Advertisement

European Journal of Epidemiology

, Volume 21, Issue 7, pp 493–499 | Cite as

Changes in haemoglobin levels according to changes in body mass index and smoking habits, a 20-year follow-up of a male cohort

The Tromsø Study 1974–1995
  • Tove Skjelbakken
  • Inger Marie S. Dahl
  • Tom Wilsgaard
  • Bodil Langbakk
  • Maja-Lisa Løchen
Cardiovascular Diseases

Abstract

Haemoglobin level declines with increasing age in cross sectional studies. Little is known about the longitudinal changes of haemoglobin. Because both high or low haemoglobin levels increase mortality and morbidity we examined how changes in lifestyle factors like body mass index (BMI) and smoking habits influence cohort changes in haemoglobin level. In all, 4159 men aged 20–49 years at baseline were examined in 1974 and 1994–1995 in a longitudinal, population-based study from the municipality of Tromsø, Northern Norway. Mean haemoglobin was 148 g/l. There was no difference in mean haemoglobin after 20 years in any strata of age. Mean BMI increased 2.1 kg/m2. The prevalence of smokers decreased 20.1 percentage points. In a multiple regression analysis increase in BMI was associated with increased haemoglobin change. Smoking cessation lowered mean haemoglobin 1.6 g/l compared to never smokers. Haemoglobin increased 0.8 g/l in smoking quitters whose BMI increased >2.5 kg/m2 compared to a decrease of 6.7 g/l in weight reducers. There was a positive dose–response relationship between changes in cigarettes smoked per day and change in haemoglobin among consistent smokers. In conclusion, in contrast to cross sectional studies, mean haemoglobin did not change during 20 years ageing of relatively young men. This could be explained by higher BMI and less smoking. The increase in BMI affected haemoglobin change to such an extent that the reduction in haemoglobin due to smoking cessation was counteracted. Prospective studies are needed to address the health implications.

Keywords

Body mass index Haemoglobin Lifestyle Longitudinal Smoking 

Abbreviations

BMI

body mass index

CI

confidence interval

SD

standard deviation

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Notes

Acknowledgements

The Institute of Community Medicine, University of Tromsø, conducted the survey, in 1994–1995 in co-operation with the National Health Screening Service. The authors’ salaries were from the University Hospital of North Norway and the University of Tromsø.

References

  1. 1.
    Carlson LA, Böttiger LE (1985). Risk factors for ischaemic heart disease in men and women. Results of the 19-year follow-up of the Stockholm Prospective Study. Acta Med Scand 218:207–211PubMedCrossRefGoogle Scholar
  2. 2.
    Sarnak MJ, Tighiouart H, Manjunath G, et al. (2002) Anemia as a risk factor for cardiovascular disease in The Atherosclerosis Risk in Communities (ARIC) study. J Am Coll Cardiol 40:27–33PubMedCrossRefGoogle Scholar
  3. 3.
    Salive ME, Cornoni HJ, Guralnik JM, et al. (1992) Anemia and hemoglobin levels in older persons: Relationship with age, gender, and health status. J Am Geriatr Soc 40:489–496PubMedGoogle Scholar
  4. 4.
    Bentley DP (1982). Anaemia and chronic disease. Clin Haematol 11:465–479PubMedGoogle Scholar
  5. 5.
    Natvig H (1963). Studies on hemoglobin values in Norway. I. Hemoglobin levels in adults. Acta Med Scand 173:423–434PubMedCrossRefGoogle Scholar
  6. 6.
    Yip R, Johnson C, Dallman PR (1984) Age-related changes in laboratory values used in the diagnosis of anemia and iron deficiency. Am J Clin Nutr 39:427–436PubMedGoogle Scholar
  7. 7.
    Skjelbakken T, Langbakk B, Dahl IM, et al. (2005). Haemoglobin and anaemia in a gender perspective: The Tromsø Study. Eur J Haematol 74:381–388PubMedCrossRefGoogle Scholar
  8. 8.
    Yamada M, Wong FL, Suzuki G (2003) Longitudinal trends of hemoglobin levels in a Japanese population – RERF’s Adult Health Study subjects. Eur J Haematol 70:129–135PubMedCrossRefGoogle Scholar
  9. 9.
    Vlassov VV (1999) Changes in blood hemoglobin concentration of middle-aged healthy men. Mil Med 164:311–315PubMedGoogle Scholar
  10. 10.
    Nilsson-Ehle H, Jagenburg R, Landahl S, et al. (1989) Decline of blood haemoglobin in the aged: A longitudinal study of an urban Swedish population from age 70 to 81. Br J Haematol 71:437–442PubMedCrossRefGoogle Scholar
  11. 11.
    Micozzi MS, Albanes D, Stevens RG (1989). Relation of body size and composition to clinical biochemical and hematologic indices in US men and women. Am J Clin Nutr 50:1276–1281PubMedGoogle Scholar
  12. 12.
    Milman N, Byg KE, Mulvad G, et al. (2001) Haemoglobin concentrations appear to be lower in indigenous Greenlanders than in Danes: Assessment of haemoglobin in 234 Greenlanders and in 2804 Danes. Eur J Haematol 67:23–29PubMedCrossRefGoogle Scholar
  13. 13.
    Shimakawa T, Bild DE (1993). Relationship between hemoglobin and cardiovascular risk factors in young adults. J Clin Epidemiol 46:1257–1266PubMedCrossRefGoogle Scholar
  14. 14.
    Njølstad I, Arnesen E, Lund-Larsen PG (1996). Smoking, serum lipids, blood pressure, and sex differences in myocardial infarction. A 12-year follow-up of the Finnmark Study. Circulation 93:450–456PubMedGoogle Scholar
  15. 15.
    Rimm EB, Stampfer MJ, Giovannucci E, et al. (1995). Body size and fat distribution as predictors of coronary heart disease among middle-aged and older US men. Am J Epidemiol 141:1117–1127PubMedGoogle Scholar
  16. 16.
    World Health Organization (2000). Obesity: Preventing and managing the global epidemic. Report of a WHO consultation. WHO Techn Rep Ser 894:i–253Google Scholar
  17. 17.
    Molarius A, Parsons RW, Dobson AJ, et al. (2001). Trends in cigarette smoking in 36 populations from the early 1980s to the mid-1990s: Findings from the WHO MONICA Project. Am J Public Health 91:206–212PubMedCrossRefGoogle Scholar
  18. 18.
    Green MS, Harari G (1995). A prospective study of the effects of changes in smoking habits on blood count, serum lipids and lipoproteins, body weight and blood pressure in occupationally active men. The Israeli CORDIS Study. J Clin Epidemiol 48:1159–1166PubMedCrossRefGoogle Scholar
  19. 19.
    Thelle DS, Førde OH, Try K, et al. (1976). The Tromsø heart study. Methods and main results of the cross-sectional study. Acta Med Scand 200:107–118PubMedCrossRefGoogle Scholar
  20. 20.
    Skjelbakken T, Løchen ML, Dahl IM (2002). Haematological malignancies in a general population, based on information collected from a population study, hospital records, and the Cancer Registry of Norway: The Tromsø Study. Eur J Haematol 69:67–75PubMedCrossRefGoogle Scholar
  21. 21.
    Bønaa KH, Arnesen E (1992). Association between heart rate and atherogenic blood lipid fractions in a population. The Tromsø Study. Circulation 86:394–405PubMedGoogle Scholar
  22. 22.
    Thune I, Njølstad I, Løchen ML, et al. (1998). Physical activity improves the metabolic risk profiles in men and women: the Tromsø Study. Arch Intern Med 158:1633–1640PubMedCrossRefGoogle Scholar
  23. 23.
    International Committee for Standardization in Haematology (1965). Reccommendations and requirements for haemoglobinometry in human blood. Scand J Clin Lab Invest 17:617–620Google Scholar
  24. 24.
    Koepke JA (1977). The calibration of automated instruments for accuracy in hemoglobinometry. Am J Clin Pathol 68:180–184PubMedGoogle Scholar
  25. 25.
    Salvati AM, Samoggia P, Taggi F, et al. (1977). Hemoglobinometry: A comparison between the hemiglobincyanide method and the Coulter S counter. Clin Chim Acta 77:13–20PubMedCrossRefGoogle Scholar
  26. 26.
    World Health Organization. Nutritional anaemias. WHO Techn Rep Ser 1968; 405Google Scholar
  27. 27.
    Jacobsen BK, Njølstad I, Thune I, et al. (2001). Increase in weight in all birth cohorts in a general population: The Tromsø Study, 1974–1994. Arch Intern Med 161:466–472PubMedCrossRefGoogle Scholar
  28. 28.
    Garn SM, Clark DC (1975) Haemoglobin and fatness. Ecol Food Nutr 4:131–133CrossRefGoogle Scholar
  29. 29.
    Nordenberg D, Yip R, Binkin NJ (1990). The effect of cigarette smoking on hemoglobin levels and anemia screening. JAMA 264:1556–1559PubMedCrossRefGoogle Scholar
  30. 30.
    WHO/UNICEF/UNO (eds). Iron Deficiency Anaemia. Assessment, Prevention, and Control. A guide for programme managers. WHO/NHD/01.3. Geneva, World Health Organization, 2001Google Scholar
  31. 31.
    Knottnerus JA, Swaen GM, Slangen JJ, et al. (1988). Haematologic parameters as risk factors for cardiac infarction, in an occupational health care setting. J Clin Epidemiol 41:67–74PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Tove Skjelbakken
    • 1
    • 2
  • Inger Marie S. Dahl
    • 2
  • Tom Wilsgaard
    • 1
  • Bodil Langbakk
    • 3
  • Maja-Lisa Løchen
    • 1
    • 4
  1. 1.Institute of Community MedicineUniversity of TromsøTromsøNorway
  2. 2.Department of MedicineUniversity Hospital of North NorwayTromsøNorway
  3. 3.Department of Clinical ChemistryUniversity Hospital of North NorwayTromsøNorway
  4. 4.Department of CardiologyUniversity Hospital of North NorwayTromsøNorway

Personalised recommendations