| 21. |
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| 22. |
- Mowe, Morten, et al.
(author)
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Insufficient nutritional knowledge among health care workers?
- 2008
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In: Clinical nutrition (Edinburgh, Scotland). - : Elsevier BV. - 1532-1983 .- 0261-5614. ; 27:2, s. 196-202
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Journal article (peer-reviewed)abstract
- BACKGROUND & AIMS: Though a great interest and willingness to nutrition therapy, there is an insufficient practice compared to the proposed ESPEN guidelines for nutrition therapy. The aim of this questionnaire was to study doctors and nurses' self-reported knowledge in nutritional practice, with focus on ESPEN's guidelines in nutritional screening, assessment and treatment. METHODS: A questionnaire about different aspects of nutritional practice was answered by 4512 doctors and nurses in Denmark, Sweden and Norway. RESULTS: The most common cause for insufficient nutritional practice was lack of nutritional knowledge. Twenty-five percent found it difficult to identify patient in need of nutritional therapy, 39% lacked techniques for identifying malnourished patients, and 53% found it difficult to calculate the patients' energy requirement and 66% lacked national guidelines for clinical nutrition. Twenty-eight percent answered that insufficient nutrition practice could lead to complications and prolonged hospital stay. Those that answered that their nutritional knowledge was good had also a better nutritional practice. CONCLUSION: The self-reported nutritional knowledge was inadequate among Scandinavian doctors and nurses. Increased nutritional knowledge seems to improve the nutritional practice. A combination of an integrated nutrition curriculum during the education, together with post-graduated education for both physicians and nurses should be established.
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| 23. |
- Norden, J., et al.
(author)
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Nutrition impact symptoms and body composition in patients with COPD
- 2015
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In: European Journal of Clinical Nutrition. - : Nature Publishing Group. - 0954-3007 .- 1476-5640. ; 69:2, s. 256-261
-
Journal article (peer-reviewed)abstract
- BACKGROUND/OBJECTIVES: Anorexia or lack of appetite is common in chronic obstructive pulmonary disease (COPD) and may be caused or augmented by several symptoms affecting appetite and eating. We aimed to investigate and quantify the extent of nutrition impact symptoms (NIS) in patients with COPD and to explore relationships between NIS and fat-free mass depletion.SUBJECTS/METHODS: The results in this cross-sectional study are based on 169 COPD patients (62% female subjects). Body composition was assessed using bioelectrical impedance spectroscopy and the patients reported NIS by two newly developed questionnaires: the Eating Symptoms Questionnaire (ESQ) and the Disease-Related Appetite Questionnaire (DRAQ).RESULTS: Symptoms with the highest prevalence were dry mouth (71%), stomach ache (39%), pain or aches affecting appetite (36%) and constipation (35%). Problems with diarrhoea and feeling affected by smells were more severe among women compared with men (P < 0.05). Thirty-six percent of the patients were depleted (fat-free mass index (FFMI) < 15 kg/m(2) for women and FFMI < 16 kg/m(2) for men). Depleted patients had more NIS (P < 0.05) and also rated appetite and taste of food as worse compared with non-depleted patients (P < 0.05).CONCLUSIONS: NIS are common in patients with COPD, and depleted patients have more severe symptoms. To investigate how these symptoms are best prevented and/or managed and whether NIS prevention/treatment can affect development of malnutrition in patients with COPD is a challenge for the future.
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| 24. |
- Rothenberg, Elisabeth, 1960, et al.
(author)
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Energiomsättning från 73 till 86 års ålder – en longitudinell upp följning
- 2009
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In: Medicinska Riksstämman.
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Conference paper (peer-reviewed)abstract
- Energiomsättning och kroppssammansättning förändras med stigande ålder. För ökad kunskap om hur dessa processer utvecklas krävs uppföljning över tid på individnivå. Dubbelmärkt vatten (DLW) anses vara ”the golden standard” för att mäta totalt kroppsvatten (TBW) och totala energi utgifter (TEE). Longitudinella studier med DLW på äldre är mycket få. Energiomsättning och kroppssammansättning hos friska äldre har mätts vid 73, 78, 82 och 86 års ålder. Här presenteras resultaten av mätningen vid 86 års ålder i jämförelse med resultaten vid 73 års ålder. Metod: 8 friska individer (1 man, 7 kvinnor), mätta vid 73 och 86 års ålder. TEE och TBW mättes med DLW och viloomsättning (RMR) med indirekt kalorimetri (Deltatrac) efter vila. Fysisk aktivitetsnivå beräknades som (PAL=TEE/RMR) och energiåtgång för fysisk aktivitet (AEE=TEE-RMR). Fettfri massa (FFM) beräknades enligt FFM=TBW/0,732. BMI beräknades utifrån första tillgänglig längd vid 46 års ålder för kvinnorna. Skillnader mellan mätningarna vid 73 och 86 års ålder värderades med parat t-test. Vid 86 år var RMR 4562 kJ/d (SD 503), en minskning med 1200 kJ/d (p<0,05) jämfört med 73 års ålder, AEE var 2797 (SD 833) en minskning med 868 (ns), TEE var 7359 (SD 936) en minskning med 2069 (p<0,01), PAL var 1,62 (SD 0,20) en minskning med 0,30 (ns), TBW var 28,8 kg (SD 3,17) en minskning med 2,6 kg (p<0,001), FFM 39,4 (SD 4,3) en minskning med 3,6 (p<0,001), kroppsvikten var 60,9 (SD 6,13) en minskning med 3,7 (p<0,05), BMI var 21,6 (SD 2,60) en minskning 1,27 kg/m2 (p<0,05). Vid 86 år bidrog REE med 63 och AEE med 37% till TEE jämfört 61 och 39% vid 73 års ålder. Vid 86 år utgjorde FFM 65% av kroppsmassan. RMR, AEE och TEE minskade med 21-24%, medan PAL och RMR respektive AEE som andelar av TEE, förhöll sig relativt konstanta mellan 73 och 86 år. Såväl kroppsvikt, BMI, TBW och FFM minskade med 6-8%. Minskad FFM är således som väntat relaterad till lägre RMR. Medel-AEE minskade men ej signifikant, pga. stor spridning i gruppen. Det är därmed svårt att i denna lilla grupp dra några slutsatser om förändringar i AEE. Förlusten av TBW och FFM är i linje med den naturliga åldersförändingen av kroppssammansättning - sarkopeni - som innebär såväl förlust av muskelmassa och -styrka, men också organatrofi.
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| 25. |
- Rothenberg, Elisabeth, 1960
(author)
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Experience of dietary assessment and validation from three Swedish studies in the elderly
- 2009
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In: European Journal of Clinical Nutrition. - 1476-5640. ; 63:Suppl 1, s. 64-8
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Journal article (peer-reviewed)abstract
- BACKGROUND/OBJECTIVES: The elderly are a growing part of the population. The objectives have been to describe the dietary assessment methods undertaken, and to evaluate the different validation methods and their performance in free-living elderly populations. SUBJECTS/METHODS: Participants were from three studies, the Johanneberg, H70 and Nordic Research on Ageing (NORA) studies undertaken in Sweden. The mean age across these studies ranged from 70 to 80 years, and cohort size ranged from n=173 to a total of 1360 in the four cohorts of the H70 geriatric population study. A food frequency questionnaire (FFQ) was used in Johanneberg and a diet history (DH) in H70 and NORA. Validation was undertaken using a 4-day food record (FR), four 24-h urinary nitrogen (UN) collections and energy intake/basal metabolic rate (EI/BMR) cutoffs in Johanneberg, EI/BMR cutoffs, total energy expenditure (TEE) estimated by heart rate monitoring, activity diary and doubly labelled water in H70, and EI/BMR cutoffs in NORA. RESULTS: The FFQ provided higher intakes of EI and nutrients vs FR, confirmed by UN for protein. Compared with EI/BMR cutoffs, overestimation of EI was moderate. DH showed that slight underestimation vs heart rate was in accordance with activity diary, but compared with doubly labelled water, DH underestimated EI by 12%. In NORA, EI/BMR was high compared with EI/BMR cutoffs. Validation methods detected under- and over-reporting. EI and nutrient intake were in accordance with recommendations. CONCLUSIONS: Elderly up to their 80s can perform well in dietary studies. However, people over the age of 80 years may tend to report food habits from earlier in life.
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| 26. |
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| 27. |
- Rydberg Sterner, Therese, et al.
(author)
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The Gothenburg H70 Birth cohort study 2014-16: design, methods and study population.
- 2019
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In: European journal of epidemiology. - : Springer Science and Business Media LLC. - 1573-7284 .- 0393-2990. ; 34:2, s. 191-209
-
Journal article (peer-reviewed)abstract
- To improve health care for older persons, we need to learn more about ageing, e.g. identify protective factors and early markers for diseases. The Gothenburg H70 Birth Cohort Studies (the H70 studies) are multidisciplinary epidemiological studies examining representative birth cohorts of older populations in Gothenburg, Sweden. So far, six birth cohorts of 70-year-olds have been examined over time, and examinations have been virtually identical between studies. This paper describes the study procedures for the baseline examination of the Birth cohort 1944, conducted in 2014-16. In this study, all men and women born 1944 on specific dates, and registered as residents in Gothenburg, were eligible for participation (n=1839). A total of 1203 (response rate 72.2%; 559 men and 644 women; mean age 70.5years) agreed to participate in the study. The study comprised sampling of blood and cerebrospinal fluid, psychiatric, cognitive, and physical health examinations, examinations of genetics and family history, use of medications, social factors, functional ability and disability, physical fitness and activity, body composition, lung function, audiological and ophthalmological examinations, diet, brain imaging, as well as a close informant interview, and qualitative studies. As in previous examinations, data collection serves as a basis for future longitudinal follow-up examinations. The research gained from the H70 studies has clinical relevance in relation to prevention, early diagnosis, clinical course, experience of illness, understanding pathogenesis and prognosis. Results will increase our understanding of ageing and inform service development, which may lead to enhanced quality of care for older persons.
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| 28. |
- Samuelsson, Jessica, et al.
(author)
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A Western-style dietary pattern is associated with cerebrospinal fluid biomarker levels for preclinical Alzheimer's disease -A population-based cross-sectional study among 70-year-olds
- 2021
-
In: Alzheimer's & dementia (New York, N. Y.). - : Wiley. - 2352-8737. ; 7:1, s. 10
-
Journal article (peer-reviewed)abstract
- Background: Diet may be a modifiable factor for reducing the risk of Alzheimer's disease (AD). Western-style dietary patterns are considered to increase the risk, whereas Mediterranean-style dietary patterns are considered to reduce the risk. An association between diet and AD-related biomarkers have been suggested, but studies are limited. Aim: To investigate potential relations between dietary patterns and cerebrospinal fluid (CSF) biomarkers for AD among dementia-free older adults. Methods: Data were derived from the population-based Gothenburg H70 Birth Cohort Studies, Sweden. A total of 269 dementia-free 70-year-olds with dietary and cerebrospinal fluid (CSF) amyloid beta (Aβ42 and Aβ40), total tau (t-tau), and phosphorylated tau (p-tau) data were investigated. Dietary intake was determined by the diet history method, and four dietary patterns were derived by principal component analysis. A Western dietary pattern, a Mediterranean/prudent dietary pattern, a high-protein and alcohol pattern, and a high-total and saturated fat pattern. Logistic regression models, with CSF biomarker pathology (yes/no) as dependent variables, and linear regression models with continuous CSF biomarker levels as dependent variables were performed. The analyses were adjusted for sex, energy intake, body mass index (BMI), educational level, and physical activity level. Results: The odds ratio for having total tau pathology (odds ratio [OR] 1.43; 95% confidence interval [CI] 1.02 to 2.01) and preclinical AD (Aβ42 and tau pathology; OR 1.79; 95% CI 1.03 to 3.10) was higher among those with a higher adherence to a Western dietary pattern. There were no other associations between the dietary patterns and CSF biomarkers that remained significant in both unadjusted and adjusted models. Discussion: Our findings suggest that higher adherence to a Western dietary pattern may be associated with pathological levels of AD biomarkers in the preclinical phase of AD. These findings can be added to the increasing amount of evidence linking dietwith AD and may be useful for future intervention studies investigating dietary intake in relation to AD.
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| 29. |
- Thoresen, L, et al.
(author)
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Doctors and nurses on wards with greater access to clinical dietitians have better focus on clinical nutrition.
- 2008
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In: Journal of human nutrition and dietetics : the official journal of the British Dietetic Association. - 1365-277X. ; 21:3, s. 239-47
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Journal article (peer-reviewed)abstract
- BACKGROUND: According to the Council of Europe, clinical dietitians should assume a more central role in nutritional support. The aim of this study was to assess the opinions among doctors, nurses and clinical dietitians regarding the use of clinical dietitians' expertise in the hospital units and, further, to assess whether the presence of clinical dietitians in hospital departments influenced doctors and nurses focus on clinical nutrition. METHODS: A questionnaire about the use of clinical nutrition was mailed to 6000 doctors and 6000 nurses working in hospital units where undernutrition is documented to be common, as well as to 678 clinical dietitians working in Scandinavian hospitals. RESULTS: The response rate of clinical dietitians, nurses and doctors were 53%, 46% and 29%, respectively. Nurses and doctors who saw clinical dietitians often found it less difficult to identify undernourished patients and found that insight into the importance of adequate nutrition was better than those who saw clinical dietitians seldom. Clinical nutrition had a higher priority in units with frequent visits by clinical dietitians. CONCLUSIONS: The present study shows that doctors and nurses on wards with greater access to clinical dietitians had better focus on clinical nutrition.
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| 30. |
- Tognon, Gianluca, 1976, et al.
(author)
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Dairy product intake and mortality in a cohort of 70-year-old Swedes: a contribution to the Nordic diet discussion
- 2018
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In: European Journal of Nutrition. - : Springer Science and Business Media LLC. - 1436-6207 .- 1436-6215. ; 57:8, s. 2869-2876
-
Journal article (peer-reviewed)abstract
- © 2017 The Author(s) Introduction: Conflicting results in the literature exist on the role of dairy products in the context of a Nordic Healthy Diet (NHD). Two recent Swedish studies indicate both negative and positive associations with total mortality when comparing key dairy products. There is no consensus about how to include these foods into the NHD. Purpose: To study consumption of cheese and milk products (milk, sour milk and unsweetened yoghurt) by 70-year-old Swedes in relation to all-cause mortality. Methods: Cox proportional hazard models, adjusted for potential confounders and stratified by follow-up duration, were used to assess the prediction of all-cause mortality by the above foods. The associations of fat from cheese and milk products with mortality were tested in separate models. Results: Cheese intake inversely predicted total mortality, particularly at high protein intakes, and this association decreased in strength with increasing follow-up time. Milk products predicted increased mortality with stable HRs over follow-up. The association between milk products and mortality was strongly influenced by the group with the highest consumption. Fat from cheese mirrored the protective association of cheese intake with mortality, whereas fat from milk products predicted excess mortality, but only in an energy-adjusted model. Conclusion: Based on our results, it may be argued that the role of dairy products in the context of a Nordic healthy diet should be more clearly defined by disaggregating cheese and milk products and not necessarily focusing on dairy fat content. Future epidemiological research should consider dairy products as disaggregated food items due to their great diversity in health properties.
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