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  • 1.
    Adamsson, Viola
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Vessby, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Riserus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Influence of a healthy Nordic diet on serum fatty acid composition and associations with blood lipoproteins: results from the NORDIET study2014In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 58, p. 24114-Article in journal (Other academic)
    Abstract [en]

    Background: The fatty acid (FA) composition of serum lipids is related to the quality of dietary fat. The aim of this study was to investigate the effects of a healthy Nordic diet (ND) on the FA composition of serum cholesterol esters (CE-FA) and assess the associations between changes in the serum CE-FA composition and blood lipoproteins during a controlled dietary intervention.

    Methods: The NORDIET trial was a six-week randomised, controlled, parallel-group dietary intervention study that included 86 adults (53±8 years) with elevated low-density lipoprotein cholesterol LDL-C. Serum CE-FA composition was measured using gas chromatography. Diet history interviews were conducted, and daily intake was assessed using checklists.

    Results: Food and nutrient intake data indicated that there was a reduction in the fat intake from dairy and meat products and an increase in the consumption of fatty fish with the ND, decreasing the levels of saturated fatty acids (SFA) in the diet, slightly decreasing the levels of monounsaturated fatty acids (MUFA) and moderately increasing the levels of polyunsaturated fatty acids (PUFA). Concomitantly, the levels of CE-SFA 14:0, 15:0 and 18:0, but not 16:0, decreased during the ND, and these changes differed from those observed in the control diet group (p<0.01). In contrast, serum 22:6n-3 increased during the ND compared with the control diet (p<0.01). The changes in CE-SFA 14:0, 15:0 and 18:0 during the intervention correlated positively with those in LDL-C, HDL-C, LDL-C/HDL-C, ApoA1 and ApoB (p<0.01), whereas the changes in CE-PUFA 22:6n-3 were negatively correlated with changes in the corresponding serum lipids.

    Conclusions: The decreased intake of saturated fat and increased intake of n-3 PUFA in a healthy Nordic diet are partly reflected by changes in the serum CE-FA composition, which are associated with an improved serum lipoprotein pattern.

  • 2.
    Adamsson, Viola
    et al.
    Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Reumark, Anna
    Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Cederholm, Tommy
    Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Vessby, Bengt
    Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Risérus, Ulf
    Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Johansson, Gunnar
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    What is a healthy Nordic diet? Foods and nutrients in the NORDIET study2012In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 56, article id 18189Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: A healthy Nordic diet (ND), a diet based on foods originating from the Nordic countries, improves blood lipid profile and insulin sensitivity and lowers blood pressure and body weight in hypercholesterolemic subjects.

    OBJECTIVE: To describe and compare food and nutrient composition of the ND in relation to the intake of a Swedish reference population (SRP) and the recommended intake (RI) and average requirement (AR), as described by the Nordic nutrition recommendations (NNR).

    DESIGN: The analyses were based on an estimate of actual food and nutrient intake of 44 men and women (mean age 53±8 years, BMI 26±3), representing an intervention arm receiving ND for 6 weeks.

    RESULTS: The main difference between ND and SRP was the higher intake of plant foods, fish, egg and vegetable fat and a lower intake of meat products, dairy products, sweets and desserts and alcoholic beverages during ND (p<0.001 for all food groups). Intake of cereals and seeds was similar between ND and SRP (p>0.3). The relative intake of protein, fat and carbohydrates during ND was in accordance with RI. Intake of all vitamins and minerals was above AR, whereas sodium intake was below RI.

    CONCLUSIONS: When compared with the food intake of an SRP, ND is primarily a plant-based diet. ND represents a balanced food intake that meets the current RI and AR of NNR 2004 and has a dietary pattern that is associated with decreased morbidity and mortality.

    © 2012 Viola Adamsson et al.

  • 3.
    Adamsson, Viola
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Reumark, Anna
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Vessby, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Risérus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Johansson, Gunnar
    What is a healthy Nordic diet?: Foods and nutrients in the NORDIET study2012In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 56, p. 18189-Article in journal (Refereed)
    Abstract [en]

    Background: A healthy Nordic diet (ND), a diet based on foods originating from the Nordic countries, improves blood lipid profile and insulin sensitivity and lowers blood pressure and body weight in hypercholesterolemic subjects. Objective: To describe and compare food and nutrient composition of the ND in relation to the intake of a Swedish reference population (SRP) and the recommended intake (RI) and average requirement (AR), as described by the Nordic nutrition recommendations (NNR). Design: The analyses were based on an estimate of actual food and nutrient intake of 44 men and women (mean age 53 +/- 8 years, BMI 26 +/- 3), representing an intervention arm receiving ND for 6 weeks. Results: The main difference between ND and SRP was the higher intake of plant foods, fish, egg and vegetable fat and a lower intake of meat products, dairy products, sweets and desserts and alcoholic beverages during ND (p<0.001 for all food groups). Intake of cereals and seeds was similar between ND and SRP (p>0.3). The relative intake of protein, fat and carbohydrates during ND was in accordance with RI. Intake of all vitamins and minerals was above AR, whereas sodium intake was below RI. Conclusions: When compared with the food intake of an SRP, ND is primarily a plant-based diet. ND represents a balanced food intake that meets the current RI and AR of NNR 2004 and has a dietary pattern that is associated with decreased morbidity and mortality.

  • 4.
    Ali, Mohamed Atiya
    et al.
    Karolinska Inst, Novum, Dept Biosci & Nutr, Unit Publ Hlth Nutr, SE-14183 Huddinge, Sweden; Akershus Univ Coll, Fac Hlth Nutr & Management, Lillestrom, Norway.
    Poortvliet, Eric
    Show the Organization-Enhanced name(s).
    Stromberg, Roger
    Karolinska Inst, Novum, Dept Biosci & Nutr, SE-14183 Huddinge, Sweden.
    Yngve, Agneta
    Karolinska Inst, Dept Biosci & Nutr, S-10401 Stockholm, Sweden.
    Polyamines: total daily intake in adolescents compared to the intake estimated from the Swedish Nutrition Recommendations Objectified (SNO)2011In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 55, p. 5455-Article in journal (Refereed)
    Abstract [en]

    Background: Dietary polyamines have been shown to give a significant contribution to the body pool of polyamines. Knowing the levels of polyamines (putrescine, spermidine, and spermine) in different foods and the contribution of daily food choice to polyamine intake is of interest, due to the association of these bioactive amines to health and disease. Objective: To estimate polyamine intake and food contribution to this intake in adolescents compared to a diet fulfilling the Swedish Nutrition Recommendations. Design: A cross-sectional study of dietary intake in adolescents and an 'ideal diet' (Swedish nutrition recommendations objectified [SNO]) list of foods was used to compute polyamine intake using a database of polyamine contents of foods. For polyamine intake estimation, 7-day weighed food records collected from 93 adolescents were entered into dietetic software (Dietist XP) including data on polyamine contents of foods. The content of polyamines in foods recommended according to SNO was entered in the same way. Results: The adolescents' mean daily polyamine intake was 316 +/- 170 mu mol/day, while the calculated contribution according to SNO was considerably higher with an average polyamine intake of 541 mu mol/day. In both adolescent's intake and SNO, fruits contributed to almost half of the total polyamine intake. The reason why the intake among the adolescents was lower than the one calculated from SNO was mainly due to the low vegetable consumption in the adolescents group. Conclusions: The average daily total polyamine intake was similar to that previously reported in Europe. With an 'ideal' diet according to Swedish nutrition recommendations, the intake of this bioactive non-nutrient would be higher than that reported by our adolescents and also higher than that previously reported from Europe.

  • 5.
    Ali, Mohamed Atiya
    et al.
    Novum, Dept Biosci & Nutr, Unit Publ Hlth Nutr, Karolinska Institute, Huddinge, Sweden; Fac Hlth Nutr & Management, Akershus Univ Coll, Lilleström, Norway.
    Poortvliet, Eric
    Novum, Dept Biosci & Nutr, Unit Publ Hlth Nutr, Karolinska Institute, Huddinge, Sweden.
    Stromberg, Roger
    Novum, Dept Biosci & Nutr, Karolinska Institute, Huddinge, Sweden.
    Yngve, Agneta
    Dept Biosci & Nutr, Karolinska Institute, Stockholm, Sweden.
    Polyamines: total daily intake in adolescents compared to the intake estimated from the Swedish Nutrition Recommendations Objectified (SNO)2011In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 55, p. 5455-Article in journal (Refereed)
    Abstract [en]

    Background: Dietary polyamines have been shown to give a significant contribution to the body pool of polyamines. Knowing the levels of polyamines (putrescine, spermidine, and spermine) in different foods and the contribution of daily food choice to polyamine intake is of interest, due to the association of these bioactive amines to health and disease. Objective: To estimate polyamine intake and food contribution to this intake in adolescents compared to a diet fulfilling the Swedish Nutrition Recommendations. Design: A cross-sectional study of dietary intake in adolescents and an 'ideal diet' (Swedish nutrition recommendations objectified [SNO]) list of foods was used to compute polyamine intake using a database of polyamine contents of foods. For polyamine intake estimation, 7-day weighed food records collected from 93 adolescents were entered into dietetic software (Dietist XP) including data on polyamine contents of foods. The content of polyamines in foods recommended according to SNO was entered in the same way. Results: The adolescents' mean daily polyamine intake was 316 +/- 170 mu mol/day, while the calculated contribution according to SNO was considerably higher with an average polyamine intake of 541 mu mol/day. In both adolescent's intake and SNO, fruits contributed to almost half of the total polyamine intake. The reason why the intake among the adolescents was lower than the one calculated from SNO was mainly due to the low vegetable consumption in the adolescents group. Conclusions: The average daily total polyamine intake was similar to that previously reported in Europe. With an 'ideal' diet according to Swedish nutrition recommendations, the intake of this bioactive non-nutrient would be higher than that reported by our adolescents and also higher than that previously reported from Europe.

  • 6.
    Ali, Mohamed Atiya
    et al.
    Karolinska Inst, Novum, Dept Biosci & Nutr, Unit Publ Hlth Nutr, SE-14183 Huddinge, Sweden; Akershus Univ Coll, Fac Hlth Nutr & Management, Lillestrom, Norway.
    Poortvliet, Eric
    Karolinska Inst, Novum, Dept Biosci & Nutr, Unit Publ Hlth Nutr, SE-14183 Huddinge, Sweden.
    Strömberg, Roger
    Karolinska Inst, Novum, Dept Biosci & Nutr, SE-14183 Huddinge, Sweden.
    Yngve, Agneta
    Karolinska Inst, Dept Biosci & Nutr, S-10401 Stockholm, Sweden.
    Polyamines in foods: development of a food database2011In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 55, p. 5572-Article in journal (Refereed)
    Abstract [en]

    Background: Knowing the levels of polyamines (putrescine, spermidine, and spermine) in different foods is of interest due to the association of these bioactive nutrients to health and diseases. There is a lack of relevant information on their contents in foods. Objective: To develop a food polyamine database from published data by which polyamine intake and food contribution to this intake can be estimated, and to determine the levels of polyamines in Swedish dairy products. Design: Extensive literature search and laboratory analysis of selected Swedish dairy products. Polyamine contents in foods were collected using an extensive literature search of databases. Polyamines in different types of Swedish dairy products (milk with different fat percentages, yogurt, cheeses, and sour milk) were determined using high performance liquid chromatography (HPLC) equipped with a UV detector. Results: Fruits and cheese were the highest sources of putrescine, while vegetables and meat products were found to be rich in spermidine and spermine, respectively. The content of polyamines in cheese varied considerably between studies. In analyzed Swedish dairy products, matured cheese had the highest total polyamine contents with values of 52.3, 1.2, and 2.6 mg/kg for putrescine, spermidine, and spermine, respectively. Low fat milk had higher putrescine and spermidine, 1.2 and 1.0 mg/kg, respectively, than the other types of milk. Conclusions: The database aids other researchers in their quest for information regarding polyamine intake from foods. Connecting the polyamine contents in food with the Swedish Food Database allows for estimation of polyamine contents per portion.

  • 7.
    Ali, Mohamed Atiya
    et al.
    Novum, Dept Biosci & Nutr, Unit Publ Hlth Nutr, Karolinska Inst, Huddinge, Sweden;Fac Hlth Nutr & Management, Akershus University College, Lilleström, Norway.
    Poortvliet, Eric
    Novum, Dept Biosci & Nutr, Unit Publ Hlth Nutr, Karolinska Institute, Huddinge, Sweden.
    Strömberg, Roger
    Novum, Dept Biosci & Nutr, Karolinska Institute, Huddinge, Sweden.
    Yngve, Agneta
    Dept Biosci & Nutr, Karolinska Institute, Stockholm, Sweden.
    Polyamines in foods: development of a food database2011In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 55, p. 5572-Article in journal (Refereed)
    Abstract [en]

    Background: Knowing the levels of polyamines (putrescine, spermidine, and spermine) in different foods is of interest due to the association of these bioactive nutrients to health and diseases. There is a lack of relevant information on their contents in foods. Objective: To develop a food polyamine database from published data by which polyamine intake and food contribution to this intake can be estimated, and to determine the levels of polyamines in Swedish dairy products. Design: Extensive literature search and laboratory analysis of selected Swedish dairy products. Polyamine contents in foods were collected using an extensive literature search of databases. Polyamines in different types of Swedish dairy products (milk with different fat percentages, yogurt, cheeses, and sour milk) were determined using high performance liquid chromatography (HPLC) equipped with a UV detector. Results: Fruits and cheese were the highest sources of putrescine, while vegetables and meat products were found to be rich in spermidine and spermine, respectively. The content of polyamines in cheese varied considerably between studies. In analyzed Swedish dairy products, matured cheese had the highest total polyamine contents with values of 52.3, 1.2, and 2.6 mg/kg for putrescine, spermidine, and spermine, respectively. Low fat milk had higher putrescine and spermidine, 1.2 and 1.0 mg/kg, respectively, than the other types of milk. Conclusions: The database aids other researchers in their quest for information regarding polyamine intake from foods. Connecting the polyamine contents in food with the Swedish Food Database allows for estimation of polyamine contents per portion.

  • 8.
    Almon, Ricardo
    et al.
    Örebro University, School of Health and Medical Sciences.
    Nilsson, Torbjorn K.
    Dept Lab Med, Örebro Univ Hosp, Örebro, Sweden.
    Sjöström, Michael
    Unit Prevent Nutr, Dept Biosci & Nutr, Karolinska Institute, Huddinge, Sweden.
    Engfeldt, Peter
    Örebro University, School of Health and Medical Sciences.
    Lactase persistence and milk consumption are associated with body height in Swedish preadolescents and adolescents2011In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 55, article id 7253Article in journal (Refereed)
    Abstract [en]

    Background: Body height is a classic polygenic trait. About 80%-90% of height is inherited and 10%-20% owed to environmental factors, of which the most important ones are nutrition and diseases in preadolescents and adolescents.

    Objective: The aim of this study was to explore potential relations between the LCT (lactase) C > T-13910 polymorphism, milk consumption, and body height in a sample of Swedish preadolescents and adolescents.

    Design: In a cross-sectional study, using a random sample of preadolescents and adolescents (n = 597), dietary intakes were determined. Anthropometric measurements including sexual maturity (Tanner stage) and birth weight were assessed. Parental body height and socio-economic status (SES) were obtained by questionnaires. Genotyping for the LCT C > T-13910 polymorphism that renders individuals lactase persistent (LP) or lactase non-persistent (LNP) was performed by DNA sequencing. Stepwise backward multivariate linear regression was used.

    Results: Milk consumption was significantly and positively associated with body height (beta =0.45; 95% CI: 0.040, 0.87, p =0.032). Adjustments were performed for sex, parental height, birth weight, body mass index (BMI), SES, and Tanner stage. This model explains 90% of the observed variance of body height (adjusted R-2 =0.89). The presence of the -13910 T allele was positively associated with body height (beta = 2.05; 95% CI: 0.18, 3.92, p =0.032).

    Conclusions: Milk consumption is positively associated with body height in preadolescents and adolescents. We show for the first time that a nutrigenetic variant might be able to explain in part phenotypic variation of body height in preadolescents and adolescents. Due to the small sample size further studies are needed.

  • 9. Almon, Ricardo
    et al.
    Nilsson, Torbjörn K
    Department of Laboratory Medicine, Clinical Chemistry, Örebro University Hospital, Örebro, Sweden.
    Sjöström, Michael
    Engfeldt, Peter
    Lactase persistence and milk consumption are associated with body height in Swedish preadolescents and adolescents2011In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 55Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Body height is a classic polygenic trait. About 80%-90% of height is inherited and 10%-20% owed to environmental factors, of which the most important ones are nutrition and diseases in preadolescents and adolescents.

    OBJECTIVE: The aim of this study was to explore potential relations between the LCT (lactase) C>T-13910 polymorphism, milk consumption, and body height in a sample of Swedish preadolescents and adolescents.

    DESIGN: In a cross-sectional study, using a random sample of preadolescents and adolescents (n = 597), dietary intakes were determined. Anthropometric measurements including sexual maturity (Tanner stage) and birth weight were assessed. Parental body height and socio-economic status (SES) were obtained by questionnaires. Genotyping for the LCT C>T-13910 polymorphism that renders individuals lactase persistent (LP) or lactase non-persistent (LNP) was performed by DNA sequencing. Stepwise backward multivariate linear regression was used.

    RESULTS: Milk consumption was significantly and positively associated with body height (β = 0.45; 95% CI: 0.040, 0.87, p = 0.032). Adjustments were performed for sex, parental height, birth weight, body mass index (BMI), SES, and Tanner stage. This model explains 90% of the observed variance of body height (adjusted R(2) = 0.89). The presence of the -13910 T allele was positively associated with body height (β = 2.05; 95% CI: 0.18, 3.92, p = 0.032).

    CONCLUSIONS: Milk consumption is positively associated with body height in preadolescents and adolescents. We show for the first time that a nutrigenetic variant might be able to explain in part phenotypic variation of body height in preadolescents and adolescents. Due to the small sample size further studies are needed.

  • 10.
    Almon, Ricardo
    et al.
    Örebro University, School of Health and Medical Sciences.
    Patterson, Emma
    Unit Prevent Nutr, Dept Biosci & Nutr, Karolinska Inst, Huddinge, Sweden; Sch Biol Sci, Dublin Inst Technol, Dublin, Ireland.
    Nilsson, Torbjörn K.
    Örebro University Hospital, Örebro, Sweden.
    Engfeldt, Peter
    Örebro University, School of Health and Medical Sciences.
    Sjöström, Michael
    Unit Prevent Nutr, Dept Biosci & Nutr, Karolinska Inst, Huddinge, Sweden.
    Body fat and dairy product intake in lactase persistent and non-persistent children and adolescents2010In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 54, article id 5141Article in journal (Refereed)
    Abstract [en]

    Background: Lactase non-persistent (LNP) individuals may be lactose intolerant and therefore on a more restricted diet concerning milk and milk products compared to lactase persistent (LP) individuals. This may have an impact on body fat mass.

    Objective This study examines if LP and LNP children and adolescents, defined by genotyping for the LCT-13910 C > T polymorphism, differ from each other with regard to milk and milk product intake, and measures of body fat mass.

    Design: Children (n=298, mean age 9.6 years) and adolescents (n=386, mean age 15.6 years), belonging to the Swedish part of the European Youth Heart Study, were genotyped for the LCT-13910 C > T polymorphism. Dietary intakes of reduced and full-fat dairy varieties were determined.

    Results: LNP (CC genotype) subjects consumed less milk, soured milk and yoghurt compared to LP (CT/TT genotype) subjects (p<0.001). Subsequent partitioning for age group attenuated this observation (p=0.002 for children and p=0.023 in adolescents). Six subjects were reported by parents to be 'lactose intolerant', none of whom were LNP. LNP children and adolescents consumed significantly less reduced fat milk and milk products than LP children and adolescents (p=0.009 for children and p=0.001 for adolescents).

    Conclusions: We conclude that LP is linked to an overall higher milk and dairy intake, but is not linked to higher body fat mass in children and adolescents.

  • 11. Almon, Ricardo
    et al.
    Patterson, Emma
    Nilsson, Torbjörn K
    Department of Clinical Chemistry, Örebro University Hospital.
    Engfeldt, Peter
    Sjöström, Michael
    Body fat and dairy product intake in lactase persistent and non-persistent children and adolescents2010In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 54, no 5141Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Lactase non-persistent (LNP) individuals may be lactose intolerant and therefore on a more restricted diet concerning milk and milk products compared to lactase persistent (LP) individuals. This may have an impact on body fat mass.

    OBJECTIVE: This study examines if LP and LNP children and adolescents, defined by genotyping for the LCT-13910 C > T polymorphism, differ from each other with regard to milk and milk product intake, and measures of body fat mass.

    DESIGN: Children (n=298, mean age 9.6 years) and adolescents (n=386, mean age 15.6 years), belonging to the Swedish part of the European Youth Heart Study, were genotyped for the LCT-13910 C > T polymorphism. Dietary intakes of reduced and full-fat dairy varieties were determined.

    RESULTS: LNP (CC genotype) subjects consumed less milk, soured milk and yoghurt compared to LP (CT/TT genotype) subjects (p<0.001). Subsequent partitioning for age group attenuated this observation (p=0.002 for children and p=0.023 in adolescents). Six subjects were reported by parents to be 'lactose intolerant', none of whom were LNP. LNP children and adolescents consumed significantly less reduced fat milk and milk products than LP children and adolescents (p=0.009 for children and p=0.001 for adolescents).

    CONCLUSIONS: We conclude that LP is linked to an overall higher milk and dairy intake, but is not linked to higher body fat mass in children and adolescents.

  • 12. Andersson, Asa
    et al.
    Björk, Anne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Kristiansson, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Johansson, Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Vitamin D intake and status in immigrant and native Swedish women: a study at a primary health care centre located at 60 degrees N in Sweden2013In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 57, p. UNSP 20089-Article in journal (Refereed)
    Abstract [en]

    Background: Immigration to Sweden from lower latitude countries has increased in recent years. Studies in the general population in other Nordic countries have demonstrated that these groups are at risk of developing vitamin D deficiency, but studies in primary health care patients are rare. Objectives: The aim of this study is to examine possible differences in plasma-25(OH)-vitamin D levels and intake of vitamin D between Swedish and immigrant female patients in a primary health care centre located at 60 degrees N, where half of the inhabitants have an immigrant background. Another objective was to estimate what foods contribute with most vitamin D. Design: Thirty-one female patients from the Middle East and Africa and 30 from Sweden were recruited. P-25(OH)D was measured and intake of vitamin D was estimated with a modified food frequency questionnaire (FFQ). Results: Vitamin D deficiency (plasma-25(OH)D<25 nmol/L) was common among immigrant women (61%). One immigrant woman and half of the Swedish women had optimal levels (plasma-25(OH)D>50 nmol/L). There was a positive correlation between the intake of vitamin D from food and plasma-25(OH) D. Only three women, all Swedish, reached the recommended intake of vitamin D from food. The immigrant women had lower intake compared to Swedish women (median: 3.1 vs. 5.1 mu g/day). The foods that contributed with most vitamin D were fatty fish, fortified milk and margarine. Immigrant women consumed less fortified milk and margarine but more meat. Irrespective of origin, patients with plasma-25(OH)D<25 nmol/L consumed less margarine but more meat. Conclusion: Vitamin D deficiency was common in the immigrant patients and their intake of vitamin D was lower. This highlights the need to target information about vitamin D to immigrant women in order to decrease the risk for vitamin D deficiency. The FFQ was well adapted to its purpose to estimate intake of vitamin D.

  • 13.
    Brantsaeter, Anne Lise
    et al.
    Norwegian Institute Public Heatlh, Norway .
    Olafsdottir, Anna S.
    University of Iceland, Iceland .
    Forsum, Elisabet
    Linköping University, Department of Clinical and Experimental Medicine, Nutrition. Linköping University, Faculty of Health Sciences.
    Olsen, Sjurdur F.
    Statens Serum Institute, Denmark .
    Thorsdottir, Inga
    Landspitali University Hospital, Iceland .
    Does milk and dairy consumption during pregnancy influence fetal growth and infant birthweight? A systematic literature review2012In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 56Article, review/survey (Refereed)
    Abstract [en]

    It is increasingly acknowledged that the maternal diet influences fetal development and health of the child. Milk and milk products contribute essential nutrients and bioactive substances; they are of ample supply and have a long tradition in Nordic countries. To revise and update dietary guidelines for pregnant women valid in Nordic countries, the Pregnancy and Lactation expert group within the NNR5 project identified a need to systematically review recent scientific data on infant growth measures and maternal milk consumption. The objective of this study was to assess the influence of milk and dairy consumption during pregnancy on fetal growth through a systematic review of studies published between January 2000 and December 2011. A literature search was run in June 2011. Two authors independently selected studies for inclusion from the 495 abstracts according to predefined eligibility criteria. A complementary search in January 2012 revealed 64 additional abstracts published during the period June to December 2011, among them one study of interest previously identified. Of the 33 studies extracted, eight were relevant research papers. Five were prospective cohort studies (including a retrospective chart review), one was a case-control study, and two were retrospective cohort studies. For fetal length or infant birth length, three studies reported no association and two reported positive associations with milk or dairy consumption. For birthweight related outcomes, two studies reported no associations, and four studies reported positive associations with milk and/or dairy consumption. There was large heterogeneity in exposure range and effect size between studies. A beneficial fetal growth-increase was most pronounced for increasing maternal milk intake in the lower end of the consumption range. Evidence from prospective cohort studies is limited but suggestive that moderate milk consumption relative to none or very low intake, is positively associated with fetal growth and infant birthweight in healthy, Western populations.

  • 14.
    Domellöf, Magnus
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Thorsdottir, Inga
    Thorstensen, Ketil
    Health effects of different dietary iron intakes: a systematic literature review for the 5th Nordic Nutrition Recommendations2013In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 57, no 21667Article, review/survey (Refereed)
    Abstract [en]

    Background: The present literature review is part of the NNR5 project with the aim of reviewing and updating the scientific basis of the 4th edition of the Nordic Nutrition Recommendations (NNR) issued in 2004. Objective: The objective of this systematic literature review was to assess the health effects of different intakes of iron, at different life stages (infants, children, adolescents, adults, elderly, and during pregnancy and lactation), in order to estimate the requirement for adequate growth, development, and maintenance of health.

    Methods: The initial literature search resulted in 1,076 abstracts. Out of those, 276 papers were identified as potentially relevant. Of those, 49 were considered relevant and were quality assessed (A, B, or C). An additional search on iron and diabetes yielded six articles that were quality assessed. Thus, a total of 55 articles were evaluated. The grade of evidence was classified as convincing (grade 1), probable (grade 2), suggestive (grade 3), and inconclusive (grade 4).

    Results: There is suggestive evidence that prevention or treatment of iron deficiency (ID) and iron deficiency anemia (IDA) improves cognitive, motoric, and behavioral development in young children, and that treatment of IDA improves attention and concentration in school children and adult women. There is insufficient evidence to show negative health effects of iron intakes in doses suggested by the NNR 4. There is insufficient evidence to suggest that normal birth weight, healthy, exclusively breast-fed infants need additional dietary iron before 6 months of life in the Nordic countries. An iron concentration of 4-8 mg/L in infant formulas seems to be safe and effective for normal birth weight infants. There is probable evidence that iron supplements (1-2 mg/kg/day) given up to 6 months of age to infants with low birth weight (<2,500 g) prevents IDA and possibly reduce the risk of behavioral problems later on. There is probable evidence that ID and IDA in pregnant women can be effectively prevented by iron supplementation at a dose of 40 mg/day from week 18-20 of gestation. There is probable evidence that a high intake of heme iron, but not total dietary, non-heme or supplemental iron, is associated with increased risk of type 2 diabetes (T2D) and gestational diabetes.

    Conclusions: Overall, the evidence does not support a change of the iron intakes recommended in the NNR 4. However, one could consider adding recommendations for infants below 6 months of age, low birth weight infants and pregnant women.

  • 15.
    Engelheart, Stina
    et al.
    Örebro University, School of Medical Sciences.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    Assessment of nutritional status in the elderly: a proposed function-driven model2018In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 62, article id 1366Article in journal (Refereed)
    Abstract [en]

    Background: There is no accepted or standardized definition of 'malnutrition'. Hence, there is also no definition of what constitutes an adequate nutritional status. In elderly people, assessment of nutritional status is complex and is complicated by multi-morbidity and disabilities combined with nutrition-related problems, such as dysphagia, decreased appetite, fatigue, and muscle weakness.

    Objective: We propose a nutritional status model that presents nutritional status from a comprehensive functional perspective. This model visualizes the complexity of the nutritional status in elderly people.

    Design and results: The presented model could be interpreted as the nutritional status is conditional to a person's optimal function or situation. Another way of looking at it might be that a person's nutritional status affects his or her optimal situation. The proposed model includes four domains: (1) physical function and capacity; (2) health and somatic disorders; (3) food and nutrition; and (4) cognitive, affective, and sensory function. Each domain has a major impact on nutritional status, which in turn has a major impact on the outcome of each domain.

    Conclusions: Nutritional status is a multifaceted concept and there exist several knowledge gaps in the diagnosis, prevention, and optimization of treatment of inadequate nutritional status in elderly people. The nutritional status model may be useful in nutritional assessment research, as well as in the clinical setting.

  • 16.
    Forsum, Elisabet
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Nutrition. Linköping University, Faculty of Health Sciences.
    Brantsaeter, Anne Lise
    Norwegian Institute Public Heatlh, Norway .
    Olafsdottir, Anna-Sigrid
    Landspitali University Hospital, Iceland .
    Olsen, Sjurdur F.
    Statens Serum Institute, Denmark .
    Thorsdottir, Inga
    Landspitali University Hospital, Iceland .
    Weight loss before conception: A systematic literature review2013In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 57Article, review/survey (Refereed)
    Abstract [en]

    The prevalence of overweight and obesity in women has increased during the last decades. This is a serious concern since a high BMI before conception is an independent risk factor for many adverse outcomes of pregnancy. Therefore, dietary counseling, intended to stimulate weight loss in overweight and obese women prior to conception has recently been recommended. However, dieting with the purpose to lose weight may involve health risks for mother and offspring. We conducted a systematic literature review to identify papers investigating the effects of weight loss due to dietary interventions before conception. The objective of this study is to assess the effect of weight loss prior to conception in overweight or obese women on a number of health-related outcomes in mother and offspring using studies published between January 2000 and December 2011. Our first literature search produced 486 citations and, based on predefined eligibility criteria, 58 were selected and ordered in full text. Two group members read each paper. Fifteen studies were selected for quality assessment and two of them were considered appropriate for inclusion in evidence tables. A complementary search identified 168 citations with four papers being ordered in full text. The two selected studies provided data for overweight and obese women. One showed a positive effect of weight loss before pregnancy on the risk of gestational diabetes and one demonstrated a reduced risk for large-for-gestational-age infants in women with a BMI above 25 who lost weight before pregnancy. No study investigated the effect of weight loss due to a dietary intervention before conception. There is a lack of studies on overweight and obese women investigating the effect of dietary-induced weight loss prior to conception on health-related variables in mother and offspring. Such studies are probably lacking since they are difficult to conduct. Therefore, alternative strategies to control the body weight of girls and women of reproductive age are needed.

  • 17.
    Hefni, Mohammed E.
    et al.
    Swedish University of Agricultural Sciences, Uppsala;Mansoura University, Egypt.
    Witthöft, Cornelia M.
    Swedish University of Agricultural Sciences, Uppsala.
    Enhancement of the folate content in Egyptian pita bread.2012In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 56Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Egypt has a high incidence of neural tube defects related to folate deficiency. One major food source for folate is pita (baladi) bread, which is consumed daily. Bioprocessing (e.g. germination) has been reported to increase the folate content in cereals. The aim was to produce pita bread with increased folate content using germinated wheat flour (GWF).

    METHODS: Prior to milling the effects of germination and drying conditions on folate content in wheat grains were studied. Pita bread was baked from wheat flour substituted with different levels of GWF. The folate content in dough and bread and rheological properties of dough were determined.

    RESULTS: Germination of wheat grains resulted in, depending on temperature, 3- to 4-fold higher folate content with a maximum of 61 µg/100 g DM (dry matter). The folate content in both flour and bread increased 1.5 to 4-fold depending on the level of flour replacement with GWF. Pita bread baked with 50% sieved GWF was acceptable with respect to colour and layer separation, and had a folate content of 50 µg/100 g DM compared with 30 µg/100 g DM in conventional pita bread (0% GWF).

    CONCLUSION: Using 50% GWF, pita bread with increased folate content, acceptable for the Egyptian consumer, was produced. Consumption of this bread would increase the average daily folate intake by 75 µg.

  • 18. Holmer, A.
    et al.
    Hausner, H.
    Reinbach, H.C.
    Bredie, W.L.P.
    Wendin, Karin
    SIK – Institutet för livsmedel och bioteknik.
    Acceptance of Nordic snack bars in children aged 8-11 years2012In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 56Article in journal (Refereed)
    Abstract [en]

    Background: A health promoting diet is suggested to be tailored to regional circumstances to preserve the cultural diversity in eating habits, as well as contribute to more environmentally friendly eating. It may influence consumer acceptance, however, if the components of the diet differs considerably from their habitual food. Objective: This study aimed to investigate whether snack bars composed of Nordic ingredients were accepted by 8-11 year-old Danish (n = 134) and Swedish (n = 109) children. Design: A seven-point hedonic scale was used to measure the children's acceptance of five snack bars that varied in their composition of whole grains, berries and nuts. A preference rank ordering of the five bars was also performed. Results: The results showed that samples that were rated highest in liking and were most preferred in both countries were a kamut/pumpkin bar and an oat/cranberry bar. The sample with the lowest rating that was also least preferred was a pumpernickel/sea buckthorn bar. Flavour was the most important determinant of overall liking followed by texture, odour and appearance. Conclusions: Children's acceptances and preferences were highly influenced by the sensory characteristics of the bars, mainly flavour. In agreement with earlier studies, the novel food ingredients seemed to influence children's preferences. The Nordic snack bars may have a potential to be a snack option for Danish and Swedish school children, but repeated exposures to the products are recommended to increase children's acceptance. © 2012 Anna Holmer et al.

  • 19. Holmer, A
    et al.
    Hausner, H
    Reinbach, H.C.
    Bredie, W.L.P.
    Wendin, Karin
    SP - The Technical Research Institute of Sweden.
    Acceptance of Nordic snack bars in children aged 8-11 years2012In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 56, no 10484Article in journal (Refereed)
    Abstract [en]

    Background: A health promoting diet is suggested to be tailored to regional circumstances to preserve the cultural diversity in eating habits, as well as contribute to more environmentally friendly eating. It may influence consumer acceptance, however, if the components of the diet differs considerably from their habitual food. Objective: This study aimed to investigate whether snack bars composed of Nordic ingredients were accepted by 8-11 year-old Danish (n=134) and Swedish (n=109) children. Design: A seven-point hedonic scale was used to measure the children’s acceptance of five snack bars that varied in their composition of whole grains, berries and nuts. A preference rank ordering of the five bars was also performed. Results: The results showed that samples that were rated highest in liking and were most preferred in both countries were a kamut/pumpkin bar and an oat/cranberry bar. The sample with the lowest rating that was also least preferred was a pumpernickel/sea buckthorn bar. Flavour was the most important determinant of overall liking followed by texture, odour and appearance. Conclusions: Children’s acceptances and preferences were highly influenced by the sensory characteristics of the bars, mainly flavour. In agreement with earlier studies, the novel food ingredients seemed to influence children’s preferences. The Nordic snack bars may have a potential to be a snack option for Danish and Swedish school children, but repeated exposures to the products are recommended to increase children’s acceptance.

  • 20.
    Håkansson, Andreas
    Kristianstad University, School of Education and Environment, Avdelningen för Praktisk-estetiska ämnen.
    Has it become increasingly expensive to follow a nutritious diet?: Insights from a new price index for nutritious diets in Sweden 1980-20122015In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 59, article id 26932Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Health-related illnesses such as obesity and diabetes continue to increase, particularly in groups of low socioeconomic status. The increasing cost of nutritious food has been suggested as an explanation.

    OBJECTIVE: To construct a price index describing the cost of a diet adhering to nutritional recommendations for a rational and knowledgeable consumer and, furthermore, to investigate which nutrients have become more expensive to obtain over time.

    METHODS: Linear programming and goal programming were used to calculate two optimal and nutritious diets for each year in the interval under different assumptions. The first model describes the rational choice of a cost-minimizing consumer; the second, the choice of a consumer trying to deviate as little as possible from average consumption. Shadow price analysis was used to investigate how nutrients contribute to the diet cost.

    RESULTS: The cost of a diet adhering to nutritional recommendations has not increased more than general food prices in Sweden between 1980 and 2012. However, following nutrient recommendations increases the diet cost even for a rational consumer, particularly for vitamin D, iron, and selenium. The cost of adhering to the vitamin D recommendation has increased faster than the general food prices.

    CONCLUSIONS: Not adhering to recommendations (especially those for vitamin D) offers an opportunity for consumers to lower the diet cost. However, the cost of nutritious diets has not increased more than the cost of food in general between 1980 and 2012 in Sweden.

  • 21.
    Håkansson, Andreas
    et al.
    Kristianstad University.
    Andersson, Håkan S.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Granfeldt, Yvonne
    Lund University.
    Diet inequality prevails among consumers interested and knowledgeable in nutrition2015In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 59, article id 27601Article in journal (Refereed)
    Abstract [en]

    Previous studies have demonstrated a correlation between diet cost and adherence to nutritional recommendations among consumers in general. This has adverse effects on diet and health inequality. It could be hypothesized that consumers knowledgeable in nutrition escape this correlation

  • 22.
    Hörnell, Agneta
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Lagstrom, Hanna
    Lande, Britt
    Thorsdottir, Inga
    Protein intake from 0 to 18 years of age and its relation to health: a systematic literature review for the 5th Nordic Nutrition Recommendations2013In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 57, p. 21083-Article, review/survey (Refereed)
    Abstract [en]

    The present systematic literature review is a part of the 5th revision of the Nordic Nutrition Recommendations. The aim was to assess the health effects of different levels of protein intake in infancy and childhood in a Nordic setting. The initial literature search resulted in 435 abstracts, and 219 papers were identified as potentially relevant. Full paper selection resulted in 37 quality-assessed papers (4A, 30B, and 3C). A complementary search found four additional papers (all graded B). The evidence was classified as convincing, probable, limited-suggestive, and limited-inconclusive. Higher protein intake in infancy and early childhood is convincingly associated with increased growth and higher body mass index in childhood. The first 2 years of life is likely most sensitive to high protein intake. Protein intake between 15 E% and 20 E% in early childhood has been associated with an increased risk of being overweight later in life, but the exact level of protein intake above which there is an increased risk for being overweight later in life is yet to be established. Increased intake of animal protein in childhood is probably related to earlier puberty. There was limited-suggestive evidence that intake of animal protein, especially from dairy, has a stronger association with growth than vegetable protein. The evidence was limited-suggestive for a positive association between total protein intake and bone mineral content and/ or other bone variables in childhood and adolescence. Regarding other outcomes, there were too few published studies to enable any conclusions. In conclusion, the intake of protein among children in the Nordic countries is high and may contribute to increased risk of later obesity. The upper level of a healthy intake is yet to be firmly established. In the meantime, we suggest a mean intake of 15 E% as an upper limit of recommended intake at 12 months, as a higher intake may contribute to increased risk for later obesity.

  • 23.
    Hörnell, Agneta
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Lagström, Hanna
    Lande, Britt
    Thorsdottir, Inga
    Breastfeeding, introduction of other foods and effects on health: a systematic literature review for the 5th Nordic Nutrition Recommendations2013In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 57Article, review/survey (Refereed)
    Abstract [en]

    The present systematic literature review is part of the 5th revision of the Nordic Nutrition Recommendations. The overall aim was to review recent scientific data valid in a Nordic setting on the short-and long-term health effects of breastfeeding (duration of both any and exclusive breastfeeding) and introduction of foods other than breast milk. The initial literature search resulted in 2,011 abstracts; 416 identified as potentially relevant. Full paper review resulted in 60 quality assessed papers (6A, 48B, and 6C). A complementary search found some additional papers. The grade of evidence was classified as convincing, probable, limited-suggestive, and limited-no conclusion. The evidence was convincing of a protective dose/duration effect of breastfeeding against overweight and obesity in childhood and adolescence, overall infections, acute otitis media, and gastrointestinal and respiratory tract infections. The evidence was probable that exclusive breastfeeding for longer than 4 months is associated with slower weight gain during the second half of the first year which could be part of the reason behind the reduced risk of later overweight or obesity. There was also probable evidence that breastfeeding is a protective factor against inflammatory bowel disease, celiac disease, and diabetes (type 1 and 2), provides beneficial effects on IQ and developmental scores of children as well as a small reductive effect on blood pressure and blood cholesterol levels in adulthood. Other associations explored were limited-suggestive or inconclusive. In conclusion, convincing and probable evidence was found for benefits of breastfeeding on several outcomes. The recommendation in NNR2004 about exclusive breastfeeding for 6 months and continued partial breastfeeding thereafter can stand unchanged. The relatively low proportion of infants in the Nordic countries following this recommendation indicates that strategies that protect, support and promote breastfeeding should be enhanced, and should also recognize the benefits for long-term health.

  • 24.
    Hörnell, Agneta
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Waling, Maria
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Olafsdottir, Anna Sigridur
    School of Education, University of Iceland, Reykjavik, Iceland.
    Lagström, Hanna
    Turku Institute of Child and Youth Research, University of Turku, Turku, Finland.
    Wergedahl, Hege
    Faculty of Education, Bergen University College, Bergen, Norway,.
    Jonsson, Bert
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Olsson, Cecilia
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Fossgard, Eldbjörg
    Faculty of Education, Bergen University College, Bergen, Norway.
    Holthe, Asle
    Faculty of Education, Bergen University College, Bergen, Norway.
    Talvia, Sanna
    Turku Institute of Child and Youth Research, University of Turku, Turku, Finland.
    Gunnarsdottir, Ingibjörg
    Unit for Nutrition Research, Landspitali, The National University Hospital of Iceland, and Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
    School meals and health: the PROMEAL-study2016In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 60, no 1, article id 31961Article in journal (Refereed)
  • 25. Isaksson, Hanna
    et al.
    Landberg, Rikard
    Sundberg, Birgitta
    Lundin, Eva
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Faculty of Medicine, Department of Biobank Research.
    Zhang, Jie-Xian
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Tidehag, Per
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Knudsen, Knud Erik Bach
    Moazzami, Ali A.
    Åman, Per
    High-fiber rye diet increases ileal excretion of energy and macronutrients compared with low-fiber wheat diet independent of meal frequency in ileostomy subjects2013In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 57, p. 18519-Article in journal (Refereed)
    Abstract [en]

    Background: Whole-grain foods and cereal dietary fiber intake is associated with lower body weight. This may partly result from lower energy utilization of high-fiber diets. Objective: In the present study, the impact on ileal excretion of energy and macronutrients in response to a rye bread high-fiber diet compared to a refined wheat low-fiber diet was investigated. Furthermore, the effect of meal frequency on apparent absorption of nutrients was studied for the first time. Design: Ten participants that had undergone ileostomy consumed standardized iso-caloric diets, including low-fiber wheat bread (20 g dietary fiber per day) for 2 weeks followed by high-fiber rye bread (52 g dietary fiber per day) for 2 weeks. The diets were consumed in an ordinary (three meals per day) and a nibbling (seven meals per day) meal frequency in a cross-over design. Ileal effluents were collected during 24 h at the third day of each of the four dietary periods and analyzed for gross energy and nutrient contents. Results: The results showed that intake of rye bread high-fiber diet compared to the refined wheat low-fiber diet caused an increase in ileal excretion of energy and macronutrients. The effect was independent of meal frequency. This suggests that a high intake of rye may result in lower availability of macronutrients for small intestinal digestion and absorption. A regular intake of rye may therefore have implications for weight management.

  • 26. Jonsdottir, Svandis Erna
    et al.
    Brader, Lea
    Gunnarsdottir, Ingibjorg
    Magnusdottir, Ola Kally
    Schwab, Ursula
    Kolehmainen, Marjukka
    Risérus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Herzig, Karl-Heinz
    Cloetens, Lieselotte
    Helgegren, Hannah
    Johansson-Persson, Anna
    Hukkanen, Janne
    Poutanen, Kaisa
    Uusitupa, Matti
    Hermansen, Kjeld
    Thorsdottir, Inga
    Adherence to the Nordic Nutrition Recommendations in a Nordic population with metabolic syndrome: high salt consumption and low dietary fibre intake (The SYSDIET study)2013In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 57, p. UNSP 21391-Article, review/survey (Refereed)
    Abstract [en]

    Background: The Nordic countries collaborate in setting recommendations for intake of nutrients by publishing the Nordic Nutrition Recommendations (NNR). Studies exploring how well the Nordic population adheres to the NNR are limited and none are available for the metabolic syndrome (MetS) subgroup. Individuals with MetS are a large part of the adult Nordic population and their diet's nutritional quality is of great importance as it can affect the progression of MetS. Objective: To evaluate nutritional intake in a cohort of Nordic adults with MetS or MetS risk factors and their adherence to the NNR. Design: A multi-centre study was carried out in six centres in four Nordic countries (SYSDIET CoE). Participants (n = 175) were 30-65 years of age, with BMI 27-38 kg/m(2) and had at least two criteria for MetS. The NNR was used to evaluate the baseline nutrient intake calculated from the participants' 4-day food diaries using national nutrient databases. Results: Less than 20% of participants consumed <= 10 E% from saturated fat as recommended in the NNR. Recommended intake (RI) of polyunsaturated fat was met by approximately one-third of participants. Only 20% of men and 26% of women met the RI of dietary fibre. Intake below the defined lower intake level of 2.5 mu g/day for vitamin D was observed in nearly 20% of participants. The daily median intake of salt was 8.8 g for men and 6.7 g for women. Conclusion: Dietary quality of this Nordic population with Mets or MetS risk factors is unsatisfactory and characterised by high intakes of SFA and sodium and low intakes of PUFA and dietary fibre. Vitamin D intake was below RI level in a large part of the population. Authorities in the Nordic countries are encouraged to develop intervention programmes for high-risk groups.

  • 27.
    Lassen, Anne Dahl
    et al.
    Division for Risk Assessment and Nutrition, Technical University of Denmark, Kemitorvet, Lyngby, Denmark.
    Fagt, Sisse
    Division for Risk Assessment and Nutrition, Technical University of Denmark, Kemitorvet, Lyngby, Denmark.
    Lennernäs, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science.
    Nyberg, Maria
    Department of Food and Meal Science, Kristianstad University, Kristianstad, Sweden.
    Haapalar, Irja
    School of Social and Political Sciences, The University of Melbourne, Melbourne, Victoria, Australia; School of Applied Educational Sciences and Teacher Education, Savonlinna, Finland.
    Thorsen, Anne V.
    Division for Risk Assessment and Nutrition, Technical University of Denmark, Kemitorvet, Lyngby, Denmark.
    Møbjerg, Anna C. M.
    Institute for Nursing and Nutrition, University College Copenhagen, Copenhagen N, Denmark.
    Beck, Anne M.
    Institute for Nursing and Nutrition, University College Copenhagen, Copenhagen N, Denmark; Clinical Nutrition Research Unit, Copenhagen University Hospital Herlev-Gentofte, Gentofte, Denmark.
    The impact of worksite interventions promoting healthier food and/or physical activity habits among employees working 'around the clock' hours: a systematic review2018In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 62, article id 1115Article, review/survey (Refereed)
    Abstract [en]

    We conducted a systematic review of randomised studies on the impact of worksite interventions to promote healthier food and/or physical activity among people who work irregular hours 'around the clock', that is, outside of ordinary daytime working hours. The population-intervention-comparator-outcomes-study (PICOS) design format was used. Data sources were PubMed and CINAHL. An updated search was conducted on October 2017 using Google Scholar and the related articles function in PubMed on initially included studies to identify additional studies. Risk of bias was used to assess study quality. A total of seven studies (reports published in 14 papers) were included in the systematic review: Two interventions with a broader lifestyle approach, three focusing on physical exercise and two on providing healthier food or meal options. The studies had sample sizes from 30 to 1,000 and targeted a mixture of occupations, including both male- and female-dominated occupational groups. The interventions lasted from 2 to 12 months. Only one had an extended follow-up. In general, the studies showed small-to-moderate effect sizes on several measures, including dietary and/or physical activity measures, suggesting acceptable effectiveness for interventions involving community-level behaviour change. Our findings highlight a need to further develop and implement well-designed health promotion interventions with comparable outcome measures and effect size reports. A mixture of health promotion strategies is recommended for future practice in this target population, including individually tailored programmes, improving the food and physical activity environment and using broader lifestyle approaches including the use of participatory and empowerment strategies. While more research is needed in this field, the existing knowledge base on effective approaches awaits translation into practice.

  • 28. Malmgren A, Anna
    et al.
    Hede, G W
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Lundquist, P
    Wirén, Mikael
    Faxén Irving, Gerd
    Indications for percultaneous endoscopic gastrostomy and survival in old adults2011In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 55, p. 6037-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Many diseases striking old adults result in eating difficulties. Indications for selecting individuals for percutaneous endoscopic gastrostomy (PEG) are unclear and everybody may not benefit from the procedure.

    OBJECTIVE:

    The aim of this study was to evaluate indications for and survival after PEG insertion in patients older than 65 years.

    DESIGN AND METHODS:

    A retrospective analysis including age, gender, diagnosis, indication, and date of death was made in 201 consecutive individuals, 94 male, mean age 79±7 years, who received a nutritional gastrostomy.

    RESULTS:

    Dysphagia was present in 86% of the patients and stroke was the most common diagnosis (49%). Overall median survival was 123 days and 30-day mortality was 22%. Patients with dementia and Mb Parkinson had the longest survival (i.e. 244 and 233 days), while those with other neurological diseases, and head and neck malignancy had the shortest (i.e. 75 and 106 days). There was no difference in mortality in patients older or younger than 80 years, except in patients with dementia.

    CONCLUSIONS:

    Old age should not be a contraindication for PEG. A high 30-day mortality indicates that there is a need of better criteria for selection and timing of PEG insertion in the elderly.

  • 29.
    Moen, Inger E
    et al.
    Norwegian Resource Centre for Cystic Fibrosis, Oslo University Hospital, Norway.
    Nilsson, Kristina
    Stockholm Cystic Fibrosis Center, Karolinska University Hospital, Karolinska Institutet Huddinge, Stockholm, Sweden.
    Andersson, Anna
    Stockholm Cystic Fibrosis Center, Karolinska University Hospital, Karolinska Institutet Huddinge, Stockholm, Sweden.
    Fagerland, Morten W
    Unit of Biostatistics and Epidemiology, Oslo University Hospital, Norway.
    Fluge, Gjermund
    Department of Pediatrics, Haukeland University Hospital, Department of Pediatrics, Haukeland University Hospital, Bergen, Norway.
    Hollsing, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Gilljam, Marita
    Department of Pulmonary Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Mared, Lena
    Heart and Lung Center Lund University Hospital, Lund University, Sweden.
    Pressler, Tacjana
    Department of Pediatrics Cystic Fibrosis Center, Copenhagen University Hospital, Denmark.
    Santi, Henriette
    Department of Pediatrics, Haukeland University Hospital, Department of Pediatrics, Haukeland University Hospital, Bergen, Norway.
    Storrøsten, Olav-Trond
    Norwegian Resource Centre for Cystic Fibrosis, Oslo University Hospital, Norway.
    Hjelte, Lena
    Stockholm Cystic Fibrosis Center, Karolinska University Hospital, Karolinska Institutet Huddinge, Stockholm, Sweden.
    Dietary intake and nutritional status in a Scandinavian adult cystic fibrosis-population compared with recommendations2011In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 55, p. 7561-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Malnutrition is a well-known complication in cystic fibrosis (CF). There is good evidence that maintaining a normal body-weight correlates well with improved survival in CF. Energy intake in excess of 120% of the estimated average requirement (EAR) has been advised since 1980s.

    OBJECTIVES:

    To investigate the nutritional intake and status in the adult Scandinavian CF-population.

    SUBJECTS/METHODS:

    A cross-sectional multi-centre study was used to investigate the nutritional status of 456 adult CF-patients (2003 2006). Height and weight were measured and body mass index (BMI) and z-scores were calculated. Pulmonary function was examined by dynamic spirometry. A 7-day pre-coded food record (FR) obtained energy and nutrient intake data in 180 patients.

    RESULTS:

    The mean energy intake was 114 (SD 30.0)% of EAR and thus significantly lower than the target of 120% EAR (p< 0.001) for patients with pancreatic insufficiency (PI) (n=136). Mean BMI was 22.0 (SD 2.9), the prevalence of BMI <18 was 13% and the prevalence of BMI ≥25 was 15% (n=136). Mean BMI was 20.8 (SD 2.4) in PI-patients with FEV(1) <70% and 23.2% (SD 3.0), in PI-patients with FEV(1) ≥70%, mean difference 2.4, (95% CI: 1.5, 3.3) (p<0.001), but there was no difference in energy intake. BMI ≥18.5 and a reported energy intake <120% were revealed in 54% of the PI-patients.

    CONCLUSIONS:

    The energy intake did not reach the recommended 120% EAR, but the prevalence of underweight was lower than reported in other studies. The recommendation may exceed the requirement for a number of CF-patients. The nutritional status must still be closely monitored and nutritional advice and intervention should be individualised and adjusted to actual needs.

  • 30.
    Monteagudo, Celia
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics. Univ Granada, Dept Nutr & Food Sci, Res Grp Nutr Diet & Risk Assessment AGR255, Granada, Spain..
    Scander, Henrik
    Örebro Univ, Sch Hospitality Culinary Arts & Meal Sci, Örebro, Sweden..
    Nilsen, Bente
    Örebro Univ, Sch Hospitality Culinary Arts & Meal Sci, Örebro, Sweden..
    Yngve, Agneta
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Folate intake in a Swedish adult population: Food sources and predictive factors2017In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 61, no 1, article id 1328960Article in journal (Refereed)
    Abstract [en]

    Introduction: Folate plays an important role in cell metabolism, but international studies show that intake is currently below recommendations, especially among women. The study objective was to identify folate food sources by food group, gender, and age group, and to identify factors influencing folate intake, based on food consumption data for Swedish adults in the 2010-11 Riksmaten study.

    Methods: The sample included a representative Swedish population aged 18-80 years (n = 1657; 56.3% female). Food and nutrient intakes were estimated from self-reported food records during 4 consecutive days. Food consumption was categorized into 26 food groups. Stepwise regression was used to analyze food groups as folate sources for participants. Factors predicting the highest folate intake (third tertile) were determined by logistic regression analysis.

    Results: Vegetables and pulses represented the most important folate source for all age groups and both genders, especially in women aged 45-64 years (49.7% of total folate intake). The next folate source in importance was dairy products for the youngest group (18-30 years), bread for men, and fruit and berries for women. The likelihood of being in the highest tertile of folate intake (odds ratio = 1.69, 95% confidence interval 1.354-2.104) was higher for men. Influencing factors for folate intake in the highest tertile were low body mass index and high educational level in the men, and high educational level, vegetarian diet, organic product consumption, nonsmoking, and alcohol consumption within recommendations in the women.

    Conclusion: This study describes the folate intake per food group of Swedish adults according to the 2010-11 Riksmaten survey, identifying vegetables and pulses as the most important source. Data obtained on factors related to folate consumption may be useful for the development of specific nutrition education programs to increase the intake of this vitamin in high-risk groups.

  • 31.
    Monteagudo, Celia
    et al.
    Örebro University, School of Hospitality, Culinary Arts & Meal Science. Department of Food, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden; Research Group on Nutrition, Diet and Risk Assessment-AGR255, Department of Nutrition and Food Science, University of Granada, Granada, Spain.
    Scander, Henrik
    Örebro University, School of Hospitality, Culinary Arts & Meal Science.
    Nilsen, Bente
    Örebro University, School of Hospitality, Culinary Arts & Meal Science.
    Yngve, Agneta
    Örebro University, School of Hospitality, Culinary Arts & Meal Science. Department of Food, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden.
    Folate intake in a Swedish adult population: Food sources and predictive factors2017In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 61, article id 1328960Article in journal (Refereed)
    Abstract [en]

    Introduction: Folate plays an important role in cell metabolism, but international studies show that intake is currently below recommendations, especially among women. The study objective was to identify folate food sources by food group, gender, and age group, and to identify factors influencing folate intake, based on food consumption data for Swedish adults in the 2010-11 Riksmaten study.

    Methods: The sample included a representative Swedish population aged 18-80 years (n = 1657; 56.3% female). Food and nutrient intakes were estimated from self-reported food records during 4 consecutive days. Food consumption was categorized into 26 food groups. Stepwise regression was used to analyze food groups as folate sources for participants. Factors predicting the highest folate intake (third tertile) were determined by logistic regression analysis.

    Results: Vegetables and pulses represented the most important folate source for all age groups and both genders, especially in women aged 45-64 years (49.7% of total folate intake). The next folate source in importance was dairy products for the youngest group (18-30 years), bread for men, and fruit and berries for women. The likelihood of being in the highest tertile of folate intake (odds ratio = 1.69, 95% confidence interval 1.354-2.104) was higher for men. Influencing factors for folate intake in the highest tertile were low body mass index and high educational level in the men, and high educational level, vegetarian diet, organic product consumption, nonsmoking, and alcohol consumption within recommendations in the women.

    Conclusion: This study describes the folate intake per food group of Swedish adults according to the 2010-11 Riksmaten survey, identifying vegetables and pulses as the most important source. Data obtained on factors related to folate consumption may be useful for the development of specific nutrition education programs to increase the intake of this vitamin in high-risk groups.

  • 32.
    Moraeus, Lotta
    et al.
    Natl Food Agcy, Dept Risk & Benefit Assessment, Uppsala, Sweden.
    Warensjö Lemming, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics. Natl Food Agcy, Dept Risk & Benefit Assessment, Uppsala, Sweden.
    Hursti, Ulla-Kaisa Koivisto
    Natl Food Agcy, Dept Risk & Benefit Assessment, Uppsala, Sweden.
    Arnemo, Marianne
    Natl Food Agcy, Dept Risk & Benefit Assessment, Uppsala, Sweden.
    Sipinen, Jessica Petrelius
    Natl Food Agcy, Dept Risk & Benefit Assessment, Uppsala, Sweden.
    Lindroos, Anna-Karin
    Natl Food Agcy, Dept Risk & Benefit Assessment, Uppsala, Sweden;Univ Gothenburg, Sahlgrenska Acad, Dept Internal Med & Clin Nutr, Inst Med, Gothenburg, Sweden.
    Riksmaten Adolescents 2016-17: A national dietary survey in Sweden - design, methods, and participation2018In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 62, article id 1381Article in journal (Refereed)
    Abstract [en]

    Background: Nationally representative information on food consumption data is essential to evaluate dietary habits, inform policy-making and nutritional guidelines, as well as forming a basis for risk assessment and identification of risk groups. Objective: To describe the methods used in the Swedish national dietary survey of adolescents, Riksmaten Adolescents 2016-2017. Design: Students in grades 5, 8, and 11 (mean ages 12, 15, and 18 years) were recruited in this school-based cross-sectional survey. A new, validated, web-based method was used to assess dietary intake. Information on physical activity, health, and socioeconomic background was collected through web questionnaires. Physical activity was also evaluated by accelerometers. Weight and height were measured in all participants, while blood and urine samples were collected in a subsample of 40% of the participants. Results: A total of 3,477 (68%) respondents participated and 3,099 (60%) had complete dietary information. In the subsample, 1,305 (55%) respondents participated and 1,105 (46%) had complete dietary information. The participants were overall representative for the population with regard to socioeconomic background and school organization (public or independent). All types of municipalities were represented in the survey and overall, the geographic distribution corresponded to the underlying population. Some differences by school grade were observed. Sample weights were calculated for the total sample and the subsample. Conclusion: The Riksmaten Adolescents 2016-2017 provides valuable national data on diet, physical activity, and markers of exposure in age groups where data have been lacking. The data will provide a valuable basis for risk assessment, public health policy, and in-depth analyses.

  • 33.
    Murto, Tiina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Yngve, Agneta
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Skoog Svanberg, Agneta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Altmäe, Signe
    Competence Ctr Hlth Technol, Tartu, Estonia.
    Salumets, Andres
    Competence Ctr Hlth Technol, Tartu, Estonia;Univ Tartu;Univ Helsinki;Helsinki Univ Hosp.
    Wånggren, Kjell
    Karolinska Inst.
    Stavreus-Evers, Anneli
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Compliance to the recommended use of folic acid supplements for women in Sweden is higher among those under treatment for infertility than among fertile controls and is also related to socioeconomic status and lifestyle2017In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 61, article id 1334483Article in journal (Refereed)
    Abstract [en]

    Background: Folate has been discussed in relation to fertility among women, but studies on women under treatment for infertility are lacking.

    Objective: The objective of this study was to investigate folic acid supplement use and folate status among women under treatment for infertility (hereafter infertile) and fertile women also in regard to socioeconomic and lifestyle factors.

    Design: Lifestyle and dietary habits, and use of dietary supplements were assessed using a questionnaire. Blood samples were obtained for analysis of folate status. 24-hour recall interviews were also performed.

    Results: Highly educated, employed and infertile women were most prone to using folic acid supplements. The infertile women had a significantly better folate status than the fertile women. Folate status did not correlate with socioeconomic or lifestyle factors. The infertile women were physically more active, smoked less and were employed. Our questionnaire data had only fair agreement with the data from 24-hour recalls, but the folate status data was clearly correlated to our questionnaire results.

    Conclusions: Infertile women were most prone to using folic acid supplements and had better folate status than the controls. High educational and employment status were found to be key factors for high compliance to the recommended use folic acid supplements.

  • 34.
    Olang, Beheshteh
    et al.
    Department of Nutrition and Food Health, Faculty of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran; Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran.
    Abdollahi, Zahra
    Nutrition Department, Ministry of Health and Medical Education, Tehran, Iran.
    Neshati, Roshanak
    Unit for Public Health Nutrition, Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.
    Ali, Mohamed Atiya
    Unit for Public Health Nutrition, Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.
    Naghavi, Mohsen
    Global Health Department, Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
    Yngve, Agneta
    Örebro universitet, Restaurang- och hotellhögskolan.
    Vitamin A status in pregnant women in Iran in 2001 and its relationship with province and gestational age2014In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 58, p. 25707-Article in journal (Refereed)
    Abstract [en]

    Background: Vitamin A deficiency is considered as one of the public health problems among pregnant women worldwide. Population representative data on vitamin A status in pregnancy have not previously been published from Iran.

    Objectives: The aim of this study was to publish data on vitamin A status in pregnant women in all the provinces of Iran in 2001, including urban and rural areas, and to describe the association of vitamin A status with maternal age, gestational age, and parity.

    Design: This descriptive cross-sectional study was conducted on 3,270 healthy pregnant women from the entire country, 2,631 with gestational age <= 36 weeks, and 639 with gestational age > 36 weeks. Vitamin A status was determined in serum using high-performance liquid chromatography.

    Result: Retinol levels corresponding to deficiency were detected in 6.6% (<0.36 mu mol/L) and 18% had insufficient vitamin A levels (>= 0.36- <0.7 mu mol/L). Suboptimal level of serum retinol was observed in 55.3% of the pregnant women (0.7-1.4 mu mol/L). Only about 20% of the women had optimal values (> 1.4 mu mol/L). The level of serum retinol was lower in older pregnant women (p = 0.008), and at higher gestational age (p = 0.009). High vitamin A levels were observed in pregnant women in the central areas of Iran and the lowest values in those in the southern areas of Iran.

    Conclusions: The vitamin A status was good in 2001 but should be closely monitored also in the future. About 25% of pregnant women had a vitamin A status diagnosed as insufficient or deficient (<0.7 mu mol/L). The mean serum retinol decreased as the gestational age increased. The clinical significance of this finding should be further investigated, followed by a careful risk group approach to supplementation during pregnancy.

  • 35.
    Olang, Beheshteh
    et al.
    Department of Nutrition and Food Health, Faculty of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran; Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran.
    Abdollahi, Zahra
    Nutrition Department, Ministry of Health and Medical Education, Tehran, Iran.
    Neshati, Roshanak
    Unit for Public Health Nutrition, Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.
    Ali, Mohamed Atiya
    Unit for Public Health Nutrition, Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.
    Naghavi, Mohsen
    Global Health Department, Institute for Health Metrics and Evaluation, University of Washington, Seattle WA, USA.
    Yngve, Agneta
    Örebro University, School of Hospitality, Culinary Arts & Meal Science. Unit for Public Health Nutrition, Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.
    Vitamin A status in pregnant women in Iran in 2001 and its relationship with province and gestational age2014In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 58, p. 25707-Article in journal (Refereed)
    Abstract [en]

    Background: Vitamin A deficiency is considered as one of the public health problems among pregnant women worldwide. Population representative data on vitamin A status in pregnancy have not previously been published from Iran.

    Objectives: The aim of this study was to publish data on vitamin A status in pregnant women in all the provinces of Iran in 2001, including urban and rural areas, and to describe the association of vitamin A status with maternal age, gestational age, and parity.

    Design: This descriptive cross-sectional study was conducted on 3,270 healthy pregnant women from the entire country, 2,631 with gestational age <= 36 weeks, and 639 with gestational age > 36 weeks. Vitamin A status was determined in serum using high-performance liquid chromatography.

    Result: Retinol levels corresponding to deficiency were detected in 6.6% (<0.36 mu mol/L) and 18% had insufficient vitamin A levels (>= 0.36- <0.7 mu mol/L). Suboptimal level of serum retinol was observed in 55.3% of the pregnant women (0.7-1.4 mu mol/L). Only about 20% of the women had optimal values (> 1.4 mu mol/L). The level of serum retinol was lower in older pregnant women (p = 0.008), and at higher gestational age (p = 0.009). High vitamin A levels were observed in pregnant women in the central areas of Iran and the lowest values in those in the southern areas of Iran.

    Conclusions: The vitamin A status was good in 2001 but should be closely monitored also in the future. About 25% of pregnant women had a vitamin A status diagnosed as insufficient or deficient (<0.7 mu mol/L). The mean serum retinol decreased as the gestational age increased. The clinical significance of this finding should be further investigated, followed by a careful risk group approach to supplementation during pregnancy.

  • 36. Pedersen, Agnes N.
    et al.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Health effects of protein intake in healthy elderly populations: a systematic literature review2014In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 58Article, review/survey (Refereed)
    Abstract [en]

    The purpose of this systematic review is to assess the evidence behind the dietary requirement of protein and to assess the health effects of varying protein intake in healthy elderly persons in order to evaluate the evidence for an optimal protein intake. The literature search covered year 2000-2011. Prospective cohort, case-control, and intervention studies of a general healthy population in settings similar to the Nordic countries with protein intake from food-based sources were included. Out of a total of 301 abstracts, 152 full papers were identified as potentially relevant. After careful scrutiny, 23 papers were quality graded as A (highest, n = 1), B (n = 18), or C (n = 4). The grade of evidence was classified as convincing, probable, suggestive, or inconclusive. The evidence is assessed as: probable for an estimated average requirement (EAR) of 0.66 g good-quality protein/kg body weight (BW)/day based on nitrogen balance (N-balance) studies and the subsequent recommended dietary allowance (RDA) of 0.83 g good-quality protein/kg BW/day representing the minimum dietary protein needs of virtually all healthy elderly persons. Regarding the optimal level of protein related to functional outcomes like maintenance of bone mass, muscle mass, and strength, as well as for morbidity and mortality, the evidence is ranging from suggestive to inconclusive. Results from particularly prospective cohort studies suggest a safe intake of up to at least 1.2-1.5 g protein/kg BW/day or approximately 15-20 E%. Overall, many of the included prospective cohort studies were difficult to fully evaluate since results mainly were obtained by food frequency questionnaires that were flawed by underreported intakes, although some studies were 'calibrated' to correct for under-or over-reporting. In conclusion, the evidence is assessed as probable regarding the EAR based on N-balance studies and suggestive to inconclusive regarding an optimal protein intake higher than the estimated RDA assessed from N-balance studies, but an exact level cannot be determined. Potentially adverse effects of a protein intake exceeding 20-23 E% remain to be investigated.

  • 37.
    Persson Osowski, Christine
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Lindroos, Anna Karin
    Enghardt Barbieri, Heléne
    Becker, Wulf
    The contribution of school meals to energy and nutrient intake of Swedish children in relation to dietary guidelines2015In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 59, article id 27563Article in journal (Refereed)
    Abstract [en]

    Background: In Sweden, school meals are served free of charge and Swedish law states that school meals must be nutritious. Nevertheless, data on children's energy and nutrient intake from school meals are scarce.

    Objective: The aim was to describe the contribution of school meals to Swedish children's nutrient and energy intake during weekdays and compare this to the reference values based on the Nordic Nutrition Recommendations (NNR), which have been adopted as the official Swedish recommendations.

    Design: A cross-sectional food consumption survey was performed on 1,840 Swedish children attending Grade 2 (mean age 8.6) and Grade 5 (mean age 11.7). The children's nutrient and energy intake was compared to the reference values based on the NNR.

    Results: The mean intake from school meals of energy, carbohydrates, dietary fiber, polyunsaturated fatty acids (PUFA), and vitamins D and E did not reach the reference values and the intake of saturated fatty acids (SFA) and sodium exceeded the reference values in both age groups (significant differences, all p <= 0.001). Additionally, the pupils in Grade 5 did not reach the reference values for folate, potassium, calcium, magnesium, iron, selenium, and zinc (significant differences, all p <= 0.001). Standardized for energy, dietary fiber, PUFA, and vitamins D and E did not reach the reference values, whereas the reference values for SFA and sodium were exceeded in both age groups (significant differences, all p <= 0.001).

    Conclusions: The study pointed to some central nutrients in need of improvement as regards school meals in Sweden, namely the quality of fat, dietary fiber, sodium, vitamin D, and iron. Some of these results may be attributed to the children not reporting eating the recommended number of calories, the children omitting some components of the meal, or underreporting, as a consequence of which the reference values for several nutrients were not met.

  • 38.
    Rosander, Ulla
    et al.
    Kristianstad University, School of Education and Environment, Avdelningen för Naturvetenskap.
    Rumpunen, Kimmo
    Swedish University of Agricultural Sciences.
    Olsson, Viktoria
    Kristianstad University, Research Environment Food and Meals in Everyday Life (MEAL). Kristianstad University, School of Education and Environment, Avdelningen för Mat- och måltidsvetenskap.
    Åström, Mikael
    StatCons.
    Rosander, Pia
    Kristianstad University, School of Education and Environment, Avdelningen för Humanvetenskap. Kristianstad University, Forskningsmiljön ForFame.
    Wendin, Karin
    Kristianstad University, Research Environment Food and Meals in Everyday Life (MEAL). Kristianstad University, School of Education and Environment, Avdelningen för Mat- och måltidsvetenskap. Technical Research Institute of Sweden.
    Methodological considerations in a pilot study on the effects of a berry enriched smoothie on children's performance in school2016In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 60, no 1, article id Poster presentation no. P307Article in journal (Other academic)
    Abstract [en]

    Background and aims: In many countries, the consumption of fruit, berries, and vegetables is about half the recommended. Berries contain bioactive compounds that may affect cognitive functions. School children are often hungry and thirsty during the lectures before lunch and this affects performance. Could a berry-smoothie decrease thirst and hunger, and thereby affect school performance? The aim was to investigate if a cross-over design can be used to study the effects of a smoothie on performance in a school setting.

    Methods: Methodological challenges included developing an appetizing berry-smoothie and choosing a suitable experimental design that could be adapted to school conditions.

    In the pilot study, 236 Swedish children aged 10–12 years participated in a cross-over design and were administered either a berry-smoothie or a fruit-based placebo after the midmorning break. Both beverages provided 5% of the daily energy intake. Performance was assessed using the d2 Test of Attention measuring attention span and concentration. Statistical analyses were performed using the Wilcoxon signed rank test in StatXact v 10.3.

    Results: The consumption of both the smoothie and the placebo increased the attention span and concentration significantly.

    Conclusion: The children's performance in the d2 Test of Attention was positively affected by beverage consumption. The effect was attributed to the supplementation of water and energy. In this design, the study did not permit any conclusive results regarding the effect of bioactive compounds on performance. In a coming study, a third group, receiving no beverage, should be included aiming to identify the cause of the effect.

  • 39.
    Samuelson, Gösta
    University West, Department of Health Sciences, Specialist Nursing programme.
    Water intoxication: a dangerous condition2003In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 47, no 3, p. 107-107Article in journal (Refereed)
  • 40.
    Sandvik, Pernilla
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Kihlberg, Iwona
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Lindroos, Anna Karin
    Marklinder, Ingela
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nydahl, Margaretha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Bread consumption patterns in a Swedish national dietary survey focusing particularly on whole-grain and rye bread2014In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 58, p. 24024-Article in journal (Refereed)
    Abstract [en]

    Background: Bread types with high contents of whole grains and rye are associated with beneficial health effects. Consumer characteristics of different bread consumption patterns are however not well known.

    Objective: To compare bread consumption patterns among Swedish adults in relation to selected socio-demographic, geographic, and lifestyle-related factors. For selected consumer groups, the further aim is to investigate the intake of whole grains and the context of bread consumption, that is, where and when it is consumed.

    Design: Secondary analysis was performed on bread consumption data from a national dietary survey (n=1,435). Respondents were segmented into consumer groups according to the type and amount of bread consumed. Multiple logistic regressions were performed to study how selected socio-demographic, geographic, and lifestyle-related factors were associated with the consumer groups. Selected consumption groups were compared in terms of whole-grain intake and consumption context. Consumption in different age groups was analysed more in detail.

    Results: One-third of the respondents consumed mainly white bread. Socio-demographic, geographic, and healthy-lifestyle-related factors were associated with the bread type consumed. White bread consumption was associated with younger age groups, less education, children in the family, eating less fruit and vegetables, and more candy and snacks; the opposite was seen for mainly whole-grain bread consumers. Older age groups more often reported eating dry crisp bread, whole-grain bread, and whole-grain rye bread with sourdough whereas younger respondents reported eating bread outside the home, something that also mainly white bread eaters did. Low consumers of bread also consumed less whole grain in total.

    Conclusions: Traditional bread consumption structures were observed, as was a transition among young consumers who more often consumed fast food bread and bread outside the home, as well as less rye and whole-grain bread. Target groups for communication strategies and product development of more sensorily attractive rye or whole-grain-rich bread should be younger age groups (18–30 years), families with children, and groups with lower educational levels.

  • 41. Schwab, Ursula
    et al.
    Lauritzen, Lotte
    Tholstrup, Tine
    Haldorssoni, Thorhallur
    Risérus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Uusitupa, Matti
    Becker, Wulf
    Effect of the amount and type of dietary fat on cardiometabolic risk factors and risk of developing type 2 diabetes, cardiovascular diseases, and cancer: a systematic review2014In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 58, p. 25145-Article, review/survey (Refereed)
    Abstract [en]

    The effects of both the amount and quality of dietary fat have been studied intensively during the past decades. Previously, low-fat diets were recommended without much attention to the quality of fat, whereas there is general emphasis on the quality of fat in current guidelines. The objective of this systematic review (SR) was to assess the evidence of an effect of the amount and type of dietary fat on body weight (BW), risk factors, and risk of non-communicable diseases, that is, type 2 diabetes (T2DM), cardiovascular diseases (CVD), and cancer in healthy subjects or subjects at risk for these diseases. This work was performed in the process of updating the fourth edition of the Nordic Nutrition Recommendations from 2004. The literature search was performed in October 2010 covering articles published since January 2000. A complementary search was done in February 2012 covering literature until December 2011. Two authors independently selected articles for inclusion from a total of about 16,000 abstracts according to predefined criteria. Randomized controlled trials (RCT) and prospective cohort studies (PCS) were included as well as nested case control studies. A few retrospective case control studies were also included when limited or no data were available from other study types. Altogether 607 articles were quality graded and the observed effects in these papers were summarized. Convincing evidence was found that partial replacement of saturated fat (SFA) with polyunsaturated fat (PUFA) or monounsaturated fat (MUFA) lowers fasting serum/plasma total and LDL cholesterol concentrations. The evidence was probable for a decreasing effect of fish oil on concentration of serum/plasma total triglycerides as compared with MUFA. Beneficial effect of MUFA both on insulin sensitivity and fasting plasma/serum insulin concentration was considered as probable in comparisons of MUFA and carbohydrates versus SFA, whereas no effect was found on fasting glucose concentration in these comparisons. There was probable evidence for a moderate direct association between total fat intake and BW. Furthermore, there was convincing evidence that partial replacement of SFA with PUFA decreases the risk of CVD, especially in men. This finding was supported by an association with biomarkers of PUFA intake; the evidence of a beneficial effect of dietary total PUFA, n-6 PUFA, and linoleic acid (LA) on CVD mortality was limited suggestive. Evidence for a direct association between total fat intake and risk of T2DM was inconclusive, whereas there was limited-suggestive evidence from biomarker studies that LA is inversely associated with the risk of T2DM. However, there was limited-suggestive evidence in biomarker studies that odd-chain SFA found in milk fat and fish may be inversely related to T2DM, but these associations have not been supported by controlled studies. The evidence for an association between dietary n-3 PUFA and T2DM was inconclusive. Evidence for effects of fat on major types of cancer was inconclusive regarding both the amount and quality of dietary fat, except for prostate cancer where there was limited-suggestive evidence for an inverse association with intake of ALA and for ovarian cancer for which there was limited-suggestive evidence for a positive association with intake of SFA. This SR reviewed a large number of studies focusing on several different health outcomes. The time period covered by the search may not have allowed obtaining the full picture of the evidence in all areas covered by this SR. However, several SRs and meta-analyses that covered studies published before year 2000 were evaluated, which adds confidence to the results. Many of the investigated questions remain unresolved, mainly because of few studies on certain outcomes, conflicting results from studies, and lack of high quality-controlled studies. There is thus an evident need of highly controlled RCT and PCS with sufficient number of subjects and long enough duration, specifically regarding the effects of the amount and quality of dietary fat on insulin sensitivity, T2DM, low-grade inflammation, and blood pressure. New metabolic and other potential risk markers and utilization of new methodology in the area of lipid metabolism may provide new insight.

  • 42.
    Sepp, Hanna
    et al.
    Kristianstad University, Research Environment Food and Meals in Everyday Life (MEAL). Kristianstad University, School of Education and Environment, Avdelningen för Mat- och måltidsvetenskap.
    Höijer, Karin
    Kristianstad University, Research Environment Food and Meals in Everyday Life (MEAL). Kristianstad University, School of Education and Environment, Avdelningen för Mat- och måltidsvetenskap.
    Food as a tool for learning in everyday activities at preschool: an exploratory study from Sweden2016In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 60, no 1, article id 32603Article in journal (Refereed)
    Abstract [en]

    Background: There is a need for research both in relation to food education at preschools and in relation to how the individual teacher can handle and relate to the many different scientific facts and paradigms that are prevalent in relation to food, health, and a sustainable lifestyle.

    Objective: The aim of this study was to explore the experiences and meanings that preschool teachers associate with involving food as a tool for learning in planned educational activities.

    Design: An exploratory study was conducted in 14 preschools with 131 teachers. Twenty semi-structured individual or group interviews with 45 preschool staff were conducted, and 10 interviews were selected for analysis.

    Results: According to participants, both children and teachers developed a sensory language; children became more positive towards tasting and teachers discovered new possibilities for interdisciplinary work. However, the results also show that an allowing system, with both an interested and confident teacher who recognises the competent child and a supportive organisation, is needed in order to make food a meaningful tool for learning in preschool.

    Discussion: According to previous studies, food has the potential to play an important part in everyday activities at preschool, both in planned educational activities as well as at meal situations. Our results imply that a holistic understanding of food in preschool is required for long-term work with food as a natural part of the everyday activities.

    Conclusion: The results imply that it is fun and meaningful for both children and teachers, and quite possible, to work with food as a tool for learning in everyday activities at preschool. In order to include food as a way to work with the preschool curriculum for a sustainable lifestyle, an allowing system is needed.

  • 43.
    Smedman, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Lindmark-Månsson, Helena
    Drewnowski, Adam
    Edman, Anna-Karin Modin
    Nutrient density of beverages in relation to climate impact2010In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 54, article id 5170Article in journal (Refereed)
    Abstract [en]

    The food chain contributes to a substantial part of greenhouse gas (GHG) emissions and growing evidence points to the urgent need to reduce GHGs emissions worldwide. Among suggestions were proposals to alter food consumption patterns by replacing animal foods with more plant-based foods. However, the nutritional dimensions of changing consumption patterns to lower GHG emissions still remains relatively unexplored. This study is the first to estimate the composite nutrient density, expressed as percentage of Nordic Nutrition Recommendations (NNR) for 21 essential nutrients, in relation to cost in GHG emissions of the production from a life cycle perspective, expressed in grams of CO(2)-equivalents, using an index called the Nutrient Density to Climate Impact (NDCI) index. The NDCI index was calculated for milk, soft drink, orange juice, beer, wine, bottled carbonated water, soy drink, and oat drink. Due to low-nutrient density, the NDCI index was 0 for carbonated water, soft drink, and beer and below 0.1 for red wine and oat drink. The NDCI index was similar for orange juice (0.28) and soy drink (0.25). Due to a very high-nutrient density, the NDCI index for milk was substantially higher (0.54) than for the other beverages. Future discussion on how changes in food consumption patterns might help avert climate change need to take both GHG emission and nutrient density of foods and beverages into account.

  • 44.
    Smedman, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Mansson, Helena Lindmark
    Drewnowski, Adam
    Edman, Anna-Karin Modin
    Response-letter to the editor regarding nutrient density of beverages in relation to climate impact2010In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 54, article id 5732Article in journal (Refereed)
  • 45. Svederberg, E.
    et al.
    Wendin, Karin
    SIK – Institutet för livsmedel och bioteknik.
    Swedish consumers' cognitive approaches to nutrition claims and health claims2011In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 55, p. 5929-Article in journal (Refereed)
    Abstract [en]

    Introduction and Aim: Studies show frequent use of nutrition claims and health claims in consumers' choice of food products. The aim of the present study was to investigate how consumers' thoughts about these claims and food products are affected by various types of food-related experiences. Material and Methods: The data collection comprised 30 individual interviews among Swedish consumers aged 25 to 64 years. Results: The results indicated that participants who expressed special concern for their own and their families'health were eager to find out the meaning of concepts and statements made. A lack of understanding and lack of credibility of concepts and expressions often caused suspicion of the product. However, in some cases this was counterbalanced by confidence in manufacturers, retailers, and/or the Swedish food legislation. Discussion and Conclusion: To achieve effective written communication of food products' health-conducive properties on food labels, there is a need to consider the importance many consumers attach to understanding the meaning of concepts and expressions used and the importance of credibility in certain expressions. Consumers' varying cognitive approaches are suggested as a basis for pre-tests of nutrition claims and health claims. © 2011 Eva Svederberg and Karin Wendin.

  • 46. Svederberg, E.
    et al.
    Wendin, Karin
    SIK – Institutet för livsmedel och bioteknik.
    Swedish consumers' cognitive approaches to nutrition claims health claims2011In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 55, no 1Article in journal (Refereed)
    Abstract [en]

    Introduction and Aim: Studies show frequent use of nutrition claims and health claims in consumers' choice of food products. The aim of the present study was to investigate how consumers' thoughts about these claims and food products are affected by various types of food-related experiences. Material and Methods: The data collection comprised 30 individual interviews among Swedish consumers aged 25 to 64 years. Results: The results indicated that participants who expressed special concern for their own and their families' health were eager to find out the meaning of concepts and statements made. A lack of understanding and lack of credibility of concepts and expressions often caused suspicion of the product. However, in some cases this was counterbalanced by confidence in manufacturers, retailers, and/or the Swedish food legislation. Discussion and Conclusion: To achieve effective written communication of food products' health-conducive properties on food labels, there is a need to consider the importance many consumers attach to understanding the meaning of concepts and expressions used and the importance of credibility in certain expressions. Consumers' varying cognitive approaches are suggested as a basis for pre-tests of nutrition claims and health claims. © 2011 Eva Svederberg and Karin Wendin.

  • 47.
    Vallén, Christina
    et al.
    Central Hospital, Kristianstad.
    Hagell, Peter
    Department of Health Sciences, Lund University.
    Westergren, Albert
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Validity and user-friendliness of the minimal eating observation and nutrition form version II (MEONF II) for undernutrition risk screening2011In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, no 55, p. 5801-Article in journal (Refereed)
    Abstract [en]

    Objective To analyze the criterion-related validity and user-friendliness of the Minimal Eating Observation and Nutrition Form – Version II (MEONF – II) and Malnutrition Universal Screening Tool (MUST) in relation to the Mini Nutritional Assessment (MNA). In addition, the effect of substituting body mass index (BMI) with calf circumference (CC) was explored for the MEONF-II. Methods The study included 100 patients who were assessed for nutritional status with the MNA (full version), considered here to be the gold standard, and screened with the MUST and the MEONF-II. The MEONF-II includes assessments of involuntary weight loss, BMI (or calf circumference), eating difficulties, and presence of clinical signs of undernutrition. Results The MEONF-II sensitivity (0.73) and specificity (0.88) were acceptable. Sensitivity and specificity for the MUST were 0.57 and 0.93, respectively. Replacing the BMI with CC in the MEONF-II gave similar results (sensitivity 0.68, specificity 0.90). Assessors considered MEONF-II instructions and items to be relevant, easy to understand and complete (100%), and the questions to be relevant (98%). MEONF-II and MUST took 8.8 and 4.7 minutes to complete, respectively, and both were considered relevant and easy to finish. In addition, MEONF-II was thought to reveal problems that allows for nursing interventions. Conclusions The MEONF-II is an easy to use, relatively quick, and sensitive screening tool to assess risk of undernutrition among hospital inpatients, which allows for substituting BMI with CC in situations where measures of patient height and weight cannot be easily obtained. High sensitivity is of primary concern in nutritional screening and the MEONF-II outperforms the MUST in this regard.

  • 48.
    van Vliet, Jolanda S.
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Gustafsson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Nelson Follin, Nina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping. Karolinska University Hospital, Sweden.
    Feeling ‘too fat’ rather than being ‘too fat’ increases unhealthy eating habits among adolescents – even in boys2016In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 60, article id 29530Article in journal (Refereed)
    Abstract [en]

    Background: Adolescence is a period of gender-specific physical changes, during which eating habits develop. To better understand what factors determine unhealthy eating habits such as dieting to lose weight, skipping meals and consumption of unhealthy foods, we studied how physical measurements and body perception relate to eating habits in boys and girls, before and during adolescence.

    Methods: For this cross-sectional study, we obtained data from both written questionnaires and physical measurements of height, weight and waist circumference (WC).

    Results: Dieting to lose weight and skipping breakfast were more common among adolescents than among younger boys and girls (p<0.05). The strongest risk factor for dieting in both boys and girls was perception of overweight, which persisted after adjusting for age and for being overweight (p<0.01). Another independent risk factor for dieting behaviour was overweight, as defined by body mass index (BMI) among boys (p<0.01) and WC among girls (p<0.05). In both boys and girls, skipping breakfast was associated with both a more negative body perception and higher BMI (p<0.05). Skipping breakfast was also associated with age- and gender-specific unhealthy eating habits such as skipping other meals, lower consumption of fruits and vegetables, and higher consumption of sweets and sugary drinks (p<0.05).

    Conclusion: Body perception among adolescents is an important factor relating to unhealthy eating habits, not only in girls, but even in boys. Focus on body perception and eating breakfast daily is crucial for the development of healthy food consumption behaviours during adolescence and tracking into adulthood.

  • 49.
    Videhult, Frida K.
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Öhlund, Inger
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Hernell, Olle
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    West, Christina E.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Body mass but not vitamin D status is associated with bone mineral content and density in young school children in northern Sweden2016In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 60, article id 30045Article in journal (Refereed)
    Abstract [en]

    Background: High latitude of residence where sun exposure is limited affects vitamin D status. Although vitamin D levels have been associated with poor bone health, cut-off values for optimising bone health are yet to be decided. Objective: To assess vitamin D intake and status among young school children living at latitude 63-64 degrees N, in northern Sweden and to examine the association between vitamin D status and bone mineral content (BMC) and bone mineral density (BMD). Design: In a cross-sectional study, diet was assessed by a 4-day food diary and a food frequency questionnaire in 8- to 9-year-old children (n = 120). Energy, vitamin D, and calcium intakes were calculated. Physical activity was assessed using a pedometer for 7 days. Serum 25-hydroxyvitamin D (S-25[OH]D) levels were analysed by high-pressure liquid chromatography-atmospheric pressure chemical ionisation-mass spectrometry (n = 113). BMC and BMD were assessed by dual energy X-ray absorptiometry scan. Height and weight were measured by standard procedures and BMI z-score was calculated using WHO AnthroPlus programme. Results: The majority of children, 91%, did not reach the recommended vitaminDintake of 7.5 mu g/day and 50% had insufficient S-25[OH]D levels defined as <50 nmol/l. The highest concentrations of S-25[OH]D were observed during the summer months (p = 0.01). Body mass (p < 0.01) but not S-25[OH]D was associated with measures of BMC and BMD. Furthermore, boys had higher total BMC (p = 0.01), total body less head BMC (p = 0.02), fat free mass (p < 0.01), and a higher degree of physical activity (p = 0.01) compared to girls. Conclusions: Body mass was related to BMC and BMD measures in a population of prepubertal school children living at high latitudes in Sweden. Despite insufficient S-25[OH]D levels and low vitamin D intake, this did not appear to affect bone parameters. Prospective studies with repeated assessment of vitamin D status are needed to examine cut-off values for optimising bone health.

  • 50.
    Wendin, Karin
    et al.
    RISE, SP – Sveriges Tekniska Forskningsinstitut, SP Sveriges tekniska forskningsinstitut, SIK – Institutet för livsmedel och bioteknik.
    Ekman, Susanne
    RISE, SP – Sveriges Tekniska Forskningsinstitut, SP Sveriges tekniska forskningsinstitut, SIK – Institutet för livsmedel och bioteknik.
    Bulow, M.
    Stading, Mats
    RISE, SP – Sveriges Tekniska Forskningsinstitut, SP Sveriges tekniska forskningsinstitut, SIK – Institutet för livsmedel och bioteknik.
    Johansson, D.
    Rothenberg, E.
    Objective and quantitative definitions of modified food textures based on sensory and rheological methodology2010In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 54, p. 5134-Article in journal (Refereed)
    Abstract [en]

    Introduction: Patients who suffer from chewing and swallowing disorders, i.e. dysphagia, may have difficulties ingesting normal food and liquids. In these patients a texture modified diet may enable that the patient maintain adequate nutrition. However, there is no generally accepted definition of 'texture' that includes measurements describing different food textures. Objective: Objectively define and quantify categories of texture-modified food by conducting rheological measurements and sensory analyses. A further objective was to facilitate the communication and recommendations of appropriate food textures for patients with dysphagia. Design: About 15 food samples varying in texture qualities were characterized by descriptive sensory and rheological measurements. Results: Soups were perceived as homogenous; thickened soups were perceived as being easier to swallow, more melting and creamy compared with soups without thickener. Viscosity differed between the two types of soups. Texture descriptors for pâtés were characterized by high chewing resistance, firmness, and having larger particles compared with timbales and jellied products. Jellied products were perceived as wobbly, creamy, and easier to swallow. Concerning the rheological measurements, all solid products were more elastic than viscous (G? > G?), belonging to different G? intervals: jellied products (low G?) and timbales together with pâtés (higher G?). Conclusion: By combining sensory and rheological measurements, a system of objective, quantitative, and well-defined food textures was developed that characterizes the different texture categories. © 2010 Karin Wendin et al.

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