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  • 1.
    Bodén, Stina
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Wennberg, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Van Guelpen, Bethany
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Andersson, Jonas
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Shivappa, Nitin
    Hebert, James R
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Dietary inflammatory index and risk of first myocardial infarction: a prospective population-based study2017In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 16, article id 21Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Chronic, low-grade inflammation is an established risk factor for cardiovascular disease. The inflammatory impact of diet can be reflected by concentrations of inflammatory markers in the bloodstream and the inflammatory potential of diet can be estimated by the dietary inflammatory index (DII(TM)), which has been associated with cardiovascular disease risk in some previous studies. We aimed to examine the association between the DII and the risk of first myocardial infarction (MI) in a population-based study with long follow-up.

    METHOD: We conducted a prospective case-control study of 1389 verified cases of first MI and 5555 matched controls nested within the population-based cohorts of the Northern Sweden Health and Disease Study (NSHDS), of which the largest is the ongoing Västerbotten Intervention Programme (VIP) with nearly 100 000 participants during the study period. Median follow-up from recruitment to MI diagnosis was 6.4 years (6.2 for men and 7.2 for women). DII scores were derived from a validated food frequency questionnaire (FFQ) administered in 1986-2006. Multivariable conditional logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI), using quartile 1 (most anti-inflammatory diet) as the reference category. For validation, general linear models were used to estimate the association between the DII scores and two inflammatory markers, high-sensitivity C-reactive protein (hsCRP) and interleukin 6 (IL-6) in a subset (n = 605) of the study population.

    RESULTS: Male participants with the most pro-inflammatory DII scores had an increased risk of MI [ORQ4vsQ1 = 1.57 (95% CI 1.21-2.02) P trend = 0.02], which was essentially unchanged after adjustment for potential confounders, including cardiovascular risk factors [ORQ4vsQ1 = 1.50 (95% CI 1.14-1.99), P trend = 0.10]. No association was found between DII and MI in women. An increase of one DII score unit was associated with 9% higher hsCRP (95% CI 0.03-0.14) and 6% higher IL-6 (95% CI 0.02-0.11) in 605 controls with biomarker data available.

    CONCLUSION: A pro-inflammatory diet was associated with an elevated risk of first myocardial infarction in men; whereas for women the relationship was null. Consideration of the inflammatory impact of diet could improve prevention of cardiovascular disease.

  • 2.
    Bondia-Pons, Isabel
    et al.
    Department of Public Health and Clinical Nutrition, Clinical Nutrition, Food and Health Research Centre, University of Eastern Finland, Kuopio, Finland.
    Nordlund, Emilia
    VTT Technical Research Centre of Finland, Espoo, Finland.
    Mattila, Ismo
    VTT Technical Research Centre of Finland, Espoo, Finland.
    Katina, Kati
    VTT Technical Research Centre of Finland, Espoo, Finland.
    Aura, Anna-Marja
    VTT Technical Research Centre of Finland, Espoo, Finland.
    Kolehmainen, Marjukka
    Department of Public Health and Clinical Nutrition, Clinical Nutrition, Food and Health Research Centre, University of Eastern Finland, Kuopio, Finland.
    Oresic, Matej
    Örebro University, School of Medical Sciences. VTT Technical Research Centre of Finland, Espoo, Finland.
    Mykkänen, Hannu
    Department of Public Health and Clinical Nutrition, Clinical Nutrition, Food and Health Research Centre, University of Eastern Finland, Kuopio, Finland.
    Poutanen, Kaisa
    Department of Public Health and Clinical Nutrition, Clinical Nutrition, Food and Health Research Centre, University of Eastern Finland, Kuopio, Finland; VTT Technical Research Centre of Finland, Espoo, Finland.
    Postprandial differences in the plasma metabolome of healthy Finnish subjects after intake of a sourdough fermented endosperm rye bread versus white wheat bread2011In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 10, article id 116Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The mechanism behind the lowered postprandial insulin demand observed after rye bread intake compared to wheat bread is unknown. The aim of this study was to use the metabolomics approach to identify potential metabolites related to amino acid metabolism involved in this mechanism.

    METHODS: A sourdough fermented endosperm rye bread (RB) and a standard white wheat bread (WB) as a reference were served in random order to 16 healthy subjects. Test bread portions contained 50 g available carbohydrate. In vitro hydrolysis of starch and protein were performed for both test breads. Blood samples for measuring glucose and insulin concentrations were drawn over 4 h and gastric emptying rate (GER) was measured. Changes in the plasma metabolome were investigated by applying a comprehensive two-dimensional gas chromatography coupled to time-of-flight mass spectrometry metabolomics platform (GC × GC-TOF-MS).

    RESULTS: Plasma insulin response to RB was lower than to WB at 30 min (P = 0.004), 45 min (P = 0.002) and 60 min (P < 0.001) after bread intake, and plasma glucose response was significantly higher at time point 90 min after RB than WB intake (P = 0.045). The starch hydrolysis rate was higher for RB than WB, contrary to the in vitro protein digestibility. There were no differences in GER between breads. From 255 metabolites identified by the metabolomics platform, 26 showed significant postprandial relative changes after 30 minutes of bread intake (p and q values < 0.05). Among them, there were changes in essential amino acids (phenylalanine, methionine, tyrosine and glutamic acid), metabolites involved in the tricarboxylic acid cycle (alpha-ketoglutaric, pyruvic acid and citric acid) and several organic acids. Interestingly, the levels of two compounds involved in the tryptophan metabolism (picolinic acid, ribitol) significantly changed depending on the different bread intake.

    CONCLUSIONS: A single meal of a low fibre sourdough rye bread producing low postprandial insulin response brings in several changes in plasma amino acids and their metabolites and some of these might have properties beneficial for health.

  • 3. Gyll, Johanna
    et al.
    Ridell, Karin
    Malmö University, Faculty of Odontology.
    Ohlund, Inger
    Akeson, Pia Karlsland
    Johansson, Ingegerd
    Holgerson, Pernilla Lif
    Vitamin D status and dental caries in healthy Swedish children2018In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 17Article in journal (Refereed)
    Abstract [en]

    Background: Vitamin D is crucial for mineralized tissue formation and immunological functions. The purpose of this study was to evaluate the association between vitamin D status and dental status in healthy children with vitamin D supplementation in infancy and at 6 years of age. Method: Eight-year-old children who had participated, in a vitamin D intervention project when they were 6 years old were invited to participate in a dental follow-up study. They had fair or darker skin complexion and represented two geographically distant parts of Sweden. 25-hydroxy vitamin D in serum had been measured at 6 years of age and after a 3-month intervention with 25, 10 or 2 (placebo) mu g of vitamin D-3 per day. Two years later, caries and enamel defects were scored, self-reported information on e.g., oral behavior, dietary habits and intake of vitamin D supplements was collected, and innate immunity peptide LL37 levels in saliva and cariogenic mutant streptococci in tooth biofilm were analyzed. The outcome variables were caries and tooth enamel defects. Results: Dental status was evaluated in 85 of the 206 children in the basic intervention study. Low vitamin D levels were found in 28% at baseline compared to 11% after the intervention, and 34% reported continued intake of vitamin D supplements. Logistic regression supported a weak inverse association between vitamin D status at 6 years of age and caries 2 years later (odds ratio 0.96; p = 0.024) with minor attenuation after an adjustment for potential confounders. Multivariate projection regression confirmed that insufficient vitamin D levels correlated with caries and higher vitamin D levels correlated with being caries-free. Vitamin D status at 6 years of age was unrelated to enamel defects but was positively associated with saliva LL37 levels. Conclusion: An association between vitamin D status and caries was supported, but it was not completely consistent. Vitamin D status at 6 years of age was unrelated to enamel defects but was positively associated with LL37 expression.

  • 4.
    Gyll, Johanna
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Ridell, Karin
    Öhlund, Inger
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Akeson, Pia Karlsland
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Lif Holgerson, Pernilla
    Umeå University, Faculty of Medicine, Department of Odontology.
    Vitamin D status and dental caries in healthy Swedish children2018In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 17, article id 11Article in journal (Refereed)
    Abstract [en]

    Background: Vitamin D is crucial for mineralized tissue formation and immunological functions. The purpose of this study was to evaluate the association between vitamin D status and dental status in healthy children with vitamin D supplementation in infancy and at 6 years of age.

    Method: Eight-year-old children who had participated, in a vitamin D intervention project when they were 6 years old were invited to participate in a dental follow-up study. They had fair or darker skin complexion and represented two geographically distant parts of Sweden. 25-hydroxy vitamin D in serum had been measured at 6 years of age and after a 3-month intervention with 25, 10 or 2 (placebo) mu g of vitamin D-3 per day. Two years later, caries and enamel defects were scored, self-reported information on e.g., oral behavior, dietary habits and intake of vitamin D supplements was collected, and innate immunity peptide LL37 levels in saliva and cariogenic mutant streptococci in tooth biofilm were analyzed. The outcome variables were caries and tooth enamel defects.

    Results: Dental status was evaluated in 85 of the 206 children in the basic intervention study. Low vitamin D levels were found in 28% at baseline compared to 11% after the intervention, and 34% reported continued intake of vitamin D supplements. Logistic regression supported a weak inverse association between vitamin D status at 6 years of age and caries 2 years later (odds ratio 0.96; p = 0.024) with minor attenuation after an adjustment for potential confounders. Multivariate projection regression confirmed that insufficient vitamin D levels correlated with caries and higher vitamin D levels correlated with being caries-free. Vitamin D status at 6 years of age was unrelated to enamel defects but was positively associated with saliva LL37 levels.

    Conclusion: An association between vitamin D status and caries was supported, but it was not completely consistent. Vitamin D status at 6 years of age was unrelated to enamel defects but was positively associated with LL37 expression.

  • 5.
    Hagfors, Linda
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Leanderson, P.
    Sköldstam, Lars
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Johansson, Gunnar
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Andersson, J.
    Antioxidant intake, plasma antioxidants and oxidative stress in a randomized, controlled, parallel, Mediterranean dietary intervention study on patients with rheumatoid arthritis2003In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 2, no 5Article in journal (Refereed)
    Abstract [en]

    Background: Previously we have reported that patients with rheumatoid arthritis (RA) obtained a significant reduction in disease activity by adopting a Mediterranean-type diet. The present study was carried out to investigate the antioxidant intake, the plasma levels of antioxidants and a marker of oxidative stress (malondialdehyde) during the study presented earlier.

     Methods: RA patients randomized to either a Mediterranean type diet (MD group; n = 26) or a control diet (CD group; n = 25) were compared during a three month dietary intervention study. Their antioxidant intake was assessed by means of diet history interviews and their intake of antioxidant-rich foods by a self-administered questionnaire. The plasma levels of retinol, antioxidants (α- and γ-tocopherol, β-carotene, lycopene, vitamin C and uric acid) and urinary malondialdehyde (MDA), a marker for oxidative stress, were determined using high performance liquid chromatography. The Student's t-test for independent samples and paired samples were used to test differences between and within groups. For variables with skewed distributions Mann-Whitney U-test and Wilcoxon signed ranks test were performed. To evaluate associations between dietary intake of antioxidants, as well as between disease activity, MDA and antioxidants we used Pearson's product moment correlation or Spearman's rank correlation.

    Results: The MD group had significantly higher intake frequencies of antioxidant-rich foods, and also higher intakes of vitamin C (p = 0.014), vitamin E (p = 0.007) and selenium (p = 0.004), and a lower intake of retinol (p = 0.049), compared to the CD group. However, the difference between the groups regarding vitamin C intake was not significant when under- and over-repoters were excluded (p = 0.066). There were no changes in urine MDA or in the plasma levels of antioxidants (after p-lipid adjustments of the tocopherol results), from baseline to the end of the study. The levels of retinol, vitamin C and uric acid were negatively correlated to disease activity variables. No correlation was found between antioxidant intake and the plasma levels of antioxidants.

    Conclusions: Despite an increase in reported consumption of antioxidant-rich foods during the Mediterranean diet intervention, the levels of plasma antioxidants and urine MDA did not change. However, the plasma levels of vitamin C, retinol and uric acid were inversely correlated to variables related to RA disease activity.

  • 6. Hagfors, Linda
    et al.
    Leanderson, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine. Östergötlands Läns Landsting, Pain and Occupational Centre, Occupational and Environmental Medicine Centre.
    Sköldstam, Lars
    Andersson, Jan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine. Östergötlands Läns Landsting, Pain and Occupational Centre, Occupational and Environmental Medicine Centre.
    Johansson, Gunnar
    Antioxidant intake, plasma antioxidants and oxidative stress in a randomized, controlled, parallel, Mediterranean dietary intervention study on patients with rheumatoid arthritis2003In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 2Article in journal (Other (popular science, discussion, etc.))
    Abstract [en]

    Background: Previously we have reported that patients with rheumatoid arthritis (RA) obtained a significant reduction in disease activity by adopting a Mediterranean-type diet. The present study was carried out to investigate the antioxidant intake, the plasma levels of antioxidants and a marker of oxidative stress (malondialdehyde) during the study presented earlier. Methods: RA patients randomized to either a Mediterranean type diet (MD group, n = 26) or a control diet (CD group, n = 25) were compared during a three month dietary intervention study. Their antioxidant intake was assessed by means of diet history interviews and their intake of antioxidant-rich foods by a self-administered questionnaire. The plasma levels of retinol, antioxidants (a- and ?-tocopherol, ▀-carotene, lycopene, vitamin C and uric acid) and urinary malondialdehyde (MDA), a marker for oxidative stress, were determined using high performance liquid chromatography. The Student's t-test for independent samples and paired samples were used to test differences between and within groups. For variables with skewed distributions Mann-Whitney U-test and Wilcoxon signed ranks test were performed. To evaluate associations between dietary intake of antioxidants, as well as between disease activity, MDA and antioxidants we used Pearson's product moment correlation or Spearman's rank correlation. Results: The MD group had significantly higher intake frequencies of antioxidant-rich foods, and also higher intakes of vitamin C (p = 0.014), vitamin E (p = 0.007) and selenium (p = 0.004), and a lower intake of retinol (p = 0.049), compared to the CD group. However, the difference between the groups regarding vitamin C intake was not significant when under- and over-repoters were excluded (p = 0.066). There were no changes in urine MDA or in the plasma levels of antioxidants (after p-lipid adjustments of the tocopherol results), from baseline to the end of the study. The levels of retinol, vitamin C and uric acid were negatively correlated to disease activity variables. No correlation was found between antioxidant intake and the plasma levels of antioxidants. Conclusions: Despite an increase in reported consumption of antioxidant-rich foods during the Mediterranean diet intervention, the levels of plasma antioxidants and urine MDA did not change. However, the plasma levels of vitamin C, retinol and uric acid were inversely correlated to variables related to RA disease activity.

  • 7.
    Han, Hedong
    et al.
    Department of Health Statistics, Second Military Medical University, Shanghai, China.
    Fang, Xin
    Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Wei, Xin
    Mount Sinai St. Luke's and West Medical Center, New York NY, United States.
    Liu, Yuzhou
    Mount Sinai St. Luke's and West Medical Center, New York NY, United States.
    Jin, Zhicao
    Department of Health Statistics, Second Military Medical University, Shanghai, China.
    Chen, Qi
    Department of Health Statistics, Second Military Medical University, Shanghai, China.
    Fan, Zhongjie
    Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
    Aaseth, Jan
    Faculty of Public Health, Hedmark University of Applied Sciences, Elverum, Norway; Innlandet Hospital Trust, Kongsvinger Hospital Division, Kongsvinger, Norway.
    Hiyoshi, Ayako
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    He, Jia
    Department of Health Statistics, Second Military Medical University, Shanghai, China.
    Cao, Yang
    Örebro University, School of Medical Sciences. Örebro University Hospital. Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Dose-response relationship between dietary magnesium intake, serum magnesium concentration and risk of hypertension: a systematic review and meta-analysis of prospective cohort studies2017In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 16, article id 26Article, review/survey (Refereed)
    Abstract [en]

    Background: The findings of prospective cohort studies are inconsistent regarding the association between dietary magnesium intake and serum magnesium concentration and the risk of hypertension. We aimed to review the evidence from prospective cohort studies and perform a dose-response meta-analysis to investigate the relationship between dietary magnesium intake and serum magnesium concentrations and the risk of hypertension.

    Methods: We searched systematically PubMed, EMBASE and the Cochrane Library databases from October 1951 through June 2016. Prospective cohort studies reporting effect estimates with 95% confidence intervals (CIs) for hypertension in more than two categories of dietary magnesium intake and/or serum magnesium concentrations were included. Random-effects models were used to combine the estimated effects.

    Results: Nine articles (six on dietary magnesium intake, two on serum magnesium concentration and one on both) of ten cohort studies, including 20,119 cases of hypertension and 180,566 participates, were eligible for inclusion in the meta-analysis. We found an inverse association between dietary magnesium intake and the risk of hypertension [relative risk (RR) = 0.92; 95% CI: 0.86, 0.98] comparing the highest intake group with the lowest. A 100 mg/day increment in magnesium intake was associated with a 5% reduction in the risk of hypertension (RR = 0.95; 95% CI: 0.90, 1.00). The association of serum magnesium concentration with the risk of hypertension was marginally significant (RR = 0.91; 95% CI: 0.80, 1.02).

    Conclusions: Current evidence supports the inverse dose-response relationship between dietary magnesium intake and the risk of hypertension. However, the evidence about the relationship between serum magnesium concentration and hypertension is limited.

  • 8.
    Harms-Ringdahl, Mats
    et al.
    Stockholm University, Faculty of Science, Department of Genetics, Microbiology and Toxicology.
    Jenssen, Dag
    Stockholm University, Faculty of Science, Department of Genetics, Microbiology and Toxicology.
    Haghdoost, Siamak
    Stockholm University, Faculty of Science, Department of Genetics, Microbiology and Toxicology.
    Tomato juice intake suppressed serum concentration of 8-oxodG after extensive physical activity2012In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 11, p. 29-Article in journal (Refereed)
    Abstract [en]

    Background: DNA is constantly exposed to reactive oxygen species (ROS), spontaneously arising during the normal oxygen metabolism. ROS may result in temporary as well as permanent modifications in various cellular components such as lipids, proteins and DNA, which may have deleterious consequences. Demonstrating that a dietary supplementation of antioxidants can reduce oxidative DNA damage may provide evidence for the value of such supplementation in prevention of cancer and age related diseases. Findings: The present study was conducted to address whether tomato juice protects against ROS induced by extensive physical exercise in untrained individuals. As a marker of oxidative stress, serum levels of 8-oxodG were monitored using a modified ELISA. An intervention was performed involving 15 untrained healthy subjects who performed a 20 min physical exercise at 80% of maximum pulse using an ergometer bicycle. Blood samples were taken before and one hour after the exercise. The procedure was repeated after 5 weeks with a daily intake of 150 ml tomato juice and followed by a 5 weeks wash-out period and another 5 weeks with a daily intake of tomato juice. The results indicated that a daily intake of tomato juice, equal to 15 mg lycopene per day, for 5 weeks significantly reduced the serum levels of 8-oxodG after an extensive physical exercise. Conclusion: These data strongly suggest that tomato juice has a potential antioxidant effect and may reduce the elevated level of ROS induced by oxidative stress.

  • 9.
    Hu, Minyu
    et al.
    School of Public Health, Central South University, Changsha, China.
    Li, Yi-Lin
    School of Public Health, Central South University, Changsha, China.
    Jiang, Chonghe
    bMedical College of Hunan Normal University, Changsha, China.
    Liu, Zhao-Qian
    School of Public Health, Central South University, Changsha, China.
    Qu, Shulin
    bMedical College of Hunan Normal University, Changsha, China.
    Huang, Yiming
    School of Public Health, Central South University, Changsha, China.
    Comparison of lycopene and fluvastatin effects on atherosclerosis induced by a      high-fat diet in rabbits2008In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 24, no 10, p. 1030-1038Article in journal (Refereed)
    Abstract [en]
    Objective

    We evaluated the antiatherogenic effect of lycopene in rabbits fed a high-fat diet.

    Methods

    Forty adult male rabbits were divided into five groups that were fed a standard diet, a high-fat diet, a high-fat diet plus 4 mg/kg of lycopene, a high-fat diet plus 12 mg/kg of lycopene, and a high-fat diet plus 10 mg/kg of fluvastatin, respectively. Lycopene and fluvastatin were administered intragastrically. The level of serum total cholesterol, total triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total antioxidant capacity, and malondialdehyde were measured before and after 4 and 8 wk of experimental treatment. In addition, plasma levels of lycopene, oxidized low-density lipoprotein, serum nitric oxide, and interleukin-1 were measured after the experiment. The area of atherosclerotic plaque and pathologic changes of the aorta were evaluated.

    Results

    Compared with the control, levels of total cholesterol, total triacylglycerol, low-density lipoprotein cholesterol, malonaldehyde, oxidized low-density lipoprotein, and interleukin-1 were increased and total antioxidant capacity and nitric oxide were decreased in the animals with a high-fat diet (P < 0.05). Intragastric administration of lycopene counteracted the change in these parameters (P < 0.05). In this case, the data showed that lycopene in the used dose was better than the fluvastatin intervention. Morphologic analysis revealed that lycopene and fluvastatin markedly reduced the formation of atherosclerotic plaques in the aorta compared with the situation in rabbits on a high-fat diet alone.

    Conclusion

    Lycopene, like fluvastatin, significantly attenuated atherogenesis in rabbits fed a high-fat diet.

  • 10.
    Hunsberger, Monica
    et al.
    Univ Gothenburg, Dept Publ Hlth & Community Med, S-40530 Gothenburg, Sweden.
    Pena, Pablo
    Univ Gothenburg, Dept Publ Hlth & Community Med, S-40530 Gothenburg, Sweden.
    Lissner, Lauren
    Univ Gothenburg, Dept Publ Hlth & Community Med, S-40530 Gothenburg, Sweden.
    Grafstrom, Lisen
    Grafstroms Mat & Med HB, S-43994 Onsala, Sweden.
    Vanaelst, Barbara
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Boernhorst, Claudia
    Leibniz Inst Prevent Res & Epidemiol BIPS GmbH, Dept Stat Methods Epidemiol, Bremen, Germany.
    Pala, Valeria
    Fdn IRCCS Ist Nazl Tumori, Epidemiol & Prevent Unit, I-20133 Milan, Italy.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, S-40530 Gothenburg, Sweden.
    Validity of self-reported lunch recalls in Swedish school children aged 6-8 years2013In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 12, article id 129Article in journal (Refereed)
    Abstract [en]

    Background: Previous studies have suggested that young children are inaccurate reporters of dietary intake. The purpose of this study was to validate a single recall of the previous day's school lunch reported by 6-8 year old Swedish children and to assess teacher-recorded intake of the same meal in a standardized food journal. An additional research question was whether parents could report their child's intake of the previous day's lunch. Subjects constituted a convenience sample from the large, multi-country study Identification and prevention of Dietary-and lifestyle-induced health EFfects In Children and infantS (IDEFICS). Validations of both children's recalls and teachers' records were made by comparing results with the duplicate plate reference method. Findings: Twenty-five children (12 boys/13 girls) aged 6-8 years participated in the validation study at one school in western Sweden. Children were accurate self-reporters of their dietary intake at lunch, with no significant difference between reported and weighed intake (Mean difference (SD): 7(50) kcals, p=0.49). Teachers significantly over-reported intake (Mean difference (SD): 65(79) kcals, p=0.01). For both methods, child-reported and teacher-recorded, correlations with weighed intake were strong (Pearson's correlations r=0.92, p<0.001 and r=0.83, p<0.001 respectively). Bland-Altman plots showed strong agreement between child-reported and weighed intakes but confirmed systematic differences between teacher-records and weighed intakes. Foods were recalled by children with a food-match rate of 90%. In all cases parents themselves were unable to report on quantities consumed and only four of 25 children had parents with knowledge regarding food items consumed. Conclusions: Children 6-8 years of age accurately recalled their school lunch intake for one occasion while teachers recorded with less accuracy. Our findings suggest that children as young as six years of age may be better able to report on their dietary intake than previously suggested, at least for one main meal at school. Teacher-recorded intake provides a satisfactory estimate but with greater systematic deviation from the weighed intake. Parents were not able to report on their children's school lunches consumed on the previous day.

  • 11. Huseinovic, Ena
    et al.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Esberg, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Winkvist, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health. Department of Internal Medicine and Clinical Nutrition, the Sahlgrenska Academy, University of Gothenburg, Sweden.
    Changes in food intake patterns during 2000–2007 and 2008–2016 in the population-based Northern Sweden Diet Database2019In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 18, article id 36Article in journal (Refereed)
    Abstract [en]

    Background: Food intake patterns provide a summary of dietary intake. Few studies have examined trends in food intake patterns over time in large, population-based studies. We examined food intake patterns and related sociodemographic and individual characteristics in the large Northern Sweden Diet Database during the two time windows 2000–2007 and 2008–2016.

    Methods: In total, 100 507 participants (51% women) who had filled in a 64-item food frequency questionnaire and provided background and sociodemographic data between 2000 and 2016 were included. Food intake patterns were evaluated for women and men separately for the two time windows 2000–2007 and 2008–2016, respectively. Latent class analysis was used to identify distinct, latent clusters based on 40 food groups.

    Results: Among both women and men, a greater proportion of participants were classified into food intake patterns characterized by high-fat spread and high-fat dairy during 2008–2016 compared to 2000–2007. In the earlier time window, these high-fat clusters were related to lower educational level and smoking. Simultaneously, the proportion of women and men classified into a cluster characterized by high intake of fruit, vegetables, and fibre decreased from the earlier to the later time window.

    Conclusion: From a public health perspective, the increase in clusters with a high conditional mean for high-fat spread and high-fat dairy and decrease in clusters with a high conditional mean for fruit and vegetables, during the time period 2008–2016 compared to 2000–2007, is worrisome as it indicates a shift away from the recommended food habits. Subgroups of women and men with less healthy dietary patterns in the time window 2008–2016 with lower education, lower age, higher body mass index, lower levels of physical activity and more smoking were identified and future interventions may be targeted towards these groups.

  • 12.
    Hörnell, Agneta
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Winkvist, Anna
    Department of Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg .
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Weinehall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Mis-reporting, previous health status and health status of family may seriously bias the association between food patterns and disease2010In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 9, no 48Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Food pattern analyses are popular tools in the study of associations between diet and health. However, there is a need for further evaluation of this methodology. The aim of the present cross-sectional study was to evaluate the relationship between food pattern groups (FPG) and existing health, and to identify factors influencing this relationship.

    METHODS: The inhabitants of Västerbotten County in northern Sweden are invited to health check-ups when they turn 30, 40, 50, and 60 years of age. The present study includes data collected from almost 60,000 individuals between 1992 and 2005. Associations between FPG (established using K-means cluster analyses) and health were analyzed separately in men and women.

    RESULTS: The health status of the participants and their close family and reporting accuracy differed significantly between men and women and among FPG. Crude regression analyses, with the high fat FPG as reference, showed increased risks for several health outcomes for all other FPGs in both sexes. However, when limiting analysis to individuals without previous ill-health and with adequate energy intake reports, most of the risks instead showed a trend towards protective effects.

    CONCLUSIONS: Food pattern classifications reflect both eating habits and other own and family health related factors, a finding important to remember and to adjust for before singling out the diet as a primary cause for present and future health problems. Appropriate exclusions are suggested to avoid biases and attenuated associations in nutrition epidemiology.

  • 13.
    Jobs, Elisabeth
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Uppsala universitetet.
    Adamsson, Viola
    Larsson, Anders
    Jobs, Magnus
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Nerpin, Elisabet
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Ingelsson, Erik
    Ärnlöv, Johan
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Uppsala universitet.
    Risérus, Ulf
    Influence of a prudent diet on circulating cathepsin S in humans2014In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 13, no 84Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Increased circulating cathepsin S levels have been linked to increased risk of cardiometabolic diseases and cancer. However, whether cathepsin S is a modifiable risk factor is unclear. We aimed to investigate the effects of a prudent diet on plasma cathepsin S levels in healthy individuals.

    FINDINGS: Explorative analyses of a randomized study were performed in 88 normal to slightly overweight and hyperlipidemic men and women (aged 25 to 65) that were randomly assigned to ad libitum prudent diet, i.e. healthy Nordic diet (ND) or a control group (habitual Western diet) for 6 weeks. Whereas all foods in the ND were provided, the control group was advised to consume their habitual diet throughout the study. The ND was in line with dietary recommendations, e.g. low in saturated fats, sugars and salt, but high in plant-based foods rich in fibre and unsaturated fats.The ND significantly decreased cathepsin S levels (from 20.1 (+/-4.0 SD) to 19.7 μg/L (+/-4.3 SD)) compared with control group (from 18.2 (+/-2.9 SD) to 19.1 μg/L (+/-3.8 SD)). This difference remained after adjusting for sex and change in insulin sensitivity (P = 0.03), and near significant after adjusting for baseline cathepsin S levels (P = 0.06), but not for change in weight or LDL-C. Changes in cathepsin S levels were directly correlated with change in LDL-C.

    CONCLUSIONS: Compared with a habitual control diet, a provided ad libitum healthy Nordic diet decreased cathepsin S levels in healthy individuals, possibly mediated by weight loss or lowered LDL-C. These differences between groups in cathepsin S were however not robust and therefore need further investigation.

  • 14.
    Jobs, Elisabeth
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Adamsson, Viola
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Jobs, Magnus
    Nerpin, Elisabet
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Ingelsson, Erik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology.
    Ärnlöv, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology.
    Risérus, 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 prudent diet on circulating cathepsin S in humans2014In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 13, p. 84-Article in journal (Refereed)
    Abstract [en]

    Background: Increased circulating cathepsin S levels have been linked to increased risk of cardiometabolic diseases and cancer. However, whether cathepsin S is a modifiable risk factor is unclear. We aimed to investigate the effects of a prudent diet on plasma cathepsin S levels in healthy individuals. Findings: Explorative analyses of a randomized study were performed in 88 normal to slightly overweight and hyperlipidemic men and women (aged 25 to 65) that were randomly assigned to ad libitum prudent diet, i.e. healthy Nordic diet (ND) or a control group (habitual Western diet) for 6 weeks. Whereas all foods in the ND were provided, the control group was advised to consume their habitual diet throughout the study. The ND was in line with dietary recommendations, e. g. low in saturated fats, sugars and salt, but high in plant-based foods rich in fibre and unsaturated fats. The ND significantly decreased cathepsin S levels (from 20.1 (+/-4.0 SD) to 19.7 mu g/L (+/-4.3 SD)) compared with control group (from 18.2 (+/-2.9 SD) to 19.1 mu g/L (+/-3.8 SD)). This difference remained after adjusting for sex and change in insulin sensitivity (P = 0.03), and near significant after adjusting for baseline cathepsin S levels (P = 0.06), but not for change in weight or LDL-C. Changes in cathepsin S levels were directly correlated with change in LDL-C. Conclusions: Compared with a habitual control diet, a provided ad libitum healthy Nordic diet decreased cathepsin S levels in healthy individuals, possibly mediated by weight loss or lowered LDL-C. These differences between groups in cathepsin S were however not robust and therefore need further investigation.

  • 15.
    Johansson, Ingegerd
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Esberg, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Jansson, Jan-Håkan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Winkvist, Anna
    Dairy intake revisited - associations between dairy intake and lifestyle related cardio-metabolic risk factors in a high milk consuming population2018In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 17, article id 110Article in journal (Refereed)
    Abstract [en]

    Background: The association between milk and dairy intake and the incidence of cardiometabolic diseases, cancer and mortality has been evaluated in many studies, but these studies have had conflicting results with no clear conclusion on causal or confounding associations. The present study aims to further address this association by cross-sectional and longitudinal evaluation of the associations between exposure to various types of dairy products and metabolic risk markers among inhabitants in northern Sweden while taking other lifestyle factors into account.

    Methods: Respondents in the Vasterbotten Intervention Programme with complete and plausible diet data between 1991 and 2016 were included, yielding 124,934 observations from 90,512 unique subjects. For longitudinal analysis, 27,682 participants with a visit 8-12years after the first visit were identified. All participants completed a validated Food Frequency Questionnaire. Metabolic risk markers, including body mass index (BMI), blood pressure, serum (S) cholesterol and triglycerides, and blood glucose, were measured. Participants were categorized into quintiles by intake of dairy products, and risk (odds ratios, OR) of undesirable levels of metabolic risk markers was assessed in multivariable logistic regression analyses. In longitudinal analyses, intake quintiles were related to desirable levels of metabolic risk markers at both visits or deterioration at follow-up using Cox regression analyses.

    Results: The OR of being classified with an undesirable BMI decreased with increasing quintiles of total dairy, cheese and butter intake but increased with increasing non-fermented milk intake. The OR of being classified with an undesirable S-cholesterol level increased with increasing intake of total dairy, butter and high fat (3%) non-fermented milk, whereas an undesirable S-triglyceride level was inversely associated with cheese and butter intake in women. In longitudinal analyses, increasing butter intake was associated with deterioration of S-cholesterol and blood glucose levels, whereas increasing cheese intake was associated with a lower risk of deterioration of S-triglycerides.

    Conclusions: Confounding factors likely contribute to the demonstrated association between dairy intake and mortality, and other medical conditions and analyses should be stratified by dairy type.

  • 16.
    Johansson, Ingegerd
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Stegmayr, Birgitta
    The National Board of Welfare, Stockholm, Sweden .
    Boman, Kurt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. Department of Medicine, Skellefteå County Hospital, Skellefteå, Sweden.
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Winkvist, Anna
    Associations among 25-year trends in diet, cholesterol and BMI from 140,000 observations in men and women in Northern Sweden2012In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 11, article id 40Article in journal (Refereed)
    Abstract [en]

    Background: In the 1970s, men in northern Sweden had among the highest prevalences of cardiovascular diseases (CVD) worldwide. An intervention program combining population- and individual-oriented activities was initiated in 1985. Concurrently, collection of information on medical risk factors, lifestyle and anthropometry started. Today, these data make up one of the largest databases in the world on diet intake in a population- based sample, both in terms of sample size and follow-up period. The study examines trends in food and nutrient intake, serum cholesterol and body mass index (BMI) from 1986 to 2010 in northern Sweden.

    Methods: Cross-sectional information on self-reported food and nutrient intake and measured body weight, height, and serum cholesterol were compiled for over 140,000 observations. Trends and trend breaks over the 25-year period were evaluated for energy-providing nutrients, foods contributing to fat intake, serum cholesterol and BMI.

    Results: Reported intake of fat exhibited two significant trend breaks in both sexes: a decrease between 1986 and 1992 and an increase from 2002 (women) or 2004 (men). A reverse trend was noted for carbohydrates, whereas protein intake remained unchanged during the 25-year period. Significant trend breaks in intake of foods contributing to total fat intake were seen. Reported intake of wine increased sharply for both sexes (more so for women) and export beer increased for men. BMI increased continuously for both sexes, whereas serum cholesterol levels decreased during 1986 - 2004, remained unchanged until 2007 and then began to rise. The increase in serum cholesterol coincided with the increase in fat intake, especially with intake of saturated fat and fats for spreading on bread and cooking.

    Conclusions: Men and women in northern Sweden decreased their reported fat intake in the first 7 years (19861992) of an intervention program. After 2004 fat intake increased sharply for both genders, which coincided with introduction of a positive media support for low carbohydrate-high-fat (LCHF) diet. The decrease and following increase in cholesterol levels occurred simultaneously with the time trends in food selection, whereas a constant increase in BMI remained unaltered. These changes in risk factors may have important effects on primary and secondary prevention of cardiovascular disease (CVD).

  • 17.
    Khan, Ashraful Islam
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Kabir, Iqbal
    International Centre for Diarrhoeal Diseases Research, Bangladesh (ICDDR,B), Bangladesh.
    Ekström, Eva-Charlotte
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Åsling-Monemi, Kajsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Alam, Dewan Shamsul
    International Centre for Diarrhoeal Diseases Research, Bangladesh (ICDDR,B), Bangladesh.
    Frongillo, Edward A
    Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA.
    Yunus, Md
    International Centre for Diarrhoeal Diseases Research, Bangladesh (ICDDR,B), Bangladesh.
    Arifeen, Shams
    International Centre for Diarrhoeal Diseases Research, Bangladesh (ICDDR,B), Bangladesh.
    Persson, Lars-Åke
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Effects of prenatal food and micronutrient supplementation on child growth from birth to 54 months of age: a randomized trial in Bangladesh2011In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 10, p. 134-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    There is a lack of information on the optimal timing of food supplementation to malnourished pregnant women and possible combined effects of food and multiple micronutrient supplementations (MMS) on their offspring's growth. We evaluated the effects of prenatal food and micronutrient interventions on postnatal child growth. The hypothesis was that prenatal MMS and early invitation to food supplementation would increase physical growth in the offspring during 0-54 months and a combination of these interventions would further improve these outcomes.

    METHODS:

    In the large, randomized MINIMat trial (Maternal and Infant Nutrition Interventions in Matlab), Bangladesh, 4436 pregnant women were enrolled between November 2001 and October 2003 and their children were followed until March 2009. Participants were randomized into six groups comprising 30 mg Fe and 400 ug folic acid (Fe30F), 60 mg Fe and 400 ug folic acid (Fe60F) or MMS combined with either an early (immediately after identification of pregnancy) or a later usual (at the time of their choosing, i.e., usual care in this community) program invitation to food supplementation. The anthropometry of 3267 children was followed from birth to 54 months, and 2735 children were available for analysis at 54 months.

    RESULTS:

    There were no differences in characteristics of mothers and households among the different intervention groups. The average birth weight was 2694 g and birth length was 47.7 cm, with no difference among intervention groups. Early invitation to food supplementation (in comparison with usual invitation) reduced the proportion of stunting from early infancy up to 54 months for boys (p=0.01), but not for girls (p=0.31). MMS resulted in more stunting than standard Fe60F (p=0.02). There was no interaction between the food and micronutrient supplementation on the growth outcome.

    CONCLUSIONS:

    Early food supplementation in pregnancy reduced the occurrence of stunting during 0-54 months in boys, but not in girls, and prenatal MMS increased the proportion of stunting in boys. These effects on postnatal growth suggest programming effects in early fetal life. The study is registered as an International Standard Randomized Controlled Trial, number ISRCTN16581394.

  • 18.
    Krachler, Benno
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Eliasson, Mats
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Reported food intake and distribution of body fat: a repeated cross-sectional study2006In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 22, no 5, p. 34-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Body mass, as well as distribution of body fat, are predictors of both diabetes and cardiovascular disease. In Northern Sweden, despite a marked increase in average body mass, prevalence of diabetes was stagnant and myocardial infarctions decreased. A more favourable distribution of body fat is a possible contributing factor.This study investigates the relative importance of individual food items for time trends in waist circumference (WC) and hip circumference (HC) on a population level. METHODS: Independent cross-sectional surveys conducted in 1986, 1990, 1994 and 1999 in the two northernmost counties of Sweden with a common population of 250,000. Randomly selected age stratified samples, altogether 2982 men and 3087 women aged 25-64 years. Questionnaires were completed and anthropometric measurements taken. For each food item, associations between frequency of consumption and waist and hip circumferences were estimated. Partial regression coefficients for every level of reported intake were multiplied with differences in proportion of the population reporting the corresponding levels of intake in 1986 and 1999. The sum of these product terms for every food item was the respective estimated impact on mean circumference. RESULTS: Time trends in reported food consumption associated with the more favourable gynoid distribution of adipose tissue were increased use of vegetable oil, pasta and 1.5% fat milk. Trends associated with abdominal obesity were increased consumption of beer in men and higher intake of hamburgers and French fried potatoes in women. CONCLUSION: Food trends as markers of time trends in body fat distribution have been identified. The method is a complement to conventional approaches to establish associations between food intake and disease risk on a population level.

  • 19.
    Krakau, Karolina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Hansson, A.
    Karlsson, Torbjörn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    de Boussard, C.N.
    Tengvar, C.
    Borg, Jörgen
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Nutritional treatment of patients with severe traumatic brain injury during the first six months after injury2007In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 23, no 4, p. 308-317Article in journal (Refereed)
    Abstract [en]

    Objective: This study explored current nutritional treatment policies and nutritional outcome in patients with severe traumatic brain injury. Methods: We performed a retrospective, structured survey of the medical records of 64 patients up to 6 months after injury or until the patients were independent in nutritional administration. Results: Enteral nutrition was administered to 86% of patients. Fourteen patients (22%) had a gastrostomy; after 6 months four were still in use. At 6 months, 92% of patients received all food orally and 84% had gained nutritional independence. Energy intake was equal to the calculated basal metabolic rate throughout the first month after injury and increased by 21% during the second month. Sixty-eight percent exhibited signs of malnourishment with weight losses of 10-29%. Conclusion: This study suggests that most patients with severe traumatic brain injury regain their nutritional independence within the first 6 months after injury, but also that most develop signs of malnutrition.

  • 20.
    Lin, Yi
    et al.
    Ghent University, Belgium.
    Mouratidou, Theodora
    University of Zaragoza, Spain.
    Vereecken, Carine
    Ghent University, Belgium; FWO Research Foundation – Flanders, Belgium.
    Kersting, Mathilde
    University of Bonn, Germany.
    Bolca, Selin
    Ghent University, Belgium.
    de Moraes, Augusto César F.
    University of Zaragoza, Spain; University of Sao Paulo, Brazil.
    Cuenca-García, Magdalena
    Granada University, Spain.
    Moreno, Luis A.
    University of Zaragoza, Spain; University of Sao Paulo, Brazil.
    González-Gross, Marcela
    Technical University of Madrid, Spain.
    Valtueña, Jara
    Technical University of Madrid, Spain.
    Labayen, Idoia
    University of the Basque Country, Spain.
    Grammatikaki, Evangelia
    Ghent University, Belgium; Harokopio University, Greece.
    Hallström, Lena
    Mälardalen University, Sweden.
    Leclercq, Catherine
    Agricultural Research Council, Italy.
    Ferrari, Marika
    Agricultural Research Council, Italy.
    Gottrand, Frederic
    University of Lille, France; Centre d’Investigation Clinique, France.
    Beghin, Laurent
    University of Lille, France; Centre d’Investigation Clinique, France.
    Manios, Yannis
    Harokopio University, Greece.
    Ottevaere, Charlene
    Ghent University, Belgium.
    Van Oyen, Herman
    Scientific Institute of Public Health, Belgium.
    Molnar, Denes
    University of Pécs, Hungary.
    Kafatos, Anthony
    University of Crete, Greece.
    Widhalm, Kurt
    Private Medical University, Austria.
    Gómez-Martinez, Sonia
    CSIC Spanish National Research Council, Spain.
    Díaz Prieto, Ligia Esperanza
    CSIC Spanish National Research Council, Spain.
    De Henauw, Stefaan
    Ghent University, Belgium; University College Ghent, Belgium.
    Huybrechts, Inge
    Ghent University, Belgium; International Agency for Research on Cancer, France.
    Hall, Gunnar
    RISE, SP – Sveriges Tekniska Forskningsinstitut, SP Food and Bioscience, Flavour.
    Åström, Annika
    RISE, SP – Sveriges Tekniska Forskningsinstitut, SP Food and Bioscience, Flavour.
    Broberg, Agneta
    RISE, SP – Sveriges Tekniska Forskningsinstitut, SP Food and Bioscience, Flavour.
    Dietary animal and plant protein intakes and their associations with obesity and cardio-metabolic indicators in European adolescents: The HELENA cross-sectional study2015In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 14, no 10Article in journal (Refereed)
    Abstract [en]

    Background: Previous studies suggest that dietary protein might play a beneficial role in combating obesity and its related chronic diseases. Total, animal and plant protein intakes and their associations with anthropometry and serum biomarkers in European adolescents using one standardised methodology across European countries are not well documented. Objectives: To evaluate total, animal and plant protein intakes in European adolescents stratified by gender and age, and to investigate their associations with cardio-metabolic indicators (anthropometry and biomarkers). Methods: The current analysis included 1804 randomly selected adolescents participating in the HELENA study (conducted in 2006-2007) aged 12.5-17.5 y (47% males) who completed two non-consecutive computerised 24-h dietary recalls. Associations between animal and plant protein intakes, and anthropometry and serum biomarkers were examined with General linear Model multivariate analysis. Results: Average total protein intake exceeded the recommendations of World Health Organization and European Food Safety Authority. Mean total protein intake was 96 g/d (59% derived from animal protein). Total, animal and plant protein intakes (g/d) were significantly lower in females than in males and total and plant protein intakes were lower in younger participants (12.5-14.9 y). Protein intake was significantly lower in underweight subjects and higher in obese ones; the direction of the relationship was reversed after adjustments for body weight (g/(kg.d)). The inverse association of plant protein intakes was stronger with BMI z-score and body fat percentage (BF%) compared to animal protein intakes. Additionally, BMI and BF% were positively associated with energy percentage of animal protein. Conclusions: This sample of European adolescents appeared to have adequate total protein intake. Our findings suggest that plant protein intakes may play a role in preventing obesity among European adolescents. Further longitudinal studies are needed to investigate the potential beneficial effects observed in this study in the prevention of obesity and related chronic diseases.

  • 21. Lindmark, Ulrika
    et al.
    Stegmayr, Birgitta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Food selection associated with sense of coherence in adults.2005In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 28, no 4, p. 9-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Favorable dietary habits promote health, whereas unfavorable habits link to various chronic diseases. An individual's "sense of coherence" (SOC) is reported to correlate with prevalence of some diseases to which dietary habits are linked. However, understanding what determines an individual's dietary preferences and how to change his/her behavior remains limited. The aim of the present study was to evaluate associations between dietary intake and SOC in adults. METHODS: Diet intake was recorded by an 84-item semi-quantitative food frequency questionnaire and SOC was measured by the 13-item Antonovsky questionnaire in 2,446 men and 2,545 women (25-74 years old) from the population based northern Sweden MONICA screening in 1999. RESULTS: Intakes of energy, total and saturated fat, ascorbic acid, sucrose, and servings of fruits, vegetables, cereals, and sweets correlated with SOC among women, whereas intakes of total and saturated fat, ascorbic acid, fiber, and alcohol, and servings of fruits, vegetables, bread, bread and cereals, fish, and potatoes correlated with SOC among men. With a few exceptions, intakes of these nutrients/foods were significantly explained by SOC quartile scores in linear GLM models. Both women and men classified into the highest SOC quartile had significantly higher age-BMI-education standardized mean intakes of vegetables than those in the lowest quartiles. Women in the highest SOC quartile also had higher intake of fruits but lower intakes of energy, total and saturated fat, sucrose, and sweets. Projection to latent structures (PLS) multivariate modeling of intakes of the 84 food items and food aggregates simultaneously on SOC scores supported low SOC to coincide with a presumably less health promoting dietary preference, e.g. intake of pizza, soft drinks, candies, sausages for main course, hamburgers, mashed potato, chips and other snacks, potato salad, French fries, whereas men and women with high SOC scores were characterized by e.g. high intake of rye crisp whole meal bread, boiled potato, vegetables, berries, and fruits. CONCLUSION: Both men and women in the highest, as compared with the lowest, SOC score quartile reported more "healthy" food choices. Dietary habits for individuals in the lowest SOC quartile therefore may render a higher risk for various endemic diseases.

  • 22.
    Lindmark, Ulrika
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine.
    Stegmayr, Birgitta
    Nilsson, Berit
    Lindahl, Bernt
    Johansson, Ingegerd
    Food selection associated with sense of coherence in adults.2005In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 4, no 1, p. 9-Article in journal (Refereed)
  • 23.
    Lindmark, Ulrika
    et al.
    Högskolan i Jönköping, HHJ, Avd. för naturvetenskap och biomedicin.
    Stegmayr, Birgitta
    Nilsson, Berit
    Lindahl, Bernt
    Johansson, Ingegerd
    Food selection associated with sense of coherence in adults.2005In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 4, no 1, p. 9-Article in journal (Refereed)
  • 24.
    Lindvall, Kristina
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Jenkins, Paul
    Emmelin, Maria
    Lund Univ, Dept Clin Sci Social Med & Global Hlth.
    Scribani, Melissa
    Bassett Healthcare Network Res Inst.
    Norberg, Margareta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Centre for Population Studies (CPS).
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Weinehall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Centre for Population Studies (CPS).
    Primary weight maintenance: an observational study exploring candidate variables for intervention2013In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 12, p. 97-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Previous studies have focused on weight maintenance following weight loss, i.e. secondary weight maintenance (SWM). The long-term results of SWM have been rather modest and it has been suggested that preventing initial weight gain, i.e. primary weight maintenance (PWM), may be more successful. Therefore, developing a prevention strategy focused on PWM, enabling normal weight or overweight individuals to maintain their weight, would be of great interest. The aim of this study was to identify attitudes, strategies, and behaviors that are predictive of PWM in different age, sex and BMI groups in Northern Sweden. METHODS: A questionnaire was mailed to 3497 individuals in a Swedish population that had two measured weights taken ten years apart, as participants in the Västerbotten Intervention Programme. Subjects were between 41-63 years of age at the time of the survey, had a baseline BMI of 20-30, and a ten year percent change in BMI greater than -3%. The respondents were divided into twelve subgroups based on baseline age (30, 40 and 50), sex and BMI (normal weight and overweight). Analysis of variance (ANOVA), correlation, and linear regression were performed to identify independent predictors of PWM. RESULTS: Of the 166 predictors tested, 152 (91.6%) were predictive of PWM in at least one subgroup. However, only 7 of these 152 variables (4.6%) were significant in 6 subgroups or more. The number of significant predictors of PWM was higher for male (35.8) than female (27.5) subgroups (p=0.044). There was a tendency (non significant) for normal weight subgroups to have a higher number of predictors (35.3) than overweight subgroups (28.0). Adjusted R-squared values ranged from 0.1 to 0.420. CONCLUSIONS: The large number of PWM predictors identified, and accompanying high R-squared values, provide a promising first step towards the development of PWM interventions. The large disparity in the pattern of significant variables between subgroups suggests that these interventions should be tailored to the person's demographic (age, sex and BMI). The next steps should be directed towards evaluation of these predictors for causal potential.

  • 25.
    Lindvall, Kristina
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Jenkins, Paul
    Scribani, Melissa
    Emmelin, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Larsson, Christel
    Norberg, Margareta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Weinehall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Comparisons of weight change, eating habits and physical activity between women in Northern Sweden and Rural New York State-results from a longitudinal study2015In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 14, article id 88Article in journal (Refereed)
  • 26.
    Maringer, Marcus
    et al.
    Wageningen University & Research, The Netherlands.
    Van'T Veer, Pieter
    Wageningen University & Research, The Netherlands.
    Klepacz, Naomi
    University of Surrey, UK.
    Verain, Muriel C. D.
    Wageningen University & Research, The Netherlands.
    Normann, Anne
    RISE - Research Institutes of Sweden, Bioscience and Materials, Agrifood and Bioscience.
    Ekman, Susanne
    RISE - Research Institutes of Sweden, Bioscience and Materials, Agrifood and Bioscience.
    Timotijevic, Lada
    University of Surrey, UK.
    Raats, Monique M.
    University of Surrey, UK.
    Geelen, Anouk
    Wageningen University & Research, The Netherlands.
    User-documented food consumption data from publicly available apps: An analysis of opportunities and challenges for nutrition research2018In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 17, no 1, article id 59Article in journal (Refereed)
    Abstract [en]

    Background: The need for a better understanding of food consumption behaviour within its behavioural context has sparked the interest of nutrition researchers for user-documented food consumption data collected outside the research context using publicly available nutrition apps. The study aims to characterize the scientific, technical, legal and ethical features of this data in order to identify the opportunities and challenges associated with using this data for nutrition research. Method: A search for apps collecting food consumption data was conducted in October 2016 against UK Google Play and iTunes storefronts. 176 apps were selected based on user ratings and English language support. Publicly available information from the app stores and app-related websites was investigated and relevant data extracted and summarized. Our focus was on characteristics related to scientific relevance, data management and legal and ethical governance of user-documented food consumption data. Results: Food diaries are the most common form of data collection, allowing for multiple inputs including generic food items, packaged products, or images. Standards and procedures for compiling food databases used for estimating energy and nutrient intakes remain largely undisclosed. Food consumption data is interlinked with various types of contextual data related to behavioural motivation, physical activity, health, and fitness. While exchange of data between apps is common practise, the majority of apps lack technical documentation regarding data export. There is a similar lack of documentation regarding the implemented terms of use and privacy policies. While users are usually the owners of their data, vendors are granted irrevocable and royalty free licenses to commercially exploit the data. Conclusion: Due to its magnitude, diversity, and interconnectedness, user-documented food consumption data offers promising opportunities for a better understanding of habitual food consumption behaviour and its determinants. Non-standardized or non-documented food data compilation procedures, data exchange protocols and formats, terms of use and privacy statements, however, limit possibilities to integrate, process and share user-documented food consumption data. An ongoing research effort is required, to keep pace with the technical advancements of food consumption apps, their evolving data networks and the legal and ethical regulations related to protecting app users and their personal data.

  • 27. Nakamura, Ayumi
    et al.
    Itaki, Chieko
    Saito, Ayako
    Yonezawa, Toko
    Aizawa, Koichi
    Hirai, Ayumi
    Suganuma, Hiroyuki
    Miura, Tomisato
    Mariya, Yasushi
    Haghdoost, Siamak
    Stockholm University, Faculty of Science, Department of Molecular Biosciences, The Wenner-Gren Institute.
    Possible benefits of tomato juice consumption: a pilot study on irradiated human lymphocytes from healthy donors2017In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 16, article id 27Article in journal (Refereed)
    Abstract [en]

    Background: Reactive oxygen species (ROS) mediate much of the DNA damage caused by ionizing radiation. Among carotenoids, lycopene and beta-carotene, present in tomato juice, are known to be strong radical scavengers. The aim of the study was to investigate the effect of tomato juice intake on the levels of DNA damage and oxidative stress in human whole blood induced by in vitro exposure to X-rays. Methods: Ten healthy adults were asked to drink 190 g of tomato juice, containing 17 mg lycopene and 0.25 mg beta-carotene, per day for 3 weeks and then refrain from drinking it for 3 weeks. Peripheral whole blood samples were collected before and after the intake period of tomato juice and after the washout period. The blood samples were exposed in vitro to X-ray doses of 0, 0.1, 0.5, and 2 Gy. Cytogenetic damage was measured using the cytokinesis-block micronucleus (CBMN) assay and the dicentrics (DIC) assay. The level of oxidative stress was determined using serum 8-oxo-7, 8-dihydro-2-deoxyguanosine (8-oxo-dG) and plasma reactive oxygen metabolite-derived compounds (d-ROMs). The concentration of carotenoids in plasma was measured at the three time points. Results: The levels of 8-oxo-dG tended to decrease during the intake period and increase during the washout period. A non-significant inverse correlation was noted between the plasma concentration of lycopene plus beta-carotene and the level of 8-oxo-dG (P = 0.064). The radiation-induced MN and DIC frequencies increased in a dose-dependent manner, and when compared at the same dose, theMN and DIC frequencies decreased during the intake period compared with those at baseline and then increased during the washout period. The results suggest that continuous tomato juice consumption non-significantly decreases extracellular 8-oxo-dG, d-ROMs, and MN. Tomato juice intake had minimal or no effect on radiation-induced 8-oxo-dG and d-ROMs. For most radiation doses, continuously tomato juice intake lowered the levels of MN and DIC. Conclusion: Tomato juice consumption may suppress human lymphocyte DNA damage caused by radiation, but further examination is required.

  • 28.
    Nilsson, Lena Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Arctic Research Centre at Umeå University.
    Winkvist, Anna
    Univ Gothenburg, Sahlgrenska Acad, Dept Internal Med & Clin Nutr, SE-40530 Gothenburg, Sweden.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    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.
    Lenner, Per
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Van Guelpen, Bethany
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Low-carbohydrate, high-protein diet score and risk of incident cancer: a prospective cohort study2013In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 12, p. 58-Article in journal (Refereed)
    Abstract [en]

    Background: Although carbohydrate reduction of varying degrees is a popular and controversial dietary trend, potential long-term effects for health, and cancer in specific, are largely unknown. Methods: We studied a previously established low-carbohydrate, high-protein (LCHP) score in relation to the incidence of cancer and specific cancer types in a population-based cohort in northern Sweden. Participants were 62,582 men and women with up to 17.8 years of follow-up (median 9.7), including 3,059 prospective cancer cases. Cox regression analyses were performed for a LCHP score based on the sum of energy-adjusted deciles of carbohydrate (descending) and protein (ascending) intake labeled 1 to 10, with higher scores representing a diet lower in carbohydrates and higher in protein. Important potential confounders were accounted for, and the role of metabolic risk profile, macronutrient quality including saturated fat intake, and adequacy of energy intake reporting was explored. Results: For the lowest to highest LCHP scores, 2 to 20, carbohydrate intakes ranged from median 60.9 to 38.9% of total energy intake. Both protein (primarily animal sources) and particularly fat (both saturated and unsaturated) intakes increased with increasing LCHP scores. LCHP score was not related to cancer risk, except for a non-dose-dependent, positive association for respiratory tract cancer that was statistically significant in men. The multivariate hazard ratio for medium (9-13) versus low (2-8) LCHP scores was 1.84 (95% confidence interval: 1.05-3.23; p-trend = 0.38). Other analyses were largely consistent with the main results, although LCHP score was associated with colorectal cancer risk inversely in women with high saturated fat intakes, and positively in men with higher LCHP scores based on vegetable protein. Conclusion: These largely null results provide important information concerning the long-term safety of moderate carbohydrate reduction and consequent increases in protein and, in this cohort, especially fat intakes. In order to determine the effects of stricter carbohydrate restriction, further studies encompassing a wider range of macronutrient intakes are warranted.

  • 29.
    Oudin, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Wennberg, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Fish consumption and ischemic stroke in southern Sweden2011In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 10, no 109, p. 5-Article in journal (Refereed)
    Abstract [en]

    Background: The relationship between fish intake and stroke incidence has been inconsistent in previous Swedish studies. Here, we report the risk of stroke and fish intake in a cohort from southern Sweden.

    Findings: Data were obtained from an already available population based case-control study where the cases were defined as incident first-time ischemic stroke patients. Complete data on all relevant variables were obtained for 2722 controls and 2469 cases. The data were analyzed with logistic regression analysis. Stroke risk decreased with fat fish intake ([greater than or equal to] 1/week versus <1/month) in both men and women; adjusted pooled Odds Ratio (OR) 0.69, 95% Confidence Interval (CI): 0.54-0.89. However, stroke risk for women increased with intake of lean fish; adjusted OR 1.63 (95% CI: 1.17-2.28), whereas there was no association with men's lean fish intake; adjusted OR 0.97(95% CI: 0.73-1.27). Fish intake was self-reported retrospectively, yielding uncertain exposure assessment and potential recall bias. The findings regarding lean fish could be explained by recall bias if an individual's inclination to report lean fish consumption depended on both disease status and sex. The fact that the association between fat fish intake and stroke was similar in men and women does not support such a differential in recall.

    Conclusions: The results suggest fat fish intake to decrease ischemic stroke risk and lean fish intake to increase women's stroke risk. The inconsistent relationship between fish intake and stroke risk reported in previous studies is further stressed by the results of this study.

  • 30.
    Samuelsson, Jessica
    et al.
    Göteborgs universitet.
    Rothenberg, Elisabet
    Kristianstad University, Faculty of Natural Science, Research Environment Food and Meals in Everyday Life (MEAL). Kristianstad University, Faculty of Natural Science, Avdelningen för mat- och måltidsvetenskap.
    Lissner, Lauren
    Göteborgs universitet.
    Eiben, Gabriele
    Skövde universitet.
    Zettergren, Anna
    Göteborgs universitet.
    Skoog, Ingmar
    Göteborgs universitet.
    Time trends in nutrient intake and dietary patterns among five birth cohorts of 70-year-olds examined 1971-2016: results from the Gothenburg H70 birth cohort studies, Sweden.2019In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 18, no 1, article id 66Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Nutrition is a key factor in healthy ageing but there are still gaps in knowledge about risk- and protective factors linking diet and healthy ageing. The aim of this study was to investigate time trends in dietary patterns and nutrient intake in an older population, in order to increase the understanding of whether dietary recommendations are followed and if nutrient needs are met.

    METHODS: Cross-sectional data was derived from five samples of 70-year-olds examined 1971-72, 1981-83, 1992-93, 2000-02 and 2014-16 from the Gothenburg H70 birth cohort studies in Sweden. A total of 2246 individuals (56% women) participated. Dietary intake was determined by the diet history method, which is an interview including questions on usual frequencies and portion sizes of food intake during the preceding three months. Recommended values of nutrient intake and determinants of healthful dietary patterns were based on the Nordic Nutrition Recommendations 2012. Statistical analyses were performed using general linear models, student's t-test and chi-square test, stratified by sex.

    RESULTS: The intake of fruits and vegetables, fish and seafood, whole grain products and nuts and seeds increased during the study period (p < 0.0001), among both sexes. However, there was also an increase in alcohol intake (p < 0.0001), especially from wine and beer, and in 2014-16 more than 30% had an alcohol intake above recommendations. Protein intake increased (p < 0.0001 for women and p = 0.0004 for men), and 48% of the women and 37% of the men had a protein intake above recommended 1.2 g/kg body weight and day in 2014-16. The proportion of participants at risk of inadequate intake of vitamins C, D and folate decreased during the study period, among both sexes (p < 0.0001). However, vitamin D intake from diet was still below average requirement level of 7.5 μg/day for 49% of the women and 32% of the men in 2014-16.

    CONCLUSIONS: Dietary patterns have changed among 70-year-olds during the past five decades, with an increase in healthful foods and a higher nutrient density in later born birth cohorts. However, the intake of alcohol increased, especially among women. Results from this study can be useful as a basis for dietary guidelines and used for prevention strategies involving older adults in population-based and health care settings.

  • 31.
    Samuelsson, Jessica
    et al.
    Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), University of Gothenburg, Sweden.
    Rothenberg, Elisabet
    Food and Meal Science, Kristianstad University, Sweden.
    Lissner, Lauren
    Department of Community Medicine and Public Health, University of Gothenburg, Sweden.
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Zettergren, Anna
    Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), University of Gothenburg, Sweden.
    Skoog, Ingmar
    Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), University of Gothenburg, Sweden.
    Time trends in nutrient intake and dietary patterns among five birth cohorts of 70-year-olds examined 1971-2016: results from the Gothenburg H70 birth cohort studies, Sweden2019In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 18, no 1, article id 66Article in journal (Refereed)
    Abstract [en]

    Background Nutrition is a key factor in healthy ageing but there are still gaps in knowledge about risk- and protective factors linking diet and healthy ageing. The aim of this study was to investigate time trends in dietary patterns and nutrient intake in an older population, in order to increase the understanding of whether dietary recommendations are followed and if nutrient needs are met. Methods Cross-sectional data was derived from five samples of 70-year-olds examined 1971-72, 1981-83, 1992-93, 2000-02 and 2014-16 from the Gothenburg H70 birth cohort studies in Sweden. A total of 2246 individuals (56% women) participated. Dietary intake was determined by the diet history method, which is an interview including questions on usual frequencies and portion sizes of food intake during the preceding three months. Recommended values of nutrient intake and determinants of healthful dietary patterns were based on the Nordic Nutrition Recommendations 2012. Statistical analyses were performed using general linear models, student's t-test and chi-square test, stratified by sex. Results The intake of fruits and vegetables, fish and seafood, whole grain products and nuts and seeds increased during the study period (p < 0.0001), among both sexes. However, there was also an increase in alcohol intake (p < 0.0001), especially from wine and beer, and in 2014-16 more than 30% had an alcohol intake above recommendations. Protein intake increased (p < 0.0001 for women and p = 0.0004 for men), and 48% of the women and 37% of the men had a protein intake above recommended 1.2 g/kg body weight and day in 2014-16. The proportion of participants at risk of inadequate intake of vitamins C, D and folate decreased during the study period, among both sexes (p < 0.0001). However, vitamin D intake from diet was still below average requirement level of 7.5 mu g/day for 49% of the women and 32% of the men in 2014-16. Conclusions Dietary patterns have changed among 70-year-olds during the past five decades, with an increase in healthful foods and a higher nutrient density in later born birth cohorts. However, the intake of alcohol increased, especially among women. Results from this study can be useful as a basis for dietary guidelines and used for prevention strategies involving older adults in population-based and health care settings.

  • 32. Sköldstam, L
    et al.
    Brudin, Lars
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology.
    Hagfors, L
    Johansson, G
    Weight reduction is not a major reason for improvement in rheumatoid arthritis from lacto-vegetarian, vegan or mediterranean diets2005In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 4, no 15Article in journal (Refereed)
  • 33.
    Sköldstam, Lars
    et al.
    Department of Medicine, County Hospital, Visby, Sweden.
    Brudin, Lars
    Department of Clinical Physiology, County Hospital, Kalmar, Sweden.
    Hagfors, Linda
    Department of Food and Nutrition, Umeå University, SE-901 87 Umeå, Sweden.
    Johansson, Gunnar
    Umeå University, Sweden.
    Weight reduction is not a major reason for improvement in rheumatoid arthritis from lacto-vegetarian, vegan or Mediterranean diets2005In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 4, no 4, p. 15-Article in journal (Refereed)
    Abstract [en]

    Objectives: Several investigators have reported that clinical improvements of patients with rheumatoid arthritis (RA), from participating in therapeutic diet intervention studies, have been accompanied by loss of body weight. This has raised the question whether weight reduction per se can improve RA. In order to test this hypothesis, three previously conducted diet intervention studies, comprising 95 patients with RA, were pooled. Together with Age, Gender, and Disease Duration, change during the test period in body weight, characterised dichotomously as reduction or no reduction (dichoΔBody Weight), as well as Diet (dichotomously as ordinary diet or test diet), were the independent variables. Dependent variables were the difference (Δ) from baseline to conclusion of the study in five different disease outcome measures. ΔESR and ΔPain Score were both characterised numerically and dichotomously (improvement or no improvement). ΔAcute Phase Response, ΔPhysical Function, and ΔTender Joint Count were characterised dichotomously only. Multiple logistic regression was used to analyse associations between the independent and the disease outcome variables. Results: Statistically significant correlations were found between Diet and three disease outcome variables i.e. ΔAcute-Phase Response, ΔPain Score, and ΔPhysical Function. Δ Body Weight was univariately only correlated to ΔAcute-Phase Response but not significant when diet was taken into account. Conclusion: Body weight reduction did not significantly contribute to the improvement in rheumatoid arthritis when eating lacto-vegetarian, vegan or Mediterranean diets. © 2005 Sköldstam et al; licensee BioMed Central Ltd.

  • 34. Warensjo, Eva
    et al.
    Smedman, Annika
    Stegmayr, Birgitta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Weinehall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Vessby, Bengt
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Stroke and plasma markers of milk fat intake: a prospective nested case-control study2009In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 8, no 1, p. 21-28Article in journal (Refereed)
    Abstract [en]

    ABSTRACT: BACKGROUND: Dairy products are high in saturated fat and are traditionally a risk factor for vascular diseases. The fatty acids 15:0 and 17:0 of plasma lipids are biomarkers of milk fat intake. The aim of the present study was to evaluate the risk of a first-ever stroke in relation to the plasma milk fat biomarkers. METHODS: A prospective case-control study was nested within two population based health surveys in Northern Sweden. Among 129 stroke cases and 257 matched controls, plasma samples for fatty acid analyses were available in 108 cases and 216 control subjects. Proportions of 15:0 and 17:0 of plasma lipids, weight, height, blood lipids, blood pressures, and lifestyle data were employed in conditional logistic regression modelling. RESULTS: The proportions of fatty acids 17:0 and 15:0+17:0 of total plasma phospholipids were significantly higher in female controls than cases, but not in men. The standardised odds ratio (95% CI) in women to have a stroke was 0.41 (0.24-0.69) and 0.48 (95% CI 0.29-0.79) for 17:0 and 15:0+17:0 of plasma phospholipids, respectively. Adjustment for traditional cardiovascular risk factors, physical activity and diet had marginal effects on the odds ratios. A similar, but non-significant, trend was seen in men. CONCLUSIONS: It is hypothesised that dairy product or milk fat intake may be inversely related to the risk of a first event of stroke. The intriguing results of this study should be interpreted with caution. Follow up studies with greater power, and where intakes are monitored both by dietary recordings and fatty acid markers are needed.

  • 35.
    Warensjö, Eva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Smedman, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Stegmayr, Birgitta
    Hallmans, Göran
    Weinehall, Lars
    Vessby, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Johansson, Ingegerd
    Stroke and plasma markers of milk fat intake: a prospective nested case-control study2009In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 8, p. 21-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Dairy products are high in saturated fat and are traditionally a risk factor for vascular diseases. The fatty acids 15:0 and 17:0 of plasma lipids are biomarkers of milk fat intake. The aim of the present study was to evaluate the risk of a first-ever stroke in relation to the plasma milk fat biomarkers. METHODS: A prospective case-control study was nested within two population based health surveys in Northern Sweden. Among 129 stroke cases and 257 matched controls, plasma samples for fatty acid analyses were available in 108 cases and 216 control subjects. Proportions of 15:0 and 17:0 of plasma lipids, weight, height, blood lipids, blood pressures, and lifestyle data were employed in conditional logistic regression modelling. RESULTS: The proportions of fatty acids 17:0 and 15:0+17:0 of total plasma phospholipids were significantly higher in female controls than cases, but not in men. 17:0 and 15:0+17:0 were significantly and inversely related to stroke in the whole study sample as well as in women. The standardised odds ratio (95% CI) in women to have a stroke was 0.41 (0.24-0.69) for 17:0 in plasma phospholipids. Adjustment for traditional cardiovascular risk factors, physical activity and diet had marginal effects on the odds ratios. A similar, but non-significant, trend was seen in men. CONCLUSION: It is hypothesised that dairy or milk fat intake may be inversely related to the risk of a first event of stroke. The intriguing results of this study should be interpreted with caution. Follow up studies with greater power, and where intakes are monitored both by dietary recordings and fatty acid markers are needed.

  • 36.
    Wennberg, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Jansson, Jan-Håkan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Norberg, Margareta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Skerfving, Staffan
    Strömberg, Ulf
    Wiklund, Per-Gunnar
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Bergdahl, Ingvar A
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Faculty of Medicine, Department of Biobank Research.
    Fish consumption and risk of stroke: a second prospective case-control study from northern Sweden2016In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 15, no 1, article id 98Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Fish consumption has been concluded to be associated with decreased risk of stroke in several reviews. However, among men, but not women, an increased risk of stroke was previously found at high fish consumption (>3 meals/week) in northern Sweden. This study investigates if previous results on elevated stroke risk with high fish consumption in men in northern Sweden can be confirmed in a larger study with new cases in the same population.

    METHODS: A prospective nested case-control study was performed within the population-based Northern Sweden Health and Disease Study cohort. Information on fish consumption, other lifestyle and medical data was collected at baseline. Incident stroke cases (1987-2007, n = 735) were identified and 2698 controls matched for gender, age, year of baseline and geographical region.

    RESULTS: There were no associations between total fish or fatty fish consumption and stroke risk; thus the previous finding of increased risk of stroke with high fish consumption in men could not be repeated. High intake of lean fish (>twice/week compared to < once/month) was associated with increased stroke risk in men [OR 1.80 (95% CI 1.00, 3.21), but not in women [OR 0.50 (95% CI 0.24, 1.10)]. The association was driven by men living alone.

    CONCLUSIONS: The previous association between high total fish consumption and risk of stroke in men could not be repeated. The increased risk found in men with high intake of lean fish may be due to chance or confounding specific for this group.

  • 37.
    Wennberg, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Tornevi, Andreas
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Norberg, Margareta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Centre for Population Studies (CPS).
    Bergdahl, Ingvar A
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Diet and lifestyle factors associated with fish consumption in men and women: a study of whether gender differences can result in gender-specific confounding2012In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 11, p. 101-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Fish consumption and intake of omega-3 fatty acids from fish are associated with a lower risk of cardiovascular disease. However, a prospective study from northern Sweden showed that high consumption of fish is associated with an increased risk of stroke in men, but not in women. The current study aimed to determine if fish consumption is differently related to lifestyle in men compared with women in northern Sweden.

    METHODS: Lifestyle information on 32,782 men and 34,866 women (aged 30--60 years) was collected between 1992 and 2006 within the Vasterbotten Intervention Programme (a health intervention in northern Sweden). Spearman correlation coefficients (Rs) were calculated for associations between self-reported consumption of fish and other food items or lifestyle variables.

    RESULTS: Fish consumption was positively associated with other foods considered healthy (e.g., root vegetables, lettuce/cabbage/spinach/broccoli, chicken, and berries; Rs = 0.21-0.30), as well as with other healthy lifestyle factors (e.g., exercise and not smoking) and a higher educational level, in both men and women. The only gender difference found, concerned the association between fish consumption and alcohol consumption. Men who were high consumers of fish had a higher intake of all types of alcohol compared with low to moderate fish consumers. For women, this was true only for wine.

    CONCLUSIONS: Except for alcohol, the association between fish consumption and healthy lifestyle did not differ between men and women in northern Sweden. It is important to adjust for other lifestyle variables and socioeconomic variables in studies concerning the effect of fish consumption on disease outcome.

  • 38. Westergren, Albert
    et al.
    Wann-Hansson, Christine
    Malmö högskola, Faculty of Health and Society (HS).
    Berg Börgdal, Elisabeth
    Sjölander, Jeanette
    Strömblad, Rose-Marie
    Klevsgård, Rosmarie
    Axelsson, C
    Lindholm, Christina
    Ulander, Kerstin
    Malnutrition prevalence and precision in nutritional care differed in relation to hospital volume: a cross-sectional survey2009In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 8, no 20, article id 20Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: To explore the point prevalence of the risk of malnutrition and the targeting of nutritional interventions in relation to undernutrition risk and hospital volume. METHODS: A cross-sectional survey performed in nine hospitals including 2 170 (82.8%) patients that agreed to participate. The hospitals were divided into large, middle, and small sized hospitals. Undernutrition risk and overweight (including obesity) were assessed. RESULTS: The point prevalence of moderate/high undernutrition risk was 34%, 26% and 22% in large, middle and small sized hospitals respectively. The corresponding figures for overweight were 38%, 43% and 42%. The targeting of nutritional interventions in relation to moderate/high undernutrition risk was, depending on hospital size, that 7-17% got Protein- and Energy Enriched food (PE-food), 43-54% got oral supplements, 8-22% got artificial nutrition, and 14-20% received eating assistance. Eating assistance was provided to a greater extent and artificial feeding to a lesser extent in small compared to in middle and large sized hospitals. CONCLUSION: The prevalence of malnutrition risk and the precision in provision of nutritional care differed significantly depending on hospital volume, i.e. case mix. It can be recommended that greater efforts should be taken to increase the use of PE-food and oral supplements for patients with eating problems in order to prevent or treat undernutrition. A great effort needs to be taken in order to also decrease the occurrence of overweight.

  • 39.
    Westergren, Albert
    et al.
    Kristianstad University College, School of Health and Society.
    Wann-Hansson, Christine
    Faculty of Health and Society, Malmö University and Malmö University Hospital.
    Bergh Börgdal, Elisabet
    Department of Medicine, Malmö University Hospital.
    Sjölander, Jeanette
    Department of Clinical Nutrition, Lund University Hospital.
    Strömblad, Rosmarie
    Hospital Management, Blekinge Hospital.
    Klevsgård, Rose-Marie
    Hospital Management, Lund University Hospital.
    Axelsson, Carolina
    Kristianstad University College, School of Health and Society.
    Lindholm, Christina
    Kristianstad University College, School of Health and Society.
    Ulander, Kerstin
    Kristianstad University College, School of Health and Society.
    Malnutrition prevalence and precision in nutritional care differed in relation to hospital volume: a cross-sectional survey2009In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 8, no 1Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: To explore the point prevalence of the risk of malnutrition and the targeting of nutritional interventions in relation to undernutrition risk and hospital volume. METHOD: A cross-sectional survey performed in nine hospitals including 2 170 (82.8%) patients that agreed to participate. The hospitals were divided into large, middle, and small sized hospitals. Undernutrition risk and overweight (including obesity) were assessed. RESULTS: The point prevalence of moderate/high undernutrition risk was 34%, 26% and 22% in large, middle and small sized hospitals respectively. The corresponding figures for overweight were 38%, 43% and 42%. The targeting of nutritional interventions in relation to moderate/high undernutrition risk was, depending on hospital size, that 7-17% got Protein- and Energy Enriched food (PE-food), 43-54% got oral supplements, 8-22% got artificial nutrition, and 14-20% received eating assistance. Eating assistance was provided to a greater extent and artificial feeding to a lesser extent in small compared to in middle and large sized hospitals. CONCLUSIONS: The prevalence of malnutrition risk and the precision in provision of nutritional care differed significantly depending on hospital volume, i.e. case mix. It can be recommended that greater efforts should be taken to increase the use of PE-food and oral supplements for patients with eating problems in order to prevent or treat undernutrition. A great effort needs to be taken in order to also decrease the occurrence of overweight.

  • 40. Winkvist, Anna
    et al.
    Hulten, Bodil
    Kim, Jeong-Lim
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Toren, Kjell
    Brisman, Jonas
    Forslund, Helene Berteus
    Dietary intake, leisure time activities and obesity among adolescents in Western Sweden: a cross-sectional study2016In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 15, article id 41Article in journal (Refereed)
    Abstract [en]

    Background: Overweight and obesity among adolescents are increasing worldwide. Risk factors include dietary intake characteristics and high levels of physical inactivity. In Sweden, few large comprehensive population-based surveys of dietary intake and lifestyle among adolescents have been carried out. Thus, the purpose of the current study was to describe dietary intake and food choices as well as leisure time activities in relation to overweight and obesity in a total sample of all schoolchildren aged 15 years in Western Sweden.

    Methods: In 2008, a questionnaire was sent to all 21,651 adolescents born in 1992 in Västra Götaland Region, Sweden. Participation rate was 54.3 % (50.7 % girls/49.3 % boys). The questionnaire included a 73-item semi-quantitative food frequency questionnaire and questions on lifestyle. Results were evaluated against the Nordic Nutrition Recommendations and Swedish indicators of healthy diet and exercise habits. Associations with concurrent overweight and obesity were evaluated in multiple linear regression analysis.

    Results: Among girls, 49.5 % reached the goal of consuming fruit and vegetables at least daily, whereas for boys the figure was 34.4 %. Among both sexes, 15 % reached the goal of consuming fish at least twice weekly. Two-thirds of both sexes reached the goal of regular moderate or vigorous physical activity weekly. In total, 12.4 % were overweight and 2.4 % were obese. More girls than boys were underweight, whereas more boys than girls were overweight or obese (p < 0.001). Boys exhibited a more frequent intake of sodas and concentrated fruit juices, milk 3 % fat, bread and potatoes and fast food (p < 0.001). Frequent intake of candies and chocolate was reported by both sexes. Among girls and boys, living in rural areas, living in apartments and reporting no frequent leisure time physical activity were significant risk factors for being overweight or obese, also when adjusted for other risk factors.

    Conclusions: Dietary habits of adolescents in Western Sweden warrant improvements. Public health actions should be taken to increase consumption of fruit, vegetables and fish, and decrease consumption of sodas and candies and also to increase frequency of physical activity. These actions may be helpful in reducing risks for overweight and obesity.

  • 41.
    Winkvist, Anna
    et al.
    Department of Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Weinehall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    More distinct food intake patterns among women than men in northern Sweden: a population-based survey2009In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Nutrition journal, Vol. 8, no 1, p. 1-9Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The need to promote a healthy diet to curb the current obesity epidemic has today been recognized by most countries. A prerequisite for planning and evaluating interventions on dietary intake is the existence of valid information on long-term average dietary intake in a population. Few large, population-based studies of dietary intake have been carried out in Sweden. The largest to date is the Vasterbotten Intervention Program (VIP), which was initiated in 1985, with data collection still ongoing. This paper reports on the first comprehensive analyses of the dietary data and presents dietary intake patterns among over 60,000 women and men in northern Sweden during 1992-2005. METHODS: Between 1992 and 2005, 71,367 inhabitants in Vasterbotten county aged 30, 40, 50, and 60 years visited their local health care center as part of the VIP. Participants of VIP filled in an 84- or 64-item food frequency questionnaire (FFQ) and provided sociodemographic information. Complete and realistic information on consumption frequency was provided by 62,531 individuals. Food intake patterns were analyzed using K-means cluster analyses. RESULTS: The mean daily energy intake was 6,83 (+/-1,77) MJ among women and 8,71 (+/- 2,26) MJ among men. More than half of both women and men were classified as Low Energy Reporters (defined as individuals reporting a food intake level below the lower 95% confidence interval limit of the physical activity level). Larger variation in frequency of daily intake was seen among women than among men for most food groups. Among women, four dietary clusters were identified, labeled "Fruit and vegetables", "High fat", "Coffee and sandwich", and "Tea and ice cream". Among men, three dietary clusters were identified, labeled "Fruit and vegetables", "High fat", and "Tea, soda and cookies". CONCLUSION: More distinct food intake patterns were seen among women than men in this study in northern Sweden. Due to large proportions of Low Energy Reporters, our results on dietary intake may not be suitable for comparisons with recommended intake levels. However, the results on food intake patterns should still be valid and useful as a basis for targeting interventions to groups most in need.

  • 42.
    Winkvist, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Department of Internal Medicine and Clinical Nutrition, Sahlgenska Academy, University of Gothenburg, Box 459SE-405 30 Gothenburg, Sweden.
    Klingberg, Sofia
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University.
    Wennberg, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Renström, Frida
    Umeå University, Faculty of Medicine, Department of Biobank Research. Department of Clinical Sciences, Genetic & Molecular Epidemiology Unit, Lund University, Malmö, Sweden.
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Boman, Kurt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Longitudinal 10-year changes in dietary intake and associations with cardio-metabolic risk factors in the Northern Sweden Health and Disease Study2017In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 16, article id 20Article in journal (Refereed)
    Abstract [en]

    Background: Dietary risks today constitute the largest proportion of disability-adjusted life years (DALYs) globally and in Sweden. An increasing number of people today consume highly processed foods high in saturated fat, refined sugar and salt and low in dietary fiber, vitamins and minerals. It is important that dietary trends over time are monitored to predict changes in disease risk.

    Methods: In total, 15,995 individuals with two visits 10 (±1) years apart in the population-based Västerbotten Intervention Programme 1996–2014 were included. Dietary intake was captured with a 64-item food frequency questionnaire. Percent changes in intake of dietary components, Healthy Diet Score and Dietary Inflammatory Index were calculated and related to body mass index (BMI), serum cholesterol and triglyceride levels and blood pressure at the second visit in multivariable regression analyses.

    Results: For both sexes, on group level, proportion of energy intake (E%) from carbohydrates and sucrose decreased (largest carbohydrate decrease among 40 year-olds) and E% protein and total fat as well as saturated and poly-unsaturated fatty acids (PUFA) increased (highest protein increase among 30 year-olds and highest fat increase among 60 year-olds) over the 10-year period. Also, E% trans-fatty acids decreased. On individual basis, for both sexes decreases in intake of cholesterol and trans-fatty acids were associated with lower BMI and serum cholesterol at second visit (all P < 0.05). For men, increases in intake of whole grain and Healthy Diet Score were associated with lower BMI and serum cholesterol at second visit (all P < 0.05). Also for men, decreases in intake of trans-fatty acids and increases in Healthy Diet Score were associated with lower systolic blood pressure at second visit (P = 0.002 and P < 0.000). For women, increases in intake of PUFA and Healthy Diet Score were associated with lower BMI at second visit (P = 0.01 and P < 0.05). Surprisingly, increases in intake of sucrose among women were associated with lower BMI at second visit (P = 0.02).

    Conclusions: In this large population-based sample, dietary changes over 10 years towards less carbohydrates and more protein and fat were noted. Individual changes towards the Nordic dietary recommendations were associated with healthier cardio-metabolic risk factor profile at second visit.

  • 43.
    Xu, Jie
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Jonsson, Tommy
    Lund Univ, Sweden.
    Plaza, Merichel
    Univ Alcala De Henares, Spain; Lund Univ, Sweden.
    Hakansson, Asa
    Lund Univ, Sweden.
    Antonsson, Martin
    ProViva AB, Sweden.
    Ahren, Irini Lazou
    Probi AB, Sweden.
    Turner, Charlotta
    Lund Univ, Sweden.
    Spegel, Peter
    Lund Univ, Sweden.
    Granfeldt, Yvonne
    Lund Univ, Sweden.
    Probiotic fruit beverages with different polyphenol profiles attenuated early insulin response2018In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 17, article id 34Article in journal (Refereed)
    Abstract [en]

    Background: Consumption of polyphenol-rich fruits and vegetables may improve postprandial glucose and insulin levels and hence promote well-being. Previously it has been observed that consumption of bilberry decreases the postprandial insulin demand. The intention with the present study was to compare the impact of different supplements with various polyphenol profiles, on the postprandial glucose and insulin responses in healthy young adults. Methods: In a randomized, controlled, crossover study the postprandial glycemic and insulin responses were observed in eleven healthy adults after intake of five different beverages containing bilberry (European blueberry), blackcurrant, beetroot, mango and rose hip, respectively; all drinks were enriched with the same composition of fermented oatmeal and probiotics. The control was a glucose drink. The profile and content of the polyphenols in the different beverages were determined by HPLC-DAD analysis. The antioxidative capacity of the different beverages were measured by TEAC and DPPH assays. Results: Beverages containing bilberry, blackcurrant, mango or rose hip significantly attenuated the early postprandial insulin response (0-90 min), but showed no effect on glucose response. Drinks with bilberry or rose hip reduced the insulin response from the very early phase (0-30 min), and had significantly lower insulin index compared with the control. The efficiency of the bilberry and rose hip to decrease early postprandial insulin responses correlated with higher phenolic contents. Conclusions: Supplements with bilberry, blackcurrant, mango or rose hip in the tested probiotic and oatmeal enriched beverage attenuated early-phase insulin response, but had no effect on the postprandial glycemic response. The improved ability of bilberry and rose hip to lower the very early phase of insulin response seems to be due to a higher phenolic content.

  • 44.
    Östlund-Lagerström, Lina
    et al.
    Nutrition and Physical Activity Research Centre, Örebro University, Örebro, Sweden; Nutrition Gut Brain Interactions Research Centre, School of Health and Medical Sciences, Faculty of Health and Medicine, Örebro University, Örebro, Sweden.
    Kihlgren, Annica
    Örebro University, School of Health Sciences. Nutrition and Physical Activity Research Centre, Örebro University, Örebro, Sweden.
    Repsilber, Dirk
    Örebro University, School of Medical Sciences.
    Björkstén, Bengt
    Nutrition and Physical Activity Research Centre, Örebro University, Örebro, Sweden; Nutrition Gut Brain Interactions Research Centre, School of Health and Medical Sciences, Faculty of Health and Medicine, Örebro University, Örebro, Sweden; Institute of Environmental Medicine, Karolinska institutet, Stockholm, Sweden.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences. Nutrition and Physical Activity Research Centre, Örebro University, Örebro, Sweden; Nutrition Gut Brain Interactions Research Centre, Örebro University, Örebro, Sweden.
    Schoultz, Ida
    Örebro University, School of Medical Sciences.
    Probiotic administration among free-living older adults: a double blinded, randomized, placebo-controlled clinical trial2016In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 15, article id 80Article in journal (Refereed)
    Abstract [en]

    Background: Diseases of the digestive system have been found to contribute to a higher symptom burden in older adults. Thus, therapeutic strategies able to treat gastrointestinal discomfort might impact the overall health status and help older adults to increase their overall health status and optimal functionality.

    Objective: The aim of this double-blinded, randomized, placebo-controlled clinical trial was to evaluate the effect of the probiotic strain Lactobacillus reuteri on digestive health and wellbeing in older adults.

    Methods: The study enrolled general older adults (>65 years). After eligibility screening qualified subjects (n = 290) participated in a 2-arm study design, with each arm consisting of 12 weeks of intervention of either active or placebo product. Primary outcome measure was set to changes in gastrointestinal symptoms and secondary outcome measures were changes in level of wellbeing, anxiety and stress. Follow up was performed at 8 and 12 weeks.

    Results: No persistent significant effects were observed on the primary or secondary outcome parameters of the study. A modest effect was observed in the probiotic arm, were levels of stress decreased at week 8 and 12. Similarly, we found that subjects suffering from indigestion and abdominal pain, respectively, showed a significant decrease of anxiety at week 8 after probiotic treatment, but not at week 12.

    Conclusion: The RCT failed to show any improvement in digestive health after daily intake of a probiotic supplement containing L. reuteri. Neither was any significant improvement in wellbeing, stress or anxiety observed. Even though the RCT had a negative outcome, the study highlights issues important to take into consideration when designing trials among older adults.

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