ABSTRACT: BACKGROUND: Our aim was to compare the effects of a Paleolithic ('Old Stone Age') diet and a diabetes diet as generally recommended on risk factors for cardiovascular disease in patients with type 2 diabetes not treated with insulin. METHODS: In a randomized cross-over study, 13 patients with type 2 diabetes, 3 women and 10 men, were instructed to eat a Paleolithic diet based on lean meat, fish, fruits, vegetables, root vegetables, eggs and nuts; and a Diabetes diet designed in accordance with dietary guidelines during two consecutive 3-month periods. Outcome variables included changes in weight, waist circumference, serum lipids, C-reactive protein, blood pressure, glycated haemoglobin (HbA1c), and areas under the curve for plasma glucose and plasma insulin in the 75g oral glucose tolerance test. Dietary intake was evaluated by use of 4-day weighed food records. RESULTS: Study participants had on average a diabetes duration of 9 years, a mean HbA1c of 6,6 % units by Mono-S standard and were usually treated with metformin alone (3 subjects) or metformin in combination with a sulfonylurea (3 subjects) or a thiazolidinedione (3 subjects). Mean average dose of metformin was 1031 mg per day. Compared to the diabetes diet, the Paleolithic diet resulted in lower mean values of HbA1c (-0.4% units, p=0.01), triacylglycerol (-0.4 mmol/L, p=0.003), diastolic blood pressure (-4 mmHg, p=0.03), weight (-3 kg, p=0.01), BMI (-1 kg/m2, p=0.04) and waist circumference (-4 cm, p=0.02), and higher mean values of high density lipoprotein cholesterol (+0.08 mmol/L, p=0.03). The Paleolithic diet was mainly lower in cereals and dairy products, and higher in fruits, vegetables, meat and eggs, as compared with the Diabetes diet. Further, the Paleolithic diet was lower in total energy, energy density, carbohydrate, dietary glycemic load, saturated fatty acids and calcium, and higher in unsaturated fatty acids, dietary cholesterol and several vitamins. Dietary GI was slightly lower in the Paleolithic diet (GI=50) than in the Diabetic diet (GI=55). CONCLUSIONS: Over a 3-month study period, a Paleolithic diet improved glycemic control and several cardiovascular risk factors compared to a Diabetes diet in patients with type 2 diabetes. Trial registration ClinicalTrials.gov NCT00435240.

Introduction: Monitoring growth rate in children reflects the state of health and nutrition of the individual as well as the state of health of a nation. Until now little information has been available about the growth pattern of Icelandic children. We report here the results of a nationwide cross-sectional study of growth in Icelandic children aged 6-20 years. Material and methods: Height, standing and sitting and weight were measured in a total of 6500 schoolchildren, 3173 girls and 3327 boys. The measurements were performed 1983-1987. Children were randomly selected from The National Registry according to date of birth from both urban and rural areas of the whole country of Iceland. Stature was measured by a Harpenden stadiometer and the children were weighed in underwear only using a standardized scale. Results: The mean values and standard deviations for height, standing and sitting and weight are presented in tables. Growth charts for height weigt and sitting height are presented. No difference in height and weight was found between children from rural and urban areas. The results show that the growth of Icelandic children is in all age groups almost identical to the growth of Norwegian children. Compaired to other Nordic and WHO growth standards, Icelandic children are tall, especially during early pubertal development. Conclusions: Icelandic children are tall and the growth of Icelandic and Norwegian children follows the same pattern wich supports the theory that the two nations are closely related. Keywords: Icelandic children, growth, height, weight. Correspondance: Atli Dagbjartsson. E-mail: atlid@rsp.is Arni V. Thorsson. E-mail: arniv@shr.is.

In a crosssectional study, 2751 healthy Icelandic boys aged 6-16 years, were examined for physical signs of puberty. The study was performed in 1983-1987 and was a part of a larger crosssectional growth study of 5526 Icelandic children all of whom were examined by the authors. Testicular volume of 4 ml (T 4) was considered the first sign of puberty in boys. The mean age of Icelandic boys reaching T 4 was 11.89 years (SD 1.08). The mean time interval between T 4 and T 12 was 2.21 years. The first signs of pubic hair growth, Tanner stage 2 (PH 2), were found at 12.74 years (SD 1.37). The mean time interval between PH 2 and PH 5 was 2.43 years. Even though comparison with studies from other countries is difficult because of different methods and different study design, we find that the timing and tempo of puberty in Icelandic boys is similar to what has been reported from other Nordic countries and countries in Western-Europe. Key words: puberty, growth, Icelandic boys. Correspondence: Arni V. Thorsson. E-mail: arniv@shr.is.

Objective: To analyse perinatal deaths in Iceland (>22 weeks or 500 g) over a five year period by a new Nordic classification. Material and methods: Medical records for all cases of perinatal death in Iceland from 1994-1998 were analysed. A classification focussing on potential avoidability from a health service perspective was used to identify major groups and areas for improvement. The classification is based on the following variables: time of death in relation to admission and delivery, fetal malformation, gestational age, growth-retardation and Apgar score at five minutes. Results: One hundred and fifty-eight perinatal deaths occurrecl. Of these 103 (65%) were stillborn babies and 55 were early neonatal deaths. The cumulative perinatal mortality rate (PNMR) was 7.3/1000 births for the period and all perinatal deaths, but using a cut-off point >28 weeks or 1000 g this was lower, 5.1/1000. Potentially avoidable groups accounted for 12% of the perinatal deaths, i.e. growthretarded singletons after >28 weeks and intrapartum deaths after >28 weeks. Almost half of the perinatal deaths (41.1%) could probably not be prevented with present methods in perinatal care. These included intrauterine deaths of non-growth retarded singletons after 28 weeks (27.8%) and intrauterine deaths be-fore 28 weeks, still considered miscarriages in some countries (13.3%). Two-thirds of the early neonatal. Conclusions: The Nordic classification used gave a good picture of the causes of avoidable and unavoidable perinatal deaths and may facilitate comparison between populations and periods.

By rendering obsolete the theoretical opposition of nature and culture, the study of the human genome has given rise to fresh networks among anthropologists and other scholars. These developments, in turn, invite a refashioning of anthropology. Because genomic studies are directly concerned with the constitution of personhood, they must engage with local notions of personhood and belonging, thus undermining the distinction between experts and laypersons and demonstrating the need for new frameworks for collaboration between anthropologists and their subjects. These trends are illustrated by research in Nunavut (Canada) and Greenland, in particular an examination of the similarities and differences between modern gene talk about the constitution of the individual and "Inuit epigenetics"--local notions of naming, subjectivity, and relatedness.

AIM: Hyponatremia can potentially have serious effects in the premature infant, Therefore, it is important to recognize its causes and prevent it if possible. The aim of this study was to evaluate the causes of hyponatremia in very low birth weight (VLBW) infants cared for at the Neonatal Intensive Care Unit (NICU) of Children's Hospital Iceland. SUBJECTS AND METHODS: Retrospective descriptive study of 20 VLBW infants at the NICU of Children's Hospital Iceland, born after <30 weeks gestation with birth weight of < or =1250 g. Information was obtained on fluid administration, weight loss, sodium administration and serum sodium concentrations during their first ten days of life. RESULTS: The median gestational age was 27 weeks (24-29 weeks) and the median birth weight was 905 g (620-1250 g). A negative correlation was found between birth weight and the amount of fluids given (R2=-0.42; p=0.002). The median weight loss was 10.6%(3.1-29.5%). A positive correlation was found between weight loss and the amount of fluids the infants received (R2=0.76; p<0.001). The amount of sodium given was on the average 5.7+3.1 mmól/kg/24 hours. The median serum sodium concentration was 137 mmól/L (127-150 mmól/L). A negative correlation was found between the amount of sodium given and serum sodium concentrations (R2=-0.42; p<0.001). There was no correlation between the amount of fluids given and serum sodium concentrations (R2=0.006; p=0.7). A negative correlation was found between birth weight and serum sodium concentrations (R2=-0.24; p=0.027). CONCLUSION: High sodium requirements in VLBW infants at our hospital suggests that their hyponatremia is mainly due to the immaturity of their kidneys, which is known to result in excessive loss of sodium in the urine.

PURPOSE:: To explore the relationship between varying aerobic fitness (fitness), fatness, and fasting insulin levels in healthy children. METHODS:: A population-based sample of 9-yr-old (9YO, 47 boys, 56 girls) and 15-yr-old (15YO, 53 boys, 51 girls) Icelandic children. Body fatness was evaluated via body mass index, waist circumference adjusted for height (waistadj), and sum of four skinfolds. Fitness was assessed with a graded maximal cycle ergometer test. Fasting insulin was measured using an ECLIA. RESULTS:: Fasting insulin correlated to all fatness measures (9YO, r = 0.43-0.46, P < 0.001; 15YO, r = 0.30-0.37, P < 0.003) and fitness (9YO, r =-0.29, P = 0.003; 15YO, r =-0.32, P = 0.001). Adjustment for fitness did not affect the relations between fatness and fasting insulin in 9YO (r = 0.33-0.37, P < 0.001); however, only waistadj remained significantly related to fasting insulin (r = 0.24, P = 0.016) in 15YO. Children in the upper half of fitness and fatness split on the median did not differ in fasting insulin from children in the upper half of fitness but lower half of fatness. Fatness was related to fasting insulin in 9YO (r = 0.51-0.54, P = 0.001) and 15YO (r = 0.31-0.35, P = 0.011-0.028) in the lower half of fitness, but no association was observed in the upper half of fitness in either group. CONCLUSION:: Fatness has a greater association with fasting insulin than fitness, especially among 9YO; however, fitness attenuates the adverse relation of fatness to fasting insulin in 15YO but does not change it in 9YO. In both age groups, being fitter and fatter does not result in greater fasting insulin than being fitter and leaner, and fatness is primarily associated with fasting insulin in lower-fit children.

AIM: To examine the association between iron status at 1 and 6 years with development at 6 years. METHODS: In a longitudinal study of children (n = 77), iron status was measured at 1 and 6 years and the Icelandic Developmental Inventory, which evaluates children's motor and verbal development, was filled in by mothers near the children's sixth birthday. RESULTS: Children, iron-deficient at 1 year (n = 10), had lower fine motor development scores at 6 years than non-iron-deficient (n = 56)(46.7 +/- 4.1 vs. 49.3 +/- 2.0; p = 0.011). Fine motor scores were also lower in children with depleted iron stores at 1 year (n = 26) than non-iron-depleted children (n = 40)(48.0 +/- 3.3 vs. 49.5 +/- 1.8; p = 0.045). Multiple regression analyses, with iron status indices at 6 years, showed that mean corpuscular volume along with male gender predicted significantly positively for expression (adj. R(2)= 0.15; p = 0.018; n = 73), while regression analyses, including iron status at 1 and 6 years, showed that haemoglobin at 6 years was positively associated with gross motor (adj. R(2)= 0.05; p = 0.038; n = 63). CONCLUSIONS: In an affluent society, iron deficiency and depleted iron stores at 1 year may contribute to worse fine motor developmental scores at 6 years, while low mean corpuscular volume and haemoglobin at 6 years might affect subsequent expression and gross motor scores negatively.

Background: Viral hepatitis B and C are a major health problem worldvide. The prevalence of these diseases varies throughout the world. In Iceland, the incidence of hepatitis B and C has increased in recent years. At the same time, the number of immigrants from countries where viral hepatitis is endemic, has also increased. The aim of this study was to investigate the epidemiology of hepatitis B and C among immigrants in Iceland. Material and methods: Immigrants from outside the European Economic Area (EEA) were screened for hepatitis B and C. Medical records for the years 2000-2002 were reviewed for country of origin, viral serology and liver transaminases. Information was gathered from the State Epidemiologist's central registry of notifiable diseases and from the Icelandic Directorate of Immigration on the number of residence permits issued. Results: 70% of all immigrants from countries outside the EEA during the study period were included in the study. Blood samples were obtained from 2946 immigrants. 83 (2.8%) had hepatitis B and 24 (0.8%) had hepatitis C. Prevalence of hepatitis B was highest among immigrants from Africa,11/171 (6.4%; 95% CI: 3.3-11.2%) and hepatitis C among immigrants from Eastern Europe, 16/1502 (1.1%; 95% CI: 0.6-1.7%). 482 (16%) had serological markers of previous hepatitis B infection. Of all registered cases of hepatitis B, immigrants were 56% and of hepatitis C 10%. Conclusions: 1. Majority of those diagnosed with hepatitis B during the study period were immigrants. 2. Among immigrants, hepatitis B was more prevalent than hepatitis C. 3) The high prevalence of hepatitis B justifies screening for the disease in this population.