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  • 201.
    Cederholm, Tommy
    et al.
    Uppsala universitet.
    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.
    Kost, nutrition och hälsa - en introduktion2015In: Mat och hälsa: en klinisk handbok / [ed] Cederholm, Tommy; Rothenberg, Elisabeth, Lund: Studentlitteratur AB, 2015, p. 23-26Chapter in book (Other academic)
  • 202.
    Cederholm, Tommy
    et al.
    Uppsala universitet.
    Rothenberg, ElisabetKristianstad 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.
    Mat och hälsa: en klinisk handbok2015Collection (editor) (Other academic)
    Abstract [sv]

    Kunskaper och vetenskapligt förankrade insikter kring matens betydelse för människans hälsa tilltar samtidigt som intresset för kost och hälsa ökar hos både patienter och allmänhet. Personal inom vård och omsorg upplever därför ofta svårigheter att orientera sig i flödet av hälsobudskap där buden dessutom kan vara motstridiga. Läkare, sjuksköterskor och annan vårdpersonal har ett kontinuerligt behov av att uppdatera sina kunskaper om mat, nutrition och hälsa. 


    Bokens första del ger råd om nutritionshandläggning vid speciella sjukdomar, t.ex. hjärt–kärlsjukdomar, diabetes och fetma.Dessutom fokuseras nutritionens betydelse vid vanliga kroniska sjukdomar såsom mag-tarm-, njur- och demenssjukdom.Åldrandet, mat och nutrition diskuteras i flera kapitel.Vårdprocessen vid utredning och behandling belyses. Bokens andra del ger kliniskt relevant kunskap om näringslära och kostrekommendationer. T.ex. avhandlas hälsoeffekter och behov av fett, kolhydrater och protein, omega-3-fettsyror och vitamin D,hälsoeffekter av traditionell medelhavskost, och dess nordiska motsvarighet, liksom olika typer av populära koster.


    I den här boken samlas kunskapen hos tjugosex av Sveriges främsta forskare inom nutritionsområdet på ett lättillgängligt sätt för att ge evidensbaserade svar på många av de frågor som möter sjukvårdspersonal.

  • 203.
    Cederholm, Tommy
    et al.
    Lunds universitet.
    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.
    Osteoporos2015In: Mat och hälsa: en klinisk handbok / [ed] Cederholm, Tommy; Rothenberg, Elisabet, Lund: Studentlitteratur AB, 2015, p. 101-104Chapter in book (Other academic)
  • 204.
    Cederholm, Tommy
    et al.
    Uppsala universitet.
    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.
    Ödlund Olin, Ann
    Karolinska universitetssjukhuset.
    Behandling av nutritionsproblem2015In: Mat och hälsa: en klinisk handbok / [ed] Cederholm, Tommy; Rothenberg, Elisabet, Studentlitteratur AB, 2015, p. 143-150Chapter in book (Other academic)
  • 205.
    Cederholm, Tommy
    et al.
    Uppsala universitet.
    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.
    Ödlund Olin, Ann
    Karolinska universitetssjukhuset.
    Utredning av nutritionsproblem (undernäring och fetma)2015In: Mat och hälsa: en klinisk handbok / [ed] Cederholm, Tommy; Rothenberg, Elisabet, Lund: Studentlitteratur AB, 2015, p. 135-142Chapter in book (Other academic)
  • 206.
    Cedernaes, Jonathan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Intestinal Gene Expression Profiling and Fatty Acid Responses to a High-fat Diet2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The gastrointestinal tract (GIT) regulates nutrient uptake, secretes hormones and has a crucial gut flora and enteric nervous system. Of relevance for these functions are the G protein-coupled receptors (GPCRs) and the solute carriers (SLCs). The Adhesion GPCR subfamily is known to mediate neural development and immune system functioning, whereas SLCs transport e.g. amino acids, fatty acids (FAs) and drugs over membranes. We aimed to comprehensively characterize Adhesion GPCR and SLC gene expression along the rat GIT. Using qPCR we measured expression of 78 SLCs as well as all 30 Adhesion GPCRs in a twelve-segment GIT model. 21 of the Adhesion GPCRs had a widespread (≥5 segments) or ubiquitous (≥11 segments) expression. Restricted expression patterns were characteristic for most group VII members. Of the SLCs, we found the majority (56 %) of these transcripts to be expressed in all GIT segments. SLCs were predominantly found in the absorption-responsible gut regions. Both Adhesion GPCRs and SLCs were widely expressed in the rat GIT, suggesting important roles. The distribution of Adhesion GPCRs defines them as a potential pharmacological target.

    FAs constitute an important energy source and have been implicated in the worldwide obesity increase. FAs and their ratios – indices for activities of e.g. the desaturase enzymes SCD-1 (SCD-16, 16:1n-7/16:0), D6D (18:3n-6/18:2n-6) and D5D (20:4n-6/20:3n-6) – have been associated with e.g. overall mortality and BMI. We examined whether differences in FAs and their indices in five lipid fractions contributed to obesity susceptibility in rats fed a high fat diet (HFD), and the associations of desaturase indices between lipid fractions in animals on different diets. We found that on a HFD, obesity-prone (OP) rats had a higher SCD-16 index and a lower linoleic acid (LA) proportions in subcutaneous adipose tissue (SAT) than obesity-resistant rats. Desaturase indices were significantly correlated between many of the lipid fractions. The higher SCD-16 may indicate higher SCD-1 activity in SAT in OP rats, and combined with lower LA proportions may provide novel insights into HFD-induced obesity. The associations between desaturase indices show that plasma measurements can serve as proxies for some lipid fractions, but the correlations seem to be affected by diet and weight gain.

  • 207.
    Cedernaes, Jonathan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Alsiö, Johan
    Department of Psychology, University of Cambridge, Cambridge.
    Risérus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Schiöth, Helgi B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Fatty acid desaturase indices in rats: Associations between plasma, liver and adipose tissue lipid fractions and the effects of a high-fat diet and diet-induced obesityManuscript (preprint) (Other academic)
    Abstract [en]

    Background: Alterations in fatty acid (FA) desaturase indices are linked to obesity-related disorders. As desaturases affect FA composition increased understanding of their regulation across lipid fractions with varying functions is essential. In this study we have examined desaturases and selected FAs to establish their degree of co-regulation in five different lipid fractions and under different dietary conditions, including diet-induced obesity (DIO).

    Methods: Sprague-Dawley rats were randomly grouped into three groups, one fed a chow diet ad libitum (control) and two fed a high-fat diet (HFD): one ad libitum (AL-HFD) and the other one calorically pair fed to the chow-fed group (HFD-paired). FA composition in subcutaneous adipose tissue triacylglycerols (SAT-TG), liver (phospholipids and triacylglycerols) and plasma (phospholipids and cholesterol esters) was assessed. Delta-5 desaturase (D5D), delta-6 desaturase (D6D) and stearoyl-CoA-desaturase 1 (SCD-16) indices were calculated from product-to-precursor FA ratios and proportions of long-chain FAs were measured.

    Results: Positive correlations were found for the desaturase indices between the five lipid fractions, especially for SCD-16 and almost exclusively between liver and plasma fractions. Only SCD-16 in SAT-TG of the AL-HFD group correlated with gain in body weight. Independent of weight gain, the HFD decreased all SCD-16 indices and most FA proportions, but D5D and D6D indices were fraction- and tissue-dependently increased.

    Conclusion: Desaturase indices are especially correlated for SCD-16 and between lipid and plasma lipid fractions, suggesting that SAT-TG desaturation is differentially regulated compared with the other studied lipid fractions. The correlations are however influenced by diet and weight gain, further suggesting such factors should be taken into account when using desaturase indices.

  • 208.
    Cedernaes, Jonathan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Alsiö, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Västermark, Åke
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Risérus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Schiöth, Helgi B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Adipose tissue stearoyl-CoA desaturase 1 index is increased and linoleic acid is decreased in obesity-prone rats fed a high-fat diet2013In: Lipids in Health and Disease, ISSN 1476-511X, E-ISSN 1476-511X, Vol. 12, no 2Article in journal (Refereed)
    Abstract [en]

    BACKGROUND

    Fatty acid (FA) composition and desaturase indices are associated with obesity and related metabolic conditions. However, it is unclear to what extent desaturase activity in different lipid fractions contribute to obesity susceptibility. Our aim was to test whether desaturase activity and FA composition are linked to an obese phenotype in rats that are either obesity prone (OP) or resistant (OR) on a high-fat diet (HFD).

    METHODS

    Two groups of Sprague-Dawley rats were given ad libitum (AL-HFD) or calorically restricted (HFD-paired; pair fed to calories consumed by chow-fed rats) access to a HFD. The AL-HFD group was categorized into OP and OR sub-groups based on weight gain over 5 weeks. Five different lipid fractions were examined in OP and OR rats with regard to proportions of essential and very long-chain polyunsaturated FAs: linoleic acid (LA), alpha-linolenic acid, eicosapentaenoic acid, docosahexaenoic acid and the stearoyl-CoA desaturase 1 (SCD-1) product 16:1n-7. FA ratios were used to estimate activities of the delta-5-desaturase (20:4n-6/20:3n-6), delta-6-desaturase (18:3n-6/18:2n-6), stearoyl-CoA desaturase 1 (SCD-1; 16:1n-7/16:0, SCD-16 and 18:1n-9/18:0, SCD-18), de novo lipogenesis (16:0/18:2n-6) and FA elongation (18:0/16:0). Fasting insulin, glucose, adiponectin and leptin concentrations were measured in plasma.

    RESULTS

    After AL-HFD access, OP rats had a significantly higher SCD-16 index and 16:1n-7 proportion, but a significantly lower LA proportion, in subcutaneous adipose tissue (SAT) triacylglycerols, as well as significantly higher insulin and leptin concentrations, compared with OR rats. No differences were found between the two phenotypes in liver (phospholipids; triacylglycerols) or plasma (cholesterol esters; phospholipids) lipid fractions or for plasma glucose or adiponectin concentrations. For the desaturase indices of the HFD-paired rats, the only significant differences compared with the OP or OR rats were higher SCD-16 and SCD-18 indices in SAT triacylglycerols in OP compared with HFD-paired rats.

    CONCLUSION

    The higher SCD-16 may reflect higher SCD-1 activity in SAT, which in combination with lower LA proportions may reflect higher insulin resistance and changes in SAT independent of other lipid fractions. Whether a lower SCD-16 index protects against diet-induced obesity is an interesting possibility that warrants further investigation.

  • 209.
    Cedernaes, Jonathan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Benedict, Christian
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Sleep duration and energy intake: timing matters2014In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 100, no 5, p. 1402-1403Article in journal (Other academic)
  • 210.
    Cedernaes, Jonathan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Brandell, Jon
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Ros, Olof
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Broman, Jan-Erik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Hogenkamp, Pleunie S.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Schiöth, Helgi B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Benedict, Christian
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Increased Impulsivity in Response to Food Cues after Sleep Loss in Healthy Young Men2014In: Obesity, ISSN 1930-7381, E-ISSN 1930-739X, Vol. 22, no 8, p. 1786-1791Article in journal (Refereed)
    Abstract [en]

    ObjectiveTo investigate whether acute total sleep deprivation (TSD) leads to decreased cognitive control when food cues are presented during a task requiring active attention, by assessing the ability to cognitively inhibit prepotent responses. MethodsFourteen males participated in the study on two separate occasions in a randomized, crossover within-subject design: one night of TSD versus normal sleep (8.5 hours). Following each nighttime intervention, hunger ratings and morning fasting plasma glucose concentrations were assessed before performing a go/no-go task. ResultsFollowing TSD, participants made significantly more commission errors when they were presented no-go food words in the go/no-go task, as compared with their performance following sleep (+56%; P<0.05). In contrast, response time and omission errors to go non-food words did not differ between the conditions. Self-reported hunger after TSD was increased without changes in fasting plasma glucose. The increase in hunger did not correlate with the TSD-induced commission errors. ConclusionsOur results suggest that TSD impairs cognitive control also in response to food stimuli in healthy young men. Whether such loss of inhibition or impulsiveness is food cue-specific as seen in obesitythus providing a mechanism through which sleep disturbances may promote obesity developmentwarrants further investigation.

  • 211. Chajes, V.
    et al.
    Assi, N.
    Biessy, C.
    Ferrari, P.
    Rinaldi, S.
    Slimani, N.
    Lenoir, G. M.
    Baglietto, L.
    His, M.
    Boutron-Ruault, M. C.
    Trichopoulou, A.
    Lagiou, P.
    Katsoulis, M.
    Kaaks, R.
    Kuehn, T.
    Panico, S.
    Pala, V.
    Masala, G.
    Bueno-de-Mesquita, H. B.
    Peeters, P. H.
    van Gils, C.
    Hjartaker, A.
    Olsen, K. Standahl
    Barnung, R. Borgund
    Barricarte, A.
    Redondo-Sanchez, D.
    Menendez, V.
    Amiano, P.
    Wennberg, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Key, T.
    Khaw, K. T.
    Merritt, M. A.
    Riboli, E.
    Gunter, M. J.
    Romieu, I.
    A prospective evaluation of plasma phospholipid fatty acids and breast cancer risk in the EPIC study2017In: Annals of Oncology, ISSN 0923-7534, E-ISSN 1569-8041, Vol. 28, no 11, p. 2836-2842Article in journal (Refereed)
    Abstract [en]

    Background: Intakes of specific fatty acids have been postulated to impact breast cancer risk but epidemiological data based on dietary questionnaires remain conflicting.

    Materials and methods: We assessed the association between plasma phospholipid fatty acids and breast cancer risk in a case–control study nested within the European Prospective Investigation into Cancer and Nutrition study. Sixty fatty acids were measured by gas chromatography in pre-diagnostic plasma phospholipids from 2982 incident breast cancer cases matched to 2982 controls. Conditional logistic regression models were used to estimate relative risk of breast cancer by fatty acid level. The false discovery rate (q values) was computed to control for multiple comparisons. Subgroup analyses were carried out by estrogen receptor (ER) and progesterone receptor expression in the tumours.

    Results: A high level of palmitoleic acid [odds ratio (OR) for the highest quartile compared with the lowest OR (Q4–Q1) 1.37; 95% confidence interval (CI), 1.14–1.64; P for trend = 0.0001, q value = 0.004] as well as a high desaturation index (DI16) (16:1n–7/16:0) [OR (Q4–Q1), 1.28; 95% C, 1.07–1.54; P for trend = 0.002, q value = 0.037], as biomarkers of de novo lipogenesis, were significantly associated with increased risk of breast cancer. Levels of industrial trans-fatty acids were positively associated with ER-negative tumours [OR for the highest tertile compared with the lowest (T3–T1)=2.01; 95% CI, 1.03–3.90; P for trend = 0.047], whereas no association was found for ER-positive tumours (P-heterogeneity =0.01). No significant association was found between n-3 polyunsaturated fatty acids and breast cancer risk, overall or by hormonal receptor.

    Conclusion: These findings suggest that increased de novo lipogenesis, acting through increased synthesis of palmitoleic acid, could be a relevant metabolic pathway for breast tumourigenesis. Dietary trans-fatty acids derived from industrial processes may specifically increase ER-negative breast cancer risk.

  • 212. Chajes, Veronique
    et al.
    Biessy, Carine
    Ferrari, Pietro
    Romieu, Isabelle
    Freisling, Heinz
    Huybrechts, Inge
    Scalbert, Augustin
    de Mesquita, Bas Bueno
    Romaguera, Dora
    Gunter, Marc J.
    Vineis, Paolo
    Hansen, Camilla Plambeck
    Jakobsen, Marianne Uhre
    Clavel-Chapelon, Francoise
    Fagherazzi, Guy
    Boutron-Ruault, Marie-Christine
    Katzke, Verana
    Neamat-Allah, Jasmine
    Boeing, Heiner
    Bachlechner, Ursula
    Trichopoulou, Antonia
    Naska, Androniki
    Orfanos, Philippos
    Pala, Valeria
    Masala, Giovanna
    Mattiello, Amalia
    Skeie, Guri
    Weiderpass, Elisabete
    Agudo, Antonio
    Maria Huerta, Jose
    Ardanaz, Eva
    Jose Sanchez, Maria
    Dorronsoro, Miren
    Ramon Quiros, Jose
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Winkvist, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Sonested, Emily
    Key, Tim
    Khaw, Kay-Tee
    Wareham, Nicolas J.
    Peeters, Petra H. M.
    Slimani, Nadia
    Plasma Elaidic Acid Level as Biomarker of Industrial Trans Fatty Acids and Risk of Weight Change: Report from the EPIC Study2015In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 2, article id e0118206Article in journal (Refereed)
    Abstract [en]

    Background Few epidemiological studies have examined the association between dietary trans fatty acids and weight gain, and the evidence remains inconsistent. The main objective of the study was to investigate the prospective association between biomarker of industrial trans fatty acids and change in weight within the large study European Prospective Investigation into Cancer and Nutrition ( EPIC) cohort. Methods Baseline plasma fatty acid concentrations were determined in a representative EPIC sample from the 23 participating EPIC centers. A total of 1,945 individuals were followed for a median of 4.9 years to monitor weight change. The association between elaidic acid level and percent change of weight was investigated using a multinomial logistic regression model, adjusted by length of follow- up, age, energy, alcohol, smoking status, physical activity, and region. Results In women, doubling elaidic acid was associated with a decreased risk of weight loss ( odds ratio ( OR) = 0.69, 95% confidence interval ( CI) = 0.55- 0.88, p = 0.002) and a trend was observed with an increased risk of weight gain during the 5- year follow- up ( OR = 1.23, 95% CI = 0.97- 1.56, p = 0.082) ( p- trend<. 0001). In men, a trend was observed for doubling elaidic acid level and risk of weight loss ( OR = 0.82, 95% CI = 0.66- 1.01, p = 0.062) while no significant association was found with risk of weight gain during the 5- year follow- up ( OR = 1.08, 95% CI = 0.88- 1.33, p = 0.454). No association was found for saturated and cismonounsaturated fatty acids. Conclusions These data suggest that a high intake of industrial trans fatty acids may decrease the risk of weight loss, particularly in women. Prevention of obesity should consider limiting the consumption of highly processed foods, the main source of industrially- produced trans fatty acids.

  • 213. Chan, SSM
    et al.
    Luben, R
    Olsen, A
    Tjonneland, A
    Kaaks, R
    Lindgren, S
    Grip, O
    Bergmann, MM
    Boeing, H
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Faculty of Medicine, Department of Biobank Research.
    Karling, Pontus
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Overvad, K
    Veno, SK
    van Schaik, F
    Bueno-de-Mesquita, B
    Oldenburg, B
    Khaw, K-T
    Riboli, E
    Hart, AR
    Association between high dietary intake of the n-3 polyunsaturated fatty acid docosahexaenoic acid and reduced risk of Crohn's disease2014In: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 39, no 8, p. 834-842Article in journal (Refereed)
    Abstract [en]

    Background There are plausible mechanisms for how dietary docosahexaenoic acid (DHA), an n-3 polyunsaturated fatty acid, could prevent Crohn's disease (CD).

    Aim To conduct a prospective study to investigate the association between increased intake of DHA and risk of CD.

    Methods Overall, 229702 participants were recruited from nine European centres between 1991 and 1998. At recruitment, dietary intakes of DHA and fatty acids were measured using validated food frequency questionnaires. The cohort was monitored through to June 2004 to identify participants who developed incident CD. In a nested case-control analysis, each case was matched with four controls; odds ratios (ORs) were calculated for quintiles of DHA intake, adjusted for total energy intake, smoking, other dietary fatty acids, dietary vitamin D and body mass index.

    Results Seventy-three participants developed incident CD. All higher quintiles of DHA intake were inversely associated with development of CD; the highest quintile had the greatest effect size (OR=0.07; 95% CI=0.02-0.81). The OR trend across quintiles of DHA was 0.54 (95% CI=0.30-0.99, P-trend=0.04). Including BMI in the multivariate analysis, due to its correlation with dietary fat showed similar associations. There were no associations with the other dietary fatty acids studied.

    Conclusion There were inverse associations, with a biological gradient between increasing dietary docosahexaenoic acid intakes and incident Crohn's disease. Further studies in other populations should measure docosahexaenoic acid to determine if the association is consistent and the hypothesis tested in randomised controlled trials of purely docosahexaenoic acid supplementation.

  • 214. Chandyo, Ram K.
    et al.
    Ulak, Manjeswori
    Sommerfelt, Halvor
    Schneede, Jørn
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Ueland, Per M.
    Strand, Tor A.
    Nutritional Intake and Status of Cobalamin and Folate among Non-Pregnant Women of Reproductive Age in Bhaktapur, Nepal2016In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 8, no 6, article id 375Article in journal (Refereed)
    Abstract [en]

    Cobalamin and folate are especially important for women of childbearing age due to their ubiquitous role in fetal growth and development. Population-based data on cobalamin and folate status are lacking from Nepal, where diets are mostly vegetarian. The objectives of the study were to investigate cobalamin and folate intake and status, and to explore associations with socio-demographics, anthropometrics, anemia, and dietary habits. Following a random selection of geographical clusters, we collected blood samples from 500 non-pregnant women and 24-h dietary recalls and food frequency questionnaires from a subsample of 379 women. Twenty percent of the women did not consume any food containing cobalamin during the days recalled, and in 72% nutritional cobalamin intake was <1 mu g/day. Eighty-four percent of the women had cobalamin intake lower than the estimated average requirement (EAR) (< 2 mu g/day). In contrast, only 12% of the women had a folate intake less than 100 mu g per day, whereas 62% had intake between 100 and 320 mu g. Low plasma cobalamin (< 150 pmol/L) was found in 42% of the women, most of whom (88%) also had elevated levels of methylmalonic acid. Our results indicated a high prevalence of nutritional cobalamin deficiency, while folate deficiency was uncommon.

  • 215. Cheung, L.
    et al.
    Gertow, J.
    Werngren, O.
    Folkersen, L.
    Petrovic, Natasa
    Stockholm University, Faculty of Science, Department of Molecular Biosciences, The Wenner-Gren Institute.
    Nedergaard, Jan
    Stockholm University, Faculty of Science, Department of Molecular Biosciences, The Wenner-Gren Institute.
    Franco-Cereceda, A.
    Eriksson, P.
    Fisher, R. M.
    Human mediastinal adipose tissue displays certain characteristics of brown fat2013In: Nutrition & Diabetes, ISSN 2044-4052, E-ISSN 2044-4052, Vol. 3, no UNSP e66Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The amount of intra-thoracic fat, of which mediastinal adipose tissue comprises the major depot, is related to various cardiometabolic risk factors. Autopsy and imaging studies indicate that the mediastinal depot in adult humans could contain brown adipose tissue (BAT). To gain a better understanding of this intra-thoracic fat depot, we examined possible BAT characteristics of human mediastinal in comparison with subcutaneous adipose tissue. MATERIALS AND METHODS: Adipose tissue biopsies from thoracic subcutaneous and mediastinal depots were obtained during open-heart surgery from 33 subjects (26 male, 63.7 +/- 13.8 years, body mass index 29.3 +/- 5.1 kg m(-2)). Microarray analysis was performed on 10 patients and genes of interest confirmed by quantitative PCR (qPCR) in samples from another group of 23 patients. Adipocyte size was determined and uncoupling protein 1 (UCP1) protein expression investigated with immunohistochemistry. RESULTS: The microarray data showed that a number of BAT-specific genes had significantly higher expression in the mediastinal depot than in the subcutaneous depot. Higher expression of UCP1 (24-fold, P < 0.001) and PPARGC1A (1.7-fold, P = 0.0047), and lower expression of SHOX2 (0.12-fold, P < 0.001) and HOXC8 (0.14-fold, P < 0.001) in the mediastinal depot was confirmed by qPCR. Gene set enrichment analysis identified two gene sets related to mitochondria, which were significantly more highly expressed in the mediastinal than in the subcutaneous depot (P < 0.01). No significant changes in UCP1 gene expression were observed in the subcutaneous or mediastinal depots following lowering of body temperature during surgery. UCP1 messenger RNA levels in the mediastinal depot were lower than those in murine BAT and white adipose tissue. In some mediastinal adipose tissue biopsies, a small number of multilocular adipocytes that stained positively for UCP1 were observed. Adipocytes were significantly smaller in the mediastinal than the subcutaneous depot (cross-sectional area 2400 +/- 810 versus 3260 +/- 980 mu m(2), P < 0.001). CONCLUSIONS: Human mediastinal adipose tissue displays some characteristics of BAT when compared with the subcutaneous depot at microscopic and molecular levels.

  • 216. Cho, Karl
    et al.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Lökk, Johan
    Calcium intake in elderly patients with hip fractures2008In: Food & nutrition research, ISSN 1654-6628, Vol. 52, p. 1654-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Dietary calcium intake is assumed important in the prevention and treatment of osteoporosis. However, people in countries with a high calcium intake from commodities such as milk and milk products have a high incidence of hip fracture. The effect and influence of calcium intake in the prevention of osteoporotic fracture vary from different studies. OBJECTIVE: To investigate premorbid daily calcium intake in patients with low energy hip fractures during four consecutive years. DESIGN: In total 120 patients (mean age 78+/-8.5 (SD) years) were included between 2002 and 2005. The patients answered a structured food frequency questionnaire (FFQ) and interviews on patients' daily calcium intake from food and supplements took place during a 6-month period before the fracture. Dual energy X-ray absorptiometry (DEXA) was performed in a subgroup of 15 patients. RESULTS: The mean daily calcium intake from food and supplementation was 970+/-500 mg. However, 38% of patients had an intake below the recommended 800 mg/day. There was no significant relationship between calcium intake and age, gender, bone mineral density, serum calcium or albumin, type of fracture or body mass index. The mean free plasma calcium concentration was 2.3+/-0.1, i.e. within the reference limit. In 2005, 80% of the patients who underwent DEXA had manifest osteoporosis. There was a trend towards decreased calcium intake over the observation period, with a mean calcium intake below 800 mg/day in 2005. CONCLUSIONS: Hip fracture patients had a mean calcium intake above the recommended daily intake, as assessed by a FFQ. However, more than one-third of patients had an intake below the recommended 800 mg/day. The intake appeared to decrease over the investigated years. The relationship between calcium intake and fracture susceptibility is complex.

  • 217.
    Cho, Sunghee
    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).
    Sugar sweetened beverages – psychosocial, behavioral, and dietary determinants, and association to obesity: A cross-sectional study among university students in San Luis Potosí and Yucatán, Mexico2015Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Background: Obesity is a rapidly growing public health problem with negative health consequences in Mexico, resulted from the nutrition transition. In Mexico calories from sugar sweetened beverages (SSB) accounts for 19% of total energy intake. Although young adults are major SSB consumers, is an understudied population.

    Aims: To investigate the association between SSB and obesity as well as associations between various factors and overconsumption of widely consumed SSB in Mexican university students.

    Methods: This cross-sectional study includes 442 nursing and nutrition students from two universities in Mexico. Demographic, psychological, behavioral, dietary, and SSB intake (soft drinks, agua frescas, juice drinks) data were collected through a self-administrative questionnaire and 24-hour dietary recall. Anthropometric data were measured. Independent t-test and binary logistic regression were used to investigate the associations.

    Results: Overweight and obese students consumed more soft drinks than normal weight students. Studying nutrition were associated with lower odds of all SSB overconsumption while consuming higher calories were associated with higher odds of all SSB overconsumption. Unhealthy diet patterns were associated with soft drinks overconsumption, but were opposite for agua frescas. Moderate-intensity exercise was associated to decreased soft drinks overconsumption but vigorous-intensity exercise was more likely to increase soft drinks and agua frescas overconsumption

    Conclusion: Agua frescas were related to better dietary patterns and considered as healthier than other SSB. Future studies need to use better assessment methods for dietary and anthropometric data and distinguish sports beverage from soft drinks for better understanding of association between physical activity and SSB intake.

  • 218.
    Chung, Rosanna
    et al.
    Heart Research Institute, Australia.
    Wang, Zeneng
    Cleveland Clin, OH 44106 USA.
    Bursill, Christina A.
    South Australian Health and Medical Research Institute, Australia.
    Wu, Ben J.
    University of New South Wales, Australia.
    Bailee, Philip J.
    University of New South Wales, Australia.
    Rye, Kerry-Anne
    University of New South Wales, Australia.
    Effect of long-term dietary sphingomyelin supplementation on atherosclerosis in mice2017In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 12, article id e0189523Article in journal (Refereed)
    Abstract [en]

    Sphingomyelin (SM) levels in the circulation correlate positively with atherosclerosis burden. SM is a ubiquitous component of human diets, but it is unclear if dietary SM increases circulating SM levels. Dietary choline increases atherosclerosis by raising circulating trimethylamine N-oxide (TMAO) levels in mice and humans. As SM has a choline head group, we ask in this study if dietary SM accelerates atherosclerotic lesion development by increasing circulating SM and TMAO levels. Three studies were performed: (Study 1) C57BL/6 mice were maintained on a high fat diet with or without SM supplementation for 4 weeks prior to quantification of serum TMAO and SM levels; (Study 2) atherosclerosis was studied in apoE(-/-) mice after 16 weeks of a high fat diet without or with SM supplementation and (Study 3) apoE(-/-) mice were maintained on a chow diet for 19 weeks without or with SM supplementation and antibiotic treatment prior to quantification of atherosclerotic lesions and serum TMAO and SM levels. SM consumption did not increase circulating SM levels or atherosclerosis in high fat-fed apoE(-/-) mice. Serum TMAO levels in C57BL/6 mice were low and had no effect atherosclerosis lesion development. Dietary SM supplementation significantly reduced atherosclerotic lesion area in the aortic arch of chow-fed apoE(-/-) mice. This study establishes that dietary SM does not affect circulating SM levels or increase atherosclerosis in high fat-fed apoE(-/-) mice, but it is anti-atherogenic in chow-fed apoE(-/-) mice.

  • 219.
    Cook, C
    et al.
    United Kingdom Sports Council, London, England .
    Beaven, C. Martyn
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Kilduff, L P
    Swansea Univ, Coll Engn, Swansea, W Glam, Wales.
    Drawer, S
    United Kingdom Sports Council, London, England .
    Acute caffeine ingestion increases voluntarily chosen resistance training load following limited sleep2012In: International Journal of Sport Nutrition & Exercise Metabolism, ISSN 1526-484X, E-ISSN 1543-2742, Vol. 22, no 3, p. 157-164Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION:This study aimed to determine whether caffeine ingestion would increase the workload voluntarily chosen by athletes in a limited sleep state.

    METHODS:In a double-blind, crossover study, sixteen professional rugby players ingested either a placebo or 4 mg·kg-1 caffeine 1 h before exercise. Athletes classified themselves into non-deprived (8 h+) or sleep-deprived states (6 h or less). Exercise comprised four sets of bench press, squats, and bent rows at 85% 1-RM. Athletes were asked to perform as many repetitions on each set as possible without failure. Saliva was collected prior to administration of placebo or caffeine, and again prior to and immediately after exercise and assayed for testosterone and cortisol.

    RESULTS:Sleep deprivation produced a very large decrease in total load (p = 1.98 x 10-7).Caffeine ingestion in the non-deprived state resulted in a moderate increase in total load with a larger effect in the sleep deprived state resulting in total load similar to those observed in the non-deprived placebo condition.Eight of the sixteen athletes were identified as caffeine responders.Baseline testosterone was higher (p < 0.05) and cortisol trended lower in non-sleep deprived states.Changes in hormones from pre-dose to pre-exercise correlated to individual workload responses to caffeine.Testosterone response to exercise increased with caffeine compared to placebo, as did cortisol response.

    CONCLUSIONS:Caffeine increased voluntary workload in professional athletes, emphasised further under conditions of self-reported limited sleep. Caffeine may prove worthwhile when athletes are perceived as tired, especially in individuals identified as responders.

  • 220. Cooper, A. J.
    et al.
    Forouhi, N. G.
    Ye, Z.
    Buijsse, B.
    Arriola, L.
    Balkau, B.
    Barricarte, A.
    Beulens, J. W. J.
    Boeing, H.
    Buchner, F. L.
    Dahm, C. C.
    de Lauzon-Guillain, B.
    Fagherazzi, G.
    Franks, Paul W.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Gonzalez, C.
    Grioni, S.
    Kaaks, R.
    Key, T. J.
    Masala, G.
    Navarro, C.
    Nilsson, P.
    Overvad, K.
    Panico, S.
    Ramon Quiros, J.
    Rolandsson, Olov
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Roswall, N.
    Sacerdote, C.
    Sanchez, M-J
    Slimani, N.
    Sluijs, I.
    Spijkerman, A. M. W.
    Teucher, B.
    Tjonneland, A.
    Tumino, R.
    Sharp, S. J.
    Langenberg, C.
    Feskens, E. J. M.
    Riboli, E.
    Wareham, N. J.
    Fruit and vegetable intake and type 2 diabetes: EPIC-InterAct prospective study and meta-analysis2012In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 66, no 10, p. 1082-1092Article, review/survey (Refereed)
    Abstract [en]

    Fruit and vegetable intake (FVI) may reduce the risk of type 2 diabetes (T2D), but the epidemiological evidence is inconclusive. The aim of this study is to examine the prospective association of FVI with T2D and conduct an updated meta-analysis. In the European Prospective Investigation into Cancer-InterAct (EPIC-InterAct) prospective case-cohort study nested within eight European countries, a representative sample of 16 154 participants and 12 403 incident cases of T2D were identified from 340 234 individuals with 3.99 million person-years of follow-up. For the meta-analysis we identified prospective studies on FVI and T2D risk by systematic searches of MEDLINE and EMBASE until April 2011. In EPIC-InterAct, estimated FVI by dietary questionnaires varied more than twofold between countries. In adjusted analyses the hazard ratio (95% confidence interval) comparing the highest with lowest quartile of reported intake was 0.90 (0.80-1.01) for FVI; 0.89 (0.76-1.04) for fruit and 0.94 (0.84-1.05) for vegetables. Among FV subtypes, only root vegetables were inversely associated with diabetes 0.87 (0.77-0.99). In meta-analysis using pooled data from five studies including EPIC-InterAct, comparing the highest with lowest category for FVI was associated with a lower relative risk of diabetes (0.93 (0.87-1.00)). Fruit or vegetables separately were not associated with diabetes. Among FV subtypes, only green leafy vegetable (GLV) intake (relative risk: 0.84 (0.74-0.94)) was inversely associated with diabetes. Subtypes of vegetables, such as root vegetables or GLVs may be beneficial for the prevention of diabetes, while total FVI may exert a weaker overall effect.

  • 221. Copland, Lotta
    et al.
    Liedman, Bengt
    Rothenberg, Elisabet
    Sahlgrenska University Hospital, Gothenburg.
    Bosaeus, Ingvar
    Effects of nutritional support long time after total gastrectomy2007In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 26, no 5, p. 605-613Article in journal (Refereed)
    Abstract [en]

    Background & aims

    Long-term effects of total gastrectomy on nutritional status are not well known, neither is the role of nutritional support. Dietary counselling is usually individualized, but generally not well defined. We aimed to evaluate effects of individualized oral nutritional support long time after total gastrectomy.

    Methods

    Dietary advice was given, aiming for an energy and protein rich diet, using ordinary food and liquid supplements tailored to individual needs and preferences. Counselling was repeated monthly. Body weight and a 4-day food record were obtained at baseline, and thereafter—at month 1, 3, 6 and 12. Body composition, resting and total energy expenditure were measured at baseline and at 12 months.

    Results

    Thirteen of 15 included patients completed the study. Though a trend of weight gain was seen after 1 month, there was no significant weight change at 12 months as weight development was quite heterogeneous. Six patients who remained healthy during the study (all with BMI<25) gained weight (p<0.05), while five patients with intercurrent co-morbidity and two with initial BMI>25 lost weight or remained stable.

    Conclusions

    Nutritional intervention long time after total gastrectomy did not change body weight, body composition or energy metabolism. Intercurrent co-morbidity appeared to have a major impact on outcome, as the nutritional support was more effective in patients who remained healthy and had a BMI<25.

  • 222. Copland, Lotta
    et al.
    Liedman, Bengt
    Rothenberg, Elisabet
    Sahlgrenska University Hospital, Gothenburg.
    Ellegård, Lars
    Hustvedt, Bo-Egil
    Bosaeus, Ingvar
    Validity of the ActiReg system and a physical activity interview in assessing total energy expenditure in long-term survivors after total gastrectomy2008In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 27, no 6, p. 842-848Article in journal (Refereed)
    Abstract [en]

    BACKGROUND & AIMS: Malnutrition is common after total gastrectomy. There is a need for clinically useful methods to assess energy requirements. We aimed to validate measurements of energy expenditure by an activity monitor (ActiReg) and a physical activity interview (HPAQ(modified)), in long-term survivors after gastrectomy for gastric carcinoma, using doubly labelled water as reference method.

    METHODS: Total energy expenditure (TEE) was estimated by DLW (14 days), ActiReg (3 days) and HPAQ(modified) (7 days) in 15 patients. Measurements were repeated after 12 months. Basal metabolic rate was measured with indirect calorimetry.

    RESULTS: ActiReg and HPAQ(modified) both underestimated TEE by 180 (+/-254 SD) and 130 (+/-326 SD)kcalday(-1), i.e. 14% vs. 12%, respectively. However, this was evident only at higher levels of physical activity (PAL(DLW)> or =1.65), whereas at lower levels (PAL<1.65) no difference was found. There were no changes in TEE over time independent of the method used. DLW and ActiReg had approximately the same width of the 95% confidence interval of this estimate, while it was 2.4 times larger by HPAQ(modified).

    CONCLUSION: Both simple methods underestimated total energy expenditure at higher, but not at lower physical activity levels. The ActiReg method appears useful to estimate changes in TEE over time.

  • 223.
    Copland, Lotta
    et al.
    Sahlgrenska University Hospital, Gothenburg.
    Rothenberg, Elisabet
    Sahlgrenska University Hospital, Gothenburg.
    Ellegård, Lars
    Sahlgrenska University Hospital, Gothenburg.
    Hyltander, Anders
    Sahlgrenska University Hospital, Gothenburg.
    Bosaeus, Ingvar
    Sahlgrenska University Hospital, Gothenburg.
    Muscle mass and exercise capacity in cancer patients after major upper gastrointestinal surgery2010In: e - SPEN: the European e-journal of clinical nutrition and metabolism, ISSN 1751-4991, Vol. 5, no 6, p. e265-e271Article in journal (Refereed)
    Abstract [en]

    Background & aims

    Nutritional therapy has traditionally been evaluated by changes in weight and in food intake, while body composition and function may be of greater clinical significance. We investigated relationships between total body skeletal muscle mass (TBSMM), energy balance and exercise capacity in 41 patients before, 6 and 12 months after curatively intended major upper gastrointestinal surgery.

    Methods

    TBSMM and body energy content were assessed by DXA. Exercise capacity was measured on a treadmill. Energy balance was defined as the difference in body energy content at two points in time.

    Results

    During the first postoperative year average weight loss was 7% although 1 our of 3 patients remained weight stable (WS). Average TBSMM decreased significantly at 6 months (0.9 kg, p < 0.01), but was regained at 12 months, as was exercise capacity. 72% of weight losing patients (WL) lost TBSMM compared to 17% of WS patients, p < 0.01. Both TBSMM and changes in TBSMM, but not changes in energy content, were correlated to exercise capacity, r2 = 0.49, p < 0.001 and r2 = 0.15, p < 0.05 respectively.

    Conclusions

    TBSMM and exercise capacity were clearly related in cancer patients after major upper gastrointestinal surgery, as were changes in TBSMM and exercise capacity. Energy balance was not directly correlated to exercise capacity, but more WS than WL patients increased their TBSMM indicating a possible influence by energy balance.

  • 224. Crowe, F. L.
    et al.
    Key, T. J.
    Appleby, P. N.
    Overvad, K.
    Schmidt, E. B.
    Egeberg, R.
    Tjonneland, A.
    Kaaks, R.
    Teucher, B.
    Boeing, H.
    Weikert, C.
    Trichopoulou, A.
    Ouranos, V.
    Valanou, E.
    Masala, G.
    Sieri, S.
    Panico, S.
    Tumino, R.
    Matullo, G.
    Bueno-de-Mesquita, H. B.
    Boer, J. M. A.
    Beulens, J. W. J.
    van der Schouw, Y. T.
    Quiros, J. R.
    Buckland, G.
    Sanchez, M-J
    Dorronsoro, M.
    Huerta, J. M.
    Moreno-Iribas, C.
    Hedblad, B.
    Jansson, J. H.
    Wennberg, Patrik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Khaw, K-T
    Wareham, N.
    Ferrari, P.
    Illner, A-K
    Chuang, S-C
    Norat, T.
    Danesh, J.
    Riboli, E.
    Dietary fibre intake and ischaemic heart disease mortality: the European Prospective Investigation into Cancer and Nutrition-Heart study2012In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 66, no 8, p. 950-956Article in journal (Refereed)
    Abstract [en]

    BACKGROUND/OBJECTIVES: Evidence from prospective studies is consistent in showing an inverse association between dietary fibre intake and risk of ischaemic heart disease (IHD), but whether dietary fibre from various food sources differ in their effect on IHD risk is less clear. The objective of this study was to assess the associations of total and food sources of dietary fibre with IHD mortality in the European Prospective Investigation into Cancer and Nutrition-Heart study. SUBJECTS/METHODS: Participants were 306 331 men and women from eight European countries. Dietary fibre intake was assessed using centre or country-specific diet questionnaires and calibrated using a 24-h diet recall. RESULTS: After an average follow-up of 11.5 years, there were 2381 IHD deaths among participants without cardiovascular disease at baseline. The calibrated intake of dietary fibre was inversely related with IHD mortality; each 10 g/day was associated with a 15% lower risk (relative risk (RR) 0.85; 95% confidence interval (CI): 0.73-0.99, P = 0.031). There was no difference in the associations of the individual food sources of dietary fibre with the risk of IHD mortality; RR for each 5 g/day higher cereal fibre intake was 0.91 (CI: 0.82-1.01), RR for each 2.5 g/day fruit fibre intake was 0.94 (CI: 0.88-1.01) and RR for each 2.5 g/day vegetable fibre intake was 0.90 (95% CI: 0.76-1.07). CONCLUSION: A higher consumption of dietary fibre is associated with a lower risk of fatal IHD with no clear difference in the association with IHD for fibre from cereals, fruits or vegetables.

  • 225. Dahl, A. K.
    et al.
    Reynolds, C. A.
    Fall, Tove
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology.
    Magnusson, P. K. E.
    Pedersen, N. L.
    Multifactorial analysis of changes in body mass index across the adult life course: a study with 65 years of follow-up2014In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 38, no 8, p. 1133-1141Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Although the negative consequences on health of being obese are well known, most adults gain weight across the lifespan. The general increase in body mass index (BMI) is mainly considered to originate from behavioral and environmental changes; however, few studies have evaluated the influence of these factors on change in BMI in the presence of genetic risk. We aimed to study the influence of multifactorial causes of change in BMI, over 65 years. METHODS AND FINDINGS: Totally, 6130 participants from TwinGene, who had up to five assessments, and 536 from the Swedish Adoption/Twin Study of Aging, who had up to 12 assessments, ranging over 65 years were included. The influence of lifestyle factors, birth cohort, cardiometabolic diseases and an individual obesity genetic risk score (OGRS) based on 32 single nucleotide polymorphisms on change in BMI was evaluated with a growth model. For both sexes, BMI increased from early adulthood to age of 65 years, after which the increase leveled off; BMI declined after age of 80 years. A higher OGRS, birth after 1925 and cardiometabolic diseases were associated with higher average BMI and a steeper increase in BMI prior to 65 years of age. Among men, few factors were identified that influence BMI trajectories in late life, whereas for women type 2 diabetes mellitus and dementia were associated with a steeper decrease in BMI after the age of 65 years. CONCLUSIONS: There are two turning points in BMI in late adulthood, one at the age of 65 years and one at the age 80 years. Factors associated with an increase in BMI in midlife were not associated with an increase in BMI after the age of 65 years. These findings indicate that the causes and consequences of change in BMI differ across the lifespan. Current health recommendations need to be adjusted accordingly.

  • 226.
    Dahl Lassen, Anne
    et al.
    Danmark.
    Thorsen, Anne Vibeke
    Danmark.
    Haapala, Irja
    Finland.
    Lennernäs Wiklund, Maria
    University of Gävle.
    Nyberg, Maria
    Kristianstad University, School of Education and Environment, Avdelningen för Mat- och måltidsvetenskap. Kristianstad University, Research Environment Food and Meals in Everyday Life (MEAL).
    Beck, Anne Marie
    Danmark.
    Fagt, Sisse
    Danmark.
    Food at Work around the Clock – The Nordic Model: report from a Nordic Workshop, November 4, 2016, Copenhagen, Denmark2017Report (Other academic)
    Abstract [en]

    This report brings together 12 invited presentations and outcomes of a workshop on food and meals for employees working irregular hours “around the clock”. The workshop, “Food at work around the clock – The Nordic Model”, was hosted by the National Food Institute at the Technical University of Denmark on November 4, 2016, in Lyngby, near Copenhagen, Denmark. This was a culmination of the collaboration started in 2015 between researchers from the hosts institute, Gävle University and Kristianstad University in Sweden, and the School of Applied Educational Sciences and Teacher Education in Finland. The workshop was funded by the Nordic Council of Ministers.

  • 227.
    Dahl Lassen, Anne
    et al.
    National Food Institute, Danish Technical University, Denmark.
    Thorsen, Anne Vibeke
    National Food Institute, Danish Technical University, Denmark.
    Haapala, Irja
    School of Applied Educational Sciences and Teacher Education, Savonlinna, Finland; School of Social and Political Sciences, the University of Melbourne, Victoria, Australia.
    Lennernäs Wiklund, Maria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science.
    Nyberg, Maria
    Department of Food and Meal Science, Kristianstad University, Sweden.
    Beck, Anne Marie
    Institute of Nutrition and Midwifery, Metropolitan University College, Denmark.
    Fagt, Sisse
    National Food Institute, Danish Technical University, Denmark.
    Food at Work around the Clock – The Nordic Model: Report from a Nordic Workshop, November 4, 2016, Copenhagen, Denmark2017Report (Other academic)
    Abstract [en]

    This report brings together 12 invited presentations and outcomes of a workshop on food and meals for employees working irregular hours “around the clock”. The workshop, “Food at work around the clock – The Nordic Model”, was hosted by the National Food Institute at the Technical University of Denmark on November 4, 2016, in Lyngby, near Copenhagen, Denmark. This was a culmination of the collaboration started in 2015 between researchers from the hosts institute, Gävle University and Kristianstad University in Sweden, and the School of Applied Educational Sciences and Teacher Education in Finland. The workshop was funded by the Nordic Council of Ministers.

  • 228. Dahm, Christina C.
    et al.
    Gorst-Rasmussen, Anders
    Crowe, Francesca L.
    Roswall, Nina
    Tjonneland, Anne
    Drogan, Dagmar
    Boeing, Heiner
    Teucher, Birgit
    Kaaks, Rudolf
    Adarakis, George
    Zylis, Dimosthenes
    Trichopoulou, Antonia
    Fedirko, Veronika
    Chajes, Veronique
    Jenab, Mazda
    Palli, Domenico
    Pala, Valeria
    Tumino, Rosario
    Ricceri, Fulvio
    van Kranen, Henk
    Bueno-de-Mesquita, H. Bas
    Quiros, Jose R.
    Sanchez, Maria-Jose
    Lujan-Barroso, Leila
    Larranaga, Nerea
    Chirlaque, Maria-Dolores
    Ardanaz, Eva
    Johansson, Mattias
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology. The Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France.
    Stattin, Pär
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology.
    Khaw, Kay-Tee
    Wareham, Nick
    Wark, Petra A.
    Norat, Teresa
    Riboli, Elio
    Key, Tim J.
    Overvad, Kim
    Fatty acid patterns and risk of prostate cancer in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition2012In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 96, no 6, p. 1354-1361Article in journal (Refereed)
    Abstract [en]

    Background: Fatty acids in blood may be related to the risk of prostate cancer, but epidemiologic evidence is inconsistent. Blood fatty acids are correlated through shared food sources and common endogenous desaturation and elongation pathways. Studies of individual fatty acids cannot take this into account, but pattern analysis can. Treelet transform (TT) is a novel method that uses data correlation structures to derive sparse factors that explain variation. Objective: The objective was to gain further insight in the association between plasma fatty acids and risk of prostate cancer by applying TT to take data correlations into account. Design: We reanalyzed previously published data from a case-control study of prostate cancer nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. TT was used to derive factors explaining the variation in 26 plasma phospholipid fatty acids of 962 incident prostate cancer cases matched to 1061 controls. Multiple imputation was used to deal with missing data in covariates. ORs of prostate cancer according to factor scores were determined by using multivariable conditional logistic regression. Results: Four simple factors explained 38% of the variation in plasma fatty acids. A high score on a factor reflecting a long-chain n-3 PUFA pattern was associated with greater risk of prostate cancer (OR for highest compared with lowest quintile: 1.36; 95% CI: 0.99, 1.86; P-trend = 0.041). Conclusion: Pattern analyses using TT groupings of correlated fatty acids indicate that intake or metabolism of long-chain n-3 PUFAs may be relevant to prostate cancer etiology. Am J Clin Nutr 2012;96:1354-61.

  • 229.
    Daivadanam, Meena
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics. Sree Chitra Tirunal Inst Med Sci & Technol, Achutha Menon Ctr Hlth Sci Studies, Thiruvananthapuram 695011, Kerala, India.;Karolinska Inst, Dept Publ Hlth Sci Global Hlth, Tomtebodavagen 18A, S-17177 Stockholm, Sweden..
    Ravindran, T. K. Sundari
    Sree Chitra Tirunal Inst Med Sci & Technol, Achutha Menon Ctr Hlth Sci Studies, Thiruvananthapuram 695011, Kerala, India..
    Thankappan, K. R.
    Sree Chitra Tirunal Inst Med Sci & Technol, Achutha Menon Ctr Hlth Sci Studies, Thiruvananthapuram 695011, Kerala, India..
    Sarma, P. S.
    Sree Chitra Tirunal Inst Med Sci & Technol, Achutha Menon Ctr Hlth Sci Studies, Thiruvananthapuram 695011, Kerala, India..
    Wahlström, Rolf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Karolinska Inst, Dept Publ Hlth Sci Global Hlth, Tomtebodavagen 18A, S-17177 Stockholm, Sweden..
    Development of a Tool to Stage Households' Readiness to Change Dietary Behaviours in Kerala, India2016In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 11, article id e0165599Article in journal (Refereed)
    Abstract [en]

    Dietary interventions and existing health behaviour theories are centred on individuals; therefore, none of the available tools are applicable to households for changing dietary behaviour. The objective of this pilot study was to develop a practical tool that could be administered by community volunteers to stage households in rural Kerala based on readiness to change dietary behaviour. Such a staging tool, comprising a questionnaire and its algorithm, focusing five dietary components (fruits, vegetables, salt, sugar and oil) and households (rather than individuals), was finalised through three consecutive pilot validation sessions, conducted over a four-month period. Each revised version was tested with a total of 80 households (n = 30, 35 and 15 respectively in the three sessions). The tool and its comparator, Motivational Interviewing (MI), assessed the stage-of-change for a household pertaining to their: 1) fruit and vegetable consumption behaviour; 2) salt, sugar and oil consumption behaviour; 3) overall readiness to change. The level of agreement between the two was tested using Kappa statistics to assess concurrent validity. A value of 0.7 or above was considered as good agreement. The final version was found to have good face and content validity, and also a high level of agreement with MI (87%; weighted kappa statistic: 0.85). Internal consistency testing was performed using Cronbach's Alpha, with a value between 0.80 and 0.90 considered to be good. The instrument had good correlation between the items in each section (Cronbach's Alpha: 0.84 (fruit and vegetables), 0.85 (salt, sugar and oil) and 0.83 (Overall)). Pre-contemplation was the most difficult stage to identify; for which efficacy and perceived cooperation at the household level were important. To the best of our knowledge, this is the first staging tool for households. This tool represents a new concept in community-based dietary interventions. The tool can be easily administered by lay community workers and can therefore be used in large population-based studies. A more robust validation process with a larger sample is needed before it can be widely used.

  • 230.
    Daivadanam, Meena
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Wahlström, Rolf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Thankappan, K. R.
    Ravindran, T. K. Sundari
    Balancing expectations amidst limitations: the dynamics of food decision-making in rural Kerala2015In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, article id 644Article in journal (Refereed)
    Abstract [en]

    Background: Food decision-making is a complex process and varies according to the setting, based on cultural and contextual factors. The study aimed to understand the process of food decision-making in households in rural Kerala, India, to inform the design of a dietary behaviour change intervention. Methods: Three focus group discussions (FGDs) and 17 individual interviews were conducted from September 2010 to January 2011 among 13 men and 40 women, between 23 and 75 years of age. An interview guide facilitated the process to understand: 1) food choices and decision-making in households, with particular reference to access; and 2) beliefs about foods, particularly fruits, vegetables, salt, sugar and oil. The interviews and FGDs were transcribed verbatim and analysed using qualitative content analysis. Results: The analysis revealed one main theme: 'Balancing expectations amidst limitations' with two sub-themes: 'Counting and meeting the costs'; and 'Finding the balance'. Food decisions were made at the household level, with money, time and effort costs weighed against the benefits, estimated in terms of household needs, satisfaction and expectations. The most crucial decisional point was affordability in terms of money costs, followed by food preferences of husband and children. Health and the risk of acquiring chronic diseases was not a major consideration in the decision-making process. Foods perceived as essential for children were purchased irrespective of cost, reportedly owing to the influence of food advertisements. The role of the woman as the homemaker has gendered implications, as the women disproportionately bore the burden of balancing the needs and expectations of all the household members within the available means. Conclusions: The food decision-making process occurred at household level, and within the household, by the preferences of spouse and children, and cost considerations. The socio-economic status of households was identified as limiting their ability to manoeuvre this fine balance. The study has important policy implications in terms of the need to raise public awareness of the strong link between diet and chronic non-communicable diseases.

  • 231.
    Daivadanamn, Meena
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Cajander, Åsa
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction.
    Huvila, Isto
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Arts, Department of ALM.
    Dahl, Jo-Anne
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Empowering towards healthy behaviours2016In: Ending Childhood Obesity: Actions through health and food equity, Uppsala University, 2016, p. 34-39Conference paper (Other academic)
  • 232.
    Dakanalis, Antonios
    et al.
    Univ Pavia, Dept Brain & Behav Sci, Pavia, Italy.;Univ Milano Bicocca, Dept Surg & Interdisciplinary Med, Milan, Italy..
    Clerici, Massimo
    Univ Milano Bicocca, Dept Surg & Interdisciplinary Med, Milan, Italy..
    Caslini, Manuela
    Univ Milano Bicocca, Dept Surg & Interdisciplinary Med, Milan, Italy..
    Gaudio, Santino
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology. Univ Campus Biomed, Ctr Integrated Res, Rome, Italy..
    Serino, Silvia
    Catholic Univ, Dept Psychol, Milan, Italy..
    Riva, Giuseppe
    Catholic Univ, Dept Psychol, Milan, Italy.;Ist Auxol Italiano, Appl Technol Neuropsychol Lab, Milan, Italy..
    Carra, Giuseppe
    Univ Milano Bicocca, Dept Surg & Interdisciplinary Med, Milan, Italy.;UCL, Fac Brain Sci, Div Psychiat, London, England..
    Predictors of initiation and persistence of recurrent binge eating and inappropriate weight compensatory behaviors in college men2016In: International Journal of Eating Disorders, ISSN 0276-3478, E-ISSN 1098-108X, Vol. 49, no 6, p. 581-590Article in journal (Refereed)
    Abstract [en]

    ObjectiveThe transition to college is considered as a risk period for the development of behavioral symptoms of eating disorders (BSEDs) and some evidence suggests that, amongst men, these symptoms occurring on a regular basis remain relatively stable over the college period. Nevertheless, little is known about factors associated with persistent engagement in and initiation of recurrent (or regular) binge eating and inappropriate weight compensatory behaviors in this population. The objective of this report was to address these research gaps. MethodData were examined from 2,555 male first-year college students who completed an assessment of potential vulnerability factors and BSEDs at the beginning of the autumn semester (baseline) and nine months later (end of the spring semester; follow-up). ResultsElevated negative affectivity, body dissatisfaction, self-objectification, and lower self-esteem at baseline were predictive of persistent engagement in regular binge eating and four compensatory behaviors (self-induced vomiting, laxative/diuretic abuse, fasting, exercise) at follow-up, as well as initiation of all these behaviors occurring regularly (i.e., at least weekly for 3 months). Self-objectification (thinking and monitoring the body's outward appearance from a third-person perspective) emerged as the largest contributor of both the initiation and persistence of all behavioral symptoms. DiscussionData emphasize that the same psychological factors underlie initiation and persistence of recurrent BSEDs and should shape the focus of future interventions for college men.

  • 233.
    Danielsson, Jessica
    et al.
    Kristianstad University, School of Education and Environment.
    Nilsson, Pontus
    Kristianstad University, School of Education and Environment.
    Elevers måltider under skoldagen: en undersökning av energi- och näringsintag bland elever i årskurs 32010Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Det är viktigt att elever i skolan äter tillräckligt mycket mat under skoldagen så att de orkar hålla koncentrationen uppe och kan prestera bra i skolan. Syftet var att undersöka om innehållet av energi (kcal), protein, fett och kolhydrater är tillräckligt i maten som elever i årskurs 3, som är på fritidshem före och efter skolan, äter till frukost, lunch och mellanmål under en skoldag. En kartläggning gjordes över vad åtta elever åt under tre måltider under en skoldag och intaget energi- och näringsintag beräknades i relation till Livsmedelsverkets rekommendationer. Resultatet visade att elevernas energi- och näringsintag var bäst under frukosten, även om det var lågt hos de flesta. Under lunchen minskade energi- och näringsintaget och blev ännu sämre vid eftermiddagens mellanmål. Generellt sett var elevernas energi- och näringsintag för lågt under denna skoldag i jämförelse med Livsmedelsverkets rekommendationer. Slutsatsen är att skolan behöver medverka till att barnen dels äter mer mat, dels äter mer varierat under de måltider som serveras i skolan. 

  • 234.
    Danielsson-Tham, Marie-Louise
    et al.
    Örebro University, School of Hospitality, Culinary Arts & Meal Science.
    Tham, Wilhelm
    Örebro University, School of Hospitality, Culinary Arts & Meal Science.
    Is food hygiene a part of culinary arts and meal science?2016In: 1st Granqvist Culinary Arts and Meal Science Symposium: Programme and Abstracts / [ed] Tobias Nygren, Agneta Yngve och Åsa Öström, Örebro: Örebro University , 2016, Vol. 1, p. 28-28Conference paper (Refereed)
  • 235.
    Dapi Nzefa, Leonie
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    Hörnell, Agneta
    Janlert, Urban
    Stenlund, Hans
    Larsson, Christel
    Energy and nutrient intakes in relation to sex and socio-economic status among school adolescents in urban Cameroon, Africa.2011In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 14, no 5, p. 904-13Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To assess energy and nutrient intakes and physical activity of adolescents in urban Cameroon according to sex and socio-economic status (SES).

    DESIGN: Cross-sectional study with adolescents randomly selected from schools in low-, middle- and high-SES areas. Weight and height were measured and information about food intake and physical activity was obtained through repeated individual 24 h recalls. Under- and over-reporting of energy intake and inadequacy of nutrient intake were assessed.

    SETTING: Yaoundé, Cameroon.

    SUBJECTS: Boys and girls aged 12-16 years (n 227).

    RESULTS: Boys had a lower BMI and reported higher energy expenditures and physical activity levels (PAL) than girls. Under-reporting of energy intake was large among boys and girls regardless of PAL; boys under-reported more than girls. Among those with low PAL, over-reporting of energy intake was common. Over 50% of boys and girls had protein below the recommendations. The intake of fat varied; 26% of the adolescents were below and 25% were above the recommendations. Inadequate intakes of vitamin B₁, vitamin B₃ and Fe were more common among girls, while boys more often had inadequate intake of vitamin A. Adolescents with low SES were more likely to be below the recommendations for fat and vitamins B₂, B₃, B₆ and B₁₂ than those with high SES.

    CONCLUSIONS: A high proportion of boys and girls reported inadequate intakes. However under- and over-reporting were also very common. Boys under-reported energy intake more than girls and inadequate nutrient intake was more frequently reported by adolescents with low SES than by those with high SES.

  • 236.
    Dapi Nzefa, Leonie
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    Janlert, Urban
    Nouedoui, Christophe
    Stenlund, Hans
    Håglin, Lena
    Socioeconomic and gender differences in adolescents' nutritional status in urban Cameroon, Africa.2009In: Nutrition Research, ISSN 0271-5317, E-ISSN 1879-0739, Vol. 29, no 5, p. 313-9Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to assess adolescents' nutritional status according to socioeconomic status (SES) and sex using anthropometry in urban Cameroon, Africa. Adolescent boys (n = 248) and girls (n = 333) 12 to 16 years old were recruited from randomly selected schools in a cross sectional study in Yaoundé city and grouped according to SES. Weight, height, skinfold thickness, and circumferences were measured, and body mass index, waist/hip ratio, arm muscle, and arm fat areas were calculated. Stunting, underweight, and overweight were determined using international cutoff points. Adolescents with medium and high SES were less likely to be stunted than adolescents with low SES (odds ratio [OR], 0.40; P < .01). Prevalences of stunting (12%, 6%, and 5%) and underweight (3%, 4%, and 1%) were higher among the adolescents with low and medium SES than those with high SES. Overweight prevalence was high among the adolescents with low (8%), medium (11%), and high (9%) SES. The OR for overweight was higher among girls than boys (OR, 4.13; P < .001). Girls were less likely to be stunted and underweight than boys (OR, 0.29 [P < .001] and OR, 0.20 [P < .01], respectively). Prevalences of stunting (15% and 6%) and underweight (5% and 2%) were higher among boys than girls. Pubescent adolescents were less likely to be stunted than nonpubescent (OR, 0.53; P < .05). Adolescents with low and medium SES were more underweight and stunted than adolescents with high SES. Girls were more overweight, less stunted, and underweight than boys.

  • 237.
    Dapi Nzefa, Leonie
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    Omoloko, Cécile
    Janlert, Urban
    Dahlgren, Lars
    Håglin, Lena
    "I eat to be happy, to be strong, and to live." perceptions of rural and urban adolescents in Cameroon, Africa.2007In: Journal of nutrition education and behavior, ISSN 1499-4046, E-ISSN 1878-2620, Vol. 39, no 6, p. 320-6Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate factors influencing rural and urban adolescents' food perceptions during a time of nutritional transition in Cameroon, Africa.

    DESIGN: Qualitative in-depth interviews.

    SETTINGS: Yaoundé urban and Bandja rural areas.

    PARTICIPANTS: Fifteen adolescents 12 to 15 years old purposely selected from schools in urban and rural areas.

    ANALYSIS: Interviews were audiotaped, transcribed, and analyzed using Grounded Theory method.

    FINDINGS: Factors influencing adolescents' food perceptions from the rural area were "to live" "health" and "poverty." Among adolescents from the urban poor area, "health," "beauty," and "not enough money" were factors. Among adolescents from the urban rich area, "pleasure" and "beauty" were factors. Rural girls liked "to be fat," whereas girls from the urban poor wanted "to be a little bit fat," and girls from the urban rich wanted "to be normal."

    CONCLUSIONS AND IMPLICATIONS: Food behavior is changing from a diet composed of traditional food in rural areas to a more westernized diet in urban areas. The relationship between socioeconomic factors and nutrition needs to be examined with a sufficiently large number of adolescents to investigate these factors in a quantitative survey. Healthful local food should be available at home and from vendors. Nutrition education about food and diet-related diseases is needed in school.

  • 238.
    Dapi Nzefa, Léonie
    et al.
    Linnaeus University, Faculty of Social Sciences, Department of Social Work.
    Ayuk, Tambe Betrand
    Centre for Food and Nutritional Research, Institute of Medical Research and Medicinal Plant Studies, Yaounde, Cameroon.
    Axberg, Frida
    Department of Food and Nutrition, Umeå University, Umeå.
    Lundström, Linnéa
    Department of Food and Nutrition, Umeå University, Umeå.
    Hörnell, Agneta
    Department of Food and Nutrition, Umeå University, Umeå.
    After giving birth to a baby, breastfeeding becomes your responsibility: Infant feeding perceptions and practices among women in Yaoundé, Bamenda and Bandja, Cameroon, Africa2018In: International Research Journal of Public and Environmental Health, ISSN 2360-8803, Vol. 5, no 3, p. 38-45Article in journal (Refereed)
    Abstract [en]

    The Ministry of Public Health of Cameroon advises mothers to follow the World Health Organization’s recommendation of exclusive breastfeeding during the first six months of life and to continue breastfeeding along with appropriate complementary foods up to two years or beyond. Despite these recommendations, malnutrition due to inadequate feeding practices is still prevalent in Cameroon. Therefore, this study aims to explore infant feeding perceptions and identify factors influencing infant feeding practices in Cameroon. Forty-nine women aged 19 to 38 who had infants aged 6 days to 15 months were purposively selected from hospitals during the vaccination days and interviewed until saturation. The research tools included six qualitative group interviews, with each group comprising 6 to 10 women. The study was conducted in the rural area of Bandja and the urban areas of Yaoundé and Bamenda. Data were analysed using content analysis. In the study, breastfeeding was agreed upon as the best way to feed infants and was commonly practised for 1 to 2 years. Nevertheless, few infants were breastfed exclusively. Complementary foods were often nutritionally inadequate; many children were not given fruit, vegetables or foods of animal origin on a daily basis. Cultural beliefs, tradition, community norms and low educational and economic levels negatively influenced the implementation of appropriate infant feeding recommendations. The short duration of exclusive breastfeeding and the poor food diversity are the main problems. In response, it is necessary to strengthen the position of women, increase the period of maternal leave, introduce sustainable and practical education for both parents about breastfeeding, and provide good, local complementary foods. 

  • 239.
    Dapi Nzefa, Léonie
    et al.
    Linnaeus University, Faculty of Social Sciences, Department of Social Work.
    Monebenimp, Francisca
    University of Yaoundé, Cameroon.
    Äng, Christofer
    Umeå University.
    Undernutrition among children under five in the Bandja village of Cameroon, Africa2018In: South African Journal of Clinical Nutrition, ISSN 1607-0658Article in journal (Refereed)
    Abstract [en]

    Background: Sub-Saharan Africa has a long history of struggling with child undernutrition. The prevalence of undernutrition is still high and knowledge about this public health problem and the underlying causes is essential for children’s health.

    Aim: To evaluate the anthropometric status of children under five in the Bandja village of Cameroon.

    Methods: A cross-sectional study was undertaken that included 388 children. Undernutrition was evaluated in terms of wasting, stunting and underweight. Information on sex, age, birth order, birth interval, duration of breastfeeding, and mother’s age at birth, occupation and educational level were collected.

    Results: The prevalence of wasting, stunting and underweight was 3.2%, 16.4% and 5.2%, respectively. Boys were more stunted than girls (OR 2.24; 95% CI 1.16–4.34). Children less than 30 months were more often wasted than older children (OR 17.70; 95% CI 1.82–172.40). The first and second born in order were more stunted than the third or later born in order (OR 2.06; 95% CI 1.02–4.18). Children of farming mothers were more often stunted (OR 2.87; 95% CI 1.35–6.13) and underweight (OR 3.47; 95% CI 1.09–11.09) than others. Children still being breastfed were more underweight (OR 6.52; 95% CI 1.31–32.43) than those whose mothers had finished breastfeeding.

    Conclusion: Undernutrition is highly prevalent in Bandja, and is more common among boys, younger children, first born in order, children still being breastfed and children of farming mothers. This study underlines the importance of intervention to prevent and reduce undernutrition among children.

  • 240.
    Dapi Nzefa, Léonie
    et al.
    Umeå University.
    Nouedoui, Christophe
    University of Yaounde, Cameroon.
    Janlert, Urban
    Umeå University.
    Håglin, Lena
    University Hospital Umeå.
    Adolescents' Food Habits and Nutritional Status among in urban and Rural Areas in Cameroon, Africa2005In: Scandinavian Journal of Nutrition/Næringsforskning, ISSN 1102-6480, E-ISSN 1651-2359, Vol. 49, no 4, p. 151-158Article in journal (Refereed)
    Abstract [en]

    Background: Food intake in Cameroon is based on three meals daily. The diet in rural areas is based on traditional staple foods, while that of the urban population incorporates more modern foods. The health and nutrition of adolescents is important as their eating behaviour and nutrition will affect their future health.

    Objective: To describe and compare food habits and nutritional status of adolescents in Cameroon.

    Design: A cross-Stional study using an unquantified food frequency questionnaire and anthropometric data, in urban and rural areas. Fifty-two adolescents, 12–15 years old, were selected from schools.

    Results: Frequencies of consumption of meat, vegetables, cereals, milk products and junk food were significantly higher in urban than in rural adolescents (11.8 vs 4.5, 9.5 vs 3.9, 16.5 vs 11.9, 5.7 vs 0.8, 24.2 vs 8.7, respectively). The frequency of in-between meals was higher in urban than in rural adolescents (4.9 vs 0.9, respectively). Arm muscle area (AMA, mm2) and waist/hip ratio were significantly higher in rural than in urban adolescents (3554 vs 2802 and 0.82 vs 0.79, respectively). Body mass index (BMI, kg m−2) was higher in rural than urban adolescents, although not significant (20.6 vs 19.4, respectively). There was a positive significant correlation between BMI and AMA in urban and rural areas (r=0.67 and r=0. 72, respectively).

    Conclusions: Despite a lower frequency of food consumption, rural adolescents had higher AMA and waist/hip ratio than urban adolescents. Less junk food and more traditional food consumption, more manual activities and walking in rural adolescents could explain these results.

  • 241.
    Daryani, Achraf
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. klinisk nutrition och metabolism.
    Becker, Wulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. klinisk nutrition och metabolism.
    Bengt, Vessby
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. klinisk nutrition och metabolism.
    Andersson, Agneta
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Dietary fat intake, fat sources and fatty acid composition in serum among immigrant women from Iran and Turkey compared with women of Swedish ethnicity2005In: Scandinavian Journal of Nutrition/Næringsforskning, ISSN 1102-6480, E-ISSN 1651-2359, Vol. 49, no 3, p. 106-115Article in journal (Refereed)
    Abstract [en]

    Background

    Immigrants in general seem to be more vulnerable than the host population to developing nutrition-related chronic conditions. This may in part be related to diverging dietary habits, including intake of different types and amounts of dietary fat.

    Objectives

    The main aim of this study was to investigate the dietary fatty acid composition and the dietary fat sources among first generation immigrant women from Iran and Turkey compared with women of Swedish ethnicity. The second aim was to relate the reported dietary fatty acid composition to the fatty acid composition in serum cholesterol esters, and the fatty acid composition in serum to metabolic variables.

    Design

    The study was a cross-sectional health survey of randomly selected foreign-born women (n=107) and native Swedish women (n=50) living in Uppsala. This included 24 h dietary recall repeated four times and administered in the native language.

    Results and conclusion

    A lower proportion of satura ted fatty acids, a higher proportion of linoleic acid and a higher n-6/n-3 ratio were found in the immigrants’ diet than in the diet of the Swedish women. The difference in linoleic acid was also mirrored in serum. Vegetable dishes, together with edible fats, were the major contributors of polyunsaturated fatty acids among the immigrant women. While the fatty acid profile in serum among the immigrant women had both favourable and unfavourable implications, a higher prevalence of obesity and dyslipidaemia was observed in immigrant compared with Swedish-born women.

  • 242.
    De Bourdeaudhuij, I
    et al.
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    te Velde, S
    EMGO Institute, VU University Medical Centre, Amsterdam, The Netherlands.
    Brug, J
    EMGO Institute, VU University Medical Centre, Amsterdam, The Netherlands.
    Due, P
    Department of Social Medicine, University of Copenhagen, Copenhagen, Denmark.
    Wind, M
    Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
    Sandvik, C
    Faculty of Psychology, Department of Education and Health Promotion, Research Centre for Health Promotion, University of Bergen, Bergen, Norway.
    Maes, L
    Department of Public Health, Ghent University, Ghent, Belgium.
    Wolf, A
    Institute for Nutritional Sciences, University of Vienna, Vienna, Austria.
    Perez Rodrigo, C
    Community Nutrition Unit of Bilbao, Bilbao, Spain.
    Yngve, Agneta
    Unit for Preventive Nutrition, Karolinska Institute, Stockholm, Sweden.
    Thorsdottir, I
    Unit for Nutrition Research, Landspitali University Hospital, Reykjavik, Iceland.
    Rasmussen, M
    Department of Social Medicine, University of Copenhagen, Copenhagen, Denmark.
    Elmadfa, I
    Institute for Nutritional Sciences, University of Vienna, Vienna, Austria.
    Franchini, B
    Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal.
    Klepp, K-I
    Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway.
    Personal, social and environmental predictors of daily fruit and vegetable intake in 11-year-old children in nine European countries2008In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 62, no 7, p. 834-841Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate potential personal, social and physical environmental predictors of daily fruit intake and daily vegetable intake in 11-year-old boys and girls in nine European countries.

    SUBJECTS: The total sample size was 13 305 (90.4% participation rate).

    RESULTS: Overall, 43.2% of the children reported to eat fruit every day, 46.1% reported to eat vegetables every day. Daily fruit intake and daily vegetable intake was mainly associated with knowledge of the national recommendations, positive self-efficacy, positive liking and preference, parental modeling and demand and bringing fruit to school (odds ratio between 1.40 and 2.42, P<0.02). These factors were associated fairly consistently with daily fruit intake across all nine European countries, implying that a rather uniform intervention strategy to promote fruit can be used across Europe. For vegetables, the pattern was, however, less consistent. Differences between countries in cooking and preparing vegetables might be responsible for this larger diversity.

    CONCLUSIONS: This study showed that especially a combination of personal and social factors is related to daily fruit and vegetable intake in schoolchildren. This shows that a comprehensive multilevel intervention strategy based upon a series of individual and social correlates will be most promising in the promotion of daily fruit and vegetable intake in children.

  • 243.
    De Bourdeaudhuij, I
    et al.
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    te Velde, S
    EMGO Institute, VU University Medical Centre, Amsterdam, The Netherlands.
    Brug, J
    EMGO Institute, VU University Medical Centre, Amsterdam, The Netherlands.
    Due, P
    Department of Social Medicine, University of Copenhagen, Copenhagen, Denmark.
    Wind, M
    Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
    Sandvik, C
    Faculty of Psychology, Department of Education and Health Promotion, Research Centre for Health Promotion, University of Bergen, Bergen, Norway.
    Maes, L
    Department of Public Health, Ghent University, Ghent, Belgium.
    Wolf, A
    Institute for Nutritional Sciences, University of Vienna, Vienna, Austria.
    Perez Rodrigo, C
    Community Nutrition Unit of Bilbao, Bilbao, Spain.
    Yngve, Agneta
    Unit for Preventive Nutrition, Karolinska Institute, Stockholm, Sweden.
    Thorsdottir, I
    Unit for Nutrition Research, Landspitali University Hospital, Reykjavik, Iceland.
    Rasmussen, M
    Department of Social Medicine, University of Copenhagen, Copenhagen, Denmark.
    Elmadfa, I
    Institute for Nutritional Sciences, University of Vienna, Vienna, Austria.
    Franchini, B
    Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal.
    Klepp, K-I
    Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway.
    Personal, social and environmental predictors of daily fruit and vegetable intake in 11-year-old children in nine European countries2008In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 62, no 7, p. 834-841Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate potential personal, social and physical environmental predictors of daily fruit intake and daily vegetable intake in 11-year-old boys and girls in nine European countries.

    SUBJECTS: The total sample size was 13 305 (90.4% participation rate).

    RESULTS: Overall, 43.2% of the children reported to eat fruit every day, 46.1% reported to eat vegetables every day. Daily fruit intake and daily vegetable intake was mainly associated with knowledge of the national recommendations, positive self-efficacy, positive liking and preference, parental modeling and demand and bringing fruit to school (odds ratio between 1.40 and 2.42, P<0.02). These factors were associated fairly consistently with daily fruit intake across all nine European countries, implying that a rather uniform intervention strategy to promote fruit can be used across Europe. For vegetables, the pattern was, however, less consistent. Differences between countries in cooking and preparing vegetables might be responsible for this larger diversity.

    CONCLUSIONS: This study showed that especially a combination of personal and social factors is related to daily fruit and vegetable intake in schoolchildren. This shows that a comprehensive multilevel intervention strategy based upon a series of individual and social correlates will be most promising in the promotion of daily fruit and vegetable intake in children.

  • 244.
    De Bourdeaudhuij, Ilse
    et al.
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Yngve, Agneta
    Unit for Preventive Nutrition, Karolinska Institutet, Stockholm, Sweden.
    te Velde, Saskia J
    Erasmus University Medical Center Rotterdam, Departme nt of Public Health, Rotterdam, The Netherlands.
    Klepp, Knut-Inge
    Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway.
    Rasmussen, Mette
    Department of Social Medicine, Univ ersity of Copenhagen, Copenhagen, Denmark.
    Thorsdottir, Inga
    Unit for Nutrition Research, Landspitali Un iversity Hospital, Reykjavik, Iceland.
    Wolf, Alexandra
    Institute of Nutrition, University of Vienna, Austria.
    Brug, Johannes
    Erasmus University Medical Center Rotterdam, Departme nt of Public Health, Rotterdam, The Netherlands.
    Personal, social and environmental correlates of vegetable intake in normal weight and overweight 9 to 13-year old boys2006In: International Journal of Behavioral Nutrition and Physical Activity, ISSN 1479-5868, E-ISSN 1479-5868, Vol. 3, p. 37-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The first aim of the present study was to investigate differences in correlates of vegetable intake between the normal weight and the overweight boys in the Pro Children Cross Sectional Study. The second aim was to explore whether the association between vegetable intake and potential correlates is different in overweight boys compared with normal weight boys.

    METHODS: Random samples of mainly 11-year old children were recruited in 9 European countries. The total sample size consisted of 3960 boys (16.5% overweight). A validated self-report questionnaire was used to measure vegetable intake, and personal, social and environmental factors related to vegetable intake in the classroom. Weight and height were reported by the parents of the children in parents' questionnaires.

    RESULTS: Regression analyses explained 23% to 28% of the variance in vegetable intake by potential correlates. Liking, self-efficacy and bringing vegetables to school were related to intake in both normal weight and overweight boys (beta's>0.10). Active parental encouragement and availability at home was only related to intake in overweight boys (beta's>0.10), whereas knowledge about recommendations was only related to vegetable consumption in normal weight boys (beta>0.10)

    CONCLUSION: Intervention strategies to increase vegetable intake should focus on increase in liking and preferences, increase in self-efficacy, and increase in bringing vegetables to school in both normal weight and overweight boys. Further research should investigate whether advising parents of overweight boys to encourage their child to eat vegetables every day, to insist as far as possible that their child eats vegetables regularly and to make vegetables easily available at home is effective in changing vegetable intake.

  • 245.
    De Bourdeaudhuij, Ilse
    et al.
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Yngve, Agneta
    Unit for Preventive Nutrition, Karolinska Institutet, Stockholm, Sweden.
    te Velde, Saskia J
    Erasmus University Medical Center Rotterdam, Departme nt of Public Health, Rotterdam, The Netherlands.
    Klepp, Knut-Inge
    Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway.
    Rasmussen, Mette
    Department of Social Medicine, Univ ersity of Copenhagen, Copenhagen, Denmark.
    Thorsdottir, Inga
    Unit for Nutrition Research, Landspitali Un iversity Hospital, Reykjavik, Iceland.
    Wolf, Alexandra
    Institute of Nutrition, University of Vienna, Austria.
    Brug, Johannes
    Erasmus University Medical Center Rotterdam, Departme nt of Public Health, Rotterdam, The Netherlands.
    Personal, social and environmental correlates of vegetable intake in normal weight and overweight 9 to 13-year old boys2006In: The international journal of behavioral nutrition and physical activity, ISSN 1479-5868, Vol. 3, p. 37-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The first aim of the present study was to investigate differences in correlates of vegetable intake between the normal weight and the overweight boys in the Pro Children Cross Sectional Study. The second aim was to explore whether the association between vegetable intake and potential correlates is different in overweight boys compared with normal weight boys.

    METHODS: Random samples of mainly 11-year old children were recruited in 9 European countries. The total sample size consisted of 3960 boys (16.5% overweight). A validated self-report questionnaire was used to measure vegetable intake, and personal, social and environmental factors related to vegetable intake in the classroom. Weight and height were reported by the parents of the children in parents' questionnaires.

    RESULTS: Regression analyses explained 23% to 28% of the variance in vegetable intake by potential correlates. Liking, self-efficacy and bringing vegetables to school were related to intake in both normal weight and overweight boys (beta's>0.10). Active parental encouragement and availability at home was only related to intake in overweight boys (beta's>0.10), whereas knowledge about recommendations was only related to vegetable consumption in normal weight boys (beta>0.10)

    CONCLUSION: Intervention strategies to increase vegetable intake should focus on increase in liking and preferences, increase in self-efficacy, and increase in bringing vegetables to school in both normal weight and overweight boys. Further research should investigate whether advising parents of overweight boys to encourage their child to eat vegetables every day, to insist as far as possible that their child eats vegetables regularly and to make vegetables easily available at home is effective in changing vegetable intake.

  • 246. De Carvalho, Irene Stuart Torrié
    et al.
    Granfeldt, Yvonne
    Dejmek, Petr
    Håkansson, Andreas
    Kristianstad University, School of Education and Environment, Avdelningen för Praktisk-estetiska ämnen.
    From diets to foods: using linear programming to formulate a nutritious, minimum-cost porridge mix for children aged 1 to 2 years2015In: Food and Nutrition Bulletin, ISSN 0379-5721, E-ISSN 1564-8265, Vol. 36, no 1, p. 75-86Article in journal (Refereed)
    Abstract [en]

    Background. Linear programming has been used extensively as a tool for nutritional recommendations. Extending the methodology to food formulation presents new challenges, since not all combinations of nutritious ingredients will produce an acceptable food. Furthermore, it would help in implementation and in ensuring the feasibility of the suggested recommendations.

    Objective. To extend the previously used linear programming methodology from diet optimization to food formulation using consistency constraints. In addition, to exemplify usability using the case of a porridge mix formulation for emergency situations in rural Mozambique.

    Methods. The linear programming method was extended with a consistency constraint based on previously published empirical studies on swelling of starch in soft porridges. The new method was exemplified using the formulation of a nutritious, minimum-cost porridge mix for children aged 1 to 2 years for use as a complete relief food, based primarily on local ingredients, in rural Mozambique.

    Results. A nutritious porridge fulfilling the consistency constraints was found; however, the minimum cost was unfeasible with local ingredients only. This illustrates the challenges in formulating nutritious yet economically feasible foods from local ingredients. The high cost was caused by the high cost of mineral-rich foods. A nutritious, low-cost porridge that fulfills the consistency constraints was obtained by including supplements of zinc and calcium salts as ingredients.

    Conclusions. The optimizations were successful in fulfilling all constraints and provided a feasible porridge, showing that the extended constrained linear programming methodology provides a systematic tool for designing nutritious foods. 

  • 247.
    De Craemer, Marieke
    et al.
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    De Decker, Ellen
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Verloigne, Maïté
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium; Research Foundation Flanders, Brussels, Belgium.
    De Bourdeaudhuij, Ilse
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Manios, Yannis
    Department of Nutrition and Dietetics, Harokopio University, Athens , Greece.
    Cardon, Greet
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    The effect of a cluster randomised control trial on objectively measured sedentary time and parental reports of time spent in sedentary activities in Belgian preschoolers: the ToyBox-study2016In: International Journal of Behavioral Nutrition and Physical Activity, ISSN 1479-5868, E-ISSN 1479-5868, Vol. 13, article id 1Article in journal (Refereed)
    Abstract [en]

    Background: In preschoolers, high levels of sedentary behaviour are associated with several adverse health outcomes. The purpose of this study is to report the effects of the ToyBox-intervention (a European 24-week cluster randomised controlled trial) on sedentary behaviour in preschoolers.

    Methods: In Belgium, 859 preschoolers from 27 kindergartens (15 intervention and 12 control) wore an accelerometer to objectively measure their sedentary time and 1715 parents/caregivers completed a questionnaire to assess sedentary activities in which preschoolers participate at home. Main outcomes were objectively measured sedentary time, time spent watching TV, using the computer and time spent in quiet play. Multilevel repeated measures analyses were conducted to take clustering into account. Intention to treat analysis was used to handle missing data.

    Results: A sample of 859 (29.5% of all contacted children) preschoolers (4.4 ± 0.6 years, 54.4% boys) provided valid accelerometer data at either baseline or follow-up and parents of 1715 (58.9% of all contacted children) preschoolers (4.4 ± 0.5 years, 52.5% boys) completed a questionnaire at either baseline or follow-up. No intervention effects were found on objectively and subjectively measured total sedentary time in the total sample. However, some effects on objectively and subjectively measured sedentary time were found in specific subgroups. Preschoolers from the intervention group from high SES kindergartens and preschoolers with high levels of sedentary time at baseline decreased their sedentary time, while preschoolers from the control group increased their sedentary time. Girls in the intervention group decreased their TV viewing time during weekend days (-5.83 min/day), while girls' &TV viewing in the control group increased (+4.15 min/day). In low SES kindergartens, a smaller increase for computer time during weekend days was found in preschoolers in intervention kindergartens (+6.06 min/day) than in control kindergartens (+12.49 min/day).

    Conclusion: While some small positive effects were found in some sub-groups, the ToyBox-intervention had no effect on objectively and subjectively measured sedentary time in the total sample. A longer period to implement the intervention and a more active involvement of parents/caregivers might enhance intervention effects. The ToyBox-study is registered with the clinical trials registry clinicaltrials.gov, ID: NCT02116296.

  • 248.
    De Craemer, Marieke
    et al.
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    De Decker, Ellen
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Verloigne, Maïté
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium; Research Foundation Flanders, Brussels, Belgium.
    De Bourdeaudhuij, Ilse
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Manios, Yannis
    Department of Nutrition and Dietetics, Harokopio University, Athens , Greece.
    Cardon, Greet
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    The effect of a cluster randomised control trial on objectively measured sedentary time and parental reports of time spent in sedentary activities in Belgian preschoolers: the ToyBox-study2016In: International Journal of Behavioral Nutrition and Physical Activity, ISSN 1479-5868, E-ISSN 1479-5868, Vol. 13, article id 1Article in journal (Refereed)
    Abstract [en]

    Background: In preschoolers, high levels of sedentary behaviour are associated with several adverse health outcomes. The purpose of this study is to report the effects of the ToyBox-intervention (a European 24-week cluster randomised controlled trial) on sedentary behaviour in preschoolers.

    Methods: In Belgium, 859 preschoolers from 27 kindergartens (15 intervention and 12 control) wore an accelerometer to objectively measure their sedentary time and 1715 parents/caregivers completed a questionnaire to assess sedentary activities in which preschoolers participate at home. Main outcomes were objectively measured sedentary time, time spent watching TV, using the computer and time spent in quiet play. Multilevel repeated measures analyses were conducted to take clustering into account. Intention to treat analysis was used to handle missing data.

    Results: A sample of 859 (29.5% of all contacted children) preschoolers (4.4 ± 0.6 years, 54.4% boys) provided valid accelerometer data at either baseline or follow-up and parents of 1715 (58.9% of all contacted children) preschoolers (4.4 ± 0.5 years, 52.5% boys) completed a questionnaire at either baseline or follow-up. No intervention effects were found on objectively and subjectively measured total sedentary time in the total sample. However, some effects on objectively and subjectively measured sedentary time were found in specific subgroups. Preschoolers from the intervention group from high SES kindergartens and preschoolers with high levels of sedentary time at baseline decreased their sedentary time, while preschoolers from the control group increased their sedentary time. Girls in the intervention group decreased their TV viewing time during weekend days (-5.83 min/day), while girls' &TV viewing in the control group increased (+4.15 min/day). In low SES kindergartens, a smaller increase for computer time during weekend days was found in preschoolers in intervention kindergartens (+6.06 min/day) than in control kindergartens (+12.49 min/day).

    Conclusion: While some small positive effects were found in some sub-groups, the ToyBox-intervention had no effect on objectively and subjectively measured sedentary time in the total sample. A longer period to implement the intervention and a more active involvement of parents/caregivers might enhance intervention effects. The ToyBox-study is registered with the clinical trials registry clinicaltrials.gov, ID: NCT02116296.

  • 249.
    De Craemer, Marieke
    et al.
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium .
    De Decker, Ellen
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Verloigne, Maïté
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    De Bourdeaudhuij, Ilse
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Manios, Yannis
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece .
    Cardon, Greet
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    The effect of a kindergarten-based, family-involved intervention on objectively measured physical activity in Belgian preschool boys and girls of high and low SES: the ToyBox-study.2014In: International Journal of Behavioral Nutrition and Physical Activity, ISSN 1479-5868, E-ISSN 1479-5868, Vol. 11, no 1, p. 38-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The ToyBox-study developed an evidence- and theory-based intervention to improve preschoolers' energy balance-related behaviours - including physical activity (PA) - by targeting the kindergarten environment and involving their parents/caregivers. The present study aimed to examine the effect of the ToyBox-intervention on increasing Belgian preschoolers' objectively measured PA levels.

    METHODS: A sample of 472 preschoolers (4.43 ± 0.55 years; 55.1% boys) from 27 kindergartens (15 intervention, 12 control kindergartens) in Flanders, Belgium were included in the data analyses. Preschoolers wore an ActiGraph accelerometer for six consecutive days and were included in the data analyses if they had a minimum of two weekdays and one weekend day, both at baseline and follow-up (one year later). Preschoolers' PA outcomes were estimated for an average day, weekday, weekend day, during school hours, and during after school hours. To assess intervention effects, multilevel repeated measures analyses were conducted for the total sample, and for sub-groups (according to sex, kindergarten levels of socio-economic status (SES) and risk groups (low levels of PA at baseline)) of preschoolers.

    RESULTS: Small intervention effects were found in the total sample. Most intervention effects were found in boys and in preschoolers from high SES kindergartens. Boys from the intervention group had an increase in vigorous PA (ß=1.47, p=0.03) and moderate-to-vigorous PA (ß=1.27, p=0.03) from baseline to follow-up, whereas PA levels in boys from the control group stagnated or decreased. In preschoolers from high SES kindergartens, the largest effects were found for PA outcomes during school hours and during after school hours.

    CONCLUSION: The results from the Belgian sample demonstrate that effects of the PA-component of the ToyBox-intervention on objectively measured PA were found in preschool boys and in preschoolers from high SES kindergartens, which means that the ToyBox-intervention was mainly effective in those sub-groups. Future interventions should search for alternative strategies to increase preschoolers' PA levels in preschool girls and preschoolers from low SES kindergartens, as these are the most important at-risk groups regarding PA.

  • 250.
    De Craemer, Marieke
    et al.
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium .
    De Decker, Ellen
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Verloigne, Maïté
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    De Bourdeaudhuij, Ilse
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Manios, Yannis
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece .
    Cardon, Greet
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Nilsen, Bente (Contributor)
    Oslo and Akershus University College of Applied Science, Oslo, Norway.
    The effect of a kindergarten-based, family-involved intervention on objectively measured physical activity in Belgian preschool boys and girls of high and low SES: the ToyBox-study.2014In: The international journal of behavioral nutrition and physical activity, ISSN 1479-5868, Vol. 11, no 1, p. 38-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The ToyBox-study developed an evidence- and theory-based intervention to improve preschoolers' energy balance-related behaviours - including physical activity (PA) - by targeting the kindergarten environment and involving their parents/caregivers. The present study aimed to examine the effect of the ToyBox-intervention on increasing Belgian preschoolers' objectively measured PA levels.

    METHODS: A sample of 472 preschoolers (4.43 ± 0.55 years; 55.1% boys) from 27 kindergartens (15 intervention, 12 control kindergartens) in Flanders, Belgium were included in the data analyses. Preschoolers wore an ActiGraph accelerometer for six consecutive days and were included in the data analyses if they had a minimum of two weekdays and one weekend day, both at baseline and follow-up (one year later). Preschoolers' PA outcomes were estimated for an average day, weekday, weekend day, during school hours, and during after school hours. To assess intervention effects, multilevel repeated measures analyses were conducted for the total sample, and for sub-groups (according to sex, kindergarten levels of socio-economic status (SES) and risk groups (low levels of PA at baseline)) of preschoolers.

    RESULTS: Small intervention effects were found in the total sample. Most intervention effects were found in boys and in preschoolers from high SES kindergartens. Boys from the intervention group had an increase in vigorous PA (ß=1.47, p=0.03) and moderate-to-vigorous PA (ß=1.27, p=0.03) from baseline to follow-up, whereas PA levels in boys from the control group stagnated or decreased. In preschoolers from high SES kindergartens, the largest effects were found for PA outcomes during school hours and during after school hours.

    CONCLUSION: The results from the Belgian sample demonstrate that effects of the PA-component of the ToyBox-intervention on objectively measured PA were found in preschool boys and in preschoolers from high SES kindergartens, which means that the ToyBox-intervention was mainly effective in those sub-groups. Future interventions should search for alternative strategies to increase preschoolers' PA levels in preschool girls and preschoolers from low SES kindergartens, as these are the most important at-risk groups regarding PA.

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