| 1. |
- Drake, Isabel, et al.
(author)
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Development of a diet quality index assessing adherence to the Swedish nutrition recommendations and dietary guidelines in the Malmö Diet and Cancer cohort.
- 2011
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In: Public Health Nutrition. - 1475-2727. ; 14, s. 835-845
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To develop a diet quality index (DQI) that assesses adherence to the Swedish nutrition recommendations (SNR) and the Swedish dietary guidelines (SDG). DESIGN: A cross-sectional study within the Malmö Diet and Cancer (MDC) cohort. A diet history method collected dietary data, a structured questionnaire lifestyle and socio-economic information, and anthropometric data were collected by direct measurements. The index (DQI-SNR) included six components: SFA, PUFA, fish and shellfish, dietary fibre, fruit and vegetables, and sucrose. SETTING: Malmö, Sweden. SUBJECTS: Men (n 4525) and women (n 8491) of the MDC cohort enrolled from September 1994 to October 1996. RESULTS: For participants with high DQI-SNR scores, nutrient and food intakes were close to recommendations. However, most of the study population exceeded the recommended intake for SFA (98 %) and few reached recommended intakes for dietary fibre (24 %), fruit and vegetables (32 %), vitamin D (18 %) and folate (2 %). A high DQI-SNR score was positively associated with age, physical activity, not smoking, past food habit change, education and socio-economic status. Individuals with high scores were more likely to have a diabetes diagnosis or experienced a cardiovascular event. CONCLUSIONS: Results suggest that the DQI-SNR is a useful tool for assessing adherence to the SNR 2005 and the SDG in the MDC cohort. No index has previously been developed with the aim of evaluating adherence to the current dietary recommendations in Sweden. Further validation of the DQI-SNR, and evaluation of its utility, is needed.
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| 2. |
- Hlebowicz, Joanna, et al.
(author)
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Food patterns, inflammation markers and incidence of cardiovascular disease: the Malmö Diet and Cancer study.
- 2011
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In: Journal of Internal Medicine. - : Wiley. - 1365-2796 .- 0954-6820. ; 270, s. 365-376
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Journal article (peer-reviewed)abstract
- Objectives: To examine the associations between food patterns constructed using cluster analysis and markers of systemic and vascular inflammation, and incident cardiovascular disease (CVD) after 13 years of follow-up. Design: Population-based, prospective cohort study. Setting and subjects: Cluster analysis identified six food patterns from 43 food group variables among 4999 subjects, aged 45-68 years, who participated in the Malmö Diet and Cancer cardiovascular programme between 1991 and 1994. Lipoprotein-associated phospholipase A(2) (Lp-PLA(2) ), C-reactive protein concentration and white blood cell (WBC) count were measured using blood samples at baseline. Incidence of CVD (coronary events and ischaemic stroke) was monitored over 13 years of follow-up. Results: The fibre-rich bread pattern was associated with favourable effects on WBC count in women, and the low-fat and high-fibre pattern with favourable effects on Lp-PLA(2) mass in women, and on Lp-PLA(2) activity in men. However, the milk fat and sweets and cakes patterns were both associated with adverse effects; the former on WBC count in women and on Lp-PLA(2) mass in men, and the latter on WBC count and Lp-PLA(2) mass in women. The milk fat and sweets and cakes patterns were associated with increased CVD risk in women. Conclusions: The results of this study support the present Nordic dietary recommendations indicating that diets rich in high-fibre, low-fat and low-sugar foods are favourably associated with markers of inflammation and, potentially, with CVD risk.
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| 3. |
- Sonestedt, Emily, et al.
(author)
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Association between fat intake, physical activity and mortality depending on genetic variation in FTO.
- 2011
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In: International Journal of Obesity. - : Springer Science and Business Media LLC. - 1476-5497 .- 0307-0565. ; 35, s. 1041-1049
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Journal article (peer-reviewed)abstract
- Objective:We wanted to explore if FTO genotype interacts with fat intake, or leisure-time physical activity, on fat mass, lean mass and mortality.Subjects and methods:Among 22 799 individuals (44-74 years) in the population-based Malmö diet and cancer cohort that were genotyped for rs9939609 in FTO and had information on dietary intake (from a modified diet history method) and no history of diabetes, cancer or cardiovascular disease, 2255 deaths (including 1100 cancer and 674 cardiovascular deaths) occurred during 12.0 years of follow-up. Leisure-time physical activity was determined from a list of 17 different physical activities in a questionnaire. Body composition was measured using bioelectric impedance method.Results:FTO genotype associated strongly with both fat mass and lean mass (P(trend)<1 × 10(-16) for both) but we found only significant interactions with fat intake, or physical activity, on fat mass (P(interaction)=0.01 and 0.004). No significant interaction between FTO genotype and fat intake (P(interaction)=0.72), or leisure-time physical activity (P(interaction)=0.07), on total mortality were observed. However, we observed a significant interaction between leisure-time physical activity and FTO genotype on cardiovascular mortality (P(interaction)=0.03). The highest vs lowest quintile of physical activity was associated with 46% (95% confidence interval, 17-64%) reduced cardiovascular mortality among TT-carriers (P(trend)=0.004), and 11% reduced cardiovascular mortality among A-allele carriers (P(trend)=0.68).Conclusion:Our results indicate that FTO genotype associates with both fat mass and lean mass, but the level of fat intake and physical activity only modify the association with fat mass. In addition, FTO genotype may modify the association between physical activity and cardiovascular mortality.International Journal of Obesity advance online publication, 21 December 2010; doi:10.1038/ijo.2010.263.
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| 4. |
- Sonestedt, Emily, et al.
(author)
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Dairy products and its association with incidence of cardiovascular disease: the Malmö diet and cancer cohort.
- 2011
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In: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 1573-7284 .- 0393-2990. ; 26, s. 609-618
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Journal article (peer-reviewed)abstract
- It is unclear whether specific dairy products are associated with risk of cardiovascular disease (CVD). The aim of this project was therefore to examine the association between intake of milk, cheese, cream and butter, and incidence of CVD in the Swedish Malmö Diet and Cancer cohort. Milk was separated into fermented (yoghurt and cultured sour milk) versus non-fermented milk, and low-fat versus high-fat milk. Among 26,445 individuals without a history of myocardial infarction, stroke and diabetes (44-74 years; 62% females), 2,520 CVD cases (coronary and stroke events) were identified during a mean follow-up time of 12 years. Dietary data was collected using a modified diet history method. Overall consumption of dairy products was inversely associated with risk of CVD (P (trend) = 0.05). Among the specific dairy products, a statistically significant inverse relationship was observed only for fermented milk. The highest versus lowest intake category of fermented milk was associated with 15% (95% CI: 5-24%; P (trend) = 0.003) decreased incidence of CVD. We observed a statistically significant interaction between sex and cheese intake (P = 0.046). Cheese intake was significantly associated with decreased CVD risk in women (P (trend) = 0.03), but not in men (P (trend) = 0.98). The main finding was that a high intake of fermented milk may reduce the risk of CVD. This study suggests that it is important to examine dairy products separately when investigating their health effects.
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| 5. |
- Wirfält, Elisabet, et al.
(author)
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Food sources of fat and sex hormone receptor status of invasive breast tumors in women of the malmö diet and cancer cohort.
- 2011
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In: Nutrition and Cancer. - : Informa UK Limited. - 1532-7914 .- 0163-5581. ; 63:5, s. 722-733
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Journal article (peer-reviewed)abstract
- We examined associations between food intakes and incident breast cancer, defined by estrogen receptor (ER) and progesterone receptor (PR) status in the Malmö Diet and Cancer cohort (17,000 women aged 45-73 yr). The hazard ratios (HRs) of ER+PR+ (n = 270), ER+PR- (n = 87), and ER-PR- (n = 61) tumors and all cancer (n = 544) were estimated after 10 yr of follow-up. In multivariate analysis of ER+PR+ tumors, a protective linear risk trend, indicating change between adjoining food categories, was seen with yogurt (HR = 0.89, 95% CI = 0.80-0.99), but increased risks with eggs (HR = 1.10, 95% CI = 1.01-1.20) and dried soups/sauces (HR = 1.10, 95% CI = 1.00-1.22). In ER-PR- tumors, vegetable-oil-based margarine (HR = 1.31, 95% CI = 1.09-1.59) and dried soups/sauces (HR = 1.31 95% CI = 1.05-1.64) showed increased risks. Heterogeneity was observed between ER+PR+ and ER-PR- tumors for vegetable-oil-based margarine (P < 0.01). Regular milk showed decreased, and dried soups/sauces increased, risk with all breast cancer. The study suggests that fat-containing food may contribute both to hormonal and nonhormonal mechanisms in breast tumor development and supports observations of positive associations between characteristics of Westernized diets and postmenopausal breast cancer.
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