 male subjects. MANOVA for repeated measurements were done for total HPA (expressed in min x wk(-1) and in METs x wk(-1)). Similar analyses were done for organized sports activities, leisure time activities, and all "other" activities separately (also min x wk(-1) and METs x wk(-1)), as well as for weekly time at three different levels of intensity of HPA, i.e. 4-7 MET (moderate), 7-10 MET (vigorous), and >10 MET (very vigorous). RESULTS: Our data showed regarding total HPA (min x wk(-1)) in male, but not in female, subjects a significant decrease in weekly time spent on HPA between the ages of 13 and 27. Regarding the three different levels of intensity in male and female subjects, a significant increase was found in time spent on moderate activities, where female subjects were spending significantly more time on moderate activities than male subjects; both in male and female subjects, a significant decrease was found in time spent on vigorous activities: in male subjects a significant decrease was found in time spent on very vigorous activities, whereas in female subjects time spent at this level of activity remained more or less stable. For the total weighted activity score (METs x wk(-1)), a significant decrease was found for both male (42%) and female subjects (17%). This decrease was significantly greater for male than for female subjects. Regarding more specific activities, it was found that in the course of time organized sports activities became relatively more important contributors to both weekly HPA time and energy expenditure, both in male and female subjects. CONCLUSIONS: Our data show a considerable decrease in HPA over a 15-yr period of time, both in male and female subjects. Differences between male and female subjects are predominantly caused by differences in time spent in moderate and very vigorous activities. In the course of time, organized sports activities became a relatively more important contributor of weekly HPA.
Asunto(s)
Ejercicio Físico , Estilo de Vida , Aptitud Física , Adolescente , Conducta del Adolescente , Adulto , Metabolismo Energético , Femenino , Humanos , Estudios Longitudinales , Masculino , Países Bajos , Recreación , DeportesRESUMEN
UNLABELLED: The Amsterdam Growth and Health Longitudinal Study is longitudinal co-hort study on 181 males and females initially aged 13 years, with follow-up measurements at ages 14, 15, 16, 21 and 27 years. METHODS: Anthropometrical, biological and lifestyle parameters, and age 27 also bone mineral density (BMD) of the lumbar spine (L2-L4), were measured repeatedly. Adolescent dietary intake and physical activity was related to adult cardiovascular and bone health status indicators by MLR; longitudinal relationships between physical activity and dietary intake, and cardiovascular health status indicators were assessed hy GEE-analysis. RESULTS: Adolescent physical activity was not related to most of the indicators of adult cardiovascular health status, with the exception of a positive relationship with the waist-to-hip in females; in males 'energetic' adolescent physical activity contributed significantly to adult BMD; both in males and females, when taking the entire longitudinal period into account, peak strain physical activity was a relatively more important predictor of adult BMD than 'energetic' physical activity; calcium intake during adolescence was not a significant predictor of bone health status measured at age 27, both in males and females; a consistent significant positive longitudinal relationship was found between physical activity and serum HDL-cholesterol and significant negative longitudinal relationships were found with the subscapular skinfold and with body fat mass; a positive longitudinal relationship was found between serum total cholesterol (TC) and cholesterol intake, saturated fat (SFA) intake and the Keys-score; a negative longitudinal relationship was found between TC and polyunsaturated fit and total energy intake; for HDL a positive longitudinal relationship was found with SFA intake; low tracking was found for physical (in-) activity and dietary intake variables.
Asunto(s)
Enfermedades Óseas/prevención & control , Enfermedades Cardiovasculares/prevención & control , Conductas Relacionadas con la Salud , Estado de Salud , Estilo de Vida , Adolescente , Adulto , Densidad Ósea , Femenino , Humanos , Estudios Longitudinales , Masculino , Países BajosRESUMEN
OBJECTIVE: To investigate if there is a longitudinal relationship between the development of fat mass in males and females (aged between 12-28 y) and their lifestyle, with respect to diet and physical activity. DESIGN: In the Amsterdam Growth And Health Longitudinal Study (AGAHLS), a group of 500 boys and girls are being followed from the age of 13 y (mean age 13.5 y), over a period of 20 y until the age of 32 y (mean age 32.5 y). SUBJECTS AND MEASUREMENTS: Data from AGAHLS are analysed of six repeated measurements of growth (body height, body mass, four skinfolds), health parameters with respect to cardiovascular disease (CVD) (obesity, hypertension, hypercholesterolaemia) and two important lifestyle tractors: physical activity (PA) (weighted energy output) and dietary intake (DI) (total energy intake, contribution of fat, carbohydrate and protein) of about 200 males and females between the ages of 13-27 y. RESULTS: The longitudinal results of PA show a steep decrease in the energy expenditure from the age of 13 y from about 4500 Mets per week to 3000 Mets per week at the age of 27 y in both sexes. The longitudinal results of DI also show a decrease in energy intake per kilogram body mass from about 225 kJ per day at the age of 13 y to about 155 kJ at the age of 27 y. During adolescence, boys show a 15% higher energy intake and a 20% higher energy expenditure than girls. At the age of 27 y, the difference between the sexes in energy intake is reduced to 10% and the difference in energy expenditure disappears. Results of tracking analyses over the period of 15y indicate a low stability coefficient of PA (0.34; 0.19-0.49), but higher coefficients of DI (0.55; 0.45-0.64) and fat mass (0.63; 0.56-0.71). The search for important lifestyle factors that can discriminate high- from low-risk participants for a high fat mass, estimated from the sum of four skinfolds and body mass (BM), resulted in an Odds Ratio (OR) of 1.5 (1.2-1.8) with daily intake of proteins and an OR of 0.81 (0.69-0.96) with PA. Surprisingly the fat mass is negatively related with the daily intake of energy per kg BM (OR: 0.37; 0.28-0.49). The longitudinal relation between fat mass and PA (corrected for DI) between the ages of 13-27 y, showed a significant inverse relationship (P<0.01) if fat mass was estimated from the sum of four skinfolds, but not if estimated from the body mass index (BMI). CONCLUSIONS: Over the adolescent and young adult period from 13-27 y, fat mass indicates a fairly good predictability. A high PA in both sexes is related with a low fat mass. Therefore promotion of habitual physical activity in the adolescent period seems effective in the early prevention of obesity.
Asunto(s)
Estilo de Vida , Obesidad/epidemiología , Adolescente , Adulto , Índice de Masa Corporal , Niño , Ingestión de Energía , Femenino , Humanos , Estudios Longitudinales , Masculino , Países Bajos/epidemiología , PrevalenciaRESUMEN
OBJECTIVE: To analyse the longitudinal relationships between body mass index (BMI)/sum of skinfolds (SSF) and biological and lifestyle risk factors for coronary heart disease (CHD). DESIGN: An observational longitudinal study; that is, the Amsterdam Growth and Health Study. SUBJECTS: 181 males and females, initially aged 13 y. Over a period of 15 y, six repeated measurements were carried out. MEASUREMENTS: BMI and SSF, biological CHD risk factors; that is, total cholesterol (TC), high density lipoprotein (HDL), TC:HDL ratio, systolic/diastolic blood pressure (SBP/DBP) and cardiopulmonary fitness (VO2-max) and lifestyle CHD risk factors (that is, daily physical activity, dietary parameters, smoking, and alcohol consumption). The longitudinal relationships were analysed by an autoregressive model, in which the value of the outcome variable at time-point t is not only related to the value of the predictor variable at t, but also to the value of the outcome variable at t-1. RESULTS: Both BMI and SSF were positively related to TC and the TC:HDL ratio. Only BMI was positively related to SBP and only SSF was negatively related to VO2-max. Physical activity was negatively related to SSF. None of the other lifestyle parameters were related to SSF and/or BMI. CONCLUSIONS: Both BMI and SSF were related to a high risk profile regarding CHD. Different relationships for SSF and BMI are found, because BMI not only reflects body fatness, but also lean body mass. Analyses with BMI as an indicator for body fatness should therefore be interpreted cautiously.
Asunto(s)
Composición Corporal , Índice de Masa Corporal , Enfermedad Coronaria/etiología , Grosor de los Pliegues Cutáneos , Adolescente , Adulto , Presión Sanguínea , Colesterol/sangre , HDL-Colesterol/sangre , Ejercicio Físico , Femenino , Humanos , Estilo de Vida , Estudios Longitudinales , Masculino , Países Bajos , Consumo de Oxígeno , Factores de Riesgo , Caracteres SexualesRESUMEN
Associations were investigated between the amount of physical activity, energy and macronutrient intake, smoking behavior, alcohol intake, and a central pattern of body fat (subscapular skinfold thickness and waist circumference) measured six times between the mean ages of 13 and 27 y in a healthy white population. Subjects (84 males, 98 females) were participants in the longitudinal Amsterdam Growth and Health Study. In longitudinal analyses, alcohol intake was positively associated with the subscapular skinfold thickness (beta = 0.09, 95% CI: 0.01, 0.16) in males. In females, the subscapular skinfold thickness was negatively associated with physical activity (beta = -0.10. 95% CI: -0.15, -0.05) and, unexpectedly, energy intake (beta = -0.25, 95% CI: -0.31,-0.19), whereas a positive association was found with carbohydrate intake (beta = 0.09. 95% CI: 0.02, 0.16). In both sexes, the mean value of behavioral variables, obtained from the mean value in adolescence and the values obtained at 21 and 27 y of age was not significantly associated with the subscapular skinfold thickness or waist circumference at the mean age of 27 y, except for a small positive association between physical activity and the subscapular skinfold thickness in males (R2 = 2.3%).
Asunto(s)
Tejido Adiposo/crecimiento & desarrollo , Conducta , Población Blanca , Adolescente , Adulto , Antropometría , Composición Corporal/fisiología , Constitución Corporal , Estatura/fisiología , Índice de Masa Corporal , Peso Corporal/fisiología , Metabolismo de los Hidratos de Carbono , Carbohidratos/administración & dosificación , Ingestión de Energía , Metabolismo Energético , Femenino , Estudios de Seguimiento , Crecimiento , Humanos , Estudios Longitudinales , Masculino , Análisis Multivariante , Países Bajos , Análisis de Regresión , Factores Sexuales , Grosor de los Pliegues Cutáneos , FumarRESUMEN
The aim of this study was to analyse longitudinal relationships between resting heart rate and biological risk factors for cardiovascular disease using data from the longitudinal Amsterdam Growth and Health Study (AGHS). In the AGHS, 98 females and 81 males were measured six times between 1977 and 1991. In 1977, the age of the subjects was 13 years. The variables assessed included resting heart rate, diastolic and systolic blood pressure, high-density serum lipoprotein, total serum cholesterol, the sum of four skinfolds, cardiopulmonary fitness (VO 2 max), habitual physical activity and smoking history. To investigate the longitudinal relationships between resting heart rate and diastolic blood pressure, systolic blood pressure, high-density serum lipoprotein, total serum cholesterol, sum of four skinfolds and V O 2 max, generalized estimating equations were used, leading to one standardized longitudinal regression coefficient (beta). Significant univariate relationships were found between resting heart rate and diastolic blood pressure (beta = 0.142; P = 0.00), systolic blood pressure (beta = 0.134; P = 0.00), VO 2 max (beta = -0.091; P = 0.00) and sum of four skinfolds (beta = 0.047; P = 0.021). The relationships between resting heart rate and diastolic blood pressure, systolic blood pressure and VO 2 max did not change substantially when corrected for habitual physical activity and smoking history. The relationship between resting heart rate and sum of four skinfolds was no longer found to be significant when corrected for habitual physical activity and smoking history. For these relationships, no interaction between resting heart rate and sex was found.
Asunto(s)
Presión Sanguínea , Enfermedades Cardiovasculares/etiología , Frecuencia Cardíaca , Consumo de Oxígeno , Descanso/fisiología , Adolescente , Adulto , Colesterol/sangre , Ejercicio Físico/fisiología , Femenino , Estudios de Seguimiento , Humanos , Lipoproteínas/sangre , Estudios Longitudinales , Masculino , Países Bajos , Aptitud Física , Análisis de Regresión , Factores de Riesgo , Grosor de los Pliegues Cutáneos , Fumar , Adulto JovenRESUMEN
OBJECTIVES: Because of growing interest in the potential role of calcium in preventive pediatric strategies against osteoporosis, the longitudinal development and tracking of calcium had a dairy intake from adolescence into adulthood was addressed. DESIGN: In the Amsterdam Growth and Health Study, a group of 84 males and 98 females were followed over a 15 y period from age 13-27 y. The calcium and dairy intake was assessed six times by a cross-check dietary history method. To assess tracking, two traditional approaches, interperiod correlation coefficients and percent of subjects who remained in the same quartile of calcium intake over time, and a new approach based on generalized estimating equations were used. RESULTS: The mean calcium intake was relatively high and increased over time (30%). The tracking of calcium and dairy intake from adolescence into adulthood was moderate in both sexes (for example the correlation for calcium was 0.43 in males and 0.38 in females). CONCLUSIONS: The predictability of calcium intake over time does not seem to be sufficiently strong to identify teenagers who are likely to maintain an inadequate calcium intake in adulthood. Therefore, the identification and treatment of subjects with a low calcium intake cannot be limited to the teenage period but should be extended into adulthood.
Asunto(s)
Envejecimiento , Calcio de la Dieta/administración & dosificación , Productos Lácteos , Dieta , Adolescente , Adulto , Animales , Queso , Femenino , Humanos , Estudios Longitudinales , Masculino , Leche , Evaluación Nutricional , Caracteres SexualesRESUMEN
This longitudinal study evaluates the relationship of food intake and physical activity with biological maturation of 200 boys and girls during adolescence and young adulthood. The subjects were followed during 9 years from ages 12 to 22 years, with repeated measurements at ages 13, 14, 15, 16, and 21. Biological maturation was estimated four times between ages 12 and 17 as skeletal age by radiographs of the left hand and wrist. Daily nutritional intake (macro- and micronutrients) was assessed with a cross-checked dietary history method. Daily physical activity was assessed through structured interview, whereby average weekly time spent in activity was used to assign a weighted activity score. The 107 girls and 93 boys were divided into three maturity groups: early maturers, late maturers, and average maturers. It was concluded that in both sexes, late maturation seemed to coincide with a higher energetic food intake and a slightly higher activity pattern than early maturation during adolescence.
Asunto(s)
Adolescente/fisiología , Determinación de la Edad por el Esqueleto , Ejercicio Físico , Crecimiento , Adulto , Antropometría , Niño , Ingestión de Energía , Femenino , Humanos , Estudios Longitudinales , Masculino , Estado NutricionalRESUMEN
This article presents an overview of the Amsterdam Growth and Health Longitudinal Study (AGAHLS). This study was started in the 1970s, following a whole sample of 500 healthy 13-year-old boys and girls from two secondary schools. During the school period (12-17 years) annual measurements were performed with respect to anthropometrics, physiological and psychological parameters, lifestyle characteristics (activity, diet, smoking) and health parameters. A multiple longitudinal design was applied with overlapping birth cohorts and a cross-sectional measured control group to monitor for confounding factors such as time of measurement, cohort, dropout and testing effects. Emphasis is also placed on measures that enhance adherence of the subjects. The follow-up was extended with repeated measurements at age 21, 26 and 28. This enabled us to analyze the data with respect to tracking characteristics of biological and lifestyle variables over a period of 15 years between adolescence and adulthood and also to investigate quasi-causal relationships between the effects of a healthy lifestyle and indicators for cardiovascular diseases (CVD). Also new methods such as measurement of atherosclerosis and osteoporosis will be added and related to longitudinal measurements of the same subjects in the past. The main results that were obtained in the past are summarized and research questions for the near future are explained.
Asunto(s)
Crecimiento , Estilo de Vida , Estado Nutricional , Aptitud Física , Adolescente , Adulto , Presión Sanguínea , Ejercicio Físico , Femenino , Humanos , Estudios Longitudinales , Masculino , Países Bajos , Personalidad , Proyectos de InvestigaciónRESUMEN
OBJECTIVE: To examine longitudinal relationships between nutrition and risk indicators for cardio vascular diseases (CVD) during adolescence and young adulthood. DESIGN: A longitudinal study over fifteen years. SUBJECTS: 98 females and 84 males, from 13 to 27 years. METHODS: By means of six interviews dietary patterns were determined. Blood samples were analyzed for serum concentration of total cholesterol (TC), and high-density-lipoprotein (HDL), blood pressure, body fat and maximal aerobic power (VO2max) were determined. The longitudinal relations were analyzed with generalized estimation equations (GEE), a statistical technique in which relations at different time-points are tested simultaneously. RESULTS: Compared to Dutch recommendations six out of seven macro nutrients appear to be unfavorable with respect to CVD. Borderline or high CVD risk values are apparent at 27 y in more than 25% of the subjects with respect to percentage body fat and serum total cholesterol in both sexes. In males 40% or more show borderline hypertension. The 'univariate' longitudinal analyses showed significantly positive relations: (1) between the intake of animal protein, saturated fat (SFA), cholesterol (Cho1) and TC, and HDL; (2) between total energy intake (EN) and systolic blood pressure, and VO2max. Significantly negative associations were found: (1) between EN, poly-unsaturated fat (PUFA) and TC concentrations; (2) between EN and sum of four skinfolds (SSF). CONCLUSIONS: With increasing age, over a period of 15 y in both sexes the SFA and Cho1 intake relate significantly to the development of a negative CVD risk profile. The intake of PUFA relates positive to a CVD risk profile. The significantly negative relation between EN intake and body fat (SSF) is partly explained by the relation between EN and VO2max.
Asunto(s)
Enfermedades Cardiovasculares , Dieta , Adolescente , Adulto , Presión Sanguínea , Composición Corporal , Colesterol/sangre , Colesterol en la Dieta/administración & dosificación , Proteínas en la Dieta/administración & dosificación , Ingestión de Energía , Femenino , Humanos , Lipoproteínas HDL/sangre , Estudios Longitudinales , Masculino , Consumo de Oxígeno , Factores de Riesgo , Caracteres SexualesRESUMEN
Because the magnitude of tracking coefficients (i.e., stability coefficients and tracking for subjects at risk) greatly depends on the initial age of subjects, the number and spacing of longitudinal measurements, and the length of the total time period, it is difficult to compare tracking coefficients from different studies with each other. Because in the Amsterdam Growth and Health Study both biologic (i.e., lipoproteins, blood pressure, body fatness, and cardiopulmonary fitness) and lifestyle (i.e., dietary intake, daily physical activity, smoking, and alcohol consumption) risk factors for coronary heart disease were measured, this study gives the unique possibility of comparing tracking coefficients of biologic and lifestyle risk factors within one data set. In the Amsterdam Growth and Health Study, six repeated measurements were carried out on 181 subjects over a period from 13 to 27 years of age, beginning in 1977. The results indicated that, over a period of 14 years covering adolescence and young adulthood, both stability coefficients and tracking for subjects at risk for lifestyle risk factors were low (except for smoking), indicating low predictability of early measurements for values later in life. For the biologic risk factors cardiopulmonary fitness and blood pressure, tracking was also low, while for the lipoproteins and body fatness, tracking was much better, indicating good predictability.
Asunto(s)
Composición Corporal , Enfermedad Coronaria/etiología , Hipercolesterolemia/complicaciones , Hipertensión/complicaciones , Estilo de Vida , Adolescente , Adulto , Consumo de Bebidas Alcohólicas/efectos adversos , Femenino , Humanos , Estudios Longitudinales , Masculino , Países Bajos , Aptitud Física , Valor Predictivo de las Pruebas , Factores de Riesgo , Fumar/efectos adversosRESUMEN
PURPOSE: To investigate the relationship between lifestyle (dietary intake of macronutrients, smoking behavior, alcohol consumption and daily physical activity) from 13-29 years of age ("long-term exposure") and cardiovascular disease (CVD) risk factors (lipoprotein levels, blood pressure, body fatness, and body composition) at the age of 29 years. METHODS: The study was part of the Amsterdam Growth and Health Study, which began in 1977, and in which repeated measurements were carried out over a period of 17 years on 181 subjects (98 females and 83 males). RESULTS: "Long-term exposure" to smoking behavior was inversely related to high density lipoprotein cholesterol (HDL) levels (p = 0.02) and positively to the total cholesterol/HDL ratio (p = 0.05). Both smoking behavior and alcohol consumption were inversely related to blood pressure (p < 0.01). "Long-term exposure" to daily physical activity was inversely related to body fatness (p < 0.01), but for females positively to the waist/hip ratio (p < 0.01). No relationship was found between the dietary intake of macronutrients and the CVD risk factors. When "long-term exposure" was limited to adolescence (13-16 years of age) only the relationship between daily physical activity and the waist/hip ratio for females remained significant (p < 0.01). CONCLUSIONS: "Long-term" smoking behavior was related to a high risk profile regarding hypercholesterolemia, but to a low risk profile regarding blood pressure. The latter was also found for "long-term" alcohol consumption. "Long-term" daily physical activity was related to a low risk profile regarding body fatness; but for females, surprisingly, to a high risk profile regarding body fat distribution.