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  • 101.
    Barazzoni, Rocco
    et al.
    Univ Trieste, Dept Med Surg & Hlth Sci, Internal Med, Trieste, Italy;Azienda Sanit Univ Integrata Trieste ASUITS, Trieste, Italy.
    Bischoff, Stephan C.
    Univ Hohenheim, Dept Nutr Med, Stuttgart, Germany.
    Boirie, Yves
    Univ Clermont Auvergne, INRA, UNH, CRNH Auvergne, F-63000 Clermont Ferrand, France;CHU Clermont Ferrand, Serv Nutr Clin, F-63000 Clermont Ferrand, France.
    Busetto, Luca
    Univ Padua, Dept Med, Padua, Italy;Padova Univ Hosp, Ctr Study & Integrated Management Obes EASO COM, Padua, Italy.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Dicker, Dror
    Tel Aviv Univ, Rabin Med Ctr, Internal Med Dept, Hasharon Hosp,Sackler Fac Med, Tel Aviv, Israel;Tel Aviv Univ, Rabin Med Ctr, Obes Clin, Hasharon Hosp,Sackler Fac Med, Tel Aviv, Israel.
    Toplak, Hermann
    Med Univ Graz, Dept Med, Graz, Austria.
    Van Gossum, Andre
    Free Univ Brussels, Dept Gastroenterol, Clin Intestinal Dis & Nutr Support, Hop Erasme, Brussels, Belgium.
    Yumuk, Volkan
    Istanbul Univ, Div Endocrinol Metab & Diabet, Cerrahpasa Med Fac, Istanbul, Turkey.
    Vettor, Roberto
    Univ Padua, Dept Med, Padua, Italy;Padova Univ Hosp, Ctr Study & Integrated Management Obes EASO COM, Padua, Italy.
    Sarcopenic obesity: Time to meet the challenge2018In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 37, no 6, Part A, p. 1787-1793Article in journal (Refereed)
    Abstract [en]

    The prevalence of overweight and obesity has reached epidemic proportions worldwide due to increasingly pervasive obesogenic lifestyle changes. Obesity poses unprecedented individual, social and multi-disciplinary medical challenges by increasing the risk for metabolic diseases, chronic organ failures and cancer, as well as complication rates in the presence of acute disease conditions. Whereas reducing excess adiposity remains the fundamental pathogenetic treatment for obese individuals, complex metabolic and lifestyle abnormalities as well as weight-reduction therapies per se may also compromise the ability to preserve muscle function and mass, especially when chronic disease co-exists with obesity. Emerging evidence indicates that low muscle mass and quality have a strong negative prognostic impact in obese individuals and may lead to frailty, disability and increased morbidity and mortality. Awareness of the importance of skeletal muscle maintenance in obesity is however low among clinicians and scientists. The term "sarcopenic obesity" has been proposed to identify obesity with low skeletal muscle function and mass, but its utilization is largely limited to the aging patient population, and consensus on its definition and diagnostic criteria remains insufficient. Knowledge on prevalence of sarcopenic obesity in various clinical conditions and patient subgroups, on its clinical impacts in patient risk stratification and on effective prevention and treatment strategies remain therefore dramatically inadequate. In particular, optimal dietary options and medical nutritional support strategies to preserve muscle mass in obese individuals remain largely undefined. The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) recognize and indicate obesity with altered body composition due to low skeletal muscle function and mass (sarcopenic obesity) as a scientific and clinical priority for researchers and clinicians. ESPEN and EASO therefore call for coordinated action aimed at reaching consensus on its definition, diagnostic criteria and optimal treatment with particular regard to nutritional therapy. We are convinced that achievement of these goals has strong potential to reduce the burden of morbidity and mortality in the rapidly increasing obese patient population.

  • 102. Barman, Malin
    et al.
    Nilsson, Staffan
    Torinsson Naluai, Åsa
    Sandin, Anna
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Wold, Agnes E
    Sandberg, Ann-Sofie
    Single Nucleotide Polymorphisms in the FADS Gene Cluster but not the ELOVL2 Gene are Associated with Serum Polyunsaturated Fatty Acid Composition and Development of Allergy (in a Swedish Birth Cohort)2015In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 7, no 12, p. 10100-10115Article in journal (Refereed)
    Abstract [en]

    Exposure to polyunsaturated fatty acids (PUFA) influences immune function and may affect the risk of allergy development. Long chain PUFAs are produced from dietary precursors catalyzed by desaturases and elongases encoded by FADS and ELOVL genes. In 211 subjects, we investigated whether polymorphisms in the FADS gene cluster and the ELOVL2 gene were associated with allergy or PUFA composition in serum phospholipids in a Swedish birth-cohort sampled at birth and at 13 years of age; allergy was diagnosed at 13 years of age. Minor allele carriers of rs102275 and rs174448 (FADS gene cluster) had decreased proportions of 20:4 n-6 in cord and adolescent serum and increased proportions of 20:3 n-6 in cord serum as well as a nominally reduced risk of developing atopic eczema, but not respiratory allergy, at 13 years of age. Minor allele carriers of rs17606561 in the ELOVL2 gene had nominally decreased proportions of 20:4 n-6 in cord serum but ELOVL polymorphisms (rs2236212 and rs17606561) were not associated with allergy development. Thus, reduced capacity to desaturase n-6 PUFAs due to FADS polymorphisms was nominally associated with reduced risk for eczema development, which could indicate a pathogenic role for long-chain PUFAs in allergy development.

  • 103. Batura, Neha
    et al.
    Hill, Zelee
    Haghparast-Bidgoli, Hassan
    Lingam, Raghu
    Colbourn, Timothy
    Kim, Sungwook
    Sikander, Siham
    Pulkki-Brännström, Anni-Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Institute for Global Health, University College London.
    Rahman, Atif
    Kirkwood, Betty
    Skordis-Worrall, Jolene
    Highlighting the evidence gap: how cost-effective are interventions to improve early childhood nutrition and development?2015In: Health Policy and Planning, ISSN 0268-1080, E-ISSN 1460-2237, Vol. 30, no 6, p. 813-821Article, review/survey (Refereed)
    Abstract [en]

    There is growing evidence of the effectiveness of early childhood interventions to improve the growth and development of children. Although, historically, nutrition and stimulation interventions may have been delivered separately, they are increasingly being tested as a package of early childhood interventions that synergistically improve outcomes over the life course. However, implementation at scale is seldom possible without first considering the relative cost and cost-effectiveness of these interventions. An evidence gap in this area may deter large-scale implementation, particularly in low- and middle-income countries. We conduct a literature review to establish what is known about the cost-effectiveness of early childhood nutrition and development interventions. A set of predefined search terms and exclusion criteria standardized the search across five databases. The search identified 15 relevant articles. Of these, nine were from studies set in high-income countries and six in low- and middle-income countries. The articles either calculated the cost-effectiveness of nutrition-specific interventions (n = 8) aimed at improving child growth, or parenting interventions (stimulation) to improve early childhood development (n = 7). No articles estimated the cost-effectiveness of combined interventions. Comparing results within nutrition or stimulation interventions, or between nutrition and stimulation interventions was largely prevented by the variety of outcome measures used in these analyses. This article highlights the need for further evidence relevant to low- and middle-income countries. To facilitate comparison of cost-effectiveness between studies, and between contexts where appropriate, a move towards a common outcome measure such as the cost per disability-adjusted life years averted is advocated. Finally, given the increasing number of combined nutrition and stimulation interventions being tested, there is a significant need for evidence of cost-effectiveness for combined programmes. This too would be facilitated by the use of a common outcome measure able to pool the impact of both nutrition and stimulation activities.

  • 104. Beaven, Christopher
    Dose effect of caffeine on testosterone and cortisol responses to resistance exercise2008In: International Journal of Sport Nutrition & Exercise Metabolism, ISSN 1526-484X, E-ISSN 1543-2742, Vol. 18, no 2, p. 131-141Article in journal (Refereed)
    Abstract [en]

    Introduction: Interest in the use of caffeine as an ergogenic aid has increased since the International Olympic Committee lifted the partial ban on its use. Caffeine has beneficial effects on various aspects of athletic performance, but its effects on training have been neglected.

    Purpose: To investigate the acute effect of caffeine on the exercise-associated increases in testosterone and cortisol in a double-blind crossover study.

    Methods: 24 professional rugby-league players ingested caffeine doses of 0, 200, 400 and 800 mg in random order 1 h before a resistance-exercise session. Saliva was sampled at the time of caffeine ingestion, at 15-min intervals throughout each session, and at 15 and 30 min after the session. Data were log transformed to estimate percent effects with mixed modeling, and effects were standardized to assess magnitudes.

    Results: Testosterone concentration showed a small increase of 15% (90% confidence limits, ±19%) during exercise. Caffeine raised this concentration in a dose-dependent manner by a further small 21% (±24%) at the highest dose. The 800-mg dose also produced a moderate 52% (±44%) increase in cortisol. The effect of caffeine on the testosterone/cortisol ratio was a small decline (14; ±21%).

    Conclusion: Caffeine has some potential to benefit training outcomes via the anabolic effects of the increase in testosterone concentration, but this benefit may be counteracted by the opposing catabolic effects of the increase in cortisol and resultant decline in the testosterone/cortisol ratio.

  • 105.
    Becker, Wulf
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Fetter2006In: Näringslära för högskolan, Liber AB, Stockholm , 2006, p. 460-Chapter in book (Other (popular scientific, debate etc.))
  • 106.
    Becker, Wulf
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Livsmedelskonsumtion och kostvanor i Sverige - utvecklingstrender2006In: Näringslära för högskolan, Liber AB, Stockholm , 2006, p. 460-Chapter in book (Other (popular scientific, debate etc.))
  • 107.
    Becker, Wulf
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Näringsrekommendationer2006In: Näringslära för högskolan, Liber AB, Stockholm , 2006, p. 460-Chapter in book (Other (popular scientific, debate etc.))
  • 108.
    Becker, Wulf
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Håglin, Lena
    Aschan-Åberg, Karin
    Mineralämnen2006In: Näringslära för högskolan, Liber AB, Stockholm , 2006, p. 460-Chapter in book (Other (popular scientific, debate etc.))
  • 109.
    Becker, Wulf
    et al.
    Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap.
    Lennernäs, Maria
    Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap.
    Gustafsson, Inga-Britt
    Haraldsdottir, Johanna
    Nydahl, Margareta
    Vessby, Bengt
    Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap.
    Ytterfors, A
    Precoded or weighed food records for measuring dietary habits in a population of Swedish adults: I Food intake1996Conference paper (Other academic)
  • 110. Becker, Wulf
    et al.
    Lindroos, Anna Karin
    Nälsén, Cecilia
    Warensjö, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics. National Food Agency.
    Öhrvik, Veronica
    Dietary habits, nutrient intake and biomarkers for folate, vitamin D, iodine and iron status among women of childbearing age in Sweden2016In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 121, no 4, p. 271-275Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Dietary intake and nutritional status are important for pregnancy and pregnancy outcomes. Dietary advice on folate, targeted to women of childbearing age, aims at preventing neural tube defects in the offspring.

    AIM: To describe food and nutrient intake and nutritional status among women of childbearing age in Sweden in relation to current nutrition recommendations.

    METHODS: Dietary intake was assessed using a web-based four-day consecutive food record among adults aged 18-80 years-'Riksmaten 2010-11 adults'. In a subsample, biomarkers of folate, vitamin D, iodine, and iron status were assessed.

    RESULTS: Women of childbearing age had lower intakes of fruit and vegetables, fish, and whole grains, but higher intakes of soft drinks. Macronutrient composition was generally in line with the Nordic Nutrition Recommendations, except for a lower intake of fibre, a higher intake of saturated fatty acids, and added sugars. Mean intakes of vitamin D, folate, and iron were below recommended intakes (RI). Median urinary iodine concentration (UIC) was 74 μg/L, 20% had insufficient vitamin D status, and 3% low folate concentrations with no age differences. Furthermore, 29% of women 18-44 years of age had depleted iron stores.

    CONCLUSIONS: The dietary pattern among women of childbearing age (18-44 years) was less favourable compared to older women. Intakes of some micronutrients were below RI, but no differences in vitamin D, folate, or iodine status between age groups were observed. However, improvements of folate and iodine status among women of childbearing age are warranted. This can be achieved by following dietary guidelines including use of folic acid-containing supplements.

  • 111.
    Behrendt, Marek
    et al.
    Halmstad University, School of Business and Engineering (SET).
    Ivarsson, Tommy
    Halmstad University, School of Business and Engineering (SET).
    Hunger indikerar inte akut energistatus hos friska människor: En måltidsintervention2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background

    The increasingly sedentary lifestyle of our society combined with a constantly rising caloric intake has elevated the risk of developing obesity and other metabolic diseases. There is a need to understand the underlying mechanisms of hunger regulation to effectively prevent and treat these diseases. The magnitude of which an active regulation of blood glucose has an influence on hunger regulation is rather controversial.

    Objective

    The objective of this study was to investigate how the changes in hunger and blood glucose levels may differ after a mixed meal compared to the fasting state. Research questions include: Does intermittent fasting reduce general hunger? How does an entrenched meal-pattern affect hunger? How does hunger and blood glucose change in anticipation of a meal?

    Method

    Twelve healthy subjects (7 men, 5 women), of which seven subjects regularly practiced intermittent fasting and the remaining five did not, were randomized into two groups, one group was eating pizza (Pi), and the other group was fasting (F). Blood glucose levels and hunger ratings were collected every 30 minutes, with exception of initial values that were collected 15 minutes prior to the serving of the pizzas. The subjects were unaware of which group they would be designated to until 10 minutes prior to the serving of the pizzas.

    Results

    Decline in blood glucose did not significantly differ between groups during the 5 hour window following the meal ingestion. Hunger ratings differed significantly between individuals but not between groups. However, only Pi had significantly elevated hunger ratings in the end of the test period compared to their initial ratings. In anticipation of the meal a significant change in blood glucose was observed between the groups (P = 0.05), where values dropped for Pi and rose for F. Four out of five subjects in F and one subject in Pi were considerably hungrier during time periods they reported as habitual eating occasion.

    Conclusion

    Correlations between absolute blood glucose levels and hunger could not be found. An equal rise in hunger appear regardless if subjects were fed or fasting, meaning significant hunger can appear although dietary energy still is absorbed into the blood stream. Thus our results indicate that the acute availability of dietary energy is only a relatively small part of the total hunger signaling process. A disrupted meal pattern seemed to affect hunger feelings more than the ingestion of the served meal. Thus we conclude that more research should focus on meal-pattern regulation to enable better hunger control.

  • 112.
    Beijer, Emelie
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Cerljen, Renate
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    LCHF - Low Carb High Fat: en experimentell studie av 3 veckors LCHF-kost på hälsomarkörer hos normalviktiga kvinnor2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Aim

    The aim of this study is to examine if LCHF (Low Carb High Fat) could be a healthy lifestyle based on how it affects various health markers in normal weight people where weight loss has not been pursued. Specific question: How does intake of a LCHF diet with a maximum of 30 grams of carbohydrates per day during 3 weeks affect normal-weight women´s BMR, blood lipids, blood glucose, blood pressure, body composition, waist and hip dimensions and body weight?

    Method

    An experimental study was performed on 8 normal-weight women aged 20 to 35 years old. All subject´s BMR, blood lipids, blood glucose, blood pressure, body composition, waist and hip dimensions and body weight were measured at normal living conditions before the study began. Each subject was put on a strict 3 week Low Carb High Fat diet consisting of only 30 grams of carbohydrates per day.

    Results

    BMR was reduced by an average of 4,4% which was significant (P<0,05). HDL, LDL and total cholesterol were increased significantly (P<0,01) by 21, 25 and 22%, respectively. There were no significant differences in LDL/HDL ratio, triglycerides or blood pressure. Blood glucose concentration was reduced by an average of 12%, however the reduction was not statistically significant. Percentage body fat was significantly lowered with 8,7% (P<0,01) and fat mass with 11% (P<0,01). The fat free mass showed no significant difference between pre- and post-tests. The waist circumference was significantly decreased by 2,3% (P<0,05) and average body weight of 1,24 kg (P<0,05). The hip dimension showed no significant difference between pre- and post-tests.

     

    Conclusion

    The results of this study indicate negative effects on the blood lipid profile after 3 weeks of LCHF diet, which could lead to serious consequences such as cardiovascular disease and depression provided that the effect is progressively enhanced.

  • 113. Bendinelli, B.
    et al.
    Palli, D.
    Masala, G.
    Sharp, S. J.
    Schulze, M. B.
    Guevara, M.
    van der A, D. L.
    Sera, F.
    Amiano, P.
    Balkau, B.
    Barricarte, A.
    Boeing, H.
    Crowe, F. L.
    Dahm, C. C.
    Dalmeijer, G.
    de Lauzon-Guillain, B.
    Egeberg, R.
    Fagherazzi, G.
    Franks, Paul W.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden.
    Krogh, V.
    Huerta, J. M.
    Jakszyn, P.
    Khaw, K. T.
    Li, K.
    Mattiello, A.
    Nilsson, P. M.
    Overvad, K.
    Ricceri, F.
    Rodríguez-Suárez, L.
    Rolandsson, Olov
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Sánchez, M. J.
    Slimani, N.
    Sluijs, I.
    Spijkerman, A. M. W.
    Teucher, B.
    Tjonneland, A.
    Tumino, R.
    van den Berg, S. W.
    Forouhi, N. G.
    Langenberg, C.
    Feskens, E. J. M.
    Riboli, E.
    Wareham, N. J.
    Association between dietary meat consumption and incident type 2 diabetes: the EPIC-InterAct study2013In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 56, no 1, p. 47-59Article in journal (Refereed)
    Abstract [en]

    Aims/hypothesis: A diet rich in meat has been reported to contribute to the risk of type 2 diabetes. The present study aims to investigate the association between meat consumption and incident type 2 diabetes in the EPIC-InterAct study, a large prospective case-cohort study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) study.

    Methods: During 11.7 years of follow-up, 12,403 incident cases of type 2 diabetes were identified among 340,234 adults from eight European countries. A centre-stratified random subsample of 16,835 individuals was selected in order to perform a case-cohort design. Prentice-weighted Cox regression analyses were used to estimate HR and 95% CI for incident diabetes according to meat consumption.

    Results: Overall, multivariate analyses showed significant positive associations with incident type 2 diabetes for increasing consumption of total meat (50 g increments: HR 1.08; 95% CI 1.05, 1.12), red meat (HR 1.08; 95% CI 1.03, 1.13) and processed meat (HR 1.12; 95% CI 1.05, 1.19), and a borderline positive association with meat iron intake. Effect modifications by sex and class of BMI were observed. In men, the results of the overall analyses were confirmed. In women, the association with total and red meat persisted, although attenuated, while an association with poultry consumption also emerged (HR 1.20; 95% CI 1.07, 1.34). These associations were not evident among obese participants.

    Conclusions/interpretation: This prospective study confirms a positive association between high consumption of total and red meat and incident type 2 diabetes in a large cohort of European adults.

  • 114. Benetou, Vassiliki
    et al.
    Orfanos, Philippos
    Feskanich, Diane
    Michaëlsson, Karl
    Pettersson-Kymmer, Ulrika
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Eriksson, Sture
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Grodstein, Francine
    Wolk, Alicja
    Bellavia, Andrea
    Ahmed, Luai A
    Boffeta, Paolo
    Trichopoulou, Antonia
    Fruit and Vegetable Intake and Hip Fracture Incidence in Older Men and Women: The CHANCES Project2016In: Journal of Bone and Mineral Research, ISSN 0884-0431, E-ISSN 1523-4681, Vol. 31, no 9, p. 1743-1752Article in journal (Refereed)
    Abstract [en]

    The role of fruit and vegetable intake in relation to fracture prevention during adulthood and beyond is not adequately understood. We investigated the potential association between fruit and vegetable intake and hip fracture incidence in a large sample of elderly from Europe and United States. A total of 142,018 individuals (among which 116,509 women), aged ≥60 years old, from five cohorts, were followed-up prospectively for 1,911,482 person-years accumulating 5,552 hip fractures. Fruit and vegetable intake was assessed by validated, cohort-specific, food-frequency questionnaires. Ηip fractures were ascertained through national patient registers or telephone interviews/questionnaires. Adjusted hazard ratios (HR) derived by Cox proportional-hazards regression were estimated for each cohort and subsequently pooled using random-effects meta-analysis. Intake of ≤ 1 servings/day of fruit and vegetables combined was associated with 39% higher hip fracture risk [pooled adjusted HR:1.39, 95% Confidence Intervals (CIs): 1.20, 1.58] in comparison to moderate intake (>3 and ≤5 servings/day) (pfor heterogeneity  = 0.505), whereas higher intakes (>5 servings/day) were not associated with lower risk in comparison to the same reference. Associations were more evident among women. We concluded that a daily intake of one or less servings of fruits and vegetables was associated with increased hip fracture risk in relation to moderate daily intakes. Older adults with such low fruit and vegetable consumption may benefit from raising their intakes to moderate amounts in order to reduce their hip fracture risk. 

  • 115.
    Bengtsson Tops, Anita
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Hansson, Lars
    Landlords experiences of tenants sufferingfrom severe mental illness2013In: Recovery-Oriented Mental Health Services: Therapeutic, Organisational and Economic challenges, 2013, p. 194-Conference paper (Other academic)
    Abstract [en]

    Background/Objectives

    Persons suffering from severe mental illness (SMI) live – and prefer to live – independently, in either private or public apartment blocks without on-site services. Living in own apartments increase feelings of safety and well-being and function as a robust social status marker. Landlords are important actors in gaining stability and sustainability and it has been found that landlords have a plethora of preconceptions, attitudes, emotions as well as well as ethical dilemmas in offering apartments to this group of persons. Today there is a lack systematic knowledge about the role landlords have come play in providing sustainable housing for these persons. The main aim of this qualitative study was to describe landlords’ experiences of having tenant suffering from SMI

    Methods

    Sixteen landlords in various parts of Sweden participated in open in-depth interviews three years after the government proclaimed a vision zero regarding homelessness among individuals with SMI. Data was subjected to thematic latent content analysis.

    Results

    Landlords experienced being confronted with difficult circumstances such as mismanagement of apartments, sensitivity and provocative behaviors in relation to both tenants with SMI and neighbors. In acute situations landlords tried to collaborate with the community based psychiatric service system but were neglected. As a result and without the knowledge of how to best help they started to provide support to tenants with SMI involving going beyond professional boarders.

    Discussion/Conclusion

    The findings give reasons to conclude that community-based psychiatric services need to be more pro-active in their collaboration with landlords. Also education interventions with a focus on how to best help tenants with SMI need to be developed and implemented.

  • 116.
    Benhammou, Samira
    et al.
    Research Group Nutrition, Diet and Risk Assessment, Department of Nutrition and Food Science, University of Granada, Granada, Spain.
    Heras-González, Leticia
    Research Group Nutrition, Diet and Risk Assessment, Department of Nutrition and Food Science, University of Granada, Granada, Spain.
    Ibáñez-Peinado, Diana
    Research Group Nutrition, Diet and Risk Assessment, Department of Nutrition and Food Science, University of Granada, Granada, Spain.
    Barceló, Carla
    Research Group Nutrition, Diet and Risk Assessment, Department of Nutrition and Food Science, University of Granada, Granada, Spain.
    Hamdan, May
    Department of Human Nutrition & Food Technology, Faculty of Agriculture, An-Najah National University, Nablus, Palestine.
    Rivas, Ana
    Research Group Nutrition, Diet and Risk Assessment, Department of Nutrition and Food Science, University of Granada, Granada, Spain.
    Mariscal-Arcas, Miguel
    Research Group Nutrition, Diet and Risk Assessment, Department of Nutrition and Food Science, University of Granada, Granada, Spain; Department of Food Technology, Nutrition and Food Science, University of Murcia, Campus de Lorca, Lorca, Spain.
    Olea-Serrano, Fatima
    Research Group Nutrition, Diet and Risk Assessment, Department of Nutrition and Food Science, University of Granada, Granada, Spain.
    Monteagudo, Celia
    Örebro University, School of Hospitality, Culinary Arts & Meal Science. Research Group Nutrition, Diet and Risk Assessment, Department of Nutrition and Food Science, University of Granada, Granada, Spain.
    Comparison of Mediterranean diet compliance between European and non-European populations in the Mediterranean basin2016In: Appetite, ISSN 0195-6663, E-ISSN 1095-8304, Vol. 107, p. 521-526Article in journal (Refereed)
    Abstract [en]

    Fruit, vegetables, cereals, and olive oil are common elements of the Mediterranean diet (MD), but each country in the Mediterranean basin has its own gastronomic customs influenced by socio-cultural, religious, and economic factors. This study compared the dietary habits of three Mediterranean populations with different cultures and lifestyles, a total of 600 adults (61.9% females) between 25 and 70 yrs from Spain, Morocco, and Palestine. All participants completed a self administered questionnaire, including sociodemographic and anthropometric items, a validated semi-quantitative food frequency questionnaire adapted to the foods consumed in each country, and three 24-h recalls. MD adherence was estimated with the MD Serving Score (MDSS). All populations showed a moderate adherence to the Mediterranean dietary pattern. In comparison to the Palestine population, MDSS-assessed adherence to the MD was 6.36-fold higher in the Spanish population and 3.88-fold higher in the Moroccan population. Besides the country of origin, age was another predictive factor of MD adherence, which was greater (higher MDSS) in participants aged over 50 yrs than in those aged 30 yrs or younger. This preliminary study contributes initial data on dietary differences between European and non-European countries in the Mediterranean basin. The Spanish diet was shown to be closer to MD recommendations than the diet of Morocco or Palestine. Given the impact of good dietary habits on the prevention of chronic non-transmittable diseases, health policies should focus on adherence to a healthy diet, supporting traditional dietary patterns in an era of intense commercial pressures for change.

  • 117. Berendsen, Agnes A M
    et al.
    Kang, Jae H
    van de Rest, Ondine
    Jankovic, Nicole
    Kampman, Ellen
    Kiefte-de Jong, Jessica C
    Franco, Oscar H
    Ikram, M Arfan
    Pikhart, Hynek
    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.
    Brenner, Hermann
    Boffetta, Paolo
    Rafnsson, Snorri Bjorn
    Gustafson, Deborah
    Kyrozis, Andreas
    Trichopoulou, Antonia
    Feskens, Edith J M
    Grodstein, Francine
    de Groot, Lisette C P G M
    Association of Adherence to a Healthy Diet with Cognitive Decline in European and American Older Adults: A Meta-Analysis within the CHANCES Consortium2017In: Dementia and Geriatric Cognitive Disorders, ISSN 1420-8008, E-ISSN 1421-9824, Vol. 43, no 3-4, p. 215-227Article in journal (Refereed)
    Abstract [en]

    AIM: To examine the association between a healthy diet, assessed by the Healthy Diet Indicator (HDI), and cognitive decline in older adults. METHODS: Data from 21,837 participants aged ≥55 years from 3 cohorts (Survey in Europe on Nutrition and the Elderly, a Concerted Action [SENECA], Rotterdam Study [RS], Nurses' Health Study [NHS]) were analyzed. HDI scores were based on intakes of saturated fatty acids, polyunsaturated fatty acids, mono- and disaccharides, protein, cholesterol, fruits and vegetables, and fiber. The Telephone Interview for Cognitive Status in NHS and Mini-Mental State Examination in RS and SENECA were used to assess cognitive function from multiple repeated measures. Using multivariable-adjusted, mixed linear regression, mean differences in annual rates of cognitive decline by HDI quintiles were estimated. RESULTS: Multivariable-adjusted differences in rates in the highest versus the lowest HDI quintile were 0.01 (95% CI -0.01, 0.02) in NHS, 0.00 (95% CI -0.02, 0.01) in RS, and 0.00 (95% CI -0.05, 0.05) in SENECA with a pooled estimate of 0.00 (95% CI -0.01, 0.01), I2 = 0%. CONCLUSIONS: A higher HDI score was not related to reduced rates of cognitive decline in European and American older adults.

  • 118.
    Berggren, Linda
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Olsson, Cecilia
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Talvia, S.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Rönnlund, Maria
    Umeå University, Faculty of Social Sciences, Department of applied educational science.
    Waling, Maria
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    The lived experiences of school lunch: an empathy-based study with children in Sweden2019In: Children's Geographies, ISSN 1473-3285, E-ISSN 1473-3277Article in journal (Refereed)
    Abstract [en]

    School lunch is in general regulated through policies and agendas constituted by the perspectives of adults. In this article, we focus on children’s lived experiences of school lunch with a special emphasis on emotions and how they relate to social and physical dimensions. This study draws on empathy-based stories written by 10–11 year olds (n = 171) from schools in Sweden. We identified three themes: Interaction and exposure, Routines and restrictions and Food and eating. The children’s lived experiences of school lunch and the emotions attached to them are closely associated and intertwined with the socio-spatial dimension of school lunch. A pleasant meal experience seems to require harmonization between the physical and social space whilst negative experiences contain tensions between them, something that actors working with school lunch and school lunch environments should take in consideration when resourcing, planning and scheduling school lunch, and also when designing new school restaurants.

  • 119.
    Berggren, Linda
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Talvia, Sanna
    Child and Youth Research institute, Turku, Finland,.
    Fossgard, Eldbjørg
    Faculty of Education, Bergen University College, Bergren, Norway,.
    Björk Arnfjörð, Unnur
    School of Education, University of Iceland.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Ólafsdóttir, Anna
    School of Education, University of Iceland.
    Gunnarsdóttir, Ingibjörg
    The National University Hospital of Iceland , Unit for Nutrition Research, Reykjavik, Iceland.
    Wergedahl, Hege
    Faculty of Education, Bergen University College, Bergren, Norway,.
    Lagström, Hanna
    University of Turku, Turku Institute of Child and Youth Research, Turku, Finland.
    Waling, Maria
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Olsson, Cecilia
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Perspectives about health outcomes related to food among Nordic children2016Conference paper (Refereed)
    Abstract [en]

    Perspectives about health outcomes related to food among Nordic children

    Linda Berggren* 1, Sanna Talvia2, Eldbjørg Fossgard3, Unnur Björk Arnfjörð4, Agneta Hörnell 1, Anna Ólafsdóttir 4,Ingibjörg Gunnarsdóttir 5, Hege Wergedahl 3, Hanna Lagström 6, Maria Waling1, Cecilia Olsson1

    1Umeå University, Department of food and nutrition, Umeå, Sweden, 2Child and Youth Research institute, Turku, Finland,3Faculty of Education, Bergen University College, Bergren, Norway, 4School of Education, University of Iceland, 5TheNational University Hospital of Iceland , Unit for Nutrition Research, Reykjavik, Iceland, 6University of Turku, TurkuInstitute of Child and Youth Research, Turku, Finland

    Preferred presentation type: Only Poster

    Background and aims: Dietary intake in school has previously been studied but little is known about Nordic children’sperspectives on food healthiness in the school lunch context. This study aims to explore 10-year-old Nordic children’sperspectives on outcomes of healthy eating in the school lunch context.

    Methods: Seventy-two focus groups were conducted in Sweden, Finland, Norway and Iceland with a total of 423participants. A flexible topic guide and 14 preselected photos displaying different school lunch contexts were used asstimuli material. Interviews were transcribed and analyzed using thematic analysis.

    Results: Children reasoned that school lunch are and should be healthy since the food eaten at school has short andlong term outcomes related to cognitive and physical health. It was commonly expressed that food eaten in school affectsschool work and functioning in learning activities. It was also stated that food eaten in school can have negative andpositive effects on your mood, e.g. eating unhealthy food or an insufficient amount of food, puts you in a bad mood whichcan affect the rest of the school day. The discussions mainly relied on negative short term effects such as feeling ill andreduced stamina. Some food and food groups such as vegetables, milk and fish, were mentioned in a more positivesense highlighting the positive short- and long term outcomes on health. When describing the long-term outcomes ofeating, children mentioned that healthy eating helps to build muscles, grow and prevent diseases, such as cancer anddiabetes. Sugar and fat was frequently mentioned as being the cause of overweight and some other diseases.

    Conclusion: In general, Nordic children have an adequate understanding of established relations between food andhealth. Yet, we know that many pupils do not eat according to recommendations. This highlights the importance of takingthe complexity of food choice into consideration in nutritional education.

    Disclosure of Interest: None to declare

  • 120.
    Bergh, Kurt
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Kost, gener och träning är nyckeln till ökad prestation2005In: Svensk idrottsmedicin, ISSN 1103-7652, Vol. 24, no 2, p. 4-9Article in journal (Other (popular science, discussion, etc.))
    Abstract [en]

    Kosten kan liksom fysisk aktivitet påverka våra gener. Gentranskriptionen påverkas olika beroende på kostens sammansättning och med rätt kunskap kan kosten öka den fysiska prestationsförmågan och göra återhämtningen mer effektiv.

  • 121.
    Berglund, Birgitta
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Höglund, Anders
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Esfandabad, Hassan Shams
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    A bisensory method for odor and irritation detection of formaldehyde and pyridine2012In: CHEMOSENS PERCEPT, ISSN 1936-5802, Vol. 5, no 2, p. 146-157Article in journal (Refereed)
    Abstract [en]

    A bisensory method was developed for determining the psychometric functions and absolute thresholds for odor and sensory irritation of two odorous irritants. Individual and group thresholds for formaldehyde or pyridine were measured for 31 age-matched subjects (18-35 years old). P (50) absolute thresholds were for formaldehyde odor 110 ppb (range 23-505), for pyridine odor 77 ppb (range 20-613), and for pyridine irritation 620 ppb (range 90-3,656); too few subjects' formaldehyde irritation thresholds were possible to determine (human exposures limited to 1 ppm). In spite of large interindividual differences, all thresholds for irritation were higher than for odor. The average slopes of the 62 psychometric functions for odor and the 32 possible for sensory irritation were highest for formaldehyde odor (83% per log ppb) and equal for pyridine odor and irritation (68% per log ppb). The bisensory method for measuring odor and sensory irritation jointly produced detection functions and absolute thresholds compatible with those earlier published; however, a steeper slope for sensory irritation than odor was expected for pyridine. The bisensory method is intended for measuring odor and sensory irritation to broadband mixtures and dynamic exposures, like indoor air.

  • 122.
    Berglund, Staffan K.
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics. EURISTIKOS Excellence Centre for Paediatric Research, University of Granada, Granada, Spain.
    Torres-Espinola, Francisco J.
    Garcia-Valdes, Luz
    Teresa Segura, Ma
    Martinez-Zaldivar, Cristina
    Padilla, Carmen
    Rueda, Ricardo
    Petez Garcia, Miguel
    McArdle, Harry J.
    Campoy, Cristina
    The impacts of maternal iron deficiency and being overweight during pregnancy on neurodevelopment of the offspring2017In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 118, no 7, p. 533-540Article in journal (Refereed)
    Abstract [en]

    Both maternal Fe deficiency (ID) and being overweight or obese (Ow/Ob, BMI >= 25 kg/m(2)) may negatively affect offspring brain development. However, the two risk factors correlate and their independent effects on infant neurodevelopment are unclear. PREOBE is a prospective observational study that included 331 pregnant Spanish women, of whom 166 had pre-gestational Ow/Ob. Fe status was analysed at 34 weeks and at delivery, and babies were assessed using Bayley III scales of neurodevelopment at 18 months. In confounder-adjusted analyses, maternal ID at 34 weeks was associated with lower composite motor scores at 18 months (mean 113.3 (SD 9.9) v. 117.1 (SD 9.2), P=0.039). Further, the offspring of mothers with ID at delivery had lower cognitive scores (114.0 (SD 9.7) v. 121.5 (SD 10.9), P = 0.039) and lower receptive, expressive and composite (99.5 (SD 8.6) v. 107.6 (SD 8.3), P= 0.004) language scores. The negative associations between maternal ID at delivery and Bayley scores remained even when adjusting for maternal Ow/Ob and gestational diabetes. Similarly, maternal Ow/Ob correlated with lower gross motor scores in the offspring (12.3 (SD 2.0) v. 13.0 (SD 2.1), P = 0.037), a correlation that remained when adjusting for maternal ID. In conclusion, maternal ID and pre-gestational Ow/Ob are both negatively associated with Bayley scores at 18 months, but independently and on different subscales. These results should be taken into account when considering Fe supplementation for pregnant women.

  • 123.
    Berglund, Staffan K
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Westrup, Björn
    Domellöf, Magnus
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Iron Supplementation Until 6 Months Protects Marginally Low-Birth-Weight Infants From Iron Deficiency During Their First Year of Life2015In: Journal of Pediatric Gastroenterology and Nutrition - JPGN, ISSN 0277-2116, E-ISSN 1536-4801, Vol. 60, no 3, p. 390-395Article in journal (Refereed)
    Abstract [en]

    Objectives: Low-birth-weight (LBW) infants (<2500 g) have an increased risk of iron deficiency (ID) during their first 6 months of life. The optimal dose and duration of iron supplementation to LBW infants are, however, unknown. The objective of the present study was to investigate the long-term effect on iron status and growth in marginally LBW (2000-2500 g) infants, of iron supplements given until 6 months of life. Methods: In a randomized controlled trial, 285 healthy marginally LBW infants received 0, 1, or 2 mg . kg(-1).day(-1) of iron supplements from 6 weeks to 6 months of age: At 12 months and 3.5 years of life we measured length, weight, head circumference, and indicators of iron status (hemoglobin, ferritin, mean corpuscular volume, and transferrin saturation) and assessed the prevalence of iron depletion, functional ID, and ID anemia. Results: At 12 months of age, there was a significant difference in ferritin between the groups (P = 0.00 6). Furthermore, there was a significant difference in the prevalence of iron depletion (23.7%, 10.6%, and 6.8%, respectively, in the placebo, 1-mg, and 2-mg groups, P = 0.009) and similar nonsignificant trends for functional ID and ID anemia. At 3.5 years of life there were no significant differences in iron status and the mean prevalence of iron depletion was 3.2%. Anthropometric data were not affected by the intervention. Conclusions: Iron supplements with 2 mg . kg(-1) . day(-1) until 6 months of life effectively reduces the risk of ID during the first 12 months of life and is an effective intervention for preventing early ID in marginally LBW infants.

  • 124.
    Berhane, Hanna Y
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH), International Child Health and Nutrition. Addis Continental Inst Publ Hlth, Addis Ababa 267511000, Ethiopia.
    Ekström, Eva-Charlotte
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH), International Child Health and Nutrition.
    Jirström, Magnus
    Lund Univ, Dept Human Geog, S-22362 Lund, Sweden.
    Berhane, Yemane
    Addis Continental Institute of Public Health, 26751/1000 Addis Ababa, Ethiopia.
    Turner, Christopher
    Lund Univ, Dept Human Geog, S-22362 Lund, Sweden;London Sch Hyg & Trop Med, London WC1E 7HT, England.
    Alsanius, Beatrix W
    Swedish Univ Agr Sci, Dept Biosyst & Technol, S-23053 Alnarp, Sweden.
    Trenholm, Jill E.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH), International Maternal and Reproductive Health and Migration.
    What Influences Urban Mothers' Decisions on What to Feed Their Children Aged Under Five-The Case of Addis Ababa, Ethiopia2018In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 10, no 9, article id 1142Article in journal (Refereed)
    Abstract [en]

    Mothers carry the prime responsibility for childcare and feeding in low-income countries. Understanding their experiences in providing food for their children is paramount to informing efforts to improve the nutritional status of children. Such information is lacking in Sub-Saharan Africa. To understand what influences urban mothers' food acquisition and their motivations for selecting food for their children, 36 in-depth interviews were carried out with mothers having children under five years of age. Interviews were conducted in the local language, audio-recorded, transcribed, and translated into English. Data were analyzed using thematic analysis which led to the identification of four major themes: mothers give-in to a child-driven diet; quick-fix versus the privilege of planning; keen awareness on food safety, nutrition, and diet diversity; and social, familial, and cultural influences. The findings indicate that child feeding practices are influenced by interlinked social and environmental factors. Hence, nutrition education campaigns should focus on targeting not only families but also their children. Attention should also be given to food safety regulations, as well as to the much-needed support of mothers who are struggling to ensure their children's survival in low-income countries.

  • 125. Berkius, P.
    et al.
    Rehnby, B.
    Rothenberg, Elisabet
    Kristianstad University, Research Environment Food and Meals in Everyday Life (MEAL). Kristianstad University, Forskningsmiljön Mat, måltid, hälsa i 24-timmarsperspektivet. Kristianstad University, School of Education and Environment, Avdelningen för Praktisk-estetiska ämnen. Kristianstad University, School of Education and Environment, Avdelningen för Mat- och måltidsvetenskap.
    Undernäring en fråga om patientsäkerhet2015In: Dagens medicin, ISSN 1402-1943Article in journal (Other (popular science, discussion, etc.))
  • 126.
    Bermon, Stephane
    et al.
    Monaco Inst Sports Med & Surg, Monaco.
    Castell, Lindy M
    Univ Oxford, Green Templeton Coll, Oxford, England.
    Calder, Philip C
    Bishop, Nicolette C
    Univ Southampton, Fac Med, Human Dev & Hlth Acad Unit, Southampton, Hants, England.
    Blomstrand, Eva
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Eva Blomstrand's research group.
    Mooren, Frank C
    Justus Liebig Univ, Dept Sports Med, Giessen, Germany.
    Krüger, Karsten
    Justus Liebig Univ, Dept Sports Med, Giessen, Germany.
    Kavazis, Andreas N
    Auburn Univ, Sch Kinesiol, Auburn, AL 36849 USA.
    Quindry, John C
    Univ Montana, Hlth & Human Performance, Missoula, MT 59812 USA.
    Senchina, David S
    Drake Univ, Dept Biol, Kinesiol Program, Des Moines, IA 50311 USA.
    Nieman, David C
    Appalachian State Univ, Human Performance Lab, North Carolina Res Campus, Kannapolis, NC USA.
    Gleeson, Michael
    Univ Loughborough, Sch Sport Exercise & Hlth Sci, Loughborough, Leics, England.
    Pyne, David B
    Australian Inst Sport, Bruce, Australia.
    Kitic, Cecilia M
    Univ Tasmania, Sch Hlth Sci, Sport Performance Optimisat Res Team, Launceston, Tas, Australia.
    Close, Graeme L
    Liverpool John Moores Univ, Res Inst Sport & Exercise Sci, Liverpool, Merseyside, England.
    Larson-Meyer, D Enette
    Univ Wyoming, Dept Family & Consumer Sci, Nutr & Exercise Lab, Laramie, WY 82071 USA.
    Marcos, Ascension
    CSIC, Spanish Natl Res Council, Inst Food Sci Technol & Nutr ICTAN, Madrid, Spain.
    Meydani, Simin N
    Tufts Univ, Jean Mayer USDA Human Nutr Res Ctr Aging, Boston, MA 02111 USA.
    Wu, Dayong
    Tufts Univ, Jean Mayer USDA Human Nutr Res Ctr Aging, Boston, MA 02111 USA.
    Walsh, Neil P
    Bangor Univ, Sch Sport Hlth & Exercise Sci, Bangor, Gwynedd, Wales.
    Nagatomi, Ryochi
    Tohoku Univ, Grad Sch Biomed Engn, Lab Hlth & Sports Sci, Sendai, Miyagi, Japan.
    Consensus Statement Immunonutrition and Exercise.2017In: Exercise immunology review, ISSN 1077-5552, Vol. 23, p. 8-50Article, review/survey (Refereed)
    Abstract [en]

    In this consensus statement on immunonutrition and exercise, a panel of knowledgeable contributors from across the globe provides a consensus of updated science, including the background, the aspects for which a consensus actually exists, the controversies and, when possible, suggested directions for future research.

  • 127.
    Berthelson, Helén
    Kristianstad University, School of Health and Society.
    Näringstillstånd och näringstillförsel vid svår sepsis och septisk chock: Personalens dokumentation och patientens upplevelse under och efter intensivvård2015Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Background: Assessment of nutritional status and support are complicated in the care of patients with severe sepsis and septic chock due to complexity of disease. Patient opinions on food and food intake may serve as important parameters when deciding the amount and kind of nutritional support but are sparsely investigated. The purpose was to describe assessment of nutritional status and nutritional support in patients with severe sepsis and septic chock and to investigate patient experiences of food, drinking and eating during and after intensive care. Method: A case study design was conducted using mixed methods. Assessment of nutritional status and support in medical record were investigated quantitatively in five patients. Experiences and memories were analysed qualitatively using content analysis. Result: Diverse results emerged from detailed to sparse and fragmented judgements, planning and measures taken. Established assessment tools didn´t capture nutritional problems. ICU documentation was detailed while documentation during ordinary ward care was scanty. The patients had unique experiences and memories of thirst, weight, loss of hunger and astonishment of quick loss and return of energy. Conclusion: A systematic and regular control of nutritional support and individual care is required to understand the uniqueness of patient status incritical disease. Further investigation is needed concerning tools for detection of nutritional problems during and after intensive care.

  • 128. Bischoff, Stephan C
    et al.
    Boirie, Yves
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Chourdakis, Michael
    Cuerda, Cristina
    Delzenne, Nathalie M
    Deutz, Nicolaas E
    Fouque, Denis
    Genton, Laurence
    Gil, Carmen
    Koletzko, Berthold
    Leon-Sanz, Miguel
    Shamir, Raanan
    Singer, Joelle
    Singer, Pierre
    Stroebele-Benschop, Nanette
    Thorell, Anders
    Weimann, Arved
    Barazzoni, Rocco
    Towards a multidisciplinary approach to understand and manage obesity and related diseases2017In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 36, no 4, p. 917-938, article id S0261-5614(16)31323-1Article, review/survey (Refereed)
    Abstract [en]

    Overnutrition and sedentary lifestyle result in overweight or obesity defined as abnormal or excessive fat accumulation that may impair health. According to the WHO, the worldwide prevalence of obesity nearly doubled between 1980 and 2008. In 2008, over 50% of both men and women in the WHO European Region were overweight, and approximately 23% of women and 20% of men were obese. Comprehensive diagnostic and therapeutic approaches should include nutritional treatment to favor the best metabolic and nutritional outcome, as well as to induce potential disease-specific benefits from selected nutritional regimens. Obesity is usually accompanied by an increased muscle mass. This might explain why obesity, under particular circumstances such as cancer or high age, might have protective effects, a phenomenon named the 'obesity paradox'. However, loss of muscle mass or function can also occur, which is associated with poor prognosis and termed 'sarcopenic obesity'. Therefore, treatment recommendations may need to be individualized and adapted to co-morbidities. Since obesity is a chronic systemic disease it requires a multidisciplinary approach, both at the level of prevention and therapy including weight loss and maintenance. In the present personal review and position paper, authors from different disciplines including endocrinology, gastroenterology, nephrology, pediatrics, surgery, geriatrics, intensive care medicine, psychology and psychiatry, sports medicine and rheumatology, both at the basic science and clinical level, present their view on the topic and underline the necessity to provide a multidisciplinary approach, to address this epidemic.

  • 129. Bischoff, Stephan C
    et al.
    Singer, Pierre
    Koller, Michael
    Barazzoni, Rocco
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    van Gossum, André
    Standard operating procedures for ESPEN guidelines and consensus papers2015In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 34, no 6, p. 1043-1051Article in journal (Refereed)
    Abstract [en]

    The ESPEN Guideline standard operating procedures (SOP) is based on the methodology provided by the Association of Scientific Medical Societies of Germany (AWMF), the Scottish Intercollegiate Guidelines Network (SIGN), and the Centre for Evidence-based Medicine at the University of Oxford. The SOP is valid and obligatory for all future ESPEN-sponsored guideline projects aiming to generate high-quality guidelines on a regular basis. The SOP aims to facilitate the preparation of guideline projects, to streamline the consensus process, to ensure quality and transparency, and to facilitate the dissemination and publication of ESPEN guidelines. To achieve this goal, the ESPEN Guidelines Editorial board (GEB) has been established headed by two chairmen. The GEB will support and supervise the guideline processes and is responsible for the strategic planning of ESPEN guideline activities. Key elements of the SOP are the generation of well-built clinical questions according to the PICO system, a systemic literature search, a classification of the selected literature according to the SIGN evidence levels providing an evidence table, and a clear and straight-forward consensus procedure consisting of online voting's and a consensus conference. Only experts who meet the obligation to disclosure any potential conflict of interests and who are not employed by the Industry can participate in the guideline process. All recommendations will be graded according to the SIGN grading and novel outcome models besides biomedical endpoints. This approach will further extent the leadership of ESPEN in creating up-to-date and suitable for implementation guidelines and in sharing knowledge on malnutrition and clinical nutrition.

  • 130.
    Biskup, Izabela
    et al.
    Swedish Univ Agr Sci, Dept Food Sci, Bioctr, Uppsala, Sweden..
    Kyro, Cecilie
    Danish Canc Soc, Res Ctr, Copenhagen, Denmark..
    Marklund, Matti
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Olsen, Anja
    Danish Canc Soc, Res Ctr, Copenhagen, Denmark..
    van Dam, Rob M.
    Natl Univ Singapore, Saw Swee Hock Sch Publ Hlth, Singapore, Singapore..
    Tjonneland, Anne
    Danish Canc Soc, Res Ctr, Copenhagen, Denmark..
    Lindahl, Beret
    Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden..
    Johansson, Ingegerd
    Umea Univ, Dept Odontol & Cariol, Umea, Sweden..
    Landberg, Rikard
    Swedish Univ Agr Sci, Dept Food Sci, Bioctr, Uppsala, Sweden..
    The role of nutritional biomarkers in prediction and understanding the etiology of type 2 diabetes Reply2016In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 104, no 6, p. 1725-1726Article in journal (Refereed)
  • 131.
    Biskup, Izabela
    et al.
    Swedish Univ Agr Sci, BioCtr, Dept Food Sci, Uppsala, Sweden.;Wroclaw Med Univ, Dept Pharmacognosy, Wroclaw, Poland..
    Kyro, Cecilie
    Danish Canc Soc, Res Ctr, Copenhagen, Denmark..
    Marklund, Matti
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Olsen, Anja
    Danish Canc Soc, Res Ctr, Copenhagen, Denmark..
    van Dam, Rob M.
    Natl Univ Singapore, Saw Swee Hock Sch Publ Hlth, Singapore, Singapore.;Natl Univ Singapore, Yong Loo Lin Sch Med, Dept Med, Singapore, Singapore.;Natl Univ Hlth Syst, Singapore, Singapore.;Harvard Univ, Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA 02115 USA..
    Tjonneland, Anne
    Danish Canc Soc, Res Ctr, Copenhagen, Denmark..
    Overvad, Kim
    Aarhus Univ, Dept Publ Hlth, Epidemiol Sect, Aarhus, Denmark..
    Lindahl, Bernt
    Umea Univ, Dept Publ Hlth, Umea, Sweden.;Umea Univ, Dept Clin Med, Umea, Sweden..
    Johansson, Ingegerd
    Umea Univ, Dept Odontol & Cariol, Umea, Sweden..
    Landberg, Rikard
    Swedish Univ Agr Sci, BioCtr, Dept Food Sci, Uppsala, Sweden.;Karolinska Inst, Inst Environm Med, Nutr Epidemiol Unit, Stockholm, Sweden..
    Plasma alkylresorcinols, biomarkers of whole-grain wheat and rye intake, and risk of type 2 diabetes in Scandinavian men and women2016In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 104, no 1, p. 88-96Article in journal (Refereed)
    Abstract [en]

    Background: Studies that use dietary biomarkers to investigate the association between whole-grain intake and the risk of developing type 2 diabetes (T2D) are lacking. Objective: We examined the association between plasma total alkylresorcinols and the alkylresorcinol C17:0-to-C21:0 ratio, biomarkers of whole-grain wheat and rye intake and relative whole grain rye over whole-grain wheat intake, respectively, and the risk of T2D among Scandinavian men and women. Design: A nested case-control study was established within the Northern Sweden Health and Disease Study and the Danish Diet, Cancer and Health cohort. Alkylresorcinol concentrations and the ratios of C17:0 to C21:0 were determined in plasma samples from 931 case-control pairs. ORs for T2D were calculated for plasma total alkylresorcinol concentration or C17:0-to-C21:0 ratio in quartiles with the use of conditional logistic regression that was adjusted for potential confounders. Additional analyses with whole-grain wheat and rye intake estimated from food-frequency questionnaires (FFQs) as exposures were also performed. Results: The plasma total alkylresorcinol concentration was not associated with T2D risk (OR: 1.34; 95% CI: 0.95, 1.88) for the highest compared with the lowest quartiles in multivariable adjusted models. However, the C17:0-to-C21:0 ratio was associated with a lower diabetes risk (OR: 0.54; 95% CI: 0.37, 0.78). Analyses with whole-grain intake estimated from FFQs yielded similar results. Conclusions: Total whole-grain wheat and rye intake, reflected by alkylresorcinols in plasma, was not associated with a lower risk of T2D in a population with high whole-grain intake. In contrast, the proportion of whole-grain rye to whole-grain wheat intake, indicated by the plasma C17:0-to-C21:0 ratio, was inversely associated with T2D. This suggests that whole-grain intake dominated by rye may be favorable for T2D prevention.

  • 132.
    Biskup, Izabela
    et al.
    Swedish Univ Agr Sci, Bioctr, Dept Food Sci, Uppsala, Sweden.;Wroclaw Med Univ, Dept Pharmacognosy, Wroclaw, Poland..
    Kyro, Cecilie
    Danish Canc Soc, Res Ctr, Copenhagen, Denmark..
    Marklund, Matti
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Olsen, Anja
    Danish Canc Soc, Res Ctr, Copenhagen, Denmark..
    van Dam, Rob M.
    Natl Univ Singapore, Saw Swee Hock Sch Publ Hlth, Singapore, Singapore.;Natl Univ Singapore, Yong Loo Lin Sch Med, Dept Med, Singapore, Singapore.;Natl Univ Hlth Syst, Singapore, Singapore.;Harvard Univ, Dept Nutr, Harvard TH Chan Sch Publ Hlth, Boston, MA 02115 USA..
    Tjonneland, Anne
    Danish Canc Soc, Res Ctr, Copenhagen, Denmark..
    Overvad, Kim
    Aarhus Univ, Epidemiol Sect, Dept Publ Hlth, Aarhus, Denmark..
    Lindahl, Bernt
    Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden..
    Johansson, Ingegerd
    Umea Univ, Dept Odontol & Cariol, Umea, Sweden..
    Landberg, Rikard
    Swedish Univ Agr Sci, Bioctr, Dept Food Sci, Uppsala, Sweden.;Karolinska Insitutet, Inst Environm Med, Nutr Epidemiol Unit, Stockholm, Sweden.;Chalmers, Dept Biol & Biol Engn, Gothenburg, Sweden..
    Whole-grain intake and risk of type 2 diabetes Reply2016In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 104, no 6, p. 1723-1724Article in journal (Refereed)
  • 133. Biskup, Izabela
    et al.
    Kyrø, Cecilie
    Marklund, Matti
    Olsen, Anja
    van Dam, Rob M.
    Tjonneland, Anne
    Overvad, Kim
    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.
    Landberg, Rikard
    Plasma alkylresorcinols, biomarkers of whole-grain wheat and rye intake, and risk of type 2 diabetes in Scandinavian men and women2016In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 104, no 1, p. 88-96Article in journal (Refereed)
    Abstract [en]

    Background: Studies that use dietary biomarkers to investigate the association between whole-grain intake and the risk of developing type 2 diabetes (T2D) are lacking. Objective: We examined the association between plasma total alkylresorcinols and the alkylresorcinol C17:0-to-C21:0 ratio, biomarkers of whole-grain wheat and rye intake and relative whole grain rye over whole-grain wheat intake, respectively, and the risk of T2D among Scandinavian men and women. Design: A nested case-control study was established within the Northern Sweden Health and Disease Study and the Danish Diet, Cancer and Health cohort. Alkylresorcinol concentrations and the ratios of C17:0 to C21:0 were determined in plasma samples from 931 case-control pairs. ORs for T2D were calculated for plasma total alkylresorcinol concentration or C17:0-to-C21:0 ratio in quartiles with the use of conditional logistic regression that was adjusted for potential confounders. Additional analyses with whole-grain wheat and rye intake estimated from food-frequency questionnaires (FFQs) as exposures were also performed. Results: The plasma total alkylresorcinol concentration was not associated with T2D risk (OR: 1.34; 95% CI: 0.95, 1.88) for the highest compared with the lowest quartiles in multivariable adjusted models. However, the C17:0-to-C21:0 ratio was associated with a lower diabetes risk (OR: 0.54; 95% CI: 0.37, 0.78). Analyses with whole-grain intake estimated from FFQs yielded similar results. Conclusions: Total whole-grain wheat and rye intake, reflected by alkylresorcinols in plasma, was not associated with a lower risk of T2D in a population with high whole-grain intake. In contrast, the proportion of whole-grain rye to whole-grain wheat intake, indicated by the plasma C17:0-to-C21:0 ratio, was inversely associated with T2D. This suggests that whole-grain intake dominated by rye may be favorable for T2D prevention.

  • 134. Biskup, Izabela
    et al.
    Kyrø, Cecilie
    Marklund, Matti
    Olsen, Anja
    van Dam, Rob M.
    Tjønneland, Anne
    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.
    Landberg, Rikard
    Reply to A Abbasi2016In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 104, no 6, p. 1725-1726Article in journal (Refereed)
  • 135. Biskup, Izabela
    et al.
    Kyrø, Cecilie
    Marklund, Matti
    Olsen, Anja
    van Dam, Rob M.
    Tjønneland, Anne
    Overvad, Kim
    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.
    Landberg, Rikard
    Reply to J-B Qin et al2016In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 104, no 6, p. 1723-1724Article in journal (Refereed)
  • 136. Bisschop, Charlotte N. Steins
    et al.
    van Gils, Carla H.
    Emaus, Marleen J.
    Bueno-de-Mesquita, H. Bas
    Monninkhof, Evelyn M.
    Boeing, Heiner
    Aleksandrova, Krasmira
    Jenab, Mazda
    Norat, Teresa
    Riboli, Elio
    Boutron-Rualt, Marie-Christine
    Fagherazzi, Guy
    Racine, Antoine
    Palli, Domenico
    Krogh, Vittorio
    Tumino, Rosario
    Naccarati, Alessio
    Mattiello, Amalia
    Vicente Argueeles, Marcial
    Jose Sanchez, Maria
    Jose Tormo, Maria
    Ardanaz, Eva
    Dorronsoro, Miren
    Bonet, Catalina
    Khaw, Kay-Tee
    Key, Tim
    Trichopoulou, Antonia
    Orfanos, Philippos
    Naska, Androniki
    Kaaks, Rudolph R.
    Lukanova, Annekatrin
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Pischon, Tobias
    Ljuslinder, Ingrid
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Jirstrom, Karin
    Ohlsson, Bodil
    Overvad, Kim
    Berentzen, Tina Landsvig
    Halkjaer, Jytte
    Tjonneland, Anne
    Weiderpass, Elisabete
    Skeie, Guri
    Braaten, Tonje
    Siersema, Peter D.
    Freisling, Heinz
    Ferrari, Pietro
    Peeters, Petra H. M.
    May, Anne M.
    Weight change later in life and colon and rectal cancer risk in participants in the EPIC-PANACEA study2014In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 99, no 1, p. 139-147Article in journal (Refereed)
    Abstract [en]

    Background: A moderate association exists between body mass index (BMI) and colorectal cancer. Less is known about the effect of weight change. Objective: We investigated the relation between BMI and weight change and subsequent colon and rectal cancer risk. Design: This was studied among 328,781 participants in the prospective European Prospective Investigation into Cancer Physical Activity, Nutrition, Alcohol, Cessation of Smoking, Eating study (mean age: 50 y). Body weight was assessed at recruitment and on average 5 y later. Self-reported weight change (kg/y) was categorized in sex-specific quintiles, with quintiles 2 and 3 combined as the reference category (men: -0.6 to 0.3 kg/y; women: -0.4 to 0.4 kg/y). In the subsequent years, participants were followed for the occurrence of colon and rectal cancer (median period: 6.8 y). Multivariable Cox proportional hazards regression analyses were used to study the association. Results: A total of 1261 incident colon cancer and 747 rectal cancer cases were identified. ME at recruitment was statistically significantly associated with colon cancer risk in men (HR: 1.04; 95% CI: 1.02, 1.07). Moderate weight gain (quintile 4) in men increased risk further (HR: 1.32; 95% CI: 1.04, 1.68), but this relation did not show a clear trend. In women, BMI or weight gain was not related to subsequent risk of colon cancer. No statistically significant associations for weight loss and colon cancer or for BMI and weight changes and rectal cancer were found. Conclusions: BMI attained at adulthood was associated with colon cancer risk. Subsequent weight gain or loss was not related to colon or rectal cancer risk in men or women.

  • 137.
    Bixby, Honor
    et al.
    Imperial College London, United Kingdom.
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Ezzati, Majid
    Imperial College London, United Kingdom.
    Rising rural body-mass index is the main driver of the global obesity epidemic in adults2019In: Nature, ISSN 0028-0836, E-ISSN 1476-4687, Vol. 569, no 7755, p. 260-264Article in journal (Refereed)
    Abstract [en]

    Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities1,2. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity3-6. Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.

  • 138.
    Bjarnholt, Christel
    et al.
    Karolinska Inst, Huddinge, Sweden.
    Kugelberg, Susanna
    Karolinska Inst, Huddinge, Sweden.
    Hughes, Roger
    Univ Sunshine Coast, Maroochydore, Qld, Australia.
    Stockley, Lynn
    Stockley Associates, Nr Chepstow, England.
    Margetts, Barrie M.
    Univ Southampton, Southampton, England.
    Thorsdottir, Inga
    Univ Iceland, Reykjavik, Iceland.
    Perez Rodrigo, Carmen
    Bilbao Dept Publ Hlth, Bilbao, Spain.
    Kennedy, Nick
    Trinity Coll Dublin, Dublin, Ireland.
    Yngve, Agneta
    Karolinska Inst, Huddinge, Sweden.
    Public health nutrition workforce development missing in european nutrition policies: the JOBNUT project2009In: Annals of Nutrition and Metabolism, ISSN 0250-6807, E-ISSN 1421-9697, Vol. 55, p. 185-185Article in journal (Other academic)
  • 139.
    Bjarnholt, Christel
    et al.
    Karolinska Inst, Huddinge, Sweden.
    Yngve, Agneta
    Karolinska Inst, Huddinge, Sweden.
    Krawinkel, Michael
    Univ Giessen, Giessen, Germany.
    Kristjansdottir, Asa G.
    Univ Iceland, Reykjavik, Iceland.
    Hlastan Ribic, Cirila
    Ctr Community Hlth, Ljubljana, Slovenia.
    Vaz de Almeida, Maria Daniel
    Univ Porto, Fac Ciencias Nutr & Alimentacao, P-4100 Oporto, Portugal.
    Francini, Bela
    Univ Porto, Fac Ciencias Nutr & Alimentacao, Oporto, Portugal.
    Papadaki, Alina
    Univ Crete, Iraklion, Greece.
    Karlsson, Christina
    ICA AB, Solna, Sweden.
    Brug, Johannes
    EMGO Inst Hlth & Care Res, Amsterdam, Netherlands.
    Maucec-Zakotnik, Jozica
    Ctr Community Hlth, Ljubljana, Slovenia.
    Ehrenblad, Bettina
    Karolinska Inst, Huddinge, Sweden.
    Duleva, Vesselka
    Natl Ctr Publ Hlth Protect, Sofia, Bulgaria.
    Lien, Nanna
    Univ Oslo, Oslo, Norway.
    te Velde, Saskia
    EMGO Inst Hlth & Care Res, Amsterdam, Netherlands.
    Izquierdo de Santiago, Raquel
    Freshfel Europe, Brussels, Belgium.
    Roos, Eva
    Folkhalsan, Helsinki, Finland.
    Klepp, Knut-Inge
    Univ Oslo, Oslo, Norway.
    Binard, Philippe
    Freshfel Europe, Brussels, Belgium.
    Petrova, Stefka
    Natl Ctr Publ Hlth Protect, Sofia, Bulgaria.
    Thorsdottir, Inga
    Univ Iceland, Reykjavik, Iceland.
    Progreens: promotion of fruit and vegetable intake in school children across Europe2009In: Annals of Nutrition and Metabolism, ISSN 0250-6807, E-ISSN 1421-9697, Vol. 55, p. 504-504Article in journal (Other academic)
  • 140.
    Bjermo, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Dietary Fatty Acids and Inflammation: Observational and Interventional Studies2011Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Dietary fat quality influences the risk of type 2 diabetes and cardiovascular disease. A low-grade inflammation is suggested to contribute to the disease development, often accompanied by obesity. Whereas n-3 polyunsaturated fatty acids (PUFA) have been considered anti-inflammatory, n-6 PUFA have been proposed to act pro-inflammatory. Saturated fatty acids (SFA) act pro-inflammatory in vitro.

    This thesis aimed to investigate effects of different fatty acids on low-grade inflammation in observational and interventional studies. In Paper I and II, fatty acid composition in serum cholesterol esters was used as objective marker of dietary fat quality and related to serum C-reactive protein (CRP) and other circulating inflammatory markers in two population-based cohorts, conducted in middle-aged men and elderly men and women, respectively. In Paper III and IV, the impact of diets differing in fat quality on inflammation and oxidative stress was investigated in randomised controlled studies, in subjects with metabolic syndrome and abdominal obesity.

    In Paper I and II, a low proportion of linoleic acid (18:2 n-6) in serum was associated with higher CRP concentrations, indicating that a low intake of vegetable fats may be related to low-grade inflammation. High CRP concentrations were also associated with high proportions of palmitoleic (16:1) and oleic (18:1) acids and high stearoyl coenzymeA desaturase index, possibly reflecting altered fat metabolism and/or high SFA intake in this population. When comparing two high-fat diets rich in either saturated or monounsaturated fat, and two low-fat diets with or without long-chain n-3 PUFA supplementation during 12 weeks (Paper III), no differences in inflammation or oxidative stress markers were observed. Moreover, a 10-week intervention (Paper IV) with high linoleic acid intake showed no adverse effects on inflammation or oxidative stress. Instead, interleukin-1 receptor antagonist and tumor necrosis factor receptor-2 decreased after linoleic acid intake compared with a diet high in SFA.

    The results in this thesis indicate that dietary n-6 PUFA found in vegetable fats is associated with lower inflammation marker levels, and to some extent reduces systemic inflammation when compared with SFA. Supplementation of n-3 PUFA did not exert any systemic anti-inflammatory effects, maybe due to a relatively low dose.

  • 141.
    Björklund, Johanna
    Örebro University, School of Science and Technology.
    Framgångsrika recept för hållbara måltider i offentliga kök: Erfarenheter baserade på utvärderingen av projektet Hållbara måltider i Örebro län 2014-20162016Report (Other (popular science, discussion, etc.))
  • 142.
    Björklund, Johanna
    Örebro University, School of Science and Technology.
    Hållbara måltider i Örebro län 1.0: Ett bra exempel på lärande för hållbar utveckling2014Report (Other (popular science, discussion, etc.))
  • 143.
    Björklund, Johanna
    et al.
    Örebro University, School of Science and Technology.
    Morfeldt, Peter
    Att använda skolmåltiden som pedagogiskt redskap: Erfarenheter från en forskningscirkel med lärare i åk 5-­62015Report (Other (popular science, discussion, etc.))
  • 144. Blain, H.
    et al.
    Masud, T.
    Dargent-Molina, P.
    Martin, F. C.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    van der Velde, N.
    Bousquet, J.
    Benetos, A.
    Cooper, C.
    Kanis, J. A.
    Reginster, J. Y.
    Rizzoli, R.
    Cortet, B.
    Barbagallo, M.
    Dreinhofer, K. E.
    Vellas, B.
    Maggi, S.
    Strandberg, T.
    A comprehensive fracture prevention strategy in older adults: the European Union Geriatric Medicine Society (EUGMS) statement2016In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 20, no 6, p. 647-652Article in journal (Refereed)
    Abstract [en]

    Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest Group on Falls and Fracture Prevention of the European Union Geriatric Medicine Society (EUGMS), in collaboration with the International Association of Gerontology and Geriatrics for the European Region (IAGG-ER), the European Union of Medical Specialists (EUMS), the International Osteoporosis Foundation - European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people.

  • 145. Blankenau, I.
    et al.
    Dahlin-Ivanoff, S.
    Rothenberg, Elisabet
    Kristianstad University, Forskningsmiljön Mat, måltid, hälsa i 24-timmarsperspektivet. Kristianstad University, Resrarch environment Food and Meals in Everyday Life (MEAL). Kristianstad University, School of Education and Environment, Avdelningen för Humanvetenskap.
    A comparison of body height estimated by different proxy measures in Swedish older adults2012Conference paper (Refereed)
    Abstract [en]

    Approximately 40 per cent of older adults living at home are at risk of malnutrition. To detect this condition, body mass index is often used as a tool. The standard way of measuring body height is in a standing position. Height decreases with age and further, many older adults are not physically capable to undergo standing height measures. As height is one of the components in BMI it can be affected by body height decrease which in turn will affect the estimated prevalence of malnutrition risk. There are many different ways to estimate height by proxy measures. The aim of this study was to investigate whether proxy measurements could prove to be useful when estimating height in Swedish community-dwelling older adults. Home visits were made to 51 men and 51 women, who had participated in the randomized, single-blinded health-promoting intervention study, Elderly in the Risk Zone, living in the urban district Örgryte-Härlanda in Gothenburg, Sweden. Body weight, standing height, recumbent height, knee-height and demi-span was measured. An interview was also conducted, retrieving information regarding e.g. height around 20 years of age. T-test and Wilcoxon rank tests were performed and to further examine the results regression analyses and Bland & Altman-plots were conducted. The result showed that between 20 years of age to present age the men had decreased, in body height, on average 3,8 cm and the women 4,9 cm. In both the regression analysis and in the Bland & Altman plots, recumbent height and youth height seem to best conform to standing measured height. In the men, a negative correlation was found between the difference standing and knee-height measure of body height compared to mean values of the two measures in the Bland & Altman plots, though it was the only measurement that did not show any group mean statistical significant difference from standing height by t-test. No negative or positive correlation was seen in the women by the Bland & Altman plots. Demi-span gave an underestimation of body height in both genders. The present results show that body height seems to decrease with age and that besides standing, the best proxy measure is recumbent height otherwise that right knee-height could be used. Different height measurements could affect the BMI classification. Though we need to learn more about what affects the height decrease with age and what proxy measures are reliable. It would be desirable that a larger study would be conducted.

  • 146.
    Blaznik, Urška
    et al.
    National Institute of Public Health, Ljubljana, Slovenija.
    Yngve, Agneta
    Örebro universitet, Restaurang- och hotellhögskolan.
    Eržen, Ivan
    National Institute of Public Health, Ljubljana, Slovenija; Department of the Public Health, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.
    Hlastan Ribič, Cirila
    National Institute of Public Health, Ljubljana, Slovenija; Department of the Public Health, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.
    Consumption of fruits and vegetables and probabilistic assessment of the cumulative acute exposure to organophosphorus and carbamate pesticides of schoolchildren in Slovenia2016In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 19, no 4, p. 557-563Article in journal (Refereed)
    Abstract [en]

    Objective: Adequate consumption of fruits and vegetables is a part of recommendations for a healthy diet. The aim of the present study was to assess acute cumulative dietary exposure to organophosphorus and carbamate pesticides via fruit and vegetable consumption by the population of schoolchildren aged 11-12 years and the level of risk for their health.

    Design: Cumulative probabilistic risk assessment methodology with the index compound approach was applied.

    Setting: Slovenia, primary schools.

    Subjects: Schoolchildren (n 1145) from thirty-one primary schools in Slovenia. Children were part of the PRO GREENS study 2009/10 which assessed 11-year-olds' consumption of fruit and vegetables in ten European countries.

    Results: The cumulative acute exposure amounted to 8·3 (95 % CI 7·7, 10·6) % of the acute reference dose (ARfD) for acephate as index compound (100 µg/kg body weight per d) at the 99·9th percentile for daily intake and to 4·5 (95 % CI 3·5, 4·7) % of the ARfD at the 99·9th percentile for intakes during school time and at lunch. Apples, bananas, oranges and lettuce contributed most to the total acute pesticides intake.

    Conclusions: The estimations showed that acute dietary exposure to organophosphorus and carbamate pesticides is not a health concern for schoolchildren with the assessed dietary patterns of fruit and vegetable consumption.

  • 147.
    Blaznik, Urška
    et al.
    National Institute of Public Health, Ljubljana, Slovenija.
    Yngve, Agneta
    Örebro University, School of Hospitality, Culinary Arts & Meal Science.
    Eržen, Ivan
    National Institute of Public Health, Ljubljana, Slovenija; Department of the Public Health, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.
    Hlastan Ribič, Cirila
    National Institute of Public Health, Ljubljana, Slovenija; Department of the Public Health, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.
    Consumption of fruits and vegetables and probabilistic assessment of the cumulative acute exposure to organophosphorus and carbamate pesticides of schoolchildren in Slovenia2016In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 19, no 4, p. 557-563Article in journal (Refereed)
    Abstract [en]

    Objective: Adequate consumption of fruits and vegetables is a part of recommendations for a healthy diet. The aim of the present study was to assess acute cumulative dietary exposure to organophosphorus and carbamate pesticides via fruit and vegetable consumption by the population of schoolchildren aged 11-12 years and the level of risk for their health.

    Design: Cumulative probabilistic risk assessment methodology with the index compound approach was applied.

    Setting: Slovenia, primary schools.

    Subjects: Schoolchildren (n 1145) from thirty-one primary schools in Slovenia. Children were part of the PRO GREENS study 2009/10 which assessed 11-year-olds' consumption of fruit and vegetables in ten European countries.

    Results: The cumulative acute exposure amounted to 8·3 (95 % CI 7·7, 10·6) % of the acute reference dose (ARfD) for acephate as index compound (100 µg/kg body weight per d) at the 99·9th percentile for daily intake and to 4·5 (95 % CI 3·5, 4·7) % of the ARfD at the 99·9th percentile for intakes during school time and at lunch. Apples, bananas, oranges and lettuce contributed most to the total acute pesticides intake.

    Conclusions: The estimations showed that acute dietary exposure to organophosphorus and carbamate pesticides is not a health concern for schoolchildren with the assessed dietary patterns of fruit and vegetable consumption.

  • 148.
    Blixt, Christina
    et al.
    Dept of Anaesthesia and Intensive Care, Karolinska University Hospital, Huddinge, Sweden; Dept of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Huddinge, Sweden.
    Ahlstedt, Christian
    Dept of Anaesthesia and Intensive Care, Karolinska University Hospital, Huddinge, Sweden; Dept of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Huddinge, Sweden.
    Ljungqvist, Olle
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Isaksson, Bengt
    Dept of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Huddinge, Sweden; Division of Surgery, Karolinska University Hospital, Huddinge, Sweden.
    Kalman, Sigridur
    Dept of Anaesthesia and Intensive Care, Karolinska University Hospital, Huddinge, Sweden; Dept of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Huddinge, Sweden.
    Rooyackers, Olav
    Dept of Anaesthesia and Intensive Care, Karolinska University Hospital, Huddinge, Sweden; Dept of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Huddinge, Sweden.
    Corrigendum to ‘The effect of perioperative glucose control on postoperative insulin resistance’ [Clin Nutr 31 (5) (2012) 676–681]2018In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 37, no 3, p. 1091-1091Article in journal (Refereed)
  • 149. Blixt, Christina
    et al.
    Ahlstedt, Christian
    Ljungqvist, Olle
    Örebro University, School of Medicine, Örebro University, Sweden. Dept of Surgery, Örebro University Hospital, Örebro, Sweden.
    Isaksson, Bengt
    Kalman, Sigridur
    Rooyackers, Olav
    The effect of perioperative glucose control on postoperative insulin resistance2012In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 31, no 5, p. 676-681Article in journal (Refereed)
    Abstract [en]

    BACKGROUND & AIMS: Postoperative insulin resistance and the consequent hyperglycemia affects clinical outcome. Insulin sensitivity may be modulated by preoperative nutrition, adequate pain management and minimal invasive surgery. This study aims to disclose the impact of perioperative glucose control on postoperative insulin resistance.

    METHODS: Twenty patients scheduled for elective open hepatectomy were enrolled in this prospective, randomized study. In the treatment group (n = 9) insulin was administered intravenously to keep blood glucose between 6 and 8 mmol/l during surgery. The control group (n = 8) received insulin if blood glucose >14 mmol/l. Insulin sensitivity was measured by a hyperinsulinemic normoglycemic clamp (0.8 mU/kg/min), performed on all patients both on the day before surgery and immediately postoperatively. Plasma cortisol, insulin and C-peptide were measured.

    RESULTS: There was a significant difference in mean glucose value during surgery. In the control group 8.8 mmol/l (SD 1.5) vs. 6.9 mmol/l (SD 0.4) in the treated group, p = 0.003. In the control group insulin sensitivity decreased to 21.9% ± 16.2% of the preoperative value and in the insulin treated group to 46.8 ± 15.5%, p < 0.005. Insulin levels were significantly higher in the treatment group as well as consequently lower C-peptide levels.

    CONCLUSIONS: This trial revealed a significant difference in postoperative insulin resistance in the group treated with insulin during surgery.

  • 150.
    Blomquist, Caroline
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Alvehus, Malin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Burén, Jonas
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Ryberg, Mats
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Larsson, Christel
    Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden..
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Mellberg, Caroline
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Söderström, Ingegerd
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Chorell, Elin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Attenuated Low-Grade Inflammation Following Long-Term Dietary Intervention in Postmenopausal Women with Obesity2017In: Obesity, ISSN 1930-7381, E-ISSN 1930-739X, Vol. 25, no 5, p. 892-900Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Abdominal fat accumulation after menopause is associated with low-grade inflammation and increased risk of metabolic disorders. Effective long-term lifestyle treatment is therefore needed.

    METHODS: Seventy healthy postmenopausal women (age 60 ± 5.6 years) with BMI 32.5 ± 5.5 were randomized to a Paleolithic-type diet (PD) or a prudent control diet (CD) for 24 months. Blood samples and fat biopsies were collected at baseline, 6 months, and 24 months to analyze inflammation-related parameters.

    RESULTS: Android fat decreased significantly more in the PD group (P = 0.009) during the first 6 months with weight maintenance at 24 months in both groups. Long-term significant effects (P < 0.001) on adipose gene expression were found for toll-like receptor 4 (decreased at 24 months) and macrophage migration inhibitory factor (increased at 24 months) in both groups. Serum interleukin 6 (IL-6) and tumor necrosis factor α levels were decreased at 24 months in both groups (P < 0.001) with a significant diet-by-time interaction for serum IL-6 (P = 0.022). High-sensitivity C-reactive protein was decreased in the PD group at 24 months (P = 0.001).

    CONCLUSIONS: A reduction of abdominal obesity in postmenopausal women is linked to specific changes in inflammation-related adipose gene expression.

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