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  • 51.
    Altmae, Signe
    et al.
    Div Obstet & Gynecol,Karolinska Inst, Stockholm, Sweden; Dept Clin Sci Intervent & Technol, Huddinge Hosp, Karolinska Univ, Huddinge, Sweden.
    Stavreus-Evers, Anneli
    Dept Womens & Childrens Hlth, Akad Sjukhuset, Uppsala Univ, Uppsala, Sweden.
    Ruiz, Jonatan R.
    Dept Biosci & Nutr, Unit Prevent Nutr, Karolinska Inst, Stockholm, Sweden.
    Laanpere, Margit
    Inst Mol & Cell Biol, Dept Biotechnol, Univ Tartu, Tartu, Estonia.
    Syvanen, Tiina
    Dept Womens & Childrens Hlth, Akad Sjukhuset, Uppsala Univ, Uppsala, Sweden.
    Yngve, Agneta
    Dept Biosci & Nutr, Karolinska Inst, Stockholm, Sweden.
    Salumets, Andres
    Inst Mol & Cell Biol, Dept Biotechnol, Univ Tartu, Tartu, Estonia; Dept Obstet & Gynecol, Univ Tartu, Tartu, Estonia.
    Nilsson, Torbjorn K.
    Dept Clin Chem, Orebro Univ Hosp, Orebro, Sweden.
    Variations in folate pathway genes are associated with unexplained female infertility2010In: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 94, no 1, p. 130-137Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate associations between folate-metabolizing gene variations, folate status, and unexplained female infertility. Design: An association study. Setting: Hospital-based IVF unit and university-affiliated reproductive research laboratories. Patient(s): Seventy-one female patients with unexplained infertility. Intervention(s): Blood samples for polymorphism genotyping and homocysteine, vitamin B12, and folate measurements. Main Outcome Measure(s): Allele and genotype frequencies of the following polymorphisms: 5,10-methylenetetra-hydrofolate reductase (MTHFR) 677C/T, 1298A/C, and 1793G/A, folate receptor 1 (FOLR1) 1314G/A, 1816delC, 1841G/A, and 1928C/T, transcobalamin II (TCN2) 776C/G, cystathionase (CTH) 1208G/T and solute carrier family 19, member 1 (SLC19A1) 80G/A, and concentrations of plasma homocysteine, vitamin B12, and serum folate. Result(s): MTHFR genotypes 677CT and 1793GA, as well as 1793 allele A were significantly more frequent among controls than in patients. The common MTHFR wild-type haplotype (677, 1298, 1793) CAG was less prevalent, whereas the rare haplotype CCA was more frequent in the general population than among infertility patients. The frequency of SLC19A1 80G/A genotypes differed significantly between controls and patients and the A allele was more common in the general population than in infertile women. Plasma homocysteine concentrations were influenced by CTH 1208G/T polymorphism among infertile women. Conclusion(s): Polymorphisms in folate pathway genes could be one reason for fertility complications in some women with unexplained infertility. (Fertil Steril (R) 2010;94:130-7. (C) 2010 by American Society for Reproductive Medicine.)

  • 52.
    Andersson, Agneta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Dukat för prestation - recept och näringsguide för aktiva idrottare1996Other (Other academic)
  • 53.
    Andersson, Agneta
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Glykemiskt index: ett osäkert verktyg för idrottaren2009In: Nordisk nutrition, ISSN 1654-8337, no 4, p. 21-23Article in journal (Other (popular science, discussion, etc.))
  • 54.
    Andersson, Agneta
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Idrottsnutrition2013In: Näringslära för högskolan: Från grundläggande till avancerad nutrition, Stockholm: Liber AB , 2013, 6, p. 410-439Chapter in book (Other (popular science, discussion, etc.))
  • 55.
    Andersson, Agneta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Idrottsnutrition2006In: Näringslära för högskolan, Liber AB, Stockholm , 2006, p. 394-423Chapter in book (Other (popular science, discussion, etc.))
  • 56.
    Andersson, Agneta
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Kan vi räkna med fullkorn - i maten och i blodet?2009In: Dietistaktuellt, ISSN 1102-9285, no 3, p. 15-17Article in journal (Other (popular science, discussion, etc.))
  • 57. Andersson, Agneta
    Kan vi räkna med fullkorn - maten och i blodet?2009In: Dietistaktuellt, Vol. XiX, no 3, p. 15-17Article in journal (Other (popular science, discussion, etc.))
  • 58.
    Andersson, Agneta
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Modedieter: till vilken nytta?2010Other (Other (popular science, discussion, etc.))
  • 59.
    Andersson, Agneta
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Näringslära som diciplin2013In: Näringslära för högskolan: Från grundläggande till avancerad nutrition, Stockholm: Liber AB , 2013, 6, , p. 11-16p. 11-16Chapter in book (Other (popular science, discussion, etc.))
  • 60.
    Andersson, Agneta
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Specialistkompetens - professionskvalitet och karriärsutveckling.: Hur står vi oss gentemot övrig hälso- och sjukvårdspersonal?2018In: Dietist Aktuellt, Vol. XXVII, no 4, p. 36-43Article in journal (Other (popular science, discussion, etc.))
  • 61.
    Andersson, Agneta
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Bakkman, Linda
    Berglund, Bo
    Reinebo, Peter
    Saltin, Bengt
    Kostrekommendationer för elitidrottare.: SOK:s kostpolicy för elitidrottare.2009Other (Other (popular science, discussion, etc.))
  • 62.
    Andersson, Agneta
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences. Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Domestic Sciences.
    Göranzon, Helen
    Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Domestic Sciences.
    Energi- och metabolism2006In: Näringslära för högskolan, Liber AB, Stockholm , 2006, p. 166-193Chapter in book (Other (popular scientific, debate etc.))
  • 63.
    Andersson, Agneta
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Löf, Marie
    Karolinska Insitutet Stockholm.
    Energi och metabolism2013In: Näringslära för högskolan: Från grundläggande till avancerad nutrition., Stockholm: Liber AB , 2013, 6, p. 131-159Chapter in book (Other (popular science, discussion, etc.))
  • 64.
    Andersson, Agneta
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Marklund, Matti
    Department of Food Science; Swedish University of Argiculture Sciences, Uppsala.
    Diana, Mariana
    Department of Food Science; Swedish University of Argiculture Sciences, Uppsala.
    Landberg, Rikard
    Department of Food Science; Swedish University of Argiculture Sciences, Uppsala.
    Plasma Alkylresorcinol Concentrations Correlate with Whole Grain Wheat and Rye Intake and Show Moderate Reproducibility over a 2- to 3-Month Period in Free-Living Swedish Adults2011In: Journal of Nutrition, ISSN 0022-3166, E-ISSN 1541-6100, Vol. 141, no 9, p. 1712-1718Article in journal (Refereed)
    Abstract [en]

    Plasma alkylresorcinols (AR) are useful as dietary biomarkers of wheat and rye whole grain (WG) during interventions but need to be validated in free-living populations. This study estimated the medium-term reproducibility and relative validity of plasma AR as biomarkers of WG and cereal fiber intake. Seventy-two Swedish adults kept 3-d weighed food records on 2 occasions 2-3 mo apart. Of these men and women, 51 provided a fasting blood sample at the end of each occasion. In addition, 18 participants provided 3 fasting and 3 nonfasting samples for 3 consecutive days on the first and second occasions, respectively. Dietary and blood variables did not differ between the 2 occasions. Nonfasting plasma total AR concentration [210 nmol/L (95% CI: 140, 314)] was higher than fasting [99 nmol/L (95% CI: 72, 137)] (P < 0.0001). Mean WG intake was 70 ± 61 g/d (41% from rye) and the intra-class correlation coefficient was 0.44 (95% CI: 0.26, 0.63) for total WG intake and 0.47 (95% CI: 0.27, 0.67) for the fasting plasma total AR concentration, suggesting moderate reproducibility. Fasting plasma total AR moderately correlated with WG rye + wheat (r(s) = 0.53; P < 0.001) and cereal fiber intake (r(s) = 0.32; P < 0.05) when using mean values from both occasions. This suggests that plasma AR concentration in fasting samples can be used as a biomarker of rye + wheat WG intake in free-living populations with a high and consistent WG intake.

  • 65.
    Andersson, Agneta
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nilsson, Gerd
    Kroppen, maten och generna2013In: Näringslära för högskolan: Från grundläggande till avancerad nutrition, Stockholm: Liber AB , 2013, 6, p. 17-36Chapter in book (Other (popular science, discussion, etc.))
  • 66.
    Andersson, Agneta
    et al.
    Uppsala University, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Domestic Sciences. Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Nilsson, Gerd
    Aschan-Åberg, Karin
    Kroppens uppbyggnad och hantering av näringsämnen2006In: Näringslära för högskolan, Liber AB, Stockholm , 2006, p. 58-76Chapter in book (Other (popular scientific, debate etc.))
  • 67.
    Andersson, Agneta
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Domestic Sciences.
    Sjödin, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Vessby, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Dye, Louise
    Blundell, John
    Effects of meals with calcuated high or low glycemic index compared with a high protein meal on appetite, cognitive performance and subjective state2005In: Presentation vid 23rd International Symposium on Diabetes and Nutrition, DNSG, 30 juni-3 juli, Ebeltoft, Danmark, 2005Conference paper (Other (popular science, discussion, etc.))
  • 68. Andersson, Agneta
    et al.
    Slinde, Frode
    Evidensbaseradnutrition - en exposition2008In: Dietist Aktuellt, Vol. XIX, no 2, p. 17-22Article in journal (Other (popular science, discussion, etc.))
  • 69.
    Andersson, Agneta
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences. Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Domestic Sciences.
    Tengblad, Siv
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Karlström, Brita
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences. Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Domestic Sciences.
    Kamal-Edin, Afaf
    Landberg, Rikard
    Åman, Per
    Vessby, Bengt
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Oförändrad insulinkänslighet och lipidperoxidation efter ökat intag av fullkornsprodukter hos friska män och kvinnor.2006In: Livsmedelsforskardagarna, 2006Conference paper (Other (popular scientific, debate etc.))
    Abstract [en]

    Flertalet epidemilogiska studier har visat positiva hälsoeffekter av ett högt intag av fullkornsprodukter. Framförallt är en minska risk för hjärtinfarkt/sjukdom visad, och data

    talar även för en minskad risk för typ 2 diabetes. Mekanismerna bakom fullkornets positiva effekter är dock fortfarande oklara. Såväl en förbättrad insulinkänslighet som en minskad förekomst av lipidperoxidation och inflammation har föreslagits, vilket vi därför önskade undersöka i denna studie.

    I en randomiserad cross-over design deltog 30 lätt överviktiga (BMI 282) kvinnor (n=22) och män (n=8). Under två på varandra följande 6 veckors perioder fick deltagarna antingen cerealieprodukter med fullkorn eller utan fullkorn. En standardiserad mängd (3 skivor mjukt bröd, 2 skivor hårt bröd, 1 portion musli/gryn och 1 portion pasta/ris) inkluderades dagligen i deras vanliga kost. Perifer insulinkänslighet mättes med euglykemisk hyperinsulinemisk clampteknik. Lipidperoxidationsmarkören 8-iso-PGF2 mättes i urin och inflammationsmarkörerna CRP och IL-6 mättes i plasma. Kostinterventionen monitorerades med hjälp av vägda kostregisteringar och dagboksnoteringar.

    Kostregistreringarna bekräftade ett högre intag av fiber och flertalet mineralämnen under fullkornsperioden jämfört med icke-fullkornsperioden. Vi fann dock ingen förbättring av insulinkänsligheten och inte heller någon förändring av lipidperoxidation eller inflammationsmarkörer.

    Att ersätta icke-fullkorns produkter med fullkorn under en 6 veckors period hos vuxna lätt överviktiga friska män och kvinnor gav således ingen mätbar effekt på vare sig insulinkänslighet, lipidperoxidation eller inflammationsmarkörer. Frågan om vilka mekanismerna som ligger bakom de positiva hälsoeffekterna av fullkornsprodukter kvarstår och längre koststudier på deltagare med varierande metaboltstatus behövs.

  • 70.
    Andersson, Agneta
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences. Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Domestic Sciences.
    Tengblad, Siv
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Karlström, Brita
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences. Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Domestic Sciences.
    Kamal-Eldin, Afaf
    Landberg, Rickard
    Åman, Per
    Vessby, Bengt
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Ökat intag av fullkornsprodukter. Effekter på insulinkänslighet, lipidperoxidation och inflammationsmarkörer?2006In: Svenska Läkarsällskapets Riksstämma, 2006Conference paper (Other (popular scientific, debate etc.))
    Abstract [en]

    Bakgrund: Flertalet epidemiologiska studier har visat positiva hälsoeffekter av ett högt intag av fullkornsprodukter. Framförallt är en minskad risk för hjärtinfarkt/sjukdom visad, men data talar även för en minskad risk för typ 2 diabetes. Mekanismerna bakom fullkornets positiva effekter är dock fortfarande oklara. Såväl en förbättrad insulinkänslighet som en minskad förekomst av lipidperoxidation och inflammation har föreslagits, vilket vi önskade undersöka i denna studie.

    Metod: I en randomiserad cross-over design deltog 30 lätt överviktiga (BMI 282) kvinnor (n=22) och män (n=8). Under två på varandra följande 6-veckors perioder fick deltagarna antingen cerealieprodukter med fullkorn eller utan fullkorn. En standardiserad mängd (3 skivor mjukt bröd, 2 skivor hårt bröd, 1 portion musli/gryn och 1 portion pasta/ris) inkluderades dagligen i deras vanliga kost. Perifer insulinkänslighet mättes med euglykemisk hyperinsulinemisk clampteknik. Lipidperoxidationsmarkören 8-iso-PGF2 mättes i urin och inflammationsmarkörerna CRP och IL-6 mättes i plasma. Kostinterventionen monitorerades med hjälp av vägda kostregisteringar och dagboksnoteringar.

    Resultat: Kostregistreringarna bekräftade ett högre intag av fiber och flertalet mineralämnen under fullkornsperioden jämfört med icke-fullkornsperioden. Vi fann dock ingen förbättring av insulinkänsligheten och inte heller någon förändring av lipidperoxidation eller inflammationsmarkörer.

    Sammanfattning: Att ersätta icke-fullkorns produkter med fullkorn under en 6-veckors period hos vuxna lätt överviktiga friska män och kvinnor gav ingen mätbar effekt på insulinkänslighet, lipidperoxidation eller inflammationsmarkörer. Frågan om vilka mekanismerna som ligger bakom de positiva hälsoeffekterna av fullkornsprodukter kvarstår och längre koststudier på deltagare med varierande metaboltstatus behövs.

  • 71. Andersson, Daniel P.
    et al.
    Thorell, Anders
    Lofgren, Patrik
    Wiren, Mikael
    Toft, Eva
    Qvisth, Veronica
    Risérus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Berglund, Lars
    Naslund, Erik
    Bringman, Sven
    Thorne, Anders
    Arner, Peter
    Hoffstedt, Johan
    Omentectomy in addition to gastric bypass surgery and influence on insulin sensitivity: A randomized double blind controlled trial2014In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 33, no 6, p. 991-996Article in journal (Refereed)
    Abstract [en]

    Background & aims: Accumulation of visceral adipose tissue is associated with insulin resistance and cardio-vascular disease. The aim of this study was to elucidate whether removal of a large amount of visceral fat by omentectomy in conjunction with Roux en-Y gastric bypass operation (RYGB) results in enhanced improvement of insulin sensitivity compared to gastric bypass surgery alone. Methods: Eighty-one obese women scheduled for RYGB were included in the study. They were randomized to RYGB or RYGB in conjunction with omentectomy. Insulin sensitivity was measured by hyperinsulinemic euglycemic clamp before operation and sixty-two women were also reexamined 2 years post-operatively. The primary outcome measure was insulin sensitivity and secondary outcome measures included cardio-metabolic risk factors. Results: Two-year weight loss was profound but unaffected by omentectomy. Before intervention, there were no clinical or metabolic differences between the two groups. The difference in primary outcome measure, insulin sensitivity, was not significant between the non-omentectomy (6.7 +/- 1.6 mg/kg body weight/minute) and omentectomy groups (6.6 +/- 1.5 mg/kg body weight/minute) after 2 years. Nor did any of the cardio-metabolic risk factors that were secondary outcome measures differ significantly. Conclusion: Addition of omentectomy to gastric bypass operation does not give an incremental effect on long term insulin sensitivity or cardio-metabolic risk factors. The clinical usefulness of omentectomy in addition to gastric bypass operation is highly questionable.

  • 72.
    Andersson, J.
    et al.
    Norge.
    Hulander, E.
    Norge.
    Rothenberg, Elisabet
    Kristianstad University, Research Environment Food and Meals in Everyday Life (MEAL). Kristianstad University, School of Education and Environment, Avdelningen för Mat- och måltidsvetenskap.
    Iversen, P. Ole
    Norge.
    Effect on body weight, quality of life and appetite following individualized, nutritional counselling to home-living elderly after rehabilitation: an open randomized trial2017In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 21, no 7, p. 811-818Article in journal (Refereed)
    Abstract [en]

    Objectives: We examined if individually-adapted nutritional counselling could prevent > 5% weight loss among elderly patients 3 months after discharge from a rehabilitation institution. In addition we assessed quality of life (QoL) and appetite. Design: An open, randomized trial. Setting: Godthaab Health and Rehabilitation Institution in Bærum, Norway. Participants: Patients identified as being undernourished or at risk of disease-related malnutrition using the Nutritional Risk Screening tool NRS-2002. Intervention: Shortly before discharge, patients in the intervention group received an individually-tailored nutrition plan. During the subsequent 3 months these patients were contacted 3 times via telephone calls and they received one visit at their homes, for nutrition counselling. Focus on this counselling was on optimizing meal environment, improving appetite, increasing food intake, advice on food preparation, and motivation and support. Measurements: In addition to weight, QoL and appetite were assessed using the EQ-5D questionnaire and a modified version of the Disease-Related Appetite Questionnaire, respectively. Results: Among 115 considered eligible for the study, 100 were enrolled (72 women and 28 men), with a mean age of 75 years and a mean body mass index of 20 kg/m2. Two in the intervention group (n = 52) and 5 in the control group (n = 48) lost > 5% of their body weight, giving an odds ratio of 0.34 (95% CI: 0.064 – 1.86; p = 0.22). We did not detect any significant differences in the QoL- or appetite scores between the two study groups after three months. Conclusion: An individually-adapted nutritional counselling did not improve body mass among elderly patients 3 months after discharge from a rehabilitation institution. Neither quality of life nor appetite measures were improved. Possibly, nutritional counselling should be accompanied with nutritional supplementation to be effective in this vulnerable group of elderly. The trial is registered in Clinical Trials (ID: NCT01632072).

  • 73.
    Andreae, Christina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Linkoping Univ, Dept Med & Hlth Sci, Div Nursing Sci, Linkoping, Sweden..
    Strömberg, Anna
    Linkoping Univ, Dept Med & Hlth Sci, Div Nursing Sci, Linkoping, Sweden.;Fac Med & Hlth Sci, Dept Cardiol, Linkoping, Sweden..
    Sawatzky, Richard
    Trinity Western Univ, Sch Nursing, Langley, BC, Canada.;Providence Hlth Care Res Inst, Ctr Hlth Evaluat & Outcome Sci, Vancouver, BC, Canada..
    Arestedt, Kristofer
    Linkoping Univ, Dept Med & Hlth Sci, Div Nursing Sci, Linkoping, Sweden..
    Psychometric Evaluation of Two Appetite Questionnaires in Patients With Heart Failure2015In: Journal of Cardiac Failure, ISSN 1071-9164, E-ISSN 1532-8414, Vol. 21, no 12, p. 954-958Article in journal (Refereed)
    Abstract [en]

    Background: Decreased appetite in heart failure (HF) may lead to undemutrition which could negatively influence prognosis. Appetite is a complex clinical issue that is often best measured with the use of self-report instruments. However, there is a lack of self-rated appetite instruments. The Council on Nutrition Appetite Questionnaire (CNAQ) and the Simplified Nutritional Appetite Questionnaire (SNAQ) are validated instruments developed primarily for elderly people. Yet, the psychometric properties have not been evaluated in HF populations. The aim of the present study was to evaluate the psychometric properties of CNAQ and SNAQ in patients with HE Methods and Results: A total of 186 outpatients with reduced ejection fraction and New York Heart Association (NYHA) functional classifications II-IV were included (median age 72 y; 70% men). Data were collected with the use of a questionnaire that included the CNAQ and SNAQ. The psychometric evaluation included data quality, factor structure, construct validity, known-group validity, and internal consistency. Unidimensionality was supported by means of parallel analysis and confirmatory factor analyses (CFAs). The CFA results indicated sufficient model fit. Both construct validity and known-group validity were supported. Internal consistency reliability was acceptable, with ordinal coefficient alpha estimates of 0.82 for CNAQ and 0.77 for SNAQ. Conclusions: CNAQ and SNAQ demonstrated sound psychometric properties and can be used to measure appetite in patients with HF.

  • 74. Ankarfeldt, Mikkel Z.
    et al.
    Ängquist, Lars
    Stocks, Tanja
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology. Department of Clinical Sciences in Malmö, Diabetes and Cardiovascular Diseases, Genetic Epidemiology, Lund University, Lund, Sweden.
    Jakobsen, Marianne U.
    Overvad, Kim
    Halkjær, Jytte
    Saris, Wim H. M.
    Astrup, Arne
    Sørensen, Thorkild I. A.
    Body characteristics, dietary protein and body weight regulation. Reconciling conflicting results from intervention and observational studies?2014In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, no 7, p. e101134-Article in journal (Refereed)
    Abstract [en]

    Background/Objectives: Physiological evidence indicates that high-protein diets reduce caloric intake and increase thermogenic response, which may prevent weight gain and regain after weight loss. Clinical trials have shown such effects, whereas observational cohort studies suggest an association between greater protein intake and weight gain. In both types of studies the results are based on average weight changes, and show considerable diversity in both directions. This study investigates whether the discrepancy in the evidence could be due to recruitment of overweight and obese individuals into clinical trials. Subjects/Methods: Data were available from the European Diet, Obesity and Genes (DiOGenes) post-weight-loss weight-maintenance trial and the Danish Diet, Cancer and Health (DCH) cohort. Participants of the DCH cohort were matched with participants from the DiOGenes trial on gender, diet, and body characteristics. Different subsets of the DCH-participants, comparable with the trial participants, were analyzed for weight maintenance according to the randomization status (high or low protein) of the matched trial participants. Results: Trial participants were generally heavier, had larger waist circumference and larger fat mass than the participants in the entire DCH cohort. A better weight maintenance in the high-protein group compared to the low protein group was observed in the subgroups of the DCH cohort matching body characteristics of the trial participants. Conclusion: This modified observational study, minimized the differences between the RCT and observational data with regard to dietary intake, participant characteristics and statistical analysis. Compared with low protein diet the high protein diet was associated with better weight maintenance when individuals with greater body mass index and waist circumference were analyzed. Selecting subsets of large-scale observational cohort studies with similar characteristics as participants in clinical trials may reconcile the otherwise conflicting results.

  • 75.
    Arora, Tulika
    et al.
    Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
    Velagapudi, Vidya
    VTT Technical Research Centre of Finland, Espoo, Finland; Metabolomics Unit, Institute for Molecular Medicine Finland FIMM, Helsinki, Finland.
    Pournaras, Dimitri J.
    Department of Bariatric Surgery, Musgrove Park Hospital, Taunton, United Kingdom.
    Welbourn, Richard
    Department of Bariatric Surgery, Musgrove Park Hospital, Taunton, United Kingdom.
    le Roux, Carel W.
    Diabetes Complications Research Centre, School of Medicine and Medical Science, University College Dublin, Dublin, Ireland; Gastrosurgical Laboratory, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Oresic, Matej
    Örebro University, School of Medical Sciences. VTT Technical Research Centre of Finland, Espoo, Finland; Steno Diabetes Center A/S, Gentofte, Denmark.
    Bäckhed, Fredrik
    Department of Molecular and Clinical Medicine, Institute of Medicie, University of Gothenburg, Gothenburg, Sweden; Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Receptology and Enteroendocrinology, University of Copenhagen, Copenhagen, Denmark.
    Roux-en-Y Gastric Bypass Surgery Induces Early Plasma Metabolomic and Lipidomic Alterations in Humans Associated with Diabetes Remission2015In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 5, article id e0126401Article in journal (Refereed)
    Abstract [en]

    Roux-en-Y gastric bypass (RYGB) is an effective method to attain sustained weight loss and diabetes remission. We aimed to elucidate early changes in the plasma metabolome and lipidome after RYGB. Plasma samples from 16 insulin-resistant morbidly obese subjects, of whom 14 had diabetes, were subjected to global metabolomics and lipidomics analysis at pre-surgery and 4 and 42 days after RYGB. Metabolites and lipid species were compared between time points and between subjects who were in remission and not in remission from diabetes 2 years after surgery. We found that the variables that were most discriminatory between time points were decanoic acid and octanoic acid, which were elevated 42 days after surgery, and sphingomyelins (18:1/21:0 and 18:1/23:3), which were at their lowest level 42 days after surgery. Insulin levels were lower at 4 and 42 days after surgery compared with pre-surgery levels. At 4 days after surgery, insulin levels correlated positively with metabolites of branched chain and aromatic amino acid metabolism and negatively with triglycerides with long-chain fatty acids. Of the 14 subjects with diabetes prior to surgery, 7 were in remission 2 years after surgery. The subjects in remission displayed higher pre-surgery levels of tricarboxylic acid cycle intermediates and triglycerides with long-chain fatty acids compared with subjects not in remission. Thus, metabolic alterations are induced soon after surgery and subjects with diabetes remission differ in the metabolic profiles at pre- and early post-surgery time points compared to patients not in remission.

  • 76. Arouca, Aline B
    et al.
    Santaliestra-Pasías, Alba M
    Moreno, Luis A
    Marcos, Ascensión
    Widhalm, Kurt
    Molnár, Dénes
    Manios, Yannis
    Gottrand, Frederic
    Kafatos, Anthony
    Kersting, Mathilde
    Sjöström, Michael
    Sáinz, Ángel Gutiérrez
    Ferrari, Marika
    Huybrechts, Inge
    González-Gross, Marcela
    Forsner, Maria
    Umeå University, Faculty of Medicine, Department of Nursing. School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
    De Henauw, Stefaan
    Michels, Nathalie
    Diet as a moderator in the association of sedentary behaviors with inflammatory biomarkers among adolescents in the HELENA study2018In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215Article in journal (Refereed)
    Abstract [en]

    AIM: To assess if a healthy diet might attenuate the positive sedentary-inflammation relation, whereas an unhealthy diet may increase the effect of sedentary behaviors on inflammatory biomarkers.

    METHODS: In 618 adolescents (13-17 years) of the European HELENA study, data were available on body composition, a set of inflammation markers, and food intake assessed by a self-administered computerized 24 h dietary recall for 2 days. A 9-point Mediterranean diet score and an antioxidant-rich diet z-score were used as dietary indices and tested as moderators. A set of low-grade inflammatory characteristics was used as outcome: several cytokines in an inflammatory ratio (IL-6, IL-10, TNF-α, TGFβ-1), C-reactive protein, three cell-adhesion molecules (sVCAM-1, sICAM-1, sE-selectin), three cardiovascular risk markers (GGT, ALT, homocysteine) and three immune cell types (white blood cells, lymphocytes, CD3). Sedentary behaviors were self-reported and analyzed as total screen time. Multiple linear regression analyses tested moderation by diet in the sedentary behaviors-inflammation association adjusted for age, sex, country, adiposity (sum of six skinfolds), parental education, and socio-economic status.

    RESULTS: Both diet scores, Mediterranean and antioxidant-rich diet, were significant protective moderators in the effect of sedentary behaviors on alanine-transaminase enzyme (P = 0.014; P = 0.027), and on the pro/anti-inflammatory cytokine ratio (P = 0.001; P = 0.004), but not on other inflammatory parameters.

    CONCLUSION: A higher adherence to the Mediterranean diet or an antioxidant-rich diet may attenuate the onset of oxidative stress signs associated by sedentary behaviors, whereas a poor diet seems to increase inflammation.

  • 77. Arslanoglu, Sertac
    et al.
    Corpeleijn, Willemijn
    Moro, Guido
    Braegger, Christian
    Campoy, Cristina
    Colomb, Virginie
    Decsi, Tamas
    Domellöf, Magnus
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Fewtrell, Mary
    Hojsak, Iva
    Mihatsch, Walter
    Molgaard, Christian
    Shamir, Raanan
    Turck, Dominique
    van Goudoever, Johannes
    Donor Human Milk for Preterm Infants: Current Evidence and Research Directions2013In: Journal of Pediatric Gastroenterology and Nutrition - JPGN, ISSN 0277-2116, E-ISSN 1536-4801, Vol. 57, no 4, p. 535-542Article in journal (Other academic)
    Abstract [en]

    The Committee on Nutrition of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition aims to document the existing evidence of the benefits and common concerns deriving from the use of donor human milk (DHM) in preterm infants. The comment also outlines gaps in knowledge and gives recommendations for practice and suggestions for future research directions. Protection against necrotizing enterocolitis is the major clinical benefit deriving from the use of DHM when compared with formula. Limited data also suggest unfortified DHM to be associated with improved feeding tolerance and with reduced cardiovascular risk factors during adolescence. Presence of a human milk bank (HMB) does not decrease breast-feeding rates at discharge, but decreases the use of formula during the first weeks of life. This commentary emphasizes that fresh own mother's milk (OMM) is the first choice in preterm infant feeding and strong efforts should be made to promote lactation. When OMM is not available, DHM is the recommended alternative. When neither OMM nor DHM is available, preterm formula should be used. DHM should be provided from an established HMB, which follows specific safety guidelines. Storage and processing of human milk reduces some biological components, which may diminish its health benefits. From a nutritional point of view, DHM, like HM, does not meet the requirements of preterm infants, necessitating a specific fortification regimen to optimize growth. Future research should focus on the improvement of milk processing in HMB, particularly of heat treatment; on the optimization of HM fortification; and on further evaluation of the potential clinical benefits of processed and fortified DHM.

  • 78. Arsov, S.
    et al.
    Trajceska, L.
    van Oeveren, W.
    Smit, A. J.
    Dzekova, P.
    Stegmayr, Bernd
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Sikole, A.
    Rakhorst, G.
    Graaff, R.
    The influence of body mass index on the accumulation of advanced glycation end products in hemodialysis patients2015In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 69, no 3, p. 309-313Article in journal (Refereed)
    Abstract [en]

    BACKGROUND/OBJECTIVES: The level of skin autofluorescence (AF) at a given moment is an independent predictor of mortality in hemodialysis (HD) patients. Skin AF is a measure of the accumulation of advanced glycation end products (AGEs). The aim of the study was to estimate the influence of nutrition on the 1-year increase of skin AF (Delta AF) in HD patients.

    SUBJECTS/METHODS: A total of 156 HD patients were enrolled in this study. Skin AF, body mass index (BMI), superoxide dismutase, myeloperoxidase, C-reactive protein, inter-cellular adhesion molecule-1, von Willebrand factor and heart-type fatty acid-binding protein were measured four times at intervals of approximately half a year. Data from the monthly routine blood analysis were also used. Daily calorie, protein and AGE intakes were assessed from food recordings over a period of 1 week.

    RESULTS: A J-shaped relation was found between baseline BMI and Delta AF (P = 0.01). The lowest point of the J-shaped curve is found for BMI = 24.3 kg/m(2). In the univariate analysis of the contributors to the 1-year Delta AF, we found that beside BMI = 24.3 kg/m(2), AGE and calorie intakes, as well as myeloperoxidase and HD vintage, had a P < 0.10. The sole independent predictor of the 1-year Delta AF was BMI = 24.3 kg/m(2) (P = 0.01).

    CONCLUSIONS: It appears that calorie, protein and AGE intakes hardly influence the 1-year Delta AF in HD patients. BMI of HD patients of around 24 kg/m(2) resulted in a lower 1-year Delta AF.

  • 79. Arvidsson Lenner, R
    et al.
    Carlgren, G
    Carlgren, G
    Hardell, LI
    Johansson, B
    Jonsson, G
    Samuelson, Gösta
    Sandström, B
    Food and nutrient intake in Swedish diabetic children1989In: Näringsforskning, Vol. 33, no 4, p. 149-53Article in journal (Other academic)
  • 80. Asli, Lene A.
    et al.
    Braaten, Tonje
    Olsen, Anja
    Tjonneland, Anne
    Overvad, Kim
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Renstrom, Frida
    Umeå University, Faculty of Medicine, Department of Biobank Research. Department of Clinical Sciences, Lund University, Sweden.
    Lund, Eiliv
    Skeie, Guri
    Potato consumption and risk of pancreatic cancer in the HELGA cohort2018In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 119, no 12, p. 1408-1415Article, review/survey (Refereed)
    Abstract [en]

    Potatoes have been a staple food in many countries throughout the years. Potatoes have a high glycaemic index (GI) score, and high GI has been associated with several chronic diseases and cancers. Still, the research on potatoes and health is scarce and contradictive, and we identified no prospective studies that had investigated the association between potatoes as a single food and the risk of pancreatic cancer. The aim of this study was to prospectively investigate the association between potato consumption and pancreatic cancer among 114 240 men and women in the prospective HELGA cohort, using Cox proportional hazard models. Information on diet (validated FFQ's), lifestyle and health was collected by means of a questionnaire, and 221 pancreatic cancer cases were identified through cancer registries. The mean follow-up time was 11.4 (95 % CI 0.3, 169) years. High consumption of potatoes showed a non-significantly higher risk of pancreatic cancer in the adjusted model (hazard ratio (HR) 1.44; 95 % CI 0.93, 2.22, P-for trend 0.030) when comparing the highest v. the lowest quartile of potato consumption. In the sex-specific analyses, significant associations were found for females (HR 2.00; 95 % CI 1.07, 3.72, P-for trend 0.020), but not for males (HR 1.01; 95 % CI 0.56, 1.84, P-for trend 0.34). In addition, we explored the associations by spline regression, and the absence of dose-response effects was confirmed. In this study, high potato consumption was not consistently associated with a higher risk of pancreatic cancer. Further studies with larger populations are needed to explore the possible sex difference.

  • 81. Asp, NG
    et al.
    Hallberg, L
    Hallmans, G
    Samuelson, Gösta
    Reutersvärd, AL
    Iron nutrition in health and disease: Referat från ett internationellt symposium1996In: Scandinavian Journal of Nutrition, ISSN 1102-6489, Vol. 40, no 2, p. 76-80Article in journal (Refereed)
  • 82. Assi, Nada
    et al.
    Moskal, Aurelie
    Slimani, Nadia
    Viallon, Vivian
    Chajes, Veronique
    Freisling, Heinz
    Monni, Stefano
    Knueppel, Sven
    Foerster, Jana
    Weiderpass, Elisabete
    Lujan-Barroso, Leila
    Amiano, Pilar
    Ardanaz, Eva
    Molina-Montes, Esther
    Salmeron, Diego
    Ramon Quiros, Jose
    Olsen, Anja
    Tjonneland, Anne
    Dahm, Christina C.
    Overvad, Kim
    Dossus, Laure
    Fournier, Agnes
    Baglietto, Laura
    Fortner, Renee Turzanski
    Kaaks, Rudolf
    Trichopoulou, Antonia
    Bamia, Christina
    Orfanos, Philippos
    De Magistris, Maria Santucci
    Masala, Giovanna
    Agnoli, Claudia
    Ricceri, Fulvio
    Tumino, Rosario
    de Mesquita, H. Bas Bueno
    Bakker, Marije F.
    Peeters, Petra H. M.
    Skeie, Guri
    Braaten, Tonje
    Winkvist, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Khaw, Kay-Tee
    Wareham, Nicholas J.
    Key, Tim
    Travis, Ruth
    Schmidt, Julie A.
    Merritt, Melissa A.
    Riboli, Elio
    Romieu, Isabelle
    Ferrari, Pietro
    A treelet transform analysis to relate nutrient patterns to the risk of hormonal receptor-defined breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)2016In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 19, no 2, p. 242-254Article in journal (Refereed)
    Abstract [en]

    Objective Pattern analysis has emerged as a tool to depict the role of multiple nutrients/foods in relation to health outcomes. The present study aimed at extracting nutrient patterns with respect to breast cancer (BC) aetiology. Design Nutrient patterns were derived with treelet transform (TT) and related to BC risk. TT was applied to twenty-three log-transformed nutrient densities from dietary questionnaires. Hazard ratios (HR) and 95 % confidence intervals computed using Cox proportional hazards models quantified the association between quintiles of nutrient pattern scores and risk of overall BC, and by hormonal receptor and menopausal status. Principal component analysis was applied for comparison. Setting The European Prospective Investigation into Cancer and Nutrition (EPIC). Subjects Women (n 334 850) from the EPIC study. Results The first TT component (TC1) highlighted a pattern rich in nutrients found in animal foods loading on cholesterol, protein, retinol, vitamins B-12 and D, while the second TT component (TC2) reflected a diet rich in -carotene, riboflavin, thiamin, vitamins C and B-6, fibre, Fe, Ca, K, Mg, P and folate. While TC1 was not associated with BC risk, TC2 was inversely associated with BC risk overall (HRQ5 v. Q1=089, 95 % CI 083, 095, P-trend<001) and showed a significantly lower risk in oestrogen receptor-positive (HRQ5 v. Q1=089, 95 % CI 081, 098, P-trend=002) and progesterone receptor-positive tumours (HRQ5 v. Q1=087, 95 % CI 077, 098, P-trend<001). Conclusions TT produces readily interpretable sparse components explaining similar amounts of variation as principal component analysis. Our results suggest that participants with a nutrient pattern high in micronutrients found in vegetables, fruits and cereals had a lower risk of BC.

  • 83.
    Atiya Ali, M.
    et al.
    Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Stockholm, Sweden.
    Strandvik, B.
    Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Stockholm, Sweden.
    Sabel, K-G.
    Borås Children Hospital, SÄS, Borås, Sweden.
    Palme Kilander, C.
    Division of Neonatology, Department of Paediatrics, Karolinska Institutet at Danderyd, Danderyd, Stockholm, Sweden.
    Strömberg, R.
    Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Stockholm, Sweden.
    Yngve, Agneta
    Örebro universitet, Restaurang- och hotellhögskolan.
    Polyamine levels in breast milk are associated with mothers' dietary intake and are higher in preterm than full-term human milk and formulas2014In: Journal of human nutrition and dietetics (Print), ISSN 0952-3871, E-ISSN 1365-277X, Vol. 27, no 5, p. 459-467Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Polyamine intake from milk is considered essential for post-natal maturation of the immune system and small intestine. The present study aimed to determine polyamine content in human milk after preterm delivery and the association with mothers' dietary intake. In comparison, the polyamine levels were compared with those in term breast milk and some corresponding formulas.

    METHODS: Transitional breast milk was collected from 40 mothers delivering after 24-36 weeks of gestation, and from 12 mothers delivering after full term. Food intake was assessed in mothers delivering preterm babies using a 3-day diary. Polyamines were analysed by high-performance liquid chromatography.

    RESULTS: The dietary intake of polyamines was significantly associated with breast milk content but weaker for spermine than for spermidine and putrescine. Total polyamine level was higher in preterm than term milk and lower in the corresponding formulas. Putrescine, spermidine and spermine contents [mean (SEM)] in preterm milk were 165.6 (25), 615.5 (80) and 167.7 (16) nmol dL(-1) , respectively, with the levels of putrescine and spermidine being 50% and 25% higher than in term milk. The content of spermine did not differ.

    CONCLUSIONS: Dietary intake of polyamines has an impact on the content in breast milk. The difference between human milk after preterm and term delivery might be considered when using donor human milk for preterm infants. The corresponding formulas had lower contents. Further studies are important for determining the relationship between tissue growth and maturation and optimal intake.

  • 84.
    Atiya Ali, M.
    et al.
    Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden.
    Strandvik, B.
    Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden.
    Sabel, K-G.
    Borås Children Hospital (SÄS), Borås, Sweden.
    Palme Kilander, C.
    Division of Neonatology, Department of Paediatrics, Karolinska Institute, Stockholm, Sweden.
    Strömberg, R.
    Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden.
    Yngve, Agneta
    Örebro University, School of Hospitality, Culinary Arts & Meal Science. Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden.
    Polyamine levels in breast milk are associated with mothers' dietary intake and are higher in preterm than full-term human milk and formulas2014In: Journal of human nutrition and dietetics (Print), ISSN 0952-3871, E-ISSN 1365-277X, Vol. 27, no 5, p. 459-467Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Polyamine intake from milk is considered essential for post-natal maturation of the immune system and small intestine. The present study aimed to determine polyamine content in human milk after preterm delivery and the association with mothers' dietary intake. In comparison, the polyamine levels were compared with those in term breast milk and some corresponding formulas.

    METHODS: Transitional breast milk was collected from 40 mothers delivering after 24-36 weeks of gestation, and from 12 mothers delivering after full term. Food intake was assessed in mothers delivering preterm babies using a 3-day diary. Polyamines were analysed by high-performance liquid chromatography.

    RESULTS: The dietary intake of polyamines was significantly associated with breast milk content but weaker for spermine than for spermidine and putrescine. Total polyamine level was higher in preterm than term milk and lower in the corresponding formulas. Putrescine, spermidine and spermine contents [mean (SEM)] in preterm milk were 165.6 (25), 615.5 (80) and 167.7 (16) nmol dL(-1) , respectively, with the levels of putrescine and spermidine being 50% and 25% higher than in term milk. The content of spermine did not differ.

    CONCLUSIONS: Dietary intake of polyamines has an impact on the content in breast milk. The difference between human milk after preterm and term delivery might be considered when using donor human milk for preterm infants. The corresponding formulas had lower contents. Further studies are important for determining the relationship between tissue growth and maturation and optimal intake.

  • 85.
    Aura, Anna-Marja
    et al.
    VTT Technical Research Centre of Finland, Espoo, Finland.
    Mattila, Ismo
    VTT Technical Research Centre of Finland, Espoo, Finland.
    Hyötyläinen, Tuulia
    VTT Technical Research Centre of Finland, Espoo, Finland.
    Gopalacharyulu, Peddinti
    VTT Technical Research Centre of Finland, Espoo, Finland.
    Cheynier, Veronique
    Sciences Pour l'œNologie, Institut national de la recherche agronomique (INRA), Montpellier, France.
    Souquet, Jean-Marc
    Sciences Pour l'œNologie, Institut national de la recherche agronomique (INRA), Montpellier, France.
    Bes, Magali
    Unité Expérimentale de Pech Rouge, Institut national de la recherche agronomique (INRA), Gruissan, France.
    Le Bourvellec, Carine
    Sécurité et Qualité des Produits d'Origine Végétale, Institut national de la recherche agronomique (INRA), Avignon, France.
    Guyot, Sylvain
    Cidricoles et Biotransformation des Fruits et Légumes, Institut national de la recherche agronomique (INRA), Le Rheu, France.
    Oresic, Matej
    VTT Technical Research Centre of Finland, Espoo, Finland.
    Characterization of microbial metabolism of Syrah grape products in an in vitro colon model using targeted and non-targeted analytical approaches2013In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 52, no 2, p. 833-846Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Syrah red grapes are used in the production of tannin-rich red wines. Tannins are high molecular weight molecules, proanthocyanidins (PAs), and poorly absorbed in the upper intestine. In this study, gut microbial metabolism of Syrah grape phenolic compounds was investigated.

    METHODS: Syrah grape pericarp was subjected to an enzymatic in vitro digestion model, and red wine and grape skin PA fraction were prepared. Microbial conversion was screened using an in vitro colon model with faecal microbiota, by measurement of short-chain fatty acids by gas chromatography (GC) and microbial phenolic metabolites using GC with mass detection (GC-MS). Red wine metabolites were further profiled using two-dimensional GC mass spectrometry (GCxGC-TOFMS). In addition, the effect of PA structure and dose on conversion efficiency was investigated by GC-MS.

    RESULTS: Red wine exhibited a higher degree of C1-C3 phenolic acid formation than PA fraction or grape pericarp powders. Hydroxyphenyl valeric acid (flavanols and PAs as precursors) and 3,5-dimethoxy-4-hydroxybenzoic acid (anthocyanin as a precursor) were identified from the red wine metabolite profile. In the absence of native grape pericarp or red wine matrix, the isolated PAs were found to be effective in the dose-dependent inhibition of microbial conversions and short-chain fatty acid formation.

    CONCLUSIONS: Metabolite profiling was complementary to targeted analysis. The identified metabolites had biological relevance, because the structures of the metabolites resembled fragments of their grape phenolic precursors or were in agreement with literature data.

  • 86.
    Ax, Erika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Warensjö-Lemming, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Becker, Wulf
    Andersson, Agneta
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Lindroos, Anna Karin
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Sjögren, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Fung, Teresa T.
    Dietary patterns in Swedish adults: results from a national dietary survey2016In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 115, no 1, p. 95-104Article in journal (Refereed)
    Abstract [en]

    Dietary patterns derived by statistical procedures is a way to identify overall dietary habits in specific populations. The aim of this study was to identify and characterise dietary patterns in Swedish adults using data from the national dietary survey Riksmaten adults 2010–11 (952 women, 788 men). Principal component analyses were used and two patterns were identified in both sexes: a healthy pattern loading positively on vegetables, fruits, fish and seafood, and vegetable oils, and negatively on refined bread and fast food, and a Swedish traditional pattern loading positively on potatoes, meat and processed meat, full-fat milk products, sweet bakery products, sweet condiments and margarine. In addition, a light-meal pattern was identified in women with positive loadings on fibre-rich bread, cheese, rice, pasta and food grain dishes, substitute products for meat and dairy products, candies and tea. The healthy pattern was positively correlated to dietary fibre (r 0·51–0·58) and n-3 (r 0·25–0·31) (all P<0·0001), and had a higher nutrient density of folate, vitamin D and Se. The Swedish traditional and the light-meal pattern were positively correlated to added sugar (r 0·20–0·25) and the Swedish traditional also to SFA (r 0·13–0·21) (all P<0·0001); both patterns were in general negatively correlated to micronutrients. Dietary pattern scores were associated with, for example, age, physical activity, education and income. In conclusion, we identified three major dietary patterns among Swedish adults. The patterns can be further used for examining the association between whole diet and health outcomes.

  • 87.
    Axling, U
    et al.
    Department of Experimental Medical Science, Lund University, Lund, Sweden.
    Olsson, C
    Department of Applied Nutrition and Food Chemistry, Section of Food Hygiene, Lund University, Lund, Sweden.
    Xu, J
    Department of Applied Nutrition and Food Chemistry, Section of Food Hygiene, Lund University, Lund, Sweden.
    Fernandez, C
    Department of Experimental Medical Science, Lund University, Lund, Sweden.
    Larsson, S
    Department of Experimental Medical Science, Lund University, Lund, Sweden.
    Ström, Kristoffer
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Department of Experimental Medical Science, Lund University, Lund, Sweden.
    Ahrné, S
    Department of Applied Nutrition and Food Chemistry, Section of Food Hygiene, Lund University, Lund, Sweden.
    Holm, C
    Department of Experimental Medical Science, Lund University, Lund, Sweden.
    Molin, G
    Department of Applied Nutrition and Food Chemistry, Section of Food Hygiene, Lund University, Lund, Sweden.
    Berger, K
    Department of Experimental Medical Science, Lund University, Lund, Sweden.
    Green tea powder and Lactobacillus plantarum affect gut microbiota, lipid metabolism and inflammation in high-fat fed C57BL/6J mice2012In: Nutrition and Metabolism, ISSN 1743-7075, Vol. 9, article id 105Article in journal (Refereed)
    Abstract [en]

    Background: Type 2 diabetes is associated with obesity, ectopic lipid accumulation and low-grade inflammation. A dysfunctional gut microbiota has been suggested to participate in the pathogenesis of the disease. Green tea is rich in polyphenols and has previously been shown to exert beneficial metabolic effects. Lactobacillus plantarum has the ability to metabolize phenolic acids. The health promoting effect of whole green tea powder as a prebiotic compound has not been thoroughly investigated previously. Methods. C57BL/6J mice were fed a high-fat diet with or without a supplement of 4% green tea powder (GT), and offered drinking water supplemented with Lactobacillus plantarum DSM 15313 (Lp) or the combination of both (Lp + GT) for 22 weeks. Parameters related to obesity, glucose tolerance, lipid metabolism, hepatic steatosis and inflammation were examined. Small intestinal tissue and caecal content were collected for bacterial analysis. Results: Mice in the Lp + GT group had significantly more Lactobacillus and higher diversity of bacteria in the intestine compared to both mice in the control and the GT group. Green tea strongly reduced the body fat content and hepatic triacylglycerol and cholesterol accumulation. The reduction was negatively correlated to the amount of Akkermansia and/or the total amount of bacteria in the small intestine. Markers of inflammation were reduced in the Lp + GT group compared to control. PLS analysis of correlations between the microbiota and the metabolic variables of the individual mice showed that relatively few components of the microbiota had high impact on the correlation model. Conclusions: Green tea powder in combination with a single strain of Lactobacillus plantarum was able to promote growth of Lactobacillus in the intestine and to attenuate high fat diet-induced inflammation. In addition, a component of the microbiota, Akkermansia, correlated negatively with several metabolic parameters known to be risk factors for the development of type 2 diabetes.

  • 88. Azadbakht, Leila
    et al.
    Kimiagar, Masoud
    Mehrabi, Yadollah
    Esmaillzadeh, Ahmad
    Padyab, Mojgan
    School of Public Health, Shaheed Beheshti University of Medical Sciences, Tehran.
    Hu, Frank B
    Willett, Walter C
    Soy inclusion in the diet improves features of the metabolicsyndrome: a randomized crossover study in postmenopausal women2007In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 85, no 3, p. 735-741Article in journal (Refereed)
    Abstract [en]

    Background: Little evidence exists regarding the effects of soyconsumption on the metabolic syndrome in humans.Objective: We aimed to determine the effects of soy consumptionon components of the metabolic syndrome, plasma lipids, lipoproteins,insulin resistance, and glycemic control in postmenopausalwomen with the metabolic syndrome.Design: This randomized crossover clinical trial was undertaken in42 postmenopausal women with the metabolic syndrome. Participantswere randomly assigned to consume a control diet (DietaryApproaches to Stop Hypertension, DASH), a soy-protein diet, or asoy-nut diet, each for 8 wk. Red meat in the DASH period wasreplaced by soy-protein in the soy-protein period and by soy-nut inthe soy-nut period.Results: The soy-nut regimen decreased the homeostasis model ofassessment-insulin resistance score significantly compared with thesoy-protein (difference in percentage change:7.40.8; P0.01)or control (12.9 0.9; P 0.01) diets. Consumption of soy-nutalso reduced fasting plasma glucose more significantly than did thesoy-protein (5.30.5%; P0.01) or control (5.10.6%; P0.01) diet. The soy-nut regimen decreased LDL cholesterol morethan did the soy-protein period (5.0 0.6%; P 0.01) and thecontrol (9.5 0.6%; P 0.01) diet. Soy-nut consumptionsignificantly reduced serum C-peptide concentrations comparedwith control diet (8.0 2.1; P 0.01), but consumption ofsoy-protein did not.Conclusion: Short-term soy-nut consumption improved glycemiccontrol and lipid profiles in postmenopausal women with the metabolicsyndrome.

  • 89.
    Azzinnari, M
    et al.
    University of Las Palmas, Spain.
    Martin-Rincon, M
    University of Las Palmas, Spain.
    Juan-Habib, J
    University of Las Palmas, Spain.
    Gelabert-Rebato, M
    University of Las Palmas, Spain.
    Calbet, JAL
    University of Las Palmas, Spain.
    Holmberg, Hans-Christer
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Morales –Alamo, D
    University of Las Palmas, Spain.
    Efectos del ejercicio en la señalización de NF-kB durante la restricción calórica severa2017Conference paper (Refereed)
    Abstract [es]

    El sobrepeso y la obesidad, en crecimiento en todo el mundo, se asocian con una alta tasa de mortalidad e morbilidad[1,2]. La causa principal que conduce a éstas condiciones patológicas es un balance energético positivo sostenido a largo plazo, debido a la inactividad física y la ingesta calórica excesiva[3]. Por lo tanto, ejercicio físico y restricción calórica podrían ser dos estratégias eficaces para prevenir y contrastar el excesivo acumulo de grasa corporal que caracteriza estas patologías. Sin embargo, durante dietas muy bajas en calorías (<800 Kcal/día) se pierde no solo masa grasa sino también masa muscular, reportando efectos negativos para la salud[4]. En dichas condiciones,  el ejercicio físico permite preservar masa muscular de manera local y dosis-dependiente, mientras la ingestión de proteínas no ejerce particulares efectos protectivos sobre el tejido contráctil[5]. Los mecanismos moleculares implicados en la preservación de la masa muscular inducida por el ejercicio durante este tipo de dietas no han sido definidos claramente. NF-kB es un factor de transcripción cuya activación provoca atrofia muscular, y su bloqueo puede parcialmente limitar este fenomeno[6]. NF-kB se ha mostrado activado de manera aguda por el ejercicio y la restricción calorica, sin embargo no ha sido definida su respuesta a la restricción calórica en conjunción con el ejercicio prolongado de baja intensidad. Además, cuando los niveles basales de NF-kB son altos, el ejercicio no parece aumentar ulteriormente su señalización[7]. Por las razones presentadas, NF-kB podría desempeñar un rol en la preservación de masa magra inducida por el ejercicio durante  la restricción calórica.

    El objetivo del estudio es establecer la respuesta de NF-kB a la restricción calórica severa en conjunción con el ejercicio prolongado de baja intensidad. Las hipótesis fueron las siguientes: 1) la restricción calórica severa activaría la via de NF-kB y 2) dicha activación será atenuada por el ejercicio de manera local y dosis-dependiente.

    15 sujetos con sobrepeso y obesidad fueron sometidos a tres fases experimentales: fase 1, en la que la dieta y el nivel de actividad física de los participantes fue monitorizado durante una semana (PRE); fase 2, caracterizada por cuatro días de ejercicio prolongado y de restricción calórica severa (RCE); fase 3, caracterizada por tres días de ejercicio reducido y una dieta isoenergética (DC). Durante la fase 2, los sujetos ingeriron hidratos de carbono o proteínas (0.8 g/kg peso corporal/día; 320 kcal/día) y hicieron 45 minutos de pedaleo con un solo miembro superior (15% Ppeak) seguidos de 8 horas de caminata (4.5 km/h; 35 km/día). Las biopsias musculares fueron recogidas de ambos los deltoides y del vasto lateral en la fase 1 y después de la fase 2 y 3. Mediante Western blot, se determinó la expresión de NF-κB p105, NF-κB p50, la fosforilación de la Serina 32/36 de IκBα e IκBα total. La composición corporal se midió mediante DXA. Estadística: ANOVA para medidas repetidas.

    Durante los 4 días de restricción calórica severa el deficit energético fue de 5500 Kcal. Después de la fase 2 los sujetos perdieron menos masa magra en los miembros inferiores y en el brazo ejercitado respecto al brazo de control: 57% (P<0.05) y 29% (P=0.05), respectivamente. Tras la fase 2 y 3, el contenido de p105 y de p50 fue menor en los miembros inferiores respecto a los superiores: efecto extremidad P=0.003 y P=0.024 para p105 y p50, respectivamente. Tras la fase 3, la fosforilación de la Serina 32/36 de IkBα aumentó únicamente en las piernas, mientras la expresión total IkBα fue mayor solo en los miembros ejercitados (P<0.05).

    El ejercicio físico atenuó la activación de la señalización de NF-kB durante 4 días de restricción calórica severa, limitando el incremento de la expresión de p50 y p105, que resultó más baja después de la fase 2 y la fase 3 en los miembros inferiores respecto a los miembros superiores, posiblemente debido a la mayor cantidad de ejercicio a la que fueron sometidos. Además, la expresión total de IkBα fue más alta tras la fase 3 solo en los miembros ejercitados, indicando una posible inhibición de la vía de   NF-kB inducida por el ejercicio. Por lo tanto, dado la menor activación de la señalización de NF-kB en los miembros que perdieron menor masa muscular, los resultados sugieren que los efectos protectores del ejercicio físico sobre el tejido contráctil podrían ser mediados a una menor activación de la señalización de NF-kB.

    El ejercicio físico desempeña una función preservadora sobre la masa muscular durante la restricción calórica severa. La preservación de masa muscular es dosis-dependiente (a mayor volumen, mayor preservación) y está mediada, al menos parcialmente, por una menor activación de la señalización por NF-kB.

    1.Hill, J. O., H. R. Wyatt, et al. (2012). Circulation 126(1): 126-132.2.Di Angelantonio, E., N. Bhupathiraju Sh, et al. (2016). Lancet 388(10046): 776-786. 3.Chaston, T. B., J. B. Dixon, et al. (2007). Int J Obes (Lond) 31(5): 743-750. 4.Calbet, J. A., J. G. Ponce-Gonzalez, et al. (2017). Front Physiol (Accepted, In press).5.Cai, D., J. D. Frantz, et al. (2004). Cell 119(2): 285-298.6.Tantiwong, P., K. Shanmugasundaram, et al. (2010). Am J Physiol Endocrinol Metab 299(5): E794-801.7.NCD-RisC (2016). Lancet 387(10026): 1377-1396.

  • 90.
    Baban, Bayar
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Dept of Surgery, Örebro University Hospital, Örebro, Sweden.
    Thorell, Anders
    Department of Clinical Science, Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden; Dept of Surgery, Ersta Hospital, Stockholm, Sweden.
    Nygren, Jonas
    Department of Clinical Science, Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden; Dept of Surgery, Ersta Hospital, Stockholm, Sweden.
    Bratt, Anette
    Department of Clinical Science, Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden; Dept of Surgery, Ersta Hospital, Stockholm, Sweden.
    Ljungqvist, Olle
    Örebro University, School of Medicine, Örebro University, Sweden. Örebro University Hospital. Dept of Surgery, Örebro University Hospital, Örebro, Sweden; Institution for Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
    Determination of insulin resistance in surgery: the choice of method is crucial2015In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 34, no 1, p. 123-128Article in journal (Refereed)
    Abstract [en]

    BACKGROUND & AIMS: In elective surgery, postoperative hyperglycaemia and insulin resistance are independent risk factors for complications. Since the simpler HOMA method has been used as an alternative to the hyperinsulinemic normoglycemic clamp in studies of surgery induced insulin resistance, we compared the two methods in patients undergoing elective surgery.

    METHODS: Data from 113 non-diabetic patients undergoing elective surgery were used. Insulin sensitivity, both before and after surgery, was quantified by the clamp and HOMA. Pre- and postoperatively, the results of the clamp were compared to HOMA using regression- and correlation analysis. Degree of agreement between the methods was studied using weighted linear kappa and the Bland-Altman test.

    RESULTS: Both the clamp and HOMA recorded a mean relative reduction in insulin sensitivity of 39 ± 24% and 39 ± 61% respectively after surgery; with significant correlations (p < 0.01) for pre- and post-operative measures as well as for relative changes. However r(2) values were low: 0.04, 0.07 and 0.03 respectively. The degree of agreement for the relative change in insulin sensitivity using the Bland-Altman test gave a mean of difference 0% but "limits of agreement" (±2SD) was ±125%. This poor inter-method agreement was consolidated by a weighted linear kappa value of 0.18.

    CONCLUSION: While the hyperinsulinemic euglycemic clamp measures the postoperative changes in insulin sensitivity, HOMA measures something different. Data using the HOMA method must therefore be interpreted cautiously and is not interchangeable with data obtained from the clamp.

  • 91.
    Backman, Ellen
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Regional Habilitation Center, Region Halland, Kungsbacka, Sweden.
    Karlsson, Ann-Kristin
    Department of Research and Development, Region Halland, Halmstad, Sweden.
    Sjögreen, Lotta
    Mun-H-Center Orofacial Resource Center for Rare Diseases, Public Dental Service, Gothenburg, Sweden.
    Gastrostomy tube feeding in children with developmental or acquired disorders: A longitudinal comparison on health care provision, and eating outcomes four years after gastrostomy2018In: Nutrition in clinical practice, ISSN 0884-5336, Vol. 33, no 4, p. 576-583Article in journal (Refereed)
    Abstract [en]

    Background: Studies on long‐term feeding and eating outcomes in children requiring gastrostomy tube feeding (GT) are scarce. The aim of this study was to describe children with developmental or acquired disorders receiving GT and to compare longitudinal eating and feeding outcomes. A secondary aim was to explore healthcare provision related to eating and feeding.

    Methods: This retrospective cohort study reviewed medical records of children in 1 administrative region of Sweden with GT placement between 2005 and 2012. Patient demographics, primary diagnoses, age at GT placement, and professional healthcare contacts prior to and after GT placement were recorded and compared. Feeding and eating outcomes were assessed 4 years after GT placement.

    Results: The medical records of 51 children, 28 boys and 23 girls, were analyzed and grouped according to “acquired” (n = 13) or “developmental” (n = 38) primary diagnoses. At 4 years after GT placement, 67% were still using GT. Only 6 of 37 (16%) children with developmental disorders transferred to eating all orally, as opposed to 10 of 11 (91%) children with acquired disorders. Children with developmental disorders were younger at the time of GT placement and displayed a longer duration of GT activity when compared with children with acquired disorders.

    Conclusions: This study demonstrates a clear difference between children with developmental or acquired disorders in duration of GT activity and age at GT placement. The study further shows that healthcare provided to children with GT is in some cases multidisciplinary, but primarily focuses on feeding rather than eating.

  • 92. Bakker, Marije F.
    et al.
    Peeters, Petra H. M.
    Klaasen, Veronique M.
    Bueno-de-Mesquita, H. Bas
    Jansen, Eugene H. J. M.
    Ros, Martine M.
    Travier, Noemie
    Olsen, Anja
    Tjønneland, Anne
    Overvad, Kim
    Rinaldi, Sabina
    Romieu, Isabelle
    Brennan, Paul
    Boutron-Ruault, Marie-Christine
    Perquier, Florence
    Cadeau, Claire
    Boeing, Heiner
    Aleksandrova, Krasimira
    Kaaks, Rudolf
    Kühn, Tilman
    Trichopoulou, Antonia
    Lagiou, Pagona
    Trichopoulos, Dimitrios
    Vineis, Paolo
    Krogh, Vittorio
    Panico, Salvatore
    Masala, Giovanna
    Tumino, Rosario
    Weiderpass, Elisabete
    Skeie, Guri
    Lund, Eiliv
    Ramon Quirós, J.
    Ardanaz, Eva
    Navarro, Carmen
    Amiano, Pilar
    Sánchez, María-José
    Buckland, Genevieve
    Ericson, Ulrika
    Sonestedt, Emily
    Johansson, Matthias
    Umeå University, Faculty of Medicine, Department of Biobank Research. International Agency for Research on Cancer, Lyon, France.
    Sund, Malin
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Travis, Ruth C.
    Key, Timothy J.
    Khaw, Kay-Tee
    Wareham, Nick
    Riboli, Elio
    van Gils, Carla H.
    Plasma carotenoids, vitamin C, tocopherols, and retinol and the risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition cohort2016In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 103, no 2, p. 454-464Article in journal (Refereed)
    Abstract [en]

    Background: Carotenoids and vitamin C are thought to be associated with reduced cancer risk because of their antioxidative capacity.

    Objective: This study evaluated the associations of plasma carotenoid, retinol, tocopherol, and vitamin C concentrations and risk of breast cancer.

    Design: In a nested case-control study within the European Prospective Investigation into Cancer and Nutrition cohort, 1502 female incident breast cancer cases were included, with an oversampling of premenopausal (n = 582) and estrogen receptor-negative (ER-) cases (n = 462). Controls (n = 1502) were individually matched to cases by using incidence density sampling. Prediagnostic samples were analyzed for alpha-carotene, beta-carotene, lycopene, lutein, zeaxanthin, beta-cryptoxanthin, retinol, alpha-tocopherol, gamma-tocopherol, and 454 vitamin C. Breast cancer risk was computed according to hormone receptor status and age at diagnosis (proxy for menopausal status) by using conditional logistic regression and was further stratified by smoking status, alcohol consumption, and body mass index (BMI). All statistical tests were 2-sided.

    Results: In quintile 5 compared with quintile 1, alpha-carotene (OR: 0.61; 95% CI: 0.39, 0.98) and beta-carotene (OR: 0.41; 95% CI: 0.26, 0.65) were inversely associated with risk of ER- breast tumors. The other analytes were not statistically associated with ER- breast cancer. For estrogen receptor-positive (ER+) tumors, no statistically significant associations were found. The test for heterogeneity between ER- and ER+ tumors was statistically significant only for beta-carotene (P-heterogeneity = 0.03). A higher risk of breast cancer was found for retinol in relation to ER-/progesterone receptor-negative tumors (OR: 2.37; 95% CI: 1.20, 4.67; P-heterogeneity with ER+/progesterone receptor positive = 0.06). We observed no statistically significant interaction between smoking, alcohol, or BMI and all investigated plasma analytes (based on tertile distribution).

    Conclusion: Our results indicate that higher concentrations of plasma beta-carotene and alpha-carotene are associated with lower breast cancer risk of ER tumors.

  • 93.
    Bang, Peter
    et al.
    Fac Hlth Sci, Div Pediat, Dept Clin & Expt Med, Linköping Univ, Linköping, Sweden.
    Thorell, Anders
    Dept Clin Sci, Danderyds Hosp, Karolinska Inst, Stockholm, Sweden; Dept Surg, Ersta Hosp, Stockholm, Sweden.
    Carlsson-Skwirut, Christine
    Dept Woman & Child Hlth, Pediat Endocrinol Unit, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden.
    Ljungqvist, Olle
    Örebro University Hospital. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Brismar, Kerstin
    Dept Mol Endocrinol, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden.
    Nygren, Jonas
    Dept Clin Sci, Danderyds Hosp, Karolinska Institute, Stockholm, Sweden; Dept Surg, Ersta Hosp, Stockholm, Sweden.
    Free dissociable IGF-I: Association with changes in IGFBP-3 proteolysis and insulin sensitivity after surgery2016In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 35, no 2, p. 408-413Article in journal (Refereed)
    Abstract [en]

    Background: Patients receiving a carbohydrate drink (CHO) before major abdominal surgery display improved insulin sensitivity postoperatively and increased proteolysis of IGFBP-3 (IGFBP-3-PA) compared to patients undergoing similar surgery after overnight fasting. Aims: We hypothesized that serum IGFBP-3-PA increases bioavailability of circulating IGF-I and preserves insulin sensitivity in patients given CHO. Design: Matched control study. Methods: At Karolinska University Hospital, patients given CHO before major elective abdominal surgery (CHO,n = 8) were compared to patients undergoing similar surgical procedures after overnight fasting (FAST,n = 10). Results from two different techniques for determination of free-dissociable IGF-I (fdIGF-I) were compared with changes in IGFBP-3-PA and insulin sensitivity. Results: Postoperatively, CHO displayed 18% improvement in insulin sensitivity (hyperinsulinemic clamp) and increased IGFBP-3-PA vs. FAST. As determined by IRMA, fdIGF-I increased by 48 +/- 25% in CHO while fdIGF-I decreased by 13 +/- 18% in FAST (p < 0.01 vs. CHO, when corrected for duration of surgery). However, fdIGF-I determined by ultra-filtration decreased similarly in both groups (-22 +/- 8% vs. -25 +/- 8%, p = 0.8) and IGFBP-1 increased similarly in both groups. Patients with less insulin resistance after surgery demonstrated larger increases in fdIGF-I by IRMA (r = 0.58, p < 0.05). Fifty-three % of the variability of the changes in fdIGF-I by IRMA could be explained by changes in IGFBP-3-PA and total IGF-I levels (p < 0.05), while IGFBP-1 did not contribute significantly. Conclusion: During conditions when serum IGF-I bioavailability is regulated by IGFBP-3 proteolysis, measurements of fdIGF-I by IRMA is of physiological relevance as it correlates with the associated changes in insulin sensitivity.

  • 94. Barazzoni, R
    et al.
    Deutz, N E P
    Biolo, G
    Bischoff, S
    Boirie, Y
    Cederholm, T
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Cuerda, C
    Delzenne, N
    Leon Sanz, M
    Ljungqvist, O
    Muscaritoli, M
    Pichard, C
    Preiser, J C
    Sbraccia, P
    Singer, P
    Tappy, L
    Thorens, B
    Van Gossum, A
    Vettor, R
    Calder, P C
    Carbohydrates and insulin resistance in clinical nutrition: Recommendations from the ESPEN expert group.2017In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 36, no 2, p. 355-363Article in journal (Refereed)
    Abstract [en]

    Growing evidence underscores the important role of glycemic control in health and recovery from illness. Carbohydrate ingestion in the diet or administration in nutritional support is mandatory, but carbohydrate intake can adversely affect major body organs and tissues if resulting plasma glucose becomes too high, too low, or highly variable. Plasma glucose control is especially important for patients with conditions such as diabetes or metabolic stress resulting from critical illness or surgery. These patients are particularly in need of glycemic management to help lessen glycemic variability and its negative health consequences when nutritional support is administered. Here we report on recent findings and emerging trends in the field based on an ESPEN workshop held in Venice, Italy, 8-9 November 2015. Evidence was discussed on pathophysiology, clinical impact, and nutritional recommendations for carbohydrate utilization and management in nutritional support. The main conclusions were: a) excess glucose and fructose availability may exacerbate metabolic complications in skeletal muscle, adipose tissue, and liver and can result in negative clinical impact; b) low-glycemic index and high-fiber diets, including specialty products for nutritional support, may provide metabolic and clinical benefits in individuals with obesity, insulin resistance, and diabetes; c) in acute conditions such as surgery and critical illness, insulin resistance and elevated circulating glucose levels have a negative impact on patient outcomes and should be prevented through nutritional and/or pharmacological intervention. In such acute settings, efforts should be implemented towards defining optimal plasma glucose targets, avoiding excessive plasma glucose variability, and optimizing glucose control relative to nutritional support.

  • 95.
    Barazzoni, R.
    et al.
    Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
    Deutz, N. E. P.
    Center for Translational Research in Aging & Longevity, Department of Health and Kinesiology, Texas A & M University, College Station TX, USA.
    Biolo, G.
    Department of Medical, Surgical and Health Sciences, Internal Medicine, University of Trieste, Trieste, Italy.
    Bischoff, S.
    Department of Nutritional Medicine/Prevention, University of Hohenheim, Stuttgart, Germany.
    Boirie, Y.
    Department of Clinical Nutrition, CHU de Clermont-Ferrand, CRNH, Université d'Auvergne, Clermont-Ferrand, France.
    Cederholm, T.
    Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Department of Geriatric Medicine, Uppsala University Hospital, Uppsala, Sweden.
    Cuerda, C.
    Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
    Delzenne, N.
    Department, Université Catholique de Louvain, Brussels, Belgium.
    Leon Sanz, M.
    Department of Medicine, Complutense University, Madrid, Spain.
    Ljungqvist, Olle
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Surgery.
    Muscaritoli, M.
    Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy.
    Pichard, C.
    Nutrition Unit, Geneva University Hospital, Geneva, Switzerland.
    Preiser, J. C.
    Department of Intensive Care, Erasme University Hospital, Brussels, Belgium.
    Sbraccia, R.
    Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
    Singer, P.
    Department of Intensive Care, Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Sackler School of Medicine, Tel Aviv University, Israel.
    Tappy, L.
    Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.
    Thorens, B.
    Center for Integrative Genomics, University of Lausanne, Lausanne, Switzerland.
    Van Gossum, A.
    Gastroenterology Service, Hospital Erasme, Brussels, Belgium.
    Vettor, R.
    Internal Medicine Unit and Center for the Study and Integrated Treatment of Obesity, Department of Medicine, Padua University, Padua, Italy.
    Calder, P. C.
    Faculty of Medicine, University of Southampton, Southampton, United Kingdom; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom; University of Southampton, Southampton, United Kingdom.
    Carbohydrates and insulin resistance in clinical nutrition: Recommendations from the ESPEN expert group2017In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 36, no 2, p. 355-363Article, review/survey (Refereed)
    Abstract [en]

    Growing evidence underscores the important role of glycemic control in health and recovery from illness. Carbohydrate ingestion in the diet or administration in nutritional support is mandatory, but carbohydrate intake can adversely affect major body organs and tissues if resulting plasma glucose becomes too high, too low, or highly variable. Plasma glucose control is especially important for patients with conditions such as diabetes or metabolic stress resulting from critical illness or surgery. These patients are particularly in need of glycemic management to help lessen glycemic variability and its negative health consequences when nutritional support is administered. Here we report on recent findings and emerging trends in the field based on an ESPEN workshop held in Venice, Italy, 8-9 November 2015. Evidence was discussed on pathophysiology, clinical impact, and nutritional recommendations for carbohydrate utilization and management in nutritional support. The main conclusions were: a) excess glucose and fructose availability may exacerbate metabolic complications in skeletal muscle, adipose tissue, and liver and can result in negative clinical impact; b) low-glycemic index and high-fiber diets, including specialty products for nutritional support, may provide metabolic and clinical benefits in individuals with obesity, insulin resistance, and diabetes; c) in acute conditions such as surgery and critical illness, insulin resistance and elevated circulating glucose levels have a negative impact on patient outcomes and should be prevented through nutritional and/or pharmacological intervention. In such acute settings, efforts should be implemented towards defining optimal plasma glucose targets, avoiding excessive plasma glucose variability, and optimizing glucose control relative to nutritional support. (C) 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism.

  • 96.
    Barazzoni, Rocco
    et al.
    Univ Trieste, Dept Med Surg & Hlth Sci, Internal Med, Trieste, Italy;Azienda Sanit Univ Integrata Trieste ASUITS, Trieste, Italy.
    Bischoff, Stephan
    Univ Hohenheim, Dept Nutr Med, Stuttgart, Germany.
    Boirie, Yves
    Univ Clermont Auvergne, UNH, INRA, Unite Nutr Humaine,CRNH Auvergne, Clermont Ferrand, France;CHU Clermont Ferrand, Serv Nutr Clin, Clermont Ferrand, France.
    Busetto, Luca
    Univ Padua, Dept Med, Padua, Italy;Padova Univ Hosp, Ctr Study & Integrated Management Obes EASO COM, Padua, Italy.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Dicker, Dror
    Hasharon Hosp, Rabin Med Ctr, Dept Internal Med, Petah Tiqwa, Israel;Hasharon Hosp, Rabin Med Ctr, Obes Clin, Petah Tiqwa, Israel;Tel Aviv Univ, Sackler Fac Med, Tel Aviv, Israel.
    Toplak, Hermann
    Med Univ Graz, Dept Med, Graz, Austria.
    Van Gossum, Andre
    Free Univ Brussels, Hop Erasme, Dept Gastroenterol, Clin Intestinal Dis & Nutr Support, Brussels, Belgium.
    Yumuk, Volkan
    Istanbul Univ, Cerrahpasa Med Fac, Div Endocrinol Metab & Diabet, Istanbul, Turkey.
    Vettor, Roberto
    Univ Padua, Dept Med, Padua, Italy;Padova Univ Hosp, Ctr Study & Integrated Management Obes EASO COM, Padua, Italy.
    Sarcopenic Obesity: Time to Meet the Challenge2018In: Obesity Facts, ISSN 1662-4025, E-ISSN 1662-4033, Vol. 11, no 4, p. 294-305Article, review/survey (Refereed)
    Abstract [en]

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

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

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

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

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

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

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

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

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

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

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

  • 100.
    Becker, Wulf
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Fetter2006In: Näringslära för högskolan, Liber AB, Stockholm , 2006, p. 460-Chapter in book (Other (popular scientific, debate etc.))
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