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  • 251.
    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.

  • 252.
    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.

  • 253. de Jong, E.
    et al.
    Stocks, Tanja
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology.
    Visscher, T. L. S.
    HiraSing, R. A.
    Seidell, J. C.
    Renders, C. M.
    Association between sleep duration and overweight: the importance of parenting2012In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 36, no 10, p. 1278-1284Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Sleep duration has been related to overweight in children, but determinants of sleep duration are unclear. The aims were to investigate the association between sleep duration and childhood overweight adjusted for family characteristics and unhealthy behaviours, to explore determinants of sleep duration and to determine with sleep competing activities.

    METHOD: A cross-sectional study was carried out in 2006 among 4072 children aged 4-13 years in the city of Zwolle, The Netherlands. In these children, data were available on measured height, weight and waist circumference, and from a parental questionnaire, on socio-demographic characteristics, child's sleep duration, nutrition, physical activity and sedentary behaviour. Associations were studied in 2011 using logistic and linear regression analyses, adjusted for potential confounders.

    RESULTS: Short sleep duration was associated with overweight for 4-8-year-old boys (odds ratio (OR): 3.10; 95% confidence interval (CI): 1.15-8.40), 9-13-year-old boys (OR: 4.96; 95% CI: 1.35-18.16) and 9-13-year-old girls (OR: 4.86; 95% CI: 1.59-14.88). Among 4-8-year-old girls no statistically significant association was found. Determinants for short sleep duration were viewing television during a meal, permission to have candy without asking, not being active with their caregiver and a late bedtime. For all children, short sleep duration was strongly associated with more television viewing and computer use.

    CONCLUSIONS: Association between sleep duration and overweight is not explained by socio-demographic variables, drinking sugared drinks and eating snacks. Parents have a key role in stimulating optimal sleep duration. Improving parenting skills and knowledge to offer children more structure, and possibly with that, increase sleeping hours, may be promising in prevention of overweight.

  • 254.
    de la Torre-Robles, Amelia
    et al.
    Research Group on Nutrition, Diet and Risk Assessment – AGR255, Nutrition and Food Science Department, University of Granada, Granada, Spain.
    Rivas, Ana
    Research Group on Nutrition, Diet and Risk Assessment – AGR255, Nutrition and Food Science Department, University of Granada, Granada, Spain.
    Lorenzo-Tovar, Maria Luisa
    Research Group on Nutrition, Diet and Risk Assessment – AGR255, Nutrition and Food Science Department, University of Granada, Granada, Spain.
    Monteagudo, Celia
    Research Group on Nutrition, Diet and Risk Assessment – AGR255, Nutrition and Food Science Department, University of Granada, Granada, Spain.
    Mariscal-Arcas, Miguel
    Research Group on Nutrition, Diet and Risk Assessment – AGR255, Nutrition and Food Science Department, University of Granada, Granada, Spain; Food Technology, Nutrition and Food Science Department, University of Murcia, Murcia, Spain .
    Olea-Serrano, Fátima
    Research Group on Nutrition, Diet and Risk Assessment – AGR255, Nutrition and Food Science Department, University of Granada, Granada, Spain.
    Estimation of the intake of phenol compounds from virgin olive oil of a population from southern Spain2014In: Food Additives & Contaminants, ISSN 1944-0049, E-ISSN 1944-0057, Vol. 31, no 9, p. 1460-1469Article in journal (Refereed)
    Abstract [en]

    The objective of the study was to determine the mean polyphenol composition of different varieties of virgin olive oil (VOO) habitually consumed in the region of southern Spain and to estimate the dietary exposure to olive oil polyphenols in that population. There were statistically significant differences in total polyphenols among varieties, with the Picual variety containing the largest amount with a mean value of 591.8 mg kg(-1). The main phenolic compounds found in the VOOs under study were tyrosol and hydroxytyrosol. The highest amounts of both substances were found in Picual olive oils with concentrations of 2.3-6.6 mg kg(-1). The total intake of polyphenols from VOO ranged between 8.2 mg day(-1) (SD = 4.14) for the under 19 year olds and 21.3 mg day(-1) (SD = 3) for the over 50 year olds. Some polyphenols, including tyrosol and hydroxytyrosol, were consumed principally as olive oil. The intake of these compounds in the studied population was in the range of 88.5-237.4 μg day(-1). This has particular importance as recent studies have demonstrated that hydroxytyrosol helps to improve plasma lipids levels and repair oxidative damage related to cardiovascular disease. There was a greater dietary consumption of polyphenols in olive oil among the participants who more closely followed the Mediterranean diet pattern. A higher consumption of olive oil and therefore a greater exposure to polyphenols was observed in females versus males and in participants of normal weight versus those who were overweight. The total intake of polyphenols from VOO significantly increased with higher age, reflecting the greater intake of this oil by older people, who also show a closer adherence to the Mediterranean diet. The over 50-year-old age group showed the greatest consumption of this olive oil and therefore of phenolic compounds, which are healthy protectors in the human diet that contribute to the acknowledged benefits of the Mediterranean diet.

  • 255. Debevec, Tadej
    et al.
    McDonnell, Adam C.
    Macdonald, Ian A.
    Eiken, Ola
    KTH, School of Technology and Health (STH), Basic Science and Biomedicine, Environmental Physiology.
    Mekjavic, Igor B.
    Whole body and regional body composition changes following 10-day hypoxic confinement and unloading-inactivity2014In: Applied Physiology, Nutrition and Metabolism, ISSN 1715-5312, E-ISSN 1715-5320, Vol. 39, no 3, p. 386-395Article in journal (Refereed)
    Abstract [en]

    Future planetary habitats will expose inhabitants to both reduced gravity and hypoxia. This study investigated the effects of short-term unloading and normobaric hypoxia on whole body and regional body composition (BC). Eleven healthy, recreationally active, male participants with a mean (SD) age of 24 (2) years and body mass index of 22.4 (3.2) kg.m(-2) completed the following 3 10-day campaigns in a randomised, cross-over designed protocol: (i) hypoxic ambulatory confinement (HAMB; FIO2 = 0.147 (0.008); PIO2 = 93.8 (0.9) mm Hg), (ii) hypoxic bed rest (HBR; FIO2 = 0.147 (0.008); PIO2 = 93.8 (0.9) mm Hg), and (iii) normoxic bed rest (NBR; FIO2 = 0.209; PIO2 = 133.5 (0.7) mmHg). Nutritional requirements were individually precalculated and the actual intake was monitored throughout the study protocol. Body mass, whole body, and regional BC were assessed before and after the campaigns using dual-energy X-ray absorptiometry. The calculated daily targeted energy intake values were 2071 (170) kcal for HBR and NBR and 2417 (200) kcal for HAMB. In both HBR and NBR campaigns the actual energy intake was within the targeted level, whereas in the HAMB the intake was lower than targeted (-8%, p < 0.05). Body mass significantly decreased in all 3 campaigns (-2.1%, -2.8%, and -2.0% for HAMB, HBR, and NBR, respectively; p < 0.05), secondary to a significant decrease in lean mass (-3.8%, -3.8%, -4.3% for HAMB, HBR, and NBR, respectively; p < 0.05) along with a slight, albeit not significant, increase in fat mass. The same trend was observed in the regional BC regardless of the region and the campaign. These results demonstrate that, hypoxia per se, does not seem to alter whole body and regional BC during short-term bed rest.

  • 256.
    Del Gobbo, Liana C.
    et al.
    Stanford Univ, Dept Med, Sch Med, Div Cardiovasc Med, Stanford, CA 94305 USA..
    Imamura, Fumiaki
    Univ Cambridge, Sch Clin Med, Epidemiol Unit, Med Res Council,Inst Metab Sci, Cambridge, England..
    Aslibekyan, Stella
    Univ Alabama Birmingham, Sch Publ Hlth, Dept Epidemiol, Birmingham, AL USA..
    Marklund, Matti
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Virtanen, Jyrki K.
    Univ Eastern Finland, Inst Publ Hlth & Clin Nutr, Joensuu, Finland..
    Wennberg, Maria
    Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden..
    Yakoob, Mohammad Y.
    Stanford Univ, Dept Med, Sch Med, Div Cardiovasc Med, Stanford, CA 94305 USA..
    Chiuve, Stephanie E.
    Brigham & Womens Hosp, Dept Med, Div Prevent Med, 75 Francis St, Boston, MA 02115 USA.;Harvard TH Chan Sch Publ Hlth, Dept Epidemiol, Boston, MA USA..
    dela Cruz, Luicito
    Canc Council Victoria, Canc Epidemiol Ctr, Melbourne, Vic, Australia..
    Frazier-Wood, Alexis C.
    ARS, USDA, Childrens Nutr Res Ctr, Baylor Coll Med, Houston, TX USA..
    Fretts, Amanda M.
    Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA..
    Guallar, Eliseo
    Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA..
    Matsumoto, Chisa
    Tokyo Med Univ, Div Cardiol, Tokyo, Japan.;Brigham & Womens Hosp, Div Aging, 75 Francis St, Boston, MA 02115 USA.;Harvard Med Sch, Boston, MA USA..
    Prem, Kiesha
    Natl Univ Singapore, Saw Swee Hock Sch Publ Hlth, Singapore, Singapore..
    Tanaka, Tosh
    NIA, Translat Gerontol Branch, Bethesda, MD 20892 USA..
    Wu, Jason H. Y.
    Univ Sydney, George Inst Global Hlth, Sydney Med Sch, Sydney, NSW, Australia..
    Zhou, Xia
    Univ Minnesota, Sch Publ Hlth, Div Epidemiol & Community Hlth, Minneapolis, MN USA..
    Helmer, Catherine
    Inst Sante Publ Epidemiol & Dev, Inst Natl Sante & Rech Med, Ctr Inst Natl Sante & Rech Med Epidemiol Biostat, Bordeaux, France.;Univ Bordeaux, Inst Sante Publ Epidemiol & Dev, Ctr Inst Natl Sante & Rech Med Epidemiol Biostat, Bordeaux, France..
    Ingelsson, Erik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Stanford Univ, Dept Med, Sch Med, Div Cardiovasc Med, Stanford, CA 94305 USA..
    Yuan, Jian-Min
    Univ Pittsburgh, Div Canc Control & Populat Sci, Inst Canc, Pittsburgh, PA USA.;Univ Pittsburgh, Dept Epidemiol, Grad Sch Publ Hlth, Pittsburgh, PA 15261 USA..
    Barberger-Gateau, Pascale
    Inst Sante Publ Epidemiol & Dev, Inst Natl Sante & Rech Med, Ctr Inst Natl Sante & Rech Med Epidemiol Biostat, Bordeaux, France.;Univ Bordeaux, Inst Sante Publ Epidemiol & Dev, Ctr Inst Natl Sante & Rech Med Epidemiol Biostat, Bordeaux, France..
    Campos, Hannia
    Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA..
    Chaves, Paulo H. M.
    Florida Int Univ, Benjamin Leon Ctr Geriatr Res & Educ, Miami, FL 33199 USA..
    Djousse, Luc
    Brigham & Womens Hosp, Div Aging, 75 Francis St, Boston, MA 02115 USA.;Harvard Med Sch, Boston, MA USA..
    Giles, Graham G.
    Gomez-Aracena, Jose
    Univ Malaga, Dept Prevent Med, Malaga, Spain..
    Hodge, Allison M.
    Canc Council Victoria, Canc Epidemiol Ctr, Melbourne, Vic, Australia..
    Hu, Frank B.
    Harvard Med Sch, Boston, MA USA.;Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA.;Brigham & Womens Hosp, Dept Med, Channing Div Network Med, 75 Francis St, Boston, MA 02115 USA..
    Jansson, Jan-Hakan
    Johansson, Ingegerd
    Umea Univ, Dept Odontol, Umea, Sweden..
    Khaw, Kay-Tee
    Univ Cambridge, Dept Publ Hlth & Primary Care, Cambridge, England..
    Koh, Woon-Puay
    Natl Univ Singapore, Saw Swee Hock Sch Publ Hlth, Singapore, Singapore.;Duke NUS Grad Med Sch Singapore, Singapore, Singapore..
    Lemaitre, Rozenn N.
    Univ Washington, Dept Med, Cardiovasc Hlth Res Unit, Seattle, WA USA..
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Luben, Robert N.
    Univ Cambridge, Dept Publ Hlth & Primary Care, Cambridge, England..
    Rimm, Eric B.
    Harvard TH Chan Sch Publ Hlth, Dept Epidemiol, Boston, MA USA.;Harvard Med Sch, Boston, MA USA.;Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA.;Brigham & Womens Hosp, Dept Med, Channing Div Network Med, 75 Francis St, Boston, MA 02115 USA..
    Risérus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Samieri, Cecilia
    Inst Sante Publ Epidemiol & Dev, Inst Natl Sante & Rech Med, Ctr Inst Natl Sante & Rech Med Epidemiol Biostat, Bordeaux, France.;Univ Bordeaux, Inst Sante Publ Epidemiol & Dev, Ctr Inst Natl Sante & Rech Med Epidemiol Biostat, Bordeaux, France..
    Franks, Paul W.
    Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden.;Lund Univ, Dept Clin Sci, Genet & Mol Epidemiol Unit, Lund, Sweden..
    Siscovick, David S.
    New York Acad Med, New York, NY USA..
    Stampfer, Meir
    Harvard TH Chan Sch Publ Hlth, Dept Epidemiol, Boston, MA USA.;Harvard Med Sch, Boston, MA USA.;Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA.;Brigham & Womens Hosp, Dept Med, Channing Div Network Med, 75 Francis St, Boston, MA 02115 USA..
    Steffen, Lyn M.
    Univ Minnesota, Sch Publ Hlth, Div Epidemiol & Community Hlth, Minneapolis, MN USA..
    Steffen, Brian T.
    Univ Minnesota, Sch Publ Hlth, Div Epidemiol & Community Hlth, Minneapolis, MN USA..
    Tsai, Michael Y.
    Univ Minnesota, Dept Lab Med & Pathol, Minneapolis, MN 55455 USA..
    van Dam, Rob M.
    Natl Univ Singapore, Saw Swee Hock Sch Publ Hlth, Singapore, Singapore.;Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA.;Natl Univ Singapore, Dept Med, Yong Loo Lin Sch Med, Singapore, Singapore.;Natl Univ Hlth Syst, Singapore, Singapore..
    Voutilainen, Sari
    Univ Eastern Finland, Inst Publ Hlth & Clin Nutr, Joensuu, Finland..
    Willett, Walter C.
    Harvard TH Chan Sch Publ Hlth, Dept Epidemiol, Boston, MA USA.;Harvard Med Sch, Boston, MA USA.;Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA.;Brigham & Womens Hosp, Dept Med, Channing Div Network Med, 75 Francis St, Boston, MA 02115 USA..
    Woodward, Mark
    Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA.;Univ Sydney, George Inst Global Hlth, Sydney Med Sch, Sydney, NSW, Australia.;Univ Oxford, George Inst Global Hlth, Nuffield Dept Publ Hlth, Oxford, England..
    Mozaffarian, Dariush
    Tufts Univ, Friedman Sch Nutr Sci & Policy, Boston, MA 02111 USA..
    omega-3 Polyunsaturated Fatty Acid Biomarkers and Coronary Heart Disease Pooling Project of 19 Cohort Studies2016In: JAMA Internal Medicine, ISSN 2168-6106, E-ISSN 2168-6114, Vol. 176, no 8, p. 1155-1166Article in journal (Refereed)
    Abstract [en]

    IMPORTANCE The role of omega-3 polyunsaturated fatty acids for primary prevention of coronary heart disease (CHD) remains controversial. Most prior longitudinal studies evaluated self-reported consumption rather than biomarkers. OBJECTIVE To evaluate biomarkers of seafood-derived eicosapentaenoic acid (EPA; 20: 5 omega-3), docosapentaenoic acid (DPA; 22: 5 omega-3), and docosahexaenoic acid (DHA; 22: 6 omega-3) and plant-derived alpha-linolenic acid (ALA; 18: 3 omega-3) for incident CHD. DATA SOURCES A global consortium of 19 studies identified by November 2014. STUDY SELECTION Available prospective (cohort, nested case-control) or retrospective studies with circulating or tissue omega-3 biomarkers and ascertained CHD. DATA EXTRACTION AND SYNTHESIS Each study conducted standardized, individual-level analysis using harmonized models, exposures, outcomes, and covariates. Findings were centrally pooled using random-effects meta-analysis. Heterogeneity was examined by age, sex, race, diabetes, statins, aspirin, omega-6 levels, and FADS desaturase genes. MAIN OUTCOMES AND MEASURES Incident total CHD, fatal CHD, and nonfatal myocardial infarction (MI). RESULTS The 19 studies comprised 16 countries, 45 637 unique individuals, and 7973 total CHD, 2781 fatal CHD, and 7157 nonfatal MI events, with omega-3 measures in total plasma, phospholipids, cholesterol esters, and adipose tissue. Median age at baseline was 59 years (range, 18-97 years), and 28 660 (62.8%) were male. In continuous (per 1-SD increase) multivariable-adjusted analyses, the omega-3 biomarkers ALA, DPA, and DHA were associated with a lower risk of fatal CHD, with relative risks (RRs) of 0.91 (95% CI, 0.84-0.98) for ALA, 0.90 (95% CI, 0.85-0.96) for DPA, and 0.90 (95% CI, 0.84-0.96) for DHA. Although DPA was associated with a lower risk of total CHD (RR, 0.94; 95% CI, 0.90-0.99), ALA (RR, 1.00; 95% CI, 0.95-1.05), EPA (RR, 0.94; 95% CI, 0.87-1.02), and DHA (RR, 0.95; 95% CI, 0.91-1.00) were not. Significant associations with nonfatal MI were not evident. Associations appeared generally stronger in phospholipids and total plasma. Restricted cubic splines did not identify evidence of nonlinearity in dose responses. CONCLUSIONS AND RELEVANCE On the basis of available studies of free-living populations globally, biomarker concentrations of seafood and plant-derived omega-3 fatty acids are associated with a modestly lower incidence of fatal CHD.

  • 257.
    Delisle Nyström, Christine
    et al.
    Karolinska Institute, Sweden.
    Sandin, Sven
    Karolinska Institute, Sweden; Icahn School Medical Mt Sinai, NY 10029 USA; Icahn School Medical Mt Sinai, NY 10029 USA.
    Henriksson, Pontus
    University of Granada, Spain.
    Henriksson, Hanna
    University of Granada, Spain.
    Trolle-Lagerros, Ylva
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Larsson, Christel
    University of Gothenburg, Sweden.
    Maddison, Ralph
    Deakin University, Australia.
    Ortega, Francisco B.
    University of Granada, Spain.
    Pomeroy, Jeremy
    Marshfield Clin Research Fdn, WI USA.
    Ruiz, Jonatan R.
    University of Granada, Spain.
    Silfvernagel, Kristin
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Business support and Development, Department of Health and Care Development.
    Löf, Marie
    Karolinska Institute, Sweden.
    Mobile-based intervention intended to stop obesity in preschool-aged children: the MINISTOP randomized controlled trial2017In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 105, no 6, p. 1327-1335Article in journal (Refereed)
    Abstract [en]

    Background: Traditional obesity prevention programs are time-and cost-intensive. Mobile phone technology has been successful in changing behaviors and managing weight; however, to our knowledge, its potential in young children has yet to be examined. Objective: We assessed the effectiveness of a mobile health (mHealth) obesity prevention program on body fat, dietary habits, and physical activity in healthy Swedish children aged 4.5 y. Design: From 2014 to 2015, 315 children were randomly assigned to an intervention or control group. Parents in the intervention group received a 6-mo mHealth program. The primary outcome was fat mass index (FMI), whereas the secondary outcomes were intakes of fruits, vegetables, candy, and sweetened beverages and time spent sedentary and in moderate-to-vigorous physical activity. Composite scores for the primary and secondary outcomes were computed. Results: No statistically significant intervention effect was observed for FMI between the intervention and control group (mean +/- SD: -0.23 +/- 0.56 compared with -0.20 +/- 0.49 kg/m(2)). However, the intervention group increased their mean composite score from baseline to follow-up, whereas the control group did not (+ 0.36 +/- 1.47 compared with -0.06 +/- 1.33 units; P = 0.021). This improvement was more pronounced among the children with an FMI above the median (4.11 kg/m(2)) (P = 0.019). The odds of increasing the composite score for the 6 dietary and physical activity behaviors were 99% higher for the intervention group than the control group (P = 0.008). Conclusions: This mHealth obesity prevention study in preschool-aged children found no difference between the intervention and control group for FMI. However, the intervention group showed a considerably higher postintervention composite score (a secondary outcome) than the control group, especially in children with a higher FMI. Further studies targeting specific obesity classes within preschool-aged children are warranted.

  • 258.
    Dernini, S.
    et al.
    International Foundation of Mediterranean Diet (IFMeD), London, United Kingdom; Forum on Mediterranean Food Cultures, Rome, Italy; Food and Agriculture Organization of the United Nations, Rome, Italy.
    Berry, E. M.
    International Foundation of Mediterranean Diet (IFMeD), London, United Kingdom; Department of Human Nutrition and Metabolism, Braun School of Public Health, Hebrew University-Hadassah Medical School, Jerusalem, Israel.
    Serra-Majem, L.
    International Foundation of Mediterranean Diet (IFMeD), London, United Kingdom; University of Las Palmas of Gran Canaria, Las Palmas, Spain; Inter-University International Centre of Mediterranean Food Cultures Studies (CIISCAM), Rome, Italy.
    La Vecchia, C.
    International Foundation of Mediterranean Diet (IFMeD), London, United Kingdom; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
    Capone, R.
    International Foundation of Mediterranean Diet (IFMeD), London, United Kingdom; International Centre for Advanced Mediterranean Agronomic Studies (CIHEAM), Bari, Italy.
    Medina, F. X.
    International Foundation of Mediterranean Diet (IFMeD), London, United Kingdom; Universitat Oberta de Catalunya/Open University of Catalonia, Barcelona, Spain.
    Aranceta-Bartrina, J.
    International Foundation of Mediterranean Diet (IFMeD), London, United Kingdom; University of Navarra, Navarra, Spain.
    Belahsen, R.
    International Foundation of Mediterranean Diet (IFMeD), London, United Kingdom; Chouaib Doukkali University, El Jadida, Morocco.
    Burlingame, B.
    International Foundation of Mediterranean Diet (IFMeD), London, United Kingdom; Massey University, Palmerston North, New Zealand.
    Calabrese, G.
    International Foundation of Mediterranean Diet (IFMeD), London, United Kingdom; University of Turin, Turin, Italy.
    Corella, D.
    International Foundation of Mediterranean Diet (IFMeD), London, United Kingdom; Department of Preventive Medicine, University of Valencia, Valencia, Spain; CIBER Fisiopatologia de la Obesidad y Nutricion, Valencia, Spain.
    Donini, L. M.
    International Foundation of Mediterranean Diet (IFMeD), London, United Kingdom; Inter-University International Centre of Mediterranean Food Cultures Studies (CIISCAM), Rome, Italy; INRA, INSERM, NORT/Aix-Marseille University, Marseille, France.
    Lairon, D.
    International Foundation of Mediterranean Diet (IFMeD), London, United Kingdom; Sapienza University of Rome, Rome, Italy.
    Meybeck, A.
    International Foundation of Mediterranean Diet (IFMeD), London, United Kingdom; Food and Agriculture Organization of the United Nations, Rome, Italy.
    Pekcan, A. G.
    International Foundation of Mediterranean Diet (IFMeD), London, United Kingdom; Department of Nutrition and Dietetic, Hacettepe University, Ankara, Turkey.
    Piscopo, S.
    International Foundation of Mediterranean Diet (IFMeD), London, United Kingdom; Inter-University International Centre of Mediterranean Food Cultures Studies (CIISCAM), Rome, Italy.
    Yngve, Agneta
    Örebro University, School of Hospitality, Culinary Arts & Meal Science. International Foundation of Mediterranean Diet (IFMeD), London, United Kingdom.
    Trichopoulou, A.
    International Foundation of Mediterranean Diet (IFMeD), London, United Kingdom; Hellenic Health Foundation, Athens, Greece.
    Med Diet 4.0: the Mediterranean diet with four sustainable benefits2017In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 20, no 7, p. 1322-1330Article, review/survey (Refereed)
    Abstract [en]

    Objective: To characterize the multiple dimensions and benefits of the Mediterranean diet as a sustainable diet, in order to revitalize this intangible food heritage at the country level; and to develop a multidimensional framework - the Med Diet 4.0 - in which four sustainability benefits of the Mediterranean diet are presented in parallel: major health and nutrition benefits, low environmental impacts and richness in biodiversity, high sociocultural food values, and positive local economic returns.

    Design: A narrative review was applied at the country level to highlight the multiple sustainable benefits of the Mediterranean diet into a single multidimensional framework: the Med Diet 4.0.

    Setting/subjects: We included studies published in English in peer-reviewed journals that contained data on the characterization of sustainable diets and of the Mediterranean diet. The methodological framework approach was finalized through a series of meetings, workshops and conferences where the framework was presented, discussed and ultimately refined.

    Results: The Med Diet 4.0 provides a conceptual multidimensional framework to characterize the Mediterranean diet as a sustainable diet model, by applying principles of sustainability to the Mediterranean diet.

    Conclusions: By providing a broader understanding of the many sustainable benefits of the Mediterranean diet, the Med Diet 4.0 can contribute to the revitalization of the Mediterranean diet by improving its current perception not only as a healthy diet but also a sustainable lifestyle model, with country-specific and culturally appropriate variations. It also takes into account the identity and diversity of food cultures and systems, expressed within the notion of the Mediterranean diet, across the Mediterranean region and in other parts of the world. Further multidisciplinary studies are needed for the assessment of the sustainability of the Mediterranean diet to include these new dimensions.

  • 259. Dimova, Lidiya G.
    et al.
    Zlatkov, Nikola
    Umeå University, Faculty of Medicine, Molecular Infection Medicine Sweden (MIMS). Umeå University, Faculty of Medicine, Department of Molecular Biology (Faculty of Medicine).
    Verkade, Henkjan J.
    Uhlin, Bernt Eric
    Umeå University, Faculty of Medicine, Molecular Infection Medicine Sweden (MIMS). Umeå University, Faculty of Medicine, Department of Molecular Biology (Faculty of Medicine).
    Tietge, Uwe J. F.
    High- cholesterol diet does not alter gut microbiota composition in mice2017In: Nutrition & Metabolism, ISSN 1743-7075, E-ISSN 1743-7075, Vol. 14, article id 15Article in journal (Refereed)
    Abstract [en]

    Introduction: Western diet containing both saturated fat and cholesterol impairs cardio- metabolic health partly by modulating diversity and function of the microbiota. While diet containing only high fat has comparable effects, it is unclear how diets only enriched in cholesterol impact the microbiota. Therefore, we aimed to characterize the response of host and microbiota to a high cholesterol ( HC) diet in mice susceptible to cardio- metabolic disease. Methods: LDLR knockout mice received either 1.25% HC or no cholesterol containing control diet ( NC) for 12 weeks before characterizing host cholesterol metabolism and intestinal microbiota composition ( next generation sequencing). Results: HC diet substantially increased plasma ( 1.6- fold) and liver cholesterol levels ( 21- fold), biliary cholesterol secretion ( 4.5- fold) and fecal neutral sterol excretion ( 68- fold, each p < 0.001) but not fecal bile acid excretion. Interestingly, despite the profound changes in intestinal cholesterol homeostasis no differences in microbial composition between control and HC- fed mice were detected. In both groups the main phyla were Bacteroidetes ( 55%), Firmicutes ( 27%) and Verrucomicrobia ( 14%). Conclusion: Our results demonstrate that in mice HC diet alone does not alter the microbiota composition despite inducing substantial adaptive changes in whole body cholesterol homeostasis. The impact of Western diet on intestinal microbiota thus appears to be mediated exclusively by its high fat content.

  • 260. Ding, Ming
    et al.
    Huang, Tao
    Bergholdt, Helle K. M.
    Nordestgaard, Borge G.
    Ellervik, Christina
    Qi, Lu
    Frazier-Wood, Alexis C.
    Aslibekyan, Stella
    North, Kari E.
    Voortman, Trudy
    Graff, Mariaelisa
    Smith, Caren E.
    Lai, Chao-Qiang
    Varbo, Anette
    Lemaitre, Rozenn N.
    de Jonge, Ester A. L.
    Fumeron, Frederic
    Corella, Dolores
    Wang, Carol A.
    Tjonneland, Anne
    Overvad, Kim
    Sorensen, Thorkild I. A.
    Feitosa, Mary F.
    Wojczynski, Mary K.
    Kahonen, Mika
    Ahmad, Shafqat
    Renström, Frida
    Umeå University, Faculty of Medicine, Department of Biobank Research. Department of Clinical Sciences, Lund University, Malmö, Sweden.
    Psaty, Bruce M.
    Siscovick, David S.
    Barroso, Ines
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Biobank Research.
    Hernandez, Dena
    Ferrucci, Luigi
    Bandinelli, Stefania
    Linneberg, Allan
    Sandholt, Camilla Helene
    Pedersen, Oluf
    Hansen, Torben
    Schulz, Christina-Alexandra
    Sonestedt, Emily
    Orho-Melander, Marju
    Chen, Tzu-An
    Rotter, Jerome I.
    Allison, Mathew A.
    Rich, Stephen S.
    Sorli, Jose V.
    Coltell, Oscar
    Pennell, Craig E.
    Eastwood, Peter R.
    Hofman, Albert
    Uitterlinden, Andre G.
    Zillikens, MCarola
    van Rooij, Frank J. A.
    Chu, Audrey Y.
    Rose, Lynda M.
    Ridker, Paul M.
    Viikari, Jorma
    Raitakari, Olli
    Lehtimaki, Terho
    Mikkila, Vera
    Willett, Walter C.
    Wang, Yujie
    Tucker, Katherine L.
    Ordovas, Jose M.
    Kilpelainen, Tuomas O.
    Province, Michael A.
    Franks, Paul W.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA; Department of Clinical Sciences, Lund University, Malmö, Sweden.
    Arnett, Donna K.
    Tanaka, Toshiko
    Toft, Ulla
    Ericso, Ulrika
    Franco, Oscar H.
    Mozaffarian, Dariush
    Hu, Frank B.
    Chasman, Daniel I.
    Dairy consumption, systolic blood pressure, and risk of hypertension: Mendelian randomization study2017In: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 356, article id j1000Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE To examine whether previous observed inverse associations of dairy intake with systolic blood pressure and risk of hypertension were causal. DESIGN Mendelian randomization study using the single nucleotide polymorphism rs4988235 related to lactase persistence as an instrumental variable. SETTING CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology) Consortium. PARTICIPANTS Data from 22 studies with 171 213 participants, and an additional 10 published prospective studies with 26 119 participants included in the observational analysis. MAIN OUTCOME MEASURES The instrumental variable estimation was conducted using the ratio of coefficients approach. Using metaanalysis, an additional eight published randomized clinical trials on the association of dairy consumption with systolic blood pressure were summarized. RESULTS Compared with the CC genotype (CC is associated with complete lactase deficiency), the CT/TT genotype (TT is associated with lactose persistence, and CT is associated with certain lactase deficiency) of LCT-13910 (lactase persistence gene) rs4988235 was associated with higher dairy consumption (0.23 (about 55 g/day), 95% confidence interval 0.17 to 0.29) serving/day; P<0.001) and was not associated with systolic blood pressure (0.31, 95% confidence interval -0.05 to 0.68 mm Hg; P=0.09) or risk of hypertension (odds ratio 1.01, 95% confidence interval 0.97 to 1.05; P=0.27). Using LCT-13910 rs4988235 as the instrumental variable, genetically determined dairy consumption was not associated with systolic blood pressure (beta=1.35, 95% confidence interval -0.28 to 2.97 mm Hg for each serving/day) or risk of hypertension (odds ratio 1.04, 0.88 to 1.24). Moreover, meta-analysis of the published clinical trials showed that higher dairy intake has no significant effect on change in systolic blood pressure for interventions over one month to 12 months (intervention compared with control groups: beta=-0.21, 95% confidence interval -0.98 to 0.57 mm Hg). In observational analysis, each serving/day increase in dairy consumption was associated with -0.11 (95% confidence interval -0.20 to -0.02 mm Hg; P=0.02) lower systolic blood pressure but not risk of hypertension (odds ratio 0.98, 0.97 to 1.00; P=0.11). CONCLUSION The weak inverse association between dairy intake and systolic blood pressure in observational studies was not supported by a comprehensive instrumental variable analysis and systematic review of existing clinical trials.

  • 261. Dixen, Karen
    et al.
    Basse, Astrid L.
    Murholm, Maria
    Isidor, Marie S.
    Hansen, Lillian H. L.
    Petersen, M. Christine H.
    Madsen, Lise
    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.
    Quistorff, Bjorn
    Hansen, Jacob B.
    ERR gamma Enhances UCP1 Expression and Fatty Acid Oxidation in Brown Adipocytes2013In: Obesity, ISSN 1930-7381, E-ISSN 1930-739X, Vol. 21, no 3, p. 516-524Article in journal (Refereed)
    Abstract [en]

    Objective: Estrogen-related receptors (ERRs) are important regulators of energy metabolism. Here we investigated the hypothesis that ERR gamma impacts on differentiation and function of brown adipocytes. Design and Methods: We characterize the expression of ERR gamma in adipose tissues and cell models and investigate the effects of modulating ERR? activity on UCP1 gene expression and metabolic features of brown and white adipocytes. Results: ERR gamma was preferentially expressed in brown compared to white fat depots, and ERR gamma was induced during cold-induced browning of subcutaneous white adipose tissue and brown adipogenesis. Overexpression of ERR gamma positively regulated uncoupling protein 1 (UCP1) expression levels during brown adipogenesis. This ERR gamma-induced augmentation of UCP1 expression was independent of the presence of peroxisome proliferator-activated receptor coactivator-1 (PGC-1 alpha) but was associated with increased rates of fatty acid oxidation in adrenergically stimulated cells. ERR? did not influence mitochondrial biogenesis, and its reduced expression in white adipocytes could not explain their low expression level of UCP1. Conclusions: Through its augmenting effect on expression of UCP1, ERR gamma may physiologically be involved in increasing the potential for energy expenditure in brown adipocytes, a function that is becoming of therapeutic interest.

  • 262.
    Doi, Mariko
    et al.
    Department of Epidemiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan.
    Sultana Rekha, Rokeya
    Laboratory Science Division, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B).
    Ahmed, Sultan
    Laboratory Science Division, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B).
    Okada, Masafumi
    Department of Epidemiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan.
    Kumar Roy, Anjan
    Laboratory Science Division, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B).
    El Arifeen, Shams
    Child Health Unit, Public Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B).
    Ekström, Eva-Charlotte
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Raqib, Rubhana
    Laboratory Science Division, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B).
    Wagatsuma, Yukiko
    Department of Epidemiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan.
    Association between calcium in cord blood and newborn size in Bangladesh2011In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 106, no 9, p. 1398-1407Article in journal (Refereed)
    Abstract [en]

    Ca status in the uterus during pregnancy has been suggested to affect fetal growth and size at birth. In Bangladesh, low Ca levels in pregnant women and low birth weight in infants are common. The present study explored the association between Ca levels in cord blood and newborn size at birth (birth weight and birth length) in Bangladesh. Samples and data included 223 women with live-born singleton deliveries in rural Bangladesh. Newborn weight and length were measured at birth. From cord blood obtained at delivery, Ca, 25-hydroxy vitamin D, bone-specific alkaline phosphatase and intact parathyroid hormone levels were determined. An association between size at birth and Ca levels in cord blood was found (birth weight, P = 0·022; birth length, P = 0·001). Associations between Ca and newborn size were further analysed using multivariate regression analyses. After adjusting for several covariates of characteristics in mothers and newborns (gestational weeks at birth, sex of newborn, socio-economic status, maternal height, BMI, age and season at birth), birth length still exhibited a significant relationship with Ca levels in cord blood (birth length, P = 0·030). The present study indicates that Ca status in cord blood might be associated with the birth length of newborns. Ca levels during gestation may affect fetal growth.

  • 263.
    Domellöf, Magnus
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Iron and Other Micronutrient Deficiencies in Low-Birthweight Infants2013In: Maternal and child nutrition: the first 1,000 days / [ed] Jatinder Bhatia, Zulfiqar A. Bhutta, Satish C. Kalhan, 2013, p. 197-206Conference paper (Refereed)
    Abstract [en]

    Low birthweight (LBW), defined as birthweight <2,500 g, is a major global public health problem and is associated with lifelong cognitive and behavioral problems. Very LBW (VLBW) infants (<1,500 g) are at high risk of multiple macro- and micronutrient deficiencies, but most LBW infants are larger (1,500-2,500 g), and the most common nutritional problem of those infants is iron deficiency (ID). Globally, about 25% of pre-school children have ID anemia (IDA), the most severe form of ID, and there is good evidence that ID is associated with impaired brain development. However, adverse effects of excessive iron supplementation have been observed. Delayed umbilical cord clamping, which increases infant iron stores, should be recommended for all newborns. There is good evidence that intakes of 2 mg of dietary iron per kg daily prevents IDA in LBW infants without causing adverse effects. A recent study shows that this dose of iron supplementation also reduces the risk of behavioral problems at 3 years in infants with birthweights 2,000-2,500 g.VLBW infants need 2-3 mg/kg per day. To achieve these intakes, breastfed LBW infants should receive iron supplements, and formula-fed LBW infants should receive an iron-fortified infant formula.

  • 264.
    Domellöf, Magnus
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Braegger, Christian
    Campoy, Cristina
    Colomb, Virginie
    Decsi, Tamas
    Fewtrell, Mary
    Hojsak, Iva
    Mihatsch, Walter
    Molgaard, Christian
    Shamir, Raanan
    Turck, Dominique
    van Goudoever, Johannes
    Iron Requirements of Infants and Toddlers2014In: Journal of Pediatric Gastroenterology and Nutrition - JPGN, ISSN 0277-2116, E-ISSN 1536-4801, Vol. 58, no 1, p. 119-129Article in journal (Refereed)
    Abstract [en]

    Iron deficiency (ID) is the most common micronutrient deficiency worldwide and young children are a special risk group because their rapid growth leads to high iron requirements. Risk factors associated with a higher prevalence of ID anemia (IDA) include low birth weight, high cow's-milk intake, low intake of iron-rich complementary foods, low socioeconomic status, and immigrant status. The aim of this position paper was to review the field and provide recommendations regarding iron requirements in infants and toddlers, including those of moderately or marginally low birth weight. There is no evidence that iron supplementation of pregnant women improves iron status in their offspring in a European setting. Delayed cord clamping reduces the risk of ID. There is insufficient evidence to support general iron supplementation of healthy European infants and toddlers of normal birth weight. Formula-fed infants up to 6 months of age should receive iron-fortified infant formula, with an iron content of 4 to 8 mg/L (0.6-1.2 mg <bold></bold> kg(-1) <bold></bold> day(-1)). Marginally low-birth-weight infants (2000-2500 g) should receive iron supplements of 1-2 mg <bold></bold> kg(-1) <bold></bold> day(-1). Follow-on formulas should be iron-fortified; however, there is not enough evidence to determine the optimal iron concentration in follow-on formula. From the age of 6 months, all infants and toddlers should receive iron-rich (complementary) foods, including meat products and/or iron-fortified foods. Unmodified cow's milk should not be fed as the main milk drink to infants before the age of 12 months and intake should be limited to <500 mL/day in toddlers. It is important to ensure that this dietary advice reaches high-risk groups such as socioeconomically disadvantaged families and immigrant families.

  • 265.
    Domellöf, Magnus
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Thorsdottir, Inga
    Thorstensen, Ketil
    Health effects of different dietary iron intakes: a systematic literature review for the 5th Nordic Nutrition Recommendations2013In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 57, no 21667Article, review/survey (Refereed)
    Abstract [en]

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

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

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

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

  • 266. Domingo, Jose L.
    et al.
    Ericson Jogsten, Ingrid
    Örebro University, School of Science and Technology.
    Eriksson, Ulrika
    Örebro University, School of Science and Technology.
    Martorell, Isabel
    Perello, Gemma
    Nadal, Marti
    van Bavel, Bert
    Örebro University, School of Science and Technology.
    Human dietary exposure to perfluoroalkyl substances in Catalonia, Spain: temporal trend2012In: Food Chemistry, ISSN 0308-8146, E-ISSN 1873-7072, Vol. 135, no 3, p. 1575-1582Article in journal (Refereed)
    Abstract [en]

    In this study, we assessed the levels of 18 perfluoroalkyl substances (PFASs) in the most widely consumed foodstuffs in Catalonia, Spain, as well as the total dietary intake of these compounds. Forty food items were analysed. Only perfluoropentanoic acid (PFPeA), perfluorohexadecanoic acid (PFHxDA) and perfluorooctanoicdecanoic acid (PFOcDA) were not detected in any sample. Perfluorooctane sulfonate (PFOS) was the compound found in the highest number of samples (33 out of 80), followed by perfluorooctanoic acid (PFOA), perfluoroheptanoic acid (PFHpA), perfluorohexane sulfonic acid (PFHxS), perfluorodecanoic acid (PFDA) and perfluorodecane sulfonic acid (PFDS). Fish and shellfish was the food group in which more PFASs were detected and where the highest PFAS concentrations were found. The highest dietary intakes corresponded to children, followed by male seniors, with values of 1787 and 1466 ng/day, respectively. For any of the age/gender groups of the population, the Tolerable Daily Intakes (TDIs) recommended by the EFSA were not exceeded. In general terms, PFAS levels found in the current study are lower than the concentrations recently reported in other countries.

  • 267.
    Dragsted, L.
    et al.
    Univ Copenhagen, Dept Nutr Exercise & Sports, DK-1168 Copenhagen, Denmark..
    Acar, E.
    Univ Copenhagen, Dept Food Sci, DK-1168 Copenhagen, Denmark..
    Gurdeniz, G.
    Univ Copenhagen, Dept Nutr Exercise & Sports, DK-1168 Copenhagen, Denmark..
    Andersen, M-B
    Univ Copenhagen, Dept Nutr Exercise & Sports, DK-1168 Copenhagen, Denmark..
    Poulsen, S.
    Univ Copenhagen, Dept Nutr Exercise & Sports, DK-1168 Copenhagen, Denmark..
    Astrup, A.
    Univ Copenhagen, Dept Nutr Exercise & Sports, DK-1168 Copenhagen, Denmark..
    Bro, R.
    Univ Copenhagen, Dept Food Sci, DK-1168 Copenhagen, Denmark..
    Engelsen, S. B.
    Univ Copenhagen, Dept Food Sci, DK-1168 Copenhagen, Denmark..
    Savorani, F.
    Univ Copenhagen, Dept Food Sci, DK-1168 Copenhagen, Denmark..
    Brader, L.
    Aarhus Univ Hosp, Dept Med & Endocrinol MEA, Aarhus, Denmark..
    Hermansen, K.
    Aarhus Univ Hosp, Dept Med & Endocrinol MEA, Aarhus, Denmark..
    Schwab, U.
    Univ Eastern Finland, Inst Publ Hlth & Clin Nutr, Joensuu, Finland..
    Kolehmainen, M.
    Univ Eastern Finland, Inst Publ Hlth & Clin Nutr, Joensuu, Finland..
    Paananen, J.
    Univ Eastern Finland, Inst Publ Hlth & Clin Nutr, Joensuu, Finland..
    Poutanen, K. S.
    Univ Eastern Finland, Inst Publ Hlth & Clin Nutr, Joensuu, Finland..
    Cloetens, L.
    Lund Univ, Biomed Nutr Pure & Appl Biochem, S-22100 Lund, Sweden..
    Akesson, B.
    Lund Univ, Biomed Nutr Pure & Appl Biochem, S-22100 Lund, Sweden..
    Siloaho, M.
    Univ Oulu, Dept Internal Med, Inst Clin Med, SF-90100 Oulu, Finland..
    Savolainen, M. J.
    Univ Oulu, Dept Internal Med, Inst Clin Med, SF-90100 Oulu, Finland..
    Gunnarsdottir, I
    Univ Iceland, IS-101 Reykjavik, Iceland.;Natl Univ Hosp Iceland, Landspitali, Reykjavik, Iceland..
    Thorsdottir, I
    Univ Iceland, IS-101 Reykjavik, Iceland.;Natl Univ Hosp Iceland, Landspitali, Reykjavik, Iceland..
    Ulven, S. M.
    Oslo & Akershus Univ Coll Appl Sci, Fac Hlth Sci, Dept Hlth Nutr & Management, Oslo, Norway..
    Rosqvist, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Risérus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Uusitupa, M.
    Univ Eastern Finland, Inst Publ Hlth & Clin Nutr, Joensuu, Finland..
    Larsen, T. M.
    Univ Copenhagen, Dept Nutr Exercise & Sports, DK-1168 Copenhagen, Denmark..
    Metabolomic response to Nordic foods2015In: Annals of Nutrition and Metabolism, ISSN 0250-6807, E-ISSN 1421-9697, Vol. 67, p. 55-55Article in journal (Other academic)
  • 268. Dratva, Julia
    et al.
    Bertelsen, Randi
    Janson, Christer
    Johannessen, Ane
    Benediktsdóttir, Bryndis
    Bråbäck, Lennart
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Dharmage, Shyamali C
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Gislason, Thorarinn
    Jarvis, Debbie
    Jogi, Rain
    Lindberg, Eva
    Norback, Dan
    Omenaas, Ernst
    Skorge, Trude D
    Sigsgaard, Torben
    Toren, Kjell
    Waatevik, Marie
    Wieslander, Gundula
    Schlünssen, Vivi
    Svanes, Cecilie
    Real, Francisco Gomez
    Validation of self-reported figural drawing scales against anthropometric measurements in adults2016In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 19, no 11, p. 1944-1951Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of the present study was to validate figural drawing scales depicting extremely lean to extremely obese subjects to obtain proxies for BMI and waist circumference in postal surveys.

    DESIGN: Reported figural scales and anthropometric data from a large population-based postal survey were validated with measured anthropometric data from the same individuals by means of receiver-operating characteristic curves and a BMI prediction model.

    SETTING: Adult participants in a Scandinavian cohort study first recruited in 1990 and followed up twice since.

    SUBJECTS: Individuals aged 38-66 years with complete data for BMI (n 1580) and waist circumference (n 1017).

    RESULTS: Median BMI and waist circumference increased exponentially with increasing figural scales. Receiver-operating characteristic curve analyses showed a high predictive ability to identify individuals with BMI > 25·0 kg/m2 in both sexes. The optimal figural scales for identifying overweight or obese individuals with a correct detection rate were 4 and 5 in women, and 5 and 6 in men, respectively. The prediction model explained 74 % of the variance among women and 62 % among men. Predicted BMI differed only marginally from objectively measured BMI.

    CONCLUSIONS: Figural drawing scales explained a large part of the anthropometric variance in this population and showed a high predictive ability for identifying overweight/obese subjects. These figural scales can be used with confidence as proxies of BMI and waist circumference in settings where objective measures are not feasible.

  • 269. Duarte-Salles, Talita
    et al.
    Fedirko, Veronika
    Stepien, Magdalena
    Aleksandrova, Krasimira
    Bamia, Christina
    Lagiou, Pagona
    Laursen, Anne Sofie Dam
    Hansen, Louise
    Overvad, Kim
    Tjønneland, Anne
    Boutron-Ruault, Marie-Christine
    Fagherazzi, Guy
    His, Mathilde
    Boeing, Heiner
    Katzke, Verena
    Kühn, Tilman
    Trichopoulou, Antonia
    Valanou, Elissavet
    Kritikou, Maria
    Masala, Giovanna
    Panico, Salvatore
    Sieri, Sabina
    Ricceri, Fulvio
    Tumino, Rosario
    Bueno-de-Mesquita, H B As
    Peeters, Petra H
    Hjartåker, Anette
    Skeie, Guri
    Weiderpass, Elisabete
    Ardanaz, Eva
    Bonet, Catalina
    Chirlaque, Maria-Dolores
    Dorronsoro, Miren
    Quirós, J Ramón
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Ohlsson, Bodil
    Sjöberg, Klas
    Wennberg, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Khaw, Kay-Tee
    Travis, Ruth C
    Wareham, Nick
    Ferrari, Pietro
    Freisling, Heinz
    Romieu, Isabelle
    Cross, Amanda J
    Gunter, Marc
    Lu, Yunxia
    Jenab, Mazda
    Dietary fat, fat subtypes and hepatocellular carcinoma in a large European cohort2015In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 137, no 11, p. 2715-2728Article in journal (Refereed)
    Abstract [en]

    The role of amount and type of dietary fat consumption in the etiology of hepatocellular carcinoma (HCC) is poorly understood, despite suggestive biological plausibility. The associations of total fat, fat subtypes and fat sources with HCC incidence were investigated in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, which includes 191 incident HCC cases diagnosed between 1992 and 2010. Diet was assessed by country-specific, validated dietary questionnaires. A single 24-hr diet recall from a cohort subsample was used for measurement error calibration. Hazard ratios (HR) and 95% confidence intervals (95% CI) were estimated from Cox proportional hazard models. Hepatitis B and C viruses (HBV/HCV) status and biomarkers of liver function were assessed separately in a nested case-control subset with available blood samples (HCC = 122). In multivariable calibrated models, there was a statistically significant inverse association between total fat intake and risk of HCC (per 10 g/day, HR = 0.80, 95% CI: 0.65-0.99), which was mainly driven by monounsaturated fats (per 5 g/day, HR = 0.71, 95% CI: 0.55-0.92) rather than polyunsaturated fats (per 5 g/day, HR = 0.92, 95% CI: 0.68-1.25). There was no association between saturated fats (HR = 1.08, 95% CI: 0.88-1.34) and HCC risk. The ratio of polyunsaturated/monounsaturated fats to saturated fats was not significantly associated with HCC risk (per 0.2 point, HR = 0.86, 95% CI: 0.73-1.01). Restriction of analyses to HBV/HCV free participants or adjustment for liver function did not substantially alter the findings. In this large prospective European cohort, higher consumption of monounsaturated fats is associated with lower HCC risk.

  • 270. Duarte-Salles, Talita
    et al.
    Fedirko, Veronika
    Stepien, Magdalena
    Trichopoulou, Antonia
    Bamia, Christina
    Lagiou, Pagona
    Lukanova, Annekatrin
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Trepo, Elisabeth
    Overvad, Kim
    Tjønneland, Anne
    Halkjaer, Jytte
    Boutron-Ruault, Marie-Christine
    Racine, Antoine
    Cadeau, Claire
    Kühn, Tilman
    Aleksandrova, Krasimira
    Trichopoulos, Dimitrios
    Tsiotas, Konstantinos
    Boffetta, Paolo
    Palli, Domenico
    Pala, Valeria
    Tumino, Rosario
    Sacerdote, Carlotta
    Panico, Salvatore
    Bueno-de-Mesquita, H B as
    Dik, Vincent K
    Peeters, Petra H
    Weiderpass, Elisabete
    Torhild Gram, Inger
    Hjartåker, Anette
    Ramón Quirós, Jose
    Fonseca-Nunes, Ana
    Molina-Montes, Esther
    Dorronsoro, Miren
    Navarro Sanchez, Carmen
    Barricarte, Aurelio
    Lindkvist, Björn
    Sonestedt, Emily
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Wennberg, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Khaw, Kay-Tee
    Wareham, Nick
    Travis, Ruth C
    Romieu, Isabelle
    Riboli, Elio
    Jenab, Mazda
    Dairy products and risk of hepatocellular carcinoma: the European Prospective Investigation into Cancer and Nutrition2014In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 135, no 7, p. 1662-1672Article in journal (Refereed)
    Abstract [en]

    Intake of dairy products has been associated with risk of some cancers, but findings are often inconsistent and information on hepatocellular carcinoma (HCC) risk is limited, particularly from prospective settings. The aim of our study was to investigate the association between consumption of total and specific dairy products (milk/cheese/yogurt) and their components (calcium/vitamin D/fats/protein), with first incident HCC (N(cases) = 191) in the European Prospective Investigation into Cancer and Nutrition cohort, including a nested case-control subset (N(cases) = 122) with the assessment of hepatitis B virus/hepatitis C virus infections status, liver damage and circulating insulin-like growth factor (IGF)-I levels. For cohort analyses, multivariable-adjusted Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CI). For nested case-control analyses, conditional logistic regression was used to calculate odds ratios and 95% CI. A total of 477,206 participants were followed-up for an average of 11 years (person-years follow-up = 5,415,385). In the cohort study, a significant positive HCC risk association was observed for total dairy products (highest vs. lowest tertile, HR = 1.66, 95% CI: 1.13-2.43; p(trend) = 0.012), milk (HR = 1.51, 95% CI: 1.02-2.24; p(trend) = 0.049), and cheese (HR = 1.56, 95% CI: 1.02-2.38; p(trend) = 0.101), but not yogurt (HR = 0.94, 95% CI: 0.65-1.35). Dietary calcium, vitamin D, fat and protein from dairy sources were associated with increased HCC risk, whereas the same nutrients from nondairy sources showed inverse or null associations. In the nested case-control study, similar results were observed among hepatitis-free individuals. Results from this large prospective cohort study suggest that higher consumption of dairy products, particularly milk and cheese, may be associated with increased HCC risk. Validation of these findings in other populations is necessary. Potential biologic mechanisms require further exploration.

  • 271. Duell, Eric J
    et al.
    Lujan-Barroso, Leila
    Llivina, Claudia
    Muñoz, Xavier
    Jenab, Mazda
    Boutron-Ruault, Marie-Christine
    Clavel-Chapelon, Françoise
    Racine, Antoine
    Boeing, Heiner
    Buijsse, Brian
    Canzian, Federico
    Johnson, Theron
    Dalgård, Christine
    Overvad, Kim
    Tjønneland, Anne
    Olsen, Anja
    Sánchez, Soledad C
    Sánchez-Cantalejo, Emilio
    Huerta, José-María
    Ardanaz, Eva
    Dorronsoro, Miren
    Khaw, Kay-Tee
    Travis, Ruth C
    Trichopoulou, Antonia
    Trichopoulos, Dimitrios
    Rafnsson, Snorri
    Palli, Domenico
    Sacerdote, Carlotta
    Tumino, Rosario
    Panico, Salvatore
    Grioni, Sara
    Bueno-de-Mesquita, H Bas
    Ros, Martine M
    Numans, Mattijs E
    Peeters, Petra H
    Johansen, Dorthe
    Lindkvist, Björn
    Johansson, Mattias
    Umeå University, Faculty of Medicine, Department of Biobank Research. Genetic Epidemiology Group, International Agency for Research on Cancer (IARC-WHO), Lyon, France.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Skeie, Guri
    Weiderpass, Elisabete
    Duarte-Salles, Talita
    Stenling, Roger
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Riboli, Elio
    Sala, Núria
    González, Carlos A
    Vitamin C transporter gene (SLC23A1 and SLC23A2) polymorphisms, plasma vitamin C levels, and gastric cancer risk in the EPIC cohort2013In: Genes & Nutrition, ISSN 1555-8932, E-ISSN 1865-3499, Vol. 8, no 6, p. 549-560Article in journal (Refereed)
    Abstract [en]

    Vitamin C is known to protect mucosal tissues from oxidative stress and inhibit nitrosamine formation in the stomach. High consumption of fruits, particularly citrus, and higher circulating vitamin C concentrations may be inversely associated with gastric cancer (GC) risk. We investigated 20 polymorphisms in vitamin C transporter genes SCL23A1 and SCL23A2 and GC risk in 365 cases and 1,284 controls nested within the European Prospective Investigation into Cancer and Nutrition cohort. We also evaluated the association between these polymorphisms and baseline plasma vitamin C levels in a subset of participants. Four SNPs were predictors of plasma vitamin C levels (SLC23A1 rs11950646 and rs33972313; SLC23A2 rs6053005 and rs6133175) in multivariable linear regression models. One SNP (SLC23A2 rs6116569) was associated with GC risk, in particular non-cardia GC (OR = 1.63, 95 % CI = 1.11-2.39, based on 178 non-cardia cases), but this association was attenuated when plasma vitamin C was included in the logistic regression model. Haplotype analysis of SLC23A1 yielded no associations with GC. In SLC23A2, one haplotype was associated with both overall and non-cardia GC, another haplotype was associated with GC overall, and a third was associated with intestinal-type GC. Common variants in SLC23A1 and SLC23A2 may influence plasma vitamin C concentration independent of dietary intake, and variation in SLC23A2 may influence GC risk. Additional prospective studies in large populations and consortia are recommended. Investigation of variation in vitamin C transporter genes may shed light on the preventative properties of vitamin C in gastric carcinogenesis.

  • 272. Duell, Eric J
    et al.
    Travier, Noémie
    Lujan-Barroso, Leila
    Clavel-Chapelon, Françoise
    Boutron-Ruault, Marie-Christine
    Morois, Sophie
    Palli, Domenico
    Krogh, Vittorio
    Panico, Salvatore
    Tumino, Rosario
    Sacerdote, Carlotta
    Quirós, J Ramón
    Sánchez-Cantalejo, Emilio
    Navarro, Carmen
    Gurrea, Aurelio Barricarte
    Dorronsoro, Miren
    Khaw, Kay-Tee
    Allen, Naomi E
    Key, Timothy J
    Bueno-de-Mesquita, H Bas
    Ros, Martine M
    Numans, Mattijs E
    Peeters, Petra Hm
    Trichopoulou, Antonia
    Naska, Androniki
    Dilis, Vardis
    Teucher, Birgit
    Kaaks, Rudolf
    Boeing, Heiner
    Schütze, Madlen
    Regner, Sara
    Lindkvist, Björn
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Overvad, Kim
    Umeå University, Faculty of Medicine, Department of Medical Biosciences.
    Egeberg, Rikke
    Tjønneland, Anne
    Lund, Eiliv
    Weiderpass, Elisabete
    Braaten, Tonje
    Romieu, Isabelle
    Ferrari, Pietro
    Jenab, Mazda
    Stenling, Roger
    Umeå University, Faculty of Medicine, Department of Medical Biosciences.
    Aune, Dagfinn
    Norat, Teresa
    Riboli, Elio
    González, Carlos A
    Alcohol consumption and gastric cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.2011In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 94, no 5, p. 1266-75Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Gastric cancer (GC) is the second leading cause of cancer death worldwide. The association between alcohol consumption and GC has been investigated in numerous epidemiologic studies with inconsistent results.

    OBJECTIVE: We evaluated the association between alcohol consumption and GC risk.

    DESIGN: We conducted a prospective analysis in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, which included 444 cases of first primary gastric adenocarcinoma. HRs and 95% CIs for GC were estimated by using multivariable Cox proportional hazards regression for consumption of pure ethanol in grams per day, with stratification by smoking status, anatomic subsite (cardia, noncardia), and histologic subtype (diffuse, intestinal). In a subset of participants, results were further adjusted for baseline Helicobacter pylori serostatus.

    RESULTS: Heavy (compared with very light) alcohol consumption (≥60 compared with 0.1-4.9 g/d) at baseline was positively associated with GC risk (HR: 1.65; 95% CI: 1.06, 2.58), whereas lower consumption amounts (<60 g/d) were not. When we analyzed GC risk by type of alcoholic beverage, there was a positive association for beer (≥30 g/d; HR: 1.75; 95% CI: 1.13, 2.73) but not for wine or liquor. Associations were primarily observed at the highest amounts of drinking in men and limited to noncardia subsite and intestinal histology; no statistically significant linear dose-response trends with GC risk were observed.

    CONCLUSION: Heavy (but not light or moderate) consumption of alcohol at baseline (mainly from beer) is associated with intestinal-type noncardia GC risk in men from the EPIC cohort.

  • 273. Dullemeijer, Carla
    et al.
    Zock, Peter L.
    Coronel, Ruben
    Den Ruijter, Hester M.
    Katan, Martijn B.
    Brummer, Robert
    Örebro University, School of Health and Medical Sciences.
    Kok, Frans J.
    Beekman, Jet
    Brouwer, Ingeborg A.
    Differences in fatty acid composition between cerebral brain lobes in juvenile pigs after fish oil feeding2008In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 100, no 4, p. 794-800Article in journal (Refereed)
    Abstract [en]

    Very long-chain n-3 PUFA from fish are suggested to play a role in the development of the brain. Fish oil feeding results in higher proportions of n-3 PUFA in the brains of newborn piglets. However, the effect of fish oil on the fatty acid composition of specific cerebral brain lobes in juvenile pigs is largely uninvestigated. This study examined the effect of a fish oil diet on the fatty acid composition of the frontal, parietal, temporal and occipital brain lobes in juvenile pigs (7 weeks old). Pigs were randomly allocated to a semipurified pig diet containing either 4% (w/w) fish oil (n 19) or 4% (w/w) high-oleic acid sunflower oil (HOSF diet, n 18) for a period of 8 weeks. The fish oil diet resulted in significantly higher proportions (%) of DHA in the frontal (10.6 (SD1.2)), parietal (10.2 (SD1.5)) and occipital brain lobes (9.9 (SD 1.3)), but not in the temporal lobe (7.7 (SD1.6)), compared with pigs fed the HOSF diet (frontal lobe, 7.5 (SD1.0); parietal lobe, 8.1 (SD 1.3); occipital lobe, 7.3 (SD1.2), temporal lobe, 6.6 (SD1.2). Moreover, the proportion of DHA was significantly lower in the temporal lobe compared with the frontal, parietal and occipital brain lobes in pigs fed a fish oil diet. In conclusion, the brains of juvenile pigs appear to be responsive to dietary fish oil, although the temporal brain lobe is less responsive compared with the other three brain lobes. The functional consequences of these differences are a challenging focus for future investigation.

  • 274.
    Edfors, Ellinor
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön PRO-CARE.
    Westergren, Albert
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön PRO-CARE.
    Home-living elderly people’s views on food and meals2012In: Journal of Aging Research, ISSN 2090-2204, p. 761291-Article in journal (Refereed)
    Abstract [en]

    Background.

    The aim of the study was to describe home-living elderly people’s views on the importance of food andmeals. Methods. Semistructured interviews with twelve elderly people. The interviews were analysed using qualitative content analysis.

    Results.

    Respondents described how their past influenced their present experiences and views on food and meals. Increased reliance on and need of support with food and meals frequently arose in connection with major changes in their life situations. Sudden events meant a breaking point with a transition from independence to dependence and a need for assistance from relatives and/or the community. With the perspective from the past and in the context of dependency, respondents described meals during the day, quality of food, buying, transporting, cooking, and eating food.

    Conclusions.

    Meeting the need for optimal nutritional status for older people living at home requires knowledge of individual preferences and habits, from both their earlier and current lives. It is important to pay attention to risk factors that could compromise an individual’s ability to independently manage their diet, such as major life events and hospitalisation. Individual needs for self-determination and involvement should be considered in planning and development efforts for elderly people related to food and meals.

  • 275.
    Edfors, Ellinor
    et al.
    Kristianstad University, School of Health and Society.
    Westergren, Albert
    Kristianstad University, School of Health and Society.
    "Om man ska ha mat, ska det vara god mat": äldre personers upplevelser av mat och måltider i ordinärt boende2010Report (Other academic)
    Abstract [en]

    The aim of the study was to capture the older persons' experiences in relation to foodand meals in ordinary housing.

    Method:Semi-structured interviews, with twelve older persons, on the basis of the instrument

    "Seniors in the community: Risk Evaluation for Eating and Nutrition, Version II" (SCREEN II). The interviews were analyzed with manifest and latent content analysis.

    Results:Respondents described how past life largely influenced their current experiences and views on food and meals. Increased reliance and need for support arose frequently in connection with a major change in the life situation. The results showed that the SCREEN II is useful for measuring the risk of malnutrition under Swedish conditions.

    Conclusions: Older people's knowledge about good and nutritious food as well as individual needs for self-determination and feeling involved should be considered in planning and development efforts related to food and meals in ordinary housing. SCREEN II can be considered as an appropriate instrument to use in the context of preventive home visits, in order to identify risk factors that can cause malnutrition. Further research in larger samples is needed.

  • 276.
    Edfors, Ellinor
    et al.
    Kristianstad University, School of Health and Society.
    Westergren, Albert
    Kristianstad University, School of Health and Society.
    "Om man ska ha mat, ska det vara god mat": äldres upplevelser av mat och måltid i ordinärt boende2010Conference paper (Refereed)
    Abstract [sv]

    Bakgrund: Malnutrition, vilket inkluderar både undernäring och övervikt/fetma, är ett vanligt problem bland äldre personer, som kan leda till fysiska och psykiska funktionsnedsättningar. Flertal äldre personer i ordinärt boende som lever ensamma har svårigheter med att införskaffa, tillaga och äta sin mat. Genom förebyggande åtgärder kan uppkomst och försämring av malnutrition, ökat beroende, behov av institutionell vård och försämrad livskvalitet förebyggas.

    Syfte: Syfte med studien var att utifrån äldre personers upplevelser och erfarenheter undersöka och kartlägga mat och måltider i ordinärt boende.

    Metod: Semistrukturerade intervjuer, med tolv äldre personer, utifrån instrumentet ”Seniors in the community: Risk evaluation for eating and nutrition, version II” (SCREEN II). Intervjuerna analyserades med manifest och latent innehållsanalys.

    Resultat: Analysen av intervjuerna visade att respondenternas tidigare liv i hög grad påverkade nuvarande upplevelser av och syn på mat och måltider. Ökat beroende och behov av stöd uppkom inte sällan i samband med en större förändring i livssituationen. Resultatet visar att SCREEN II är ett användbart instrument för att mäta risk för malnutrition under svenska förhållanden.

    Slutsats: Äldre personers kunskaper kring god och näringsriktig mat samt individuella behov av självbestämmande och delaktighet bör beaktas i planering och utveckling av insatser kopplade till mat och måltider i ordinärt boende. För att uppmärksamma riskfaktorer som kan leda till malnutrition kan SCREEN II vara ett lämpligt instrument att använda i samband med förebyggande hembesök. Det finns ett behov av mer omfattande forskning inom området.

  • 277. Eiben, G
    et al.
    Andersson, C S
    Rothenberg, Elisabet
    Göteborgs universitet.
    Sundh, V
    Steen, B
    Lissner, L
    Secular trends in diet among elderly Swedes: cohort comparisons over three decades2004In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 7, no 5, p. 637-644Article in journal (Refereed)
    Abstract [en]

    Objective: The purpose of this study was to compare dietary practices among different birth cohorts of 70-year-old Swedes, who were examined between 1971 and 2000.

    Setting: Göteborg, Sweden.

    Design: Four population-based samples of 1360 70-year-olds, born in 1901, 1911, 1922 and 1930, have undergone health examinations and dietary assessments over a period of almost three decades. One-hour diet history (DH) interviews were conducted in 1971, 1981, 1992 and 2000 with a total of 758 women and 602 women. The formats and contents of the dietary examinations were similar over the years. Statistical analysis of linear trends was conducted, using year of examination as the independent variable, to detect secular trends in food and nutrient intakes across cohorts.

    Results: At the 2000 examination, the majority of 70-year-olds consumed nutritionally adequate diets. Later-born cohorts consumed more yoghurt, breakfast cereals, fruit, vegetables, chicken, rice and pasta than earlier-born cohorts. Consumption of low-fat spread and milk also increased, along with that of wine, light beer and candy. In contrast, potatoes, cakes and sugar were consumed less in 2000 than in 1971. The ratio of reported energy intake to estimated basal metabolic rate did not show any systematic trend over time in women, but showed a significant upward trend in men.

    Conclusions: The diet history method has captured changes in food selections in the elderly without changing in general format over three decades. Dietary quality has improved in a number of ways, and these findings in the elderly are consistent with national food consumption trends in the general population.

  • 278.
    Ejlertsson, Göran
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Gott liv tarvar god mat2009In: Livskvalitet öster om leden: om att steka ål, äta socker och bygga hus men också om frukten, supen, bakterien, hälsan & döden, Tomelilla: ÖsterlenAkademien , 2009, p. 55-64Chapter in book (Other (popular science, discussion, etc.))
  • 279. Ek, Anna
    et al.
    Sorjonen, Kimmo
    Eli, Karin
    Lindberg, Louise
    Nyman, Jonna
    Marcus, Claude
    Nowicka, Paulina
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics. Karolinska Inst, Div Pediat, Dept Clin Sci Intervent & Technol, Stockholm, Sweden.
    Associations between Parental Concerns about Preschoolers' Weight and Eating and Parental Feeding Practices: Results from Analyses of the Child Eating Behavior Questionnaire, the Child Feeding Questionnaire, and the Lifestyle Behavior Checklist2016In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 1, article id e0147257Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Insight into parents' perceptions of their children's eating behaviors is crucial for the development of successful childhood obesity programs. However, links between children's eating behaviors and parental feeding practices and concerns have yet to be established. This study aims to examine associations between parental perceptions of preschoolers' eating behaviors and parental feeding practices. First, it tests the original 8-factor structure of the Child Eating Behavior Questionnaire (CEBQ). Second, it examines the associations with parental feeding practices, measured with the Child Feeding Questionnaire (CFQ).

    MATERIALS AND METHODS: Questionnaires were sent to parents from 25 schools/preschools in Stockholm, Sweden and to parents starting a childhood obesity intervention. The CEBQ factor structure was tested with confirmatory factor analysis (CFA). Associations between CEBQ subscales Food approach and Food avoidance and CFQ factors Restriction, Pressure to eat and Monitoring were examined with structural equation modelling (SEM), adjusting for child and parental characteristics, and parental confidence, measured with the Lifestyle Behavior Checklist (LBC). CFQ Concern for child weight and Perceived responsibility for child eating were used as mediators.

    RESULTS: 478 parents completed the questionnaires (children: 52% girls, mean age 5.5 years, 20% overweight/obese). A modified 8-factor structure showed an acceptable fit (TLI = 0.91, CFI = 0.92, RMSEA = 0.05 and SRMR = 0.06) after dropping one item and allowing three pairs of error terms to correlate. The SEM model demonstrated that Food approach had a weak direct effect on Restriction, but a moderate (β = 0.30) indirect effect via Concern, resulting in a substantial total effect (β = 0.37). Food avoidance had a strong positive effect on Pressure to eat (β = 0.71).

    DISCUSSION: The CEBQ is a valid instrument for assessing parental perceptions of preschoolers' eating behaviors. Parental pressure to eat was strongly associated with children's food avoidance. Parental restriction, however, was more strongly associated with parents' concerns about their children's weights than with children's food approach. This suggests that childhood obesity interventions should address parents' perceptions of healthy weight alongside perceptions of healthy eating.

  • 280. Ek, Weronica E.
    et al.
    Reznichenko, Anna
    Ripke, Stephan
    Niesler, Beate
    Zucchelli, Marco
    Rivera, Natalia V.
    Schmidt, Peter T.
    Pedersen, Nancy L.
    Magnusson, Patrik
    Talley, Nicholas J.
    Holliday, Elizabeth G.
    Houghton, Lesley
    Gazouli, Maria
    Karamanolis, George
    Rappold, Gudrun
    Burwinkel, Barbara
    Surowy, Harald
    Rafter, Joseph
    Assadi, Ghazaleh
    Li, Ling
    Papadaki, Evangelia
    Gambaccini, Dario
    Marchi, Santino
    Colucci, Rocchina
    Blandizzi, Corrado
    Barbaro, Raffaella
    Karling, Pontus
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Walter, Susanna
    Ohlsson, Bodil
    Tornblom, Hans
    Bresso, Francesca
    Andreasson, Anna
    Dlugosz, Aldona
    Simren, Magnus
    Agreus, Lars
    Lindberg, Greger
    Boeckxstaens, Guy
    Bellini, Massimo
    Stanghellini, Vincenzo
    Barbara, Giovanni
    Daly, Mark J.
    Camilleri, Michael
    Wouters, Mira M.
    D'Amato, Mauro
    Exploring the genetics of irritable bowel syndrome: a GWA study in the general population and replication in multinational case-control cohorts2015In: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 64, no 11, p. 1774-1782Article in journal (Refereed)
    Abstract [en]

    Objective IBS shows genetic predisposition, but adequately powered gene-hunting efforts have been scarce so far. We sought to identify true IBS genetic risk factors by means of genome-wide association (GWA) and independent replication studies. Design We conducted a GWA study (GWAS) of IBS in a general population sample of 11 326 Swedish twins. IBS cases (N=534) and asymptomatic controls (N=4932) were identified based on questionnaire data. Suggestive association signals were followed-up in 3511 individuals from six case-control cohorts. We sought genotype-gene expression correlations through single nucleotide polymorphism (SNP)-expression quantitative trait loci interactions testing, and performed in silico prediction of gene function. We compared candidate gene expression by real-time qPCR in rectal mucosal biopsies of patients with IBS and controls. Results One locus at 7p22.1, which includes the genes KDELR2 (KDEL endoplasmic reticulum protein retention receptor 2) and GRID2IP (glutamate receptor, ionotropic, delta 2 (Grid2) interacting protein), showed consistent IBS risk effects in the index GWAS and all replication cohorts and reached p=9.31 x 10(-6) in a meta-analysis of all datasets. Several SNPs in this region are associated with cis effects on KDELR2 expression, and a trend for increased mucosal KDLER2 mRNA expression was observed in IBS cases compared with controls. Conclusions Our results demonstrate that general population-based studies combined with analyses of patient cohorts provide good opportunities for gene discovery in IBS. The 7p22.1 and other risk signals detected in this study constitute a good starting platform for hypothesis testing in future functional investigations.

  • 281.
    Ekelund, Ulf
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Sjöström, Michael
    Unit for Preventive Nutrition, Department of Medical Nutrition, Karolinska Institutet, Stockholm, Sweden;.
    Yngve, Agneta
    Unit for Preventive Nutrition, Department of Medical Nutrition, Karolinska Institutet, Stockholm, Sweden;.
    Nilsson, Andreas
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Total daily energy expenditure and pattern of physical activity measured by minute-by-minute heart rate monitoring in 14-15 year old Swedish adolescents2000In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 54, no 3, p. 195-202Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To assess total daily energy expenditure (TDEE) and patterns of physical activity among Swedish male and female adolescents and to relate the amount and intensity of physical activity to existing recommendations (energy expenditure equal to or above 12.4 kJ/kg/day or accumulation of 30 min/day in moderate physical activity equal to 4.5 times sedentary energy expenditure or more).

    DESIGN: TDEE, physical activity level (PAL=TDEE/BMR), energy expenditure (EE) and time spent in different intensities of physical activity were assessed by using minute-by-minute heart rate monitoring in combination with laboratory measured sedentary energy expenditure (SEE) and peak oxygen uptake.

    SETTING: Department of Physical Education and Health, Orebro University, and Department of Clinical Physiology, Orebro Medical Centre Hospital, Sweden.

    SUBJECTS: Eighty-two 14-15 y old adolescents (42 boys, 40 girls) from the city of Orebro, randomly selected through a two-stage sampling procedure.

    RESULTS: TDEE was 12.8 MJ/day and 10.0 MJ/day for boys and girls respectively (P<0.001) and PAL was 1.74 and 1.67 (NS). Forty-four percent and 47%, respectively, of TDEE referred to EE in physical activity, of which 70% for both genders referred to light physical activity (corresponding to <4.5 times SEE). Eleven boys and 14 girls had an EE lower than 12.4 kJ/kg/day and/or did not accumulate 30 min/day in physical activity >/=4.5 SEE. Those (n=20) with the highest PAL values (>2.01 and 1.81, respectively) spent 149 min/day at a >/=4.5 SEE intensity level compared to 40 min/day for those (n=30) with the lowest PAL values (<1.55 and 1.45, respectively).

    CONCLUSIONS: Swedish adolescent boys and girls are similarly physically active. The major amount of time devoted to physical activity refers to light physical activity. At least thirty percent of adolescents seem not to achieve appropriate levels of physical activity considered to be beneficial for health.

  • 282.
    Ekelund, Ulf
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Unit for Preventive Nutrition, Department of Medical Nutrition, Karolinska Institutet, Stockholm, Sweden.
    Sjöström, Michael
    Unit for Preventive Nutrition, Department of Medical Nutrition, Karolinska Institutet, Stockholm, Sweden;.
    Yngve, Agneta
    Unit for Preventive Nutrition, Department of Medical Nutrition, Karolinska Institutet, Stockholm, Sweden;.
    Nilsson, Andreas
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Unit for Preventive Nutrition, Department of Medical Nutrition, Karolinska Institutet, Stockholm, Sweden;.
    Total daily energy expenditure and pattern of physical activity measured by minute-by-minute heart rate monitoring in 14-15 year old Swedish adolescents2000In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 54, no 3, p. 195-202Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To assess total daily energy expenditure (TDEE) and patterns of physical activity among Swedish male and female adolescents and to relate the amount and intensity of physical activity to existing recommendations (energy expenditure equal to or above 12.4 kJ/kg/day or accumulation of 30 min/day in moderate physical activity equal to 4.5 times sedentary energy expenditure or more).

    DESIGN: TDEE, physical activity level (PAL=TDEE/BMR), energy expenditure (EE) and time spent in different intensities of physical activity were assessed by using minute-by-minute heart rate monitoring in combination with laboratory measured sedentary energy expenditure (SEE) and peak oxygen uptake.

    SETTING: Department of Physical Education and Health, Orebro University, and Department of Clinical Physiology, Orebro Medical Centre Hospital, Sweden.

    SUBJECTS: Eighty-two 14-15 y old adolescents (42 boys, 40 girls) from the city of Orebro, randomly selected through a two-stage sampling procedure.

    RESULTS: TDEE was 12.8 MJ/day and 10.0 MJ/day for boys and girls respectively (P<0.001) and PAL was 1.74 and 1.67 (NS). Forty-four percent and 47%, respectively, of TDEE referred to EE in physical activity, of which 70% for both genders referred to light physical activity (corresponding to <4.5 times SEE). Eleven boys and 14 girls had an EE lower than 12.4 kJ/kg/day and/or did not accumulate 30 min/day in physical activity >/=4.5 SEE. Those (n=20) with the highest PAL values (>2.01 and 1.81, respectively) spent 149 min/day at a >/=4.5 SEE intensity level compared to 40 min/day for those (n=30) with the lowest PAL values (<1.55 and 1.45, respectively).

    CONCLUSIONS: Swedish adolescent boys and girls are similarly physically active. The major amount of time devoted to physical activity refers to light physical activity. At least thirty percent of adolescents seem not to achieve appropriate levels of physical activity considered to be beneficial for health.

  • 283. Ekelund, Ulf
    et al.
    Ward, Heather A.
    Norat, Teresa
    Luan, Jian'an
    May, Anne M.
    Weiderpass, Elisabete
    Sharp, Stephen J.
    Overvad, Kim
    Ostergaard, Jane Nautrup
    TjOnneland, Anne
    Johnsen, Nina Fons
    Mesrine, Sylvie
    Foamier, Agnes
    Fagherazzi, Guy
    Trichopoulou, Antonia
    Lagiou, Pagona
    Trichopoulos, Dimitrios
    Li, Kuanrong
    Kaaks, Rudolf
    Ferrari, Pietro
    Licaj, Idlir
    Jenab, Mazda
    Bergmann, Manuela
    Boeing, Heiner
    Palli, Domenico
    Sieri, Sabina
    Panico, Salvatore
    Tumino, Rosario
    Vineis, Paolo
    Peeters, Petra H.
    Monnikhof, Evelyn
    Bueno-de-Mesquita, H. Bas
    Ramon Quiros, J.
    Agudo, Antonio
    Sanchez, Maria-Jose
    Maria Huerta, Jose
    Ardanaz, Eva
    Arriola, Larraitz
    Hedblad, Bo
    Wirfalt, Elisabet
    Sund, Malin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Johansson, Mattias
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. International Agency for Research on Cancer (IARC), Lyon, France.
    Key, Timothy J.
    Travis, Ruth C.
    Khaw, Kay-Tee
    Brage, Soren
    Wareham, Nicholas J.
    Riboli, Elio
    Physical activity and all-cause mortality across levels of overall and abdominal adiposity in European men and women: the European Prospective Investigation into Cancer and Nutrition Study (EPIC)2015In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 101, no 3, p. 613-621Article in journal (Refereed)
    Abstract [en]

    Background: The higher risk of death resulting from excess adiposity may be attenuated by physical activity (PA). However, the theoretical number of deaths reduced by eliminating physical inactivity compared with overall and abdominal obesity remains unclear.

    Objective: We examined whether overall and abdominal adiposity modified the association between PA and all-cause mortality and estimated the population attributable fraction (PAF) and the years of life gained for these exposures.

    Design: This was a cohort study in 334,161 European men and women. The mean follow-up time was 12.4 y, corresponding to 4,154,915 person-years. Height, weight, and waist circumference (WC) were measured in the clinic. PA was assessed with a validated self-report instrument. The combined associations between PA, BMI, and WC with mortality were examined with Cox proportional hazards models, stratified by center and age group, and adjusted for sex, education, smoking, and alcohol intake. Center-specific PAF associated with inactivity, body mass index (BMI; in kg/m(2)) (>30), and WC (>= 102 cm for men, >= 88 cm for women) were calculated and combined in random-effects meta-analysis. Life-tables analyses were used to estimate gains in life expectancy for the exposures.

    Results: Significant interactions (PA x BMI and PA x WC) were observed, so HRs were estimated within BMI and WC strata. The hazards of all-cause mortality were reduced by 16-30% in moderately inactive individuals compared with those categorized as inactive in different strata of BMI and WC. Avoiding all inactivity would theoretically reduce all-cause mortality by 7.35% (95% CI: 5.88%, 8.83%). Corresponding estimates for avoiding obesity (BMI >30) were 3.66% (95% CI: 2.30%, 5.01%). The estimates for avoiding high WC were similar to those for physical inactivity.

    Conclusion: The greatest reductions in mortality risk were observed between the 2 lowest activity groups across levels of general and abdominal adiposity, which suggests that efforts to encourage even small increases in activity in inactive individuals may be beneficial to public health.

  • 284. Ekstedt, Mirjam
    et al.
    Nyberg, Gisela
    Ingre, Michael
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Ekblom, Örjan
    Marcus, Claude
    Sleep, physical activity and BMI in six to ten-year-old children measured by accelerometry: a cross-sectional study2013In: International Journal of Behavioral Nutrition and Physical Activity, ISSN 1479-5868, E-ISSN 1479-5868, Vol. 10, p. 82-Article in journal (Refereed)
    Abstract [en]

    Background: The aim of this study is to describe the relationship between objective measures of sleep, physical activity and BMI in Swedish pre-adolescents. The day-to-day association between physical activity and sleep quality as well as week-day and weekend pattern of sleep is also described. Method: We conducted a cross sectional study consisted of a cohort of 1.231 children aged six to ten years within the Stockholm county area. Sleep and physical activity were measured by accelerometry during seven consecutive days. Outcome measures are total sleep time, sleep efficiency, sleep start and sleep end; physical activity intensity divided into: sedentary (<1.5 METS), light (1.5 to 3 METS) and moderate-to-vigorous (> 3 METS); and Body Mass Index standard deviations score, BMIsds. Results: Total sleep time decreased with increasing age, and was shorter in boys than girls on both weekdays and weekends. Late bedtime but consistent wake-up time during weekends made total sleep time shorter on weekends than on weekdays. Day-to-day within-subject analysis revealed that moderate-to-vigorous intense physical activity promoted an increased sleep efficiency the following night (CI < 0.001 to 0.047), while total sleep time was not affected (CI -0.003 to 0.043). Neither sleep duration (CI -0.024 to 0.022) nor sleep efficiency (CI -0.019 to 0.028) affected mean physical activity level the subsequent day. The between-subject analysis indicates that the sleep of children characterized by high moderate-to-vigorous physical activity during the day was frequently interrupted (SE = -. 23, P < .01). A negative association between BMIsds and sleep duration was found (-. 10, p < .01). Conclusions: Short sleep duration was associated with high BMI in six to ten year old children. This study underscores the importance of consistent bedtimes throughout the week for promoting sleep duration in preadolescents. Furthermore, this study suggests that a large proportion of intensive physical activity during the day might promote good sleep quality.

  • 285.
    Ekstedt, Mirjam
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Systems Safety and Management.
    Nyberg, Gisela
    Karolinska Institutet.
    Ingre, Michael
    Stockholm University.
    Ekblom, Örjan
    Karolinska Institutet.
    Marcus, Claude
    Karolinska Institutet.
    Sleep, physical activity and BMI in six to ten-year-old children measured by accelerometry: a cross-sectional study2013In: International Journal of Behavioral Nutrition and Physical Activity, ISSN 1479-5868, E-ISSN 1479-5868, Vol. 10, no 82Article in journal (Refereed)
    Abstract [en]

    Background: The aim of this study is to describe the relationship between objective measures of sleep, physical activity and BMI in Swedish pre-adolescents. The day-to-day association between physical activity and sleep quality as well as week-day and weekend pattern of sleep is also described. Method: We conducted a cross sectional study consisted of a cohort of 1.231 children aged six to ten years within the Stockholm county area. Sleep and physical activity were measured by accelerometry during seven consecutive days. Outcome measures are total sleep time, sleep efficiency, sleep start and sleep end; physical activity intensity divided into: sedentary (<1.5 METS), light (1.5 to 3 METS) and moderate-to-vigorous (> 3 METS); and Body Mass Index standard deviations score, BMIsds. Results: Total sleep time decreased with increasing age, and was shorter in boys than girls on both weekdays and weekends. Late bedtime but consistent wake-up time during weekends made total sleep time shorter on weekends than on weekdays. Day-to-day within-subject analysis revealed that moderate-to-vigorous intense physical activity promoted an increased sleep efficiency the following night (CI < 0.001 to 0.047), while total sleep time was not affected (CI -0.003 to 0.043). Neither sleep duration (CI -0.024 to 0.022) nor sleep efficiency (CI -0.019 to 0.028) affected mean physical activity level the subsequent day. The between-subject analysis indicates that the sleep of children characterized by high moderate-to-vigorous physical activity during the day was frequently interrupted (SE = -. 23, P < .01). A negative association between BMIsds and sleep duration was found (-. 10, p < .01). Conclusions: Short sleep duration was associated with high BMI in six to ten year old children. This study underscores the importance of consistent bedtimes throughout the week for promoting sleep duration in preadolescents. Furthermore, this study suggests that a large proportion of intensive physical activity during the day might promote good sleep quality.

  • 286. Eli, Karin
    et al.
    Hörnell, Agneta
    Etminan Malek, Mahnoush
    Nowicka, Paulina
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics. Division of Pediatrics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute, 141 57 Huddinge, Sweden.
    Water, juice, or soda? Mothers and grandmothers of preschoolers discuss the acceptability and accessibility of beverages2017In: Appetite, ISSN 0195-6663, E-ISSN 1095-8304, Vol. 112, p. 133-142Article in journal (Refereed)
    Abstract [en]

    Intake of sugary beverages is strongly associated with weight gain and obesity among children; however, differences between mothers' and grandmothers' attitudes and practices concerning young children's beverage consumption remain unclear. This is notable since about a quarter of families in the US and the UK rely on grandparents as the main providers of informal childcare. The aim of this study is to examine mothers' and maternal grandmothers' attitudes, knowledge, and practices regarding preschool-age children's beverage consumption. The analysis focuses on identifying intergenerational similarities and differences, given the potential impact that such differences might have on young children's beverage consumption habits. Twenty-two semi-structured interviews, representing eleven families, were analyzed using thematic analysis. The sample included all mother-maternal grandmother dyads from The Grandparents Study, which took place in Eugene, Oregon, USA. More than half of mothers and grandmothers met overweight/obesity criteria. Among the children (mean age 4.7 years; five girls and six boys), seven met overweight/obesity criteria. Most mothers and grandmothers were unemployed, and reported an annual household income below 30,000 USD. The analysis identified three thematic categories: 1) mothers and grandmothers agree about the hierarchy of healthiness between and within beverages, though juice occupies an ambivalent position; 2) mothers and grandmothers cite role modeling and the home environment as important in regulating preschoolers' beverage intake; 3) mothers and grandmothers balance between restricting sugar-sweetened beverages and using these beverages as treats. The results suggest that when mothers and grandmothers use soda, juice, and juice-drinks as treats, they do so within a wider dynamic of balancing practices, and within two intersecting domains: the hierarchy of beverages, including the still ambivalent status of juice as healthy or unhealthy, and the definition of ‘special occasion’.

  • 287. Eli, Karin
    et al.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Malek, Mahnoush Etminan
    Nowicka, Paulina
    Water, juice, or soda?: Mothers and grandmothers of preschoolers discuss the acceptability and accessibility of beverages2017In: Appetite, ISSN 0195-6663, E-ISSN 1095-8304, Vol. 112, p. 133-142Article in journal (Refereed)
    Abstract [en]

    Intake of sugary beverages is strongly associated with weight gain and obesity among children; however, differences between mothers' and grandmothers' attitudes and practices concerning young children's beverage consumption remain unclear. This is notable since about a quarter of families in the US and the UK rely on grandparents as the main providers of informal childcare. The aim of this study is to examine mothers' and maternal grandmothers' attitudes, knowledge, and practices regarding preschool aged children's beverage consumption. The analysis focuses on identifying intergenerational similarities and differences, given the potential impact that such differences might have on young children's beverage consumption habits. Twenty-two semi-structured interviews, representing eleven families, were analyzed using thematic analysis. The sample included all mother – maternal grandmother dyads from The Grandparents Study, which took place in Eugene, Oregon, USA. More than half of mothers and grandmothers met overweight/obesity criteria. Among the children (mean age 4.7 years; five girls and six boys), seven met overweight/obesity criteria. Most mothers and grandmothers were unemployed, and most reported an annual household income below 30,000 USD. The analysis identified three thematic categories: 1) mothers and grandmothers agree about the hierarchy of healthiness between and within beverages, though juice occupies an ambivalent position; 2) mothers and grandmothers cite role modeling and the home environment as important in regulating preschoolers' beverage intake; 3) mothers and grandmothers balance between restricting sugary beverages and using these beverages as treats. The results suggest that when mothers and grandmothers use soda, juice, and juice-drinks as treats, they do so within a wider dynamic of balancing practices, and within two intersecting domains: the hierarchy of beverages, including the still ambivalent status of juice as healthy or unhealthy, and the definition of 'special occasion'.

  • 288. El-Khoury, Antoine E
    et al.
    Forslund, Anders
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Olsson, Roger
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Branth, Stefan
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Sjödin, Anders
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Andersson, Agneta
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Atkinson, Alan
    Selvaraj, Amalini
    Hambraeus, Leif
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Young, Vernon R
    Moderate exercise at energy balance does not affect 24-h leucine oxidation or nitrogen retention in healthy men1997In: American Journal of Physiology, ISSN 0002-9513, E-ISSN 2163-5773, Vol. 273, no 2, p. E394-E407Article in journal (Refereed)
    Abstract [en]

    Short-term metabolic experiments have revealed that physical exercise increases the oxidation of leucine, which has been interpreted to indicate an increased requirement for dietary protein in physically active subjects. Because it may be inaccurate to extrapolate measurements of amino acid oxidation made over a few hours to the entire day, we have carried out a continuous 24-h intravenous [1-13C]leucine/[15N]urea tracer study in eight healthy adult men. Their diet supplied 1 g protein.kg-1.day-1, and exercise (mean maximal O2 consumption 46%) was for 90 min during the 12-h fast and 12-h fed periods of the day. Subjects were adapted to the diet and exercise regimen for 6 days. Then, on day 7, they were dressed in the University of Uppsala energy metabolic unit's direct calorimeter suit, were connected to an open-hood indirect calorimeter, and received the tracers. Exercise increased leucine oxidation by approximately 50 and 30% over preexercise rates for fast and fed periods, respectively. This increase amounted to approximately 4-7% of daily leucine oxidation. Subjects remained in body leucine equilibrium (balance -4.6 +/- 10.5 mg.kg-1.day-1; -3.6 +/- 8.3% of intake; P = not significant from zero balance). Therefore, moderate exercise did not cause a significant deterioration in leucine homeostasis at a protein intake of 1 g.kg-1.day-1. These findings underscore the importance of carrying out precise, continuous, 24-h measurements of whole body leucine kinetics; this model should be of value in studies concerning the quantitative interactions among physical exercise, energy/protein metabolism, and diet in humans.

  • 289.
    Elmsjö, Albert
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Medicinal Chemistry, Analytical Pharmaceutical Chemistry.
    Rosqvist, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Engskog, Mikael K R
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Medicinal Chemistry, Analytical Pharmaceutical Chemistry.
    Haglöf, Jakob
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Medicinal Chemistry, Analytical Pharmaceutical Chemistry.
    Kullberg, Joel
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Iggman, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Johansson, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Ahlström, Håkan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Arvidsson, Torbjörn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Medicinal Chemistry, Analytical Pharmaceutical Chemistry.
    Risérus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Pettersson, Curt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Medicinal Chemistry, Analytical Pharmaceutical Chemistry.
    NMR-based metabolic profiling in healthy individuals overfed different types of fat: links to changes in liver fat accumulation and lean tissue mass.2015In: Nutrition & Diabetes, ISSN 2044-4052, E-ISSN 2044-4052, Vol. 5, no 19, p. e182-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Overeating different dietary fatty acids influence the amount of liver fat stored during weight gain, however, the mechanisms responsible are unclear. We aimed to identify non-lipid metabolites that may differentiate between saturated (SFA) and polyunsaturated fatty acid (PUFA) overfeeding using a non-targeted metabolomic approach. We also investigated the possible relationships between plasma metabolites and body fat accumulation.

    METHODS: In a randomized study (LIPOGAIN study), n=39 healthy individuals were overfed with muffins containing SFA or PUFA. Plasma samples were precipitated with cold acetonitrile and analyzed by nuclear magnetic resonance (NMR) spectroscopy. Pattern recognition techniques were used to overview the data, identify variables contributing to group classification and to correlate metabolites with fat accumulation.

    RESULTS: We previously reported that SFA causes a greater accumulation of liver fat, visceral fat and total body fat, whereas lean tissue levels increases less compared with PUFA, despite comparable weight gain. In this study, lactate and acetate were identified as important contributors to group classification between SFA and PUFA (P<0.05). Furthermore, the fat depots (total body fat, visceral adipose tissue and liver fat) and lean tissue correlated (P(corr)>0.5) all with two or more metabolites (for example, branched amino acids, alanine, acetate and lactate). The metabolite composition differed in a manner that may indicate higher insulin sensitivity after a diet with PUFA compared with SFA, but this needs to be confirmed in future studies.

    CONCLUSION: A non-lipid metabolic profiling approach only identified a few metabolites that differentiated between SFA and PUFA overfeeding. Whether these metabolite changes are involved in depot-specific fat storage and increased lean tissue mass during overeating needs further investigation.

  • 290.
    Elshorbagy, Amany K.
    et al.
    Univ Alexandria, Dept Physiol, Fac Med, Alexandria, Egypt.
    Samocha-Bonet, Dorit
    Garvan Inst Med Res, Diabet & Metab Div, Sydney, NSW, Australia;Univ New South Wales, Fac Med, Sydney, NSW, Australia.
    Jernerén, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences. Univ Oxford, Dept Pharmacol, Oxford, England.
    Turner, Cheryl
    Univ Oxford, Dept Pharmacol, Oxford, England.
    Refsum, Helga
    Univ Oslo, Inst Basic Med Sci, Dept Nutr, Oslo, Norway;Univ Oxford, Dept Pharmacol, Oxford, England.
    Heilbronn, Leonie K.
    Univ Adelaide, Discipline Med, Adelaide, SA, Australia;Garvan Inst Med Res, Diabet & Metab Div, Sydney, NSW, Australia.
    Food Overconsumption in Healthy Adults Triggers Early and Sustained Increases in Serum Branched-Chain Amino Acids and Changes in Cysteine Linked to Fat Gain2018In: Journal of Nutrition, ISSN 0022-3166, E-ISSN 1541-6100, Vol. 148, no 7, p. 1073-1080Article in journal (Refereed)
    Abstract [en]

    Background: Plasma concentrations of branched-chain amino acids (BCAAs) and the sulfur-containing amino acid cysteine are associated with obesity and insulin resistance. BCAAs predict future diabetes. Objective: We investigated amino acid changes during food overconsumption. Methods: Forty healthy men and women with a body mass index (mean +/- SEM) of 25.6 +/- 0.6 were overfed by 1250 kcal/d for 28 d, increasing consumption of all macronutrients. Insulin sensitivity and body composition were assessed at baseline (day 0) and day 28. Fasting serum amino acids were measured at days 0, 3, and 28. Linear mixed-effects models evaluated the effect of time in the total group and separately in those with low and high body fat gain (below compared with at or above median fat gain, 1.95 kg). At days 0 and 28, insulin-induced suppression of serum amino acids during a hyperinsulinemic-euglycemic clamp test and, in a subset (n = 20), adipose tissue mRNA expression of selected amino acid metabolizing enzymes were assessed. Results: Weight increased by 2.8 kg. High fat gainers gained 2.6 kg fat mass compared with 1.1 kg in low fat gainers. Valine and isoleucine increased at day 3 (+17% and +22%, respectively; P <= 0.002) and remained elevated at day 28, despite a decline in valine (P = 0.019) from day 3 values. Methionine, cystathionine, and taurine were unaffected. Serum total cysteine (tCys) transiently increased at day 3 (+11%; P = 0.022) only in high fat gainers (P-interaction = 0.043), in whom the cysteine catabolic enzyme cysteine dioxygenase (CDO1) was induced (+26%; P = 0.025) in adipose tissue (P-interaction = 0.045). Overconsumption did not alter adipose tissue mRNA expression of the BCAA-metabolizing enzymes branched-chain keto acid dehydrogenase E1 alpha polypeptide (BCKDHA) or branched-chain amino transferase 1 (BCAT1). In the total population at day 0, insulin infusion decreased all serum amino acids (-11% to -47%; P < 0.01), except for homocysteine and tCys, which were unchanged, and glutathione, which was increased by 54%. At day 28, insulin increased tCys (+8%), and the insulin-induced suppression of taurine and phenylalanine observed at day 0, but not that of BCAAs, was significantly impaired. Conclusions: These findings highlight the role of nutrient oversupply in increasing fasting BCAA concentrations in healthy adults. The link between cysteine availability, CDO1 expression, and fat gain deserves investigation.

  • 291. Emaus, Marleen J.
    et al.
    Peeters, Petra H. M.
    Bakker, Marije F.
    Overvad, Kim
    Tjonneland, Anne
    Olsen, Anja
    Romieu, Isabelle
    Ferrari, Pietro
    Dossus, Laure
    Boutron-Ruault, Marie Christine
    Baglietto, Laura
    Fortner, Renee T.
    Kaaks, Rudolf
    Boeing, Heiner
    Trichopoulou, Antonia
    Lagiou, Pagona
    Trichopoulos, Dimitrios
    Masala, Giovanna
    Pala, Valeria
    Panico, Salvatore
    Tumino, Rosario
    Polidoro, Silvia
    Skeie, Guri
    Lund, Eiliv
    Weiderpass, Elisabete
    Ramon Quiros, J.
    Travier, Noemie
    Sanchez, Maria-Jose
    Chirlaque, Maria-Dolores
    Ardanaz, Eva
    Dorronsoro, Miren
    Winkvist, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Wennberg, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Bueno-de-Mesquita, H. Bas
    Khaw, Kay-Tee
    Travis, Ruth C.
    Key, Timothy J.
    Aune, Dagfinn
    Gunter, Marc
    Riboli, Elio
    van Gils, Carla H.
    Vegetable and fruit consumption and the risk of hormone receptor-defined breast cancer in the EPIC cohort2016In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 103, no 1, p. 168-177Article in journal (Refereed)
    Abstract [en]

    Background: The recent literature indicates that a high vegetable intake and not a high fruit intake could be associated with decreased steroid hormone receptor–negative breast cancer risk.

    Objective: This study aimed to investigate the association between vegetable and fruit intake and steroid hormone receptor–defined breast cancer risk.

    Design: A total of 335,054 female participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort were included in this study (mean ± SD age: 50.8 ± 9.8 y). Vegetable and fruit intake was measured by country-specific questionnaires filled out at recruitment between 1992 and 2000 with the use of standardized procedures. Cox proportional hazards models were stratified by age at recruitment and study center and were adjusted for breast cancer risk factors.

    Results: After a median follow-up of 11.5 y (IQR: 10.1–12.3 y), 10,197 incident invasive breast cancers were diagnosed [3479 estrogen and progesterone receptor positive (ER+PR+); 1021 ER and PR negative (ER−PR−)]. Compared with the lowest quintile, the highest quintile of vegetable intake was associated with a lower risk of overall breast cancer (HRquintile 5–quintile 1: 0.87; 95% CI: 0.80, 0.94). Although the inverse association was most apparent for ER−PR− breast cancer (ER−PR−: HRquintile 5–quintile 1: 0.74; 95% CI: 0.57, 0.96; P-trend = 0.03; ER+PR+: HRquintile 5–quintile 1: 0.91; 95% CI: 0.79, 1.05; P-trend = 0.14), the test for heterogeneity by hormone receptor status was not significant (P-heterogeneity = 0.09). Fruit intake was not significantly associated with total and hormone receptor–defined breast cancer risk.

    Conclusion: This study supports evidence that a high vegetable intake is associated with lower (mainly hormone receptor–negative) breast cancer risk.

  • 292. Eneroth, Hanna
    et al.
    Wallin, Stina
    Leander, Karin
    Nilsson Sommar, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Åkesson, Agneta
    Risks and Benefits of Increased Nut Consumption: Cardiovascular Health Benefits Outweigh the Burden of Carcinogenic Effects Attributed to Aflatoxin B1 Exposure2017In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 9, no 12, article id 1355Article in journal (Refereed)
    Abstract [en]

    Nuts are rich in nutrients and mounting evidence shows that consumption reduces cardiovascular disease (CVD) incidence. Nuts may also be a major source of aflatoxin B₁, a potent liver carcinogen and the risk/benefit balance is unknown. Based on national statistics and data from the PREDIMED intervention trial, we estimated the potential CVD-reduction if Swedes aged 55-79 consumed 30 g nuts/day, instead of the current national average of five grams per day. We also assessed the reduction in disability-adjusted life years (DALYs) due to myocardial infarction (MI) and stroke. We estimated the aflatoxin B₁ exposure from nuts and calculated the margin of exposure. The approximation that one nanogram aflatoxin B₁/kg body weight/day results in one additional liver cancer case/10 million person-years was used to estimate the number of liver cancer cases. The increased nut consumption scenario prevented more than 7000 CVDs in 2013 (306/100,000 person-years) and contributed to about 55,000 saved DALYs for stroke and 22,000 for MI. The concomitant increase in aflatoxin B₁ exposure caused an estimated zero to three additional cases of liver cancer, corresponding to 159 DALYs spent, emphasizing the associated risks. Increased nut consumption, as part of a varied healthy diet, is warranted even when aflatoxin B₁ exposure is taken into account. However, efforts to reduce aflatoxin exposure from food are essential.

  • 293.
    Engelheart, Stina
    et al.
    Örebro University, School of Medical Sciences.
    Brummer, Robert Jan
    Örebro University, School of Medical Sciences.
    Assessment of nutritional status in the elderly: a proposed function-driven model2018In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 62, article id 1366Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 294. Engeset, D.
    et al.
    Skeie, G.
    Olsen, A.
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Dietary patterns and whole grain in Scandinavia. The HELGA project2013In: Annals of Nutrition and Metabolism, ISSN 0250-6807, E-ISSN 1421-9697, Vol. 63, no Supplement 1, p. 341-341Article in journal (Other academic)
    Abstract [en]

    Background and objectives: In the recent years a trendwithin nutrition epidemiology has been to assess overall dietaryquality, often by identifying dietary patterns. The HELGAstudy population is based on samples of existing cohorts fromthe three Scandinavian countries. All three cohorts are part ofthe EPIC study. The aim of this study is to find a typical wholegrain pattern in Scandinavia and see if the pattern is similar inthe three countries.Methods: The associations among the variables were investigatedby factor analysis.Results: Both Norway and Sweden had two breakfast patternsand one dinner pattern. Both the countries had a healthybreakfast pattern including food items commonly consideredhealthy, such as fruit, yoghurt and breakfast cereals. However,coarse bread was the main item in a more traditional pattern for Norway, while it was a part of the healthy pattern inSweden. The second breakfast pattern in Sweden included unhealthyitems like white bread, cakes, sweets, soft drinks andalcohol. The dinner pattern was almost equal in Sweden andNorway. Denmark differed from the other Scandinavian countriesconcerning dietary patterns. Only one breakfast patternwas found. This pattern had some similarities with the traditionalNorwegian pattern, but scored high on all whole grainitems while in Norway only wheat had a high score. Two dinnerpatterns are seen for Denmark, the healthier one includesfruit and vegetables, fish and poultry, the second includes meatand meat products, ice cream and alcohol.Conclusions: When comparing dietary patterns from thethree Scandinavian countries, we find both differences andsimilarities. The main whole grain item used in Norway andSweden seems to be wheat, while rye is more dominant in Denmark.

  • 295. Engeset, Dagrun
    et al.
    Braaten, Tonje
    Teucher, Birgit
    Kühn, Tilman
    Bueno-de-Mesquita, H B
    Leenders, Max
    Agudo, Antonio
    Bergmann, Manuela M
    Valanou, Elisavet
    Naska, Androniki
    Trichopoulou, Antonia
    Key, Timothy J
    Crowe, Francesca L
    Overvad, Kim
    Sonestedt, Emily
    Mattiello, Amalia
    Peeters, Petra H
    Wennberg, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Jansson, Jan Håkan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Boutron-Ruault, Marie-Christine
    Dossus, Laure
    Dartois, Laureen
    Li, Kuanrong
    Barricarte, Aurelio
    Ward, Heather
    Riboli, Elio
    Agnoli, Claudia
    Huerta, José María
    Sánchez, María-José
    Tumino, Rosario
    Altzibar, Jone M
    Vineis, Paolo
    Masala, Giovanna
    Ferrari, Pietro
    Muller, David C
    Johansson, Mattias
    Luisa Redondo, M
    Tjønneland, Anne
    Olsen, Anja
    Olsen, Karina Standahl
    Brustad, Magritt
    Skeie, Guri
    Lund, Eiliv
    Fish consumption and mortality in the European Prospective Investigation into Cancer and Nutrition cohort2015In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 30, no 1, p. 57-70Article in journal (Refereed)
    Abstract [en]

    Fish is a source of important nutrients and may play a role in preventing heart diseases and other health outcomes. However, studies of overall mortality and cause-specific mortality related to fish consumption are inconclusive. We examined the rate of overall mortality, as well as mortality from ischaemic heart disease and cancer in relation to the intake of total fish, lean fish, and fatty fish in a large prospective cohort including ten European countries. More than 500,000 men and women completed a dietary questionnaire in 1992-1999 and were followed up for mortality until the end of 2010. 32,587 persons were reported dead since enrolment. Hazard ratios and their 99 % confidence interval were estimated using Cox proportional hazard regression models. Fish consumption was examined using quintiles based on reported consumption, using moderate fish consumption (third quintile) as reference, and as continuous variables, using increments of 10 g/day. All analyses were adjusted for possible confounders. No association was seen for fish consumption and overall or cause-specific mortality for both the categorical and the continuous analyses, but there seemed to be a U-shaped trend (p < 0.000) with fatty fish consumption and total mortality and with total fish consumption and cancer mortality (p = 0.046).

  • 296. Engeset, Dagrun
    et al.
    Hofoss, Dag
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Olsen, Anja
    Tjønneland, Anne
    Skeie, Guri
    Dietary patterns and whole grain cereals in the Scandinavian countries: differences and similarities. The HELGA project2015In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 18, no 5, p. 905-915Article in journal (Refereed)
    Abstract [en]

    Objective: To identify dietary patterns with whole grains as a main focus to see if there is a similar whole grain pattern in the three Scandinavian countries; Denmark, Sweden and Norway. Another objective is to see if items suggested for a Nordic Food Index will form a typical Nordic pattern when using factor analysis. Setting: The HELGA study population is based on samples of existing cohorts: the Norwegian Women and Cancer Study, the Swedish Vasterbotten cohort and the Danish Diet, Cancer and Health study. The HELGA study aims to generate knowledge about the health effects of whole grain foods. Subjects: The study included a total of 119 913 participants. Design: The associations among food variables from FFQ were investigated by principal component analysis. Only food groups common for all three cohorts were included. High factor loading of a food item shows high correlation of the item to the specific diet pattern. Results: The main whole grain for Denmark and Sweden was rye, while Norway had highest consumption of wheat. Three similar patterns were found: a cereal pattern, a meat pattern and a bread pattern. However, even if the patterns look similar, the food items belonging to the patterns differ between countries. Conclusions: High loadings on breakfast cereals and whole grain oat were common in the cereal patterns for all three countries. Thus, the cereal pattern may be considered a common Scandinavian whole grain pattern. Food items belonging to a Nordic Food Index were distributed between different patterns.

  • 297.
    Englund, Davis A.
    et al.
    Tufts Univ, Jean Mayer USDA Human Nutr Res Ctr Aging, Nutr Exercise Physiol & Sarcopenia Lab, Boston, USA.
    Kirn, Dylan R.
    Tufts Univ, Jean Mayer USDA Human Nutr Res Ctr Aging, Nutr Exercise Physiol & Sarcopenia Lab, Boston, USA.
    Koochek, Afsaneh
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Zhu, Hao
    Hebrew SeniorLife, Inst Aging Res, Boston, USA.
    Travison, Thomas G.
    Hebrew SeniorLife, Inst Aging Res, Boston, USA; Harvard Med Sch, Boston, USA.
    Reid, Kieran F.
    Tufts Univ, Jean Mayer USDA Human Nutr Res Ctr Aging, Nutr Exercise Physiol & Sarcopenia Lab, Boston, USA.
    von Berens, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Melin, Michael
    Karolinska Inst, Dept Lab Med, Stockholm, Sweden.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Gustafsson, Thomas
    Karolinska Inst, Dept Lab Med, Stockholm, Sweden.
    Fielding, Roger A.
    Tufts Univ, Jean Mayer USDA Human Nutr Res Ctr Aging, Nutr Exercise Physiol & Sarcopenia Lab, Boston, USA.
    Nutritional Supplementation With Physical Activity Improves Muscle Composition in Mobility-Limited Older Adults, The VIVE2 Study: A Randomized, Double-Blind, Placebo-Controlled Trial2018In: The journals of gerontology. Series A, Biological sciences and medical sciences, ISSN 1079-5006, E-ISSN 1758-535X, Vol. 73, no 1, p. 95-101Article in journal (Refereed)
    Abstract [en]

    Background: Nutritional supplementation and physical activity have been shown to positively influence muscle mass and strength in older adults. The efficacy of long-term nutritional supplementation in combination with physical activity in older adults remains unclear.

    Methods: Mobility-limited (short physical performance battery [SPPB] ≤9) and vitamin D insufficient (serum 25(OH) D 9–24 ng/mL) older adults were recruited for this study. All subjects participated in a physical activity program. Subjects were randomized to consume a daily nutritional supplement (150 kcal, 20 g whey protein, 800 IU vitamin D, 119 mL beverage) or placebo (30 kcal, nonnutritive, 119 mL). In a prespecified secondary analysis, we examined total-body composition (dual energy X-ray absorptiometry), thigh composition (computed tomography), and muscle strength, power, and quality before and after the 6-month intervention.

    Results: One hundred and forty-nine subjects were randomized into the study [mean (standard deviation, SD) age 78.5 (5.4) years; 46.3% female; mean (SD) short physical performance battery 7.9 (1.2); mean (SD) vitamin D 18.7 (6.4) ng/mL]. After the intervention period both groups demonstrated improvements in muscle strength, body composition, and thigh composition. Nutritional supplementation lead to further losses of intermuscular fat (p = .049) and increased normal muscle density (p = .018).

    Conclusions: Six months of physical activity resulted in improvements in body composition, subcutaneous fat, intermuscular fat, and strength measures. The addition of nutritional supplementation resulted in further declines in intermuscular fat and improved muscle density compared to placebo. These results suggest nutritional supplementation provides additional benefits to mobility-limited older adults undergoing exercise training.

  • 298.
    Englund, Davis
    et al.
    Tufts Univ, Nutr Exercise Physiol & Sarcopenia Lab, Jean Mayer USDA Human Nutr Res Ctr Aging, Boston, MA 02111 USA..
    Kirn, Dylan
    Tufts Univ, Nutr Exercise Physiol & Sarcopenia Lab, Jean Mayer USDA Human Nutr Res Ctr Aging, Boston, MA 02111 USA..
    Koochek, Afsaneh
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Travison, Thomas
    Hebrew SeniorLife, Inst Aging Res, Boston, MA USA..
    Reid, Kieran
    Tufts Univ, Nutr Exercise Physiol & Sarcopenia Lab, Jean Mayer USDA Human Nutr Res Ctr Aging, Boston, MA 02111 USA..
    von Berens, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Zhu, Hao
    Hebrew SeniorLife, Inst Aging Res, Boston, MA USA..
    Lilja, Mats
    Karolinska Inst, Dept Lab Med, Stockholm, Sweden..
    Gustafsson, Thomas
    Karolinska Inst, Dept Lab Med, Stockholm, Sweden..
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Fielding, Roger
    Tufts Univ, Nutr Exercise Physiol & Sarcopenia Lab, Jean Mayer USDA Human Nutr Res Ctr Aging, Boston, MA 02111 USA..
    Nutritional supplementation with physical activity improves muscle composition in mobility-limited older adults, the VIVE2 study: a randomized, double-blind, placebo-controlled trial2017In: The FASEB Journal, ISSN 0892-6638, E-ISSN 1530-6860, Vol. 31, no S1, article id 460.3Article in journal (Other academic)
  • 299.
    Ericsson, Madelene
    et al.
    Umeå University, Faculty of Medicine, Department of Medical Biosciences.
    Sjödin, Anna
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Burén, Jonas
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Försämrad hjärtfunktion efter fyra veckors intag av lågkolhydrat/högfettkost hos möss: Kan vi lära av translationell forskning?2017In: Svensk kardiologi, ISSN 1400-5816, no 1, p. 33-35Article in journal (Other (popular science, discussion, etc.))
  • 300.
    Eriksson, Britt
    Linköping university, Linköping, Sweden.
    Metabolic, methodological and developmental aspects of body composition: Studies in women and children with special reference to early life mechanisms behind childhood obesity2010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    In recent decades the number of children with overweight has increased worldwide. To understand the mechanisms behind this development, knowledge regarding metabolism and physiology in relation to the nutritional situation in early life is of importance. In particular, information about body composition development during early childhood is relevant. This thesis presents three studies in this area. In the pregnancy study serum samples, collected from 23 women before, during and after pregnancy, were analysed for serum levels of leptin, adiponectin and resistin and used to assess insulin resistance (HOMA-IR) in relation to the total body fat (TBF) content of the women. TBF (%) and leptin were significantly correlated with HOMA-IR before and during pregnancy. When HOMA-IR was regressed on TBF (%) the slope of the regression line was 0.111 in gestational week 32 and significantly (p<0.05) higher than the value before pregnancy, 0.046, indicating that healthy pregnancy enhances the relationship between body fatness and insulin resistance. In the HF-study hydration of fat-free mass (hydration factor, HF) was assessed in 12 newborns using the doubly labelled water (DLW) method and air displacement plethysmography (PeaPod). HF was 80.9% with a low biological variability (0.81% of average HF). In the longitudinal study the body density of 108 healthy fullterm infants (53 girls, 55 boys) was measured at one and 12 weeks of age using PeaPod. Body composition was calculated using two models (Fomon’s and Butte’s). BMI values for the mothers of the infants were assessed before pregnancy. Body composition and total energy expenditure using the DLW-method were assessed in 20 of these children at the age of 1.5 years, when their sleeping metabolic rate was measured using indirect calorimetry and their resting energy metabolism was calculated using prediction equations. Butte´s model gave significantly (p<0.05) lower values for TBF than Fomon´s model, and invalid results for five newborns. Using Fomon´s model, at one week of age girls contained 13.4 ± 3.7 % and boys contained 12.5 ± 4.0 % TBF. The corresponding figures at 12 weeks were 26.3 ± 4.2 % and 26.4 ± 5.1 %. The mothers’ BMI values before pregnancy were correlated with the body weight but not with the TBF (g,%) or fat-free mass (g) of their infants at one week of age. At 1.5 years of age girls (n=9) contained 28.0±2.8 % and boys (n=11) 28.3±3.7 % TBF. Between one and 12 weeks of age all infants increased their TBF content, while 13 children increased and seven children decreased their TBF content between the ages of 12 weeks and 1.5 years. The results demonstrated that predicting rather than measuring resting energy metabolism involves a risk for spurious correlations between TBF and physical activity level. The level of physical activity (x), was negatively correlated with [TBF (%) at 1.5 years minus TBF (%) at 12 weeks] (y), r=-0.52, p=0.02. In conclusion, the results suggest that the body fat content of a woman has a stimulating effect on the growth, rather than on the fat retention, of her foetus. They also show that the Fomon model is the best available model when calculating the body composition of infants from body density. Finally, the results indicate that physical activity at the age of 1.5 years is important regarding the rate at which the high level of body fat, typical of infancy, decreases in early childhood.

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