| 1. |
- Axelsson, Mette, et al.
(författare)
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Mat vid diabetes. : En systematisk översikt med utvärdering av effekter samt hälsoekonomiska och etiska aspekter.
- 2022
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- SlutsatserTyp 1- och typ 2-diabetes Det finns ett samband mellan att äta medelhavskost och lägre risk att dö i förtid oavsett orsak (måttlig tillförlitlighet). Det finns ett samband mellan att äta en större andel2 fibrer eller baljväxter och lägre risk att dö i förtid oavsett orsak (måttlig tillförlitlighet). Det kan även finnas ett samband mellan att äta en större andel nötter och lägre risk att dö i förtid oavsett orsak (låg tillförlitlighet) samt lägre risk att insjukna i hjärt- och kärlsjukdom (låg tillförlitlighet). Det finns ett samband mellan att dricka mer2 kaffe och lägre risk att dö i förtid oavsett orsak och lägre risk att dö i förtid i kranskärlssjukdom (måttlig tillförlitlighet) samt möjligen en lägre risk att dö i förtid i hjärt- och kärlsjukdom (låg tillförlitlighet). Det råder generell brist på studier med lång uppföljningstid som jämför inverkan av olika slags kostråd på överlevnad, diabeteskomplikationer, diabetesremission3, livskvalitet och biverkningar. Tillförlitligheten av befintliga resultat är dessutom mycket låg för de flesta koster, kostbehandlingar, livsmedel och näringsämnen som har utvärderats. Effekter på hälsa och relaterade mått kan i dessa fall inte bedömas.2. Begreppet ”större andel” eller ”mer” avser inte nödvändigtvis att äta eller dricka mer totalt utan att öka mängden av ett visst livsmedel genom att byta ut annan mat eller dryck.Typ 2-diabetes Det kan finnas ett samband mellan att äta en större andel mättat fett och högre risk för att dö i förtid av hjärt- och kärlsjukdom (låg tillförlitlighet). Det kan även finnas ett samband mellan att äta en större andel enkelomättat fett och lägre risk att dö i förtid oavsett orsak (låg tillförlitlighet). En behandling med en initial period av kraftigt minskat energiintag med hjälp av lågenergipulver (VLED) med efterföljande övergång till mat för viktstabilitet jämfört med vanlig kostbehandling har gynnsamma effekter på livskvalitet (enligt EQ-5D), långtidsblodsocker (HbA1c) och vikt upp till 12 månader (måttlig tillförlitlighet)4. Vidare kan metoder där VLED ingår ha gynnsamma effekter på diabetesremission5 och midjeomfång upp till 12 månader (låg tillförlitlighet) och långtidsblodsocker (HbA1c) upp till 24 månader (låg tillförlitlighet). Intensiv livsstilsbehandling därlågfettkost kombineras med fysisk aktivitet och minskat energiintag har gynnsamma effekter jämfört med vanlig kostbehandling på långtidsblodsocker (HbA1c), vikt, kroppsmasseindex (BMI), midjeomfång och vissa blodfetter upp till 12 månader (måttlig tillförlitlighet)3. Viktminskningen kan kvarstå upp till omkring 10 år (låg tillförlitlighet). Behandlingen kan leda till bättre fysisk livskvalitet upp till 8 år (låg tillförlitlighet) medan effektskillnaden i psykisk livskvalitet under samma tid kan vara obefintlig eller försumbar (låg tillförlitlighet). Jämförelsen påvisar ingen förändrad risk att dö i förtid oavsett orsak eller att dö eller insjukna av kardiovaskulära orsaker efter omkring 10 år (låg tillförlitlighet). I det hälsoekonomiska perspektivet är intensiv livsstilsbehandling mer resurskrävande än vanlig kostbehandling, och beräkningar visar små eller inga vinster i kvalitetsjusterade levnadsår (QALYs) på individnivå. Energirestriktion i samband med intensiv livsstilsbehandling med ketogen kost eller med högproteinkost (20 E%) i kombination med fysisk aktivitet jämfört med vanlig kostbehandling kan ge en viktminskning upp till 11 månader (låg tillförlitlighet) men det saknas studier som kan visa om vikten kan bibehållas på längre sikt. Det saknas studier som undersökt kliniskt viktiga utfall som dödlighet, kardiovaskulära sjukdomar, livskvalitet och diabetesremission.3. Gäller endast vid typ 2-diabetes.4. Utgår från individer med en medelkroppsvikt på cirka 100 kg och medel-HbA1c på 60 mmol/mol.5. Resultaten för utfallet diabetesremission (att uppnå normala blodsockervärden) gäller när en diabetesdiagnos sattes för mindre än 6 år sedan eller för mindre än 3 år sedan. Definitionen för diabetesremission var ett HbA1c på mindre än 48 mmol/mol och att samtidigt vara fri från blodsockersänkande läkemedel.Graviditetsdiabetes Det saknas studier om kost vid graviditetsdiabetes med tillräcklig tillförlitlighet för att kunna bedöma effekterna.
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| 2. |
- Jakobsson, Trille, et al.
(författare)
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Physical Activity objectively assessed over a Year in Children and Adolescents with Cerebral Palsy who are Non-Ambulant using ActiGraph GT3X Accelerometer
- 2024
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Konferensbidrag (refereegranskat)abstract
- Introduction: Children gain increased health and wellbeing by participating in physical activity (PA). In children and adolescents with cerebral palsy who are non-ambulant (children with CP-NA), levels of PA have been indicated to be lower compared to children and adolescents without physical disabilities. However, research on PA in children with CP-NA is limited. Therefore, this study aims to evaluate objectively assessed PA over the course of one year when using ActiGraph GT3X accelerometer in children with CP-NA. Participants and methods: Accelerometer data were retrieved from 32 children with CP-NA (4 - 17 years) in Region Skane, Sweden. Participants wore the ActiGraph GT3X accelerometer all waking hours for up to four periods of seven consecutive days over a year. Statistically sensitivity analyses were run to explore differences in PA between subtypes of cerebral palsy and GMFCS level IV and V. Results: In total 481 days and 85 periods of valid accelerometer data were obtained. Light PA was statically significantly higher for children with dyskinetic CP-NA compared to spastic CP-NA (median (IQR) 57 (37.42-88.1) vs. 34.42 (20.42-55.96), p = <0.001). Light PA (median (IQR) 57 (36.67-88.5) vs. 25.42 (17-38.75), p = <0.001) and moderate to vigorous PA (median (IQR) 1.83 (1-4.17) vs. 1.67 (0.67-2), p = <0.001) were statically significantly higher for children with CP-NA GMFCS level IV compared to level V. Conclusion: Preliminary results indicate differences in PA levels between subtype of cerebral palsy and GMFCS level. Further analyses to explore potential differences in PA over the year will be run.
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| 3. |
- Lundström, Petra, et al.
(författare)
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Acute Response to One Bout of Dynamic Standing Exercise on Blood Glucose and Blood Lactate Among Children and Adolescents With Cerebral Palsy Who are Nonambulant
- 2022
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Ingår i: Pediatric Exercise Science. - Champaign, IL : Human Kinetics. - 0899-8493 .- 1543-2920. ; 34:2, s. 93-98
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To investigate the acute exercise effects of dynamic standing exercise (DyS) on blood glucose and blood lactate among children and adolescent with cerebral palsy (CP) who are non-ambulant. Methods: Twenty-four participants with CP who are non-ambulant performed 30 minutes of DyS using a motorized device enabling assisted passive movements in an upright weight-bearing position. Capillary blood-samples were taken from the fingertip for measurement of blood glucose and blood lactate at rest and at the end of exercise. Results: At rest, the participants had hyperlactatemia that was unaffected after exercise presented as median and interquartile range at rest 1.8 [1.3:2.7] mmol/L and after exercise 2.0 [1.1:2.5] mmol/L. Children and adolescents with GMFCS-E&R V had higher lactate levels at rest (2.5 [1.8:2.9] vs 1.4 [1.0:2.0]; p=0.030) and after exercise (2.3 [2.0:2.6] vs 1.2 [0.9:2.2]; p=0.032) compared to children and adolescents with GMFCS-E&R IV respectively. A statistically significant larger decrease in blood lactate levels after exercise was observed in children and adolescents with higher resting blood lactate levels (rho=0.56;p=0.004). There were no statistically significant changes in blood glucose. Conclusions: Forty percent of the participants had mild hyperlactatemia at rest and participants with the highest blood lactate levels at rest had the greatest decrease in blood lactate levels after one bout of exercise. Children and adolescents with classified into higher level of GMFCS-E&R had higher blood lactate levels. More studies are needed on how to prevent chronically high resting levels of lactate with exercise in children with CP who are non-ambulant.
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| 4. |
- Varga, Tibor V, et al.
(författare)
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Acute and Long-Term Changes in Blood-Borne Biomarkers in Response to Dynamic Standing in Nonambulant Children With Cerebral Palsy
- 2024
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Ingår i: Pediatric Exercise Science. - Champaign, IL : Human Kinetics. - 0899-8493 .- 1543-2920. ; 36:1, s. 15-22
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To investigate acute and long-term changes in hormonal and inflammatory biomarkers in nonambulant children with cerebral palsy in response to dynamic standing exercise.Methods: Fourteen children with severe cerebral palsy were recruited. Anthropometrics and body composition measures were obtained. Physical activity levels before the study were assessed using hip-worn accelerometry. All children underwent a 30-minute dynamic standing exercise using the Innowalk standing aid. Respiratory data during exercise were collected using indirect calorimetry. Blood samples were collected before and after exercise. Blood samples were also obtained after two 16-week exercise protocols, in a resting state. Hormonal and inflammatory metabolites were measured from blood serum/plasma, and acute and long-term changes in biomarker levels were assessed using Wilcoxon signed-rank tests.Results: Of the 14 children at baseline, all had slightly/moderately/severely elevated C-reactive protein and cortisol levels. C-reactive protein levels were decreased following a 30-minute bout of dynamic standing (before exercise: 53 mg/L [interquartile range: 40-201]; after exercise: 39 mg/L [interquartile range: 20-107]; P = .04).Conclusions: We show that several hormonal and inflammatory biomarkers are dysregulated in children with cerebral palsy. Our preliminary results from a small, but deep-phenotyped prospective cohort indicate acute and long-term alterations of several biomarkers in response to exercise. ©2023 The Authors.
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| 5. |
- Björkman, Frida Maria Eleonora
(författare)
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Validity and reliability of a submaximal cycle ergometer test for estimation of maximal oxygen uptake
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Maximal oxygen uptake (VO2max) is the highest obtained rate of oxygen consumption during a physically intense dynamic whole-body activity. VO2max is an important factor for many types of physical performance, as well as a strong independent predictor of health and longevity. Thus, it is important to have accurate and precise methods for assessment of VO2max.A direct measurement of VO2max is often conducted via indirect calorimetry during maximal exercise. The demand for maximal effort from an individual, along with the need for laboratory equipment, makes direct measurements unsuitable in the general, non-athlete population. There are also a number of contraindications that limit the possibility to conduct direct measurements of VO2max in many settings. Instead, several other exercise tests have been developed in order to facilitate the procedure of determination and evaluation of cardiorespiratory fitness in different populations. These tests can be either of submaximal or maximal character. Commonly used work modes are stepping, walking, and cycling. The overall aim of this thesis was to describe the background to, and the development of, submaximal cycle ergometer tests for estimation of VO2max.The present thesis focuses on the validity and reliability of a new submaximal cycle ergometer test – the Ekblom-Bak test (EB test). The first study described the test procedure for the new cycle ergometer test and the creation of an accompanying mathematical model (prediction equation) for estimation of VO2max. The development of the test and its associated prediction equation was continued in study II, while it was further validated in adults and adolescents in study II and IV. Study III examined the ability to use a submaximal cycle ergometer test in order to detect changes in VO2max over time.The EB test comprises of 8 minutes of continuous cycling – 4 minutes at 0.5 kp, followed by 4 minutes at a higher, individually chosen work rate – with a pedalling rate of 60 revolutions per minute. The test measures the change in HR (ΔHR) between the two different work rates (ΔPO), and the variable ΔHR/ΔPO was obtained and linked to measured VO2max. In study I, the validity and reliability of the EB test and the associated prediction equation was tested in a mixed population with regard to sex, age, and physical activity status. The subjects performed repeated submaximal cycle ergometer tests and maximal running tests for direct determination of VO2max (reference value). There was a strong correlation between estimated and measured VO2max, with an adjusted R2 of 0.82 and a corresponding coefficient of variation (CV) of 9.3%. Although there was a relatively high precision in the estimation of VO2max by the prediction equation, it was evident that individuals with high VO2max were underestimated and individuals with low VO2max were overestimated. This issue was further addressed in study II.In study II, the size of the study population was increased, in order to broaden the valid range and evaluate the use of sex-specific prediction equations. The estimation error was slightly decreased, and the sex-specific prediction equations resulted in an adjusted R2 of 0.91 and a CV of 8.7% in the whole group. The new models were also evaluated in a cross-validation group, where the adjusted R2 was 0.90 and CV 9.4%.The relation between the estimation error and changes in VO2max over time was investigated in study III. Follow-up tests were conducted in 35 subjects, in order to examine the conformity between changes in measured and estimated VO2max over a timespan of 5 to 8 years. Results showed a moderate correlation between change in measured VO2max and change in estimated VO2max (r = 0.75). Changes in body mass or changes in work efficiency did not relate to the change in assessment error. In study IV, the aim was to determine the applicability and validity of the EB test in pre-pubertal and pubertal adolescents. Medical examinations and assessment of sexual maturity (according to the stages of Tanner) were performed in addition to the physical tests. The included subjects (n = 50) were 10 to 15 years old and in Tanner stages I–IV. The measurement error (the difference between measured and estimated VO2max) was related to maturity in boys, but not in girls. The measurement error decreased for the whole group when the equation developed for women was used for the boys in Tanner I and II. This modification in the calculations of VO2max resulted in an adjusted R2 of 0.83 and SEE 0.23 L/min. Hence, the most accurate prediction of VO2max from the EB test is generated if the test result is accompanied by ratings of sexual maturity in adolescents. Analysis of the test-retest values showed no significant change in estimated VO2max from repeated tests within two weeks of each other. In summary, the EB test proved to be a reliable and valid test throughout a wide range of ages (20 to 85 years) and fitness levels (1.33 to 3.94 L/min in women, and 1.67 to 5.97 L/min in men). The test was also found to be useful and reasonably valid for determination of VO2max in pre-pubertal and pubertal adolescents, preferably after adjustment for sexual maturity status in boys. Furthermore, it was shown that the EB test captured fairly well an actual change in VO2max during a period of 5 to 8 years. However, it is still unknown whether the test has an acceptable sensitivity for detection of a training-induced increase in VO2max. Further studies are needed to evaluate if the test can be used in diseased individuals with or without different medications. The EB test can be used in health-related clinical settings, sports and fitness clubs.
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| 6. |
- Brown, Annemette, et al.
(författare)
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Parents' lived experience of early risk assessment for cerebral palsy in their young child using a mobile application after discharge from hospital in the newborn period
- 2024
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Ingår i: Annals of Medicine. - 1365-2060. ; 56:1, s. 1-11
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: General Movement assessment (GMA) is considered the golden standard for early identification of infants with a high risk of developing cerebral palsy (CP). The aim of this study was to explore parents' lived experience of early risk assessment for CP using a mobile application for home video recording after discharge from hospital stay in the newborn period.METHODS: An inductive qualitative design using a hermeneutical phenomenological approach was chosen, and fourteen parents with children at risk of CP were interviewed at home. The hermeneutical phenomenological approach describes humans' lived experiences of a specific phenomenon with a possibility of deeper understanding of the expressed statements. The interviews were analyzed using the fundamental lifeworld existential dimensions as guidelines for describing the parents' lived experience.RESULTS: The overall understanding of the parents' experience was 'Finding control in an uncontrolled life situation'. During the often-long hospitalizations, the parents struggled with loss of control and difficulty in understanding what was going on. The use of the mobile application followed by a swift result made them feel in control and have a brighter view of the future.CONCLUSIONS: The findings suggest that the mobile application did not seem to worry the parents. Instead, it provided the parents with a sense of active participation in the care and treatment of their child. The mobile application should be accompanied with clear instructions and guidelines for the parents and details about how and when the result is given.
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| 7. |
- Burri, Stina C.M., et al.
(författare)
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Antioxidant capacity and major phenol compounds of horticultural plant materials not usually used
- 2017
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Ingår i: Journal of Functional Foods. - : Elsevier BV. - 1756-4646. ; 38, s. 119-127
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Tidskriftsartikel (refereegranskat)abstract
- Horticultural plant materials not usually used from onion, carrot, beetroot, sea buckthorn, black and red currants as well as a wastewater powder from olive oil production were analyzed for total phenols content (FC), ferric reducing ability of plasma (FRAP), radical scavenging capacity (ABTS), and for major phenolic compounds by HPLC-MS. Antioxidant capacity and phenol content varied significantly between species and cultivars, with extracts of sea buckthorn leaves being superior. In different species, different phenolic compounds were closely associated with FRAP, ABTS and FC. For instance, hydrolysable tannins were major antioxidants in sea buckthorn whereas quercetin was the major antioxidant in onion peel and skin. This study shows that horticultural plant materials usually left in the field or waste materials from processing may have high antioxidant properties, and that extracts of these materials therefore could be of potential interest for development of antioxidant food additives.
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| 8. |
- Burri, Stina C.M., et al.
(författare)
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Lipid oxidation inhibition capacity of 11 plant materials and extracts evaluated in highly oxidised cooked meatballs
- 2019
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Ingår i: Foods. - : MDPI AG. - 2304-8158. ; 8:9
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Tidskriftsartikel (refereegranskat)abstract
- The underlying mechanism(s) behind the potential carcinogenicity of processed meat is a popular research subject of which the lipid oxidation is a common suspect. Different formulations and cooking parameters of a processed meat product were evaluated for their capacity to induce lipid oxidation. Meatballs made of beef or pork, containing different concentrations of fat (10 or 20 g 100 g−1), salt (2 or 4 g 100 g−1), subjected to differing cooking types (pan or deep frying), and storage times (1, 7, and 14 days), were evaluated using thiobarbituric reactive substances (TBARS). The deep-fried meatball type most susceptible to oxidation was used as the model meat product for testing the lipid oxidation inhibiting capacity of 11 plant materials and extracts, in two concentrations (100 and 200 mg kg−1 gallic acid equivalent (GAE)), measured after 14 days of storage using TBARS. Summer savory lyophilized powder was the most efficient plant material, lowering lipid oxidation to 13.8% and 21.8% at the 200 and 100 mg kg−1 concentration, respectively, followed by a sea buckthorn leaf extract, lowering lipid oxidation to 22.9% at 100 mg kg−1, compared to the meatball without added antioxidants. The lipid oxidation was thus successfully reduced using these natural antioxidants.
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| 9. |
- Burri, Stina C.M., et al.
(författare)
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Lipid oxidation inhibition capacity of plant extracts and powders in a processed meat model system
- 2020
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Ingår i: Meat Science. - : Elsevier BV. - 0309-1740 .- 1873-4138. ; 162
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Tidskriftsartikel (refereegranskat)abstract
- A meat model system was used for screening lipid oxidation inhibiting capacity of diverse horticultural plant materials. In the model, heme-containing sarcoplasmic proteins from the meat water-phase were homogenized with linoleic acid and thiobarbituric reactive substances (TBARS) were measured. 23 Plant materials were investigated at three high (50, 100, and 200 ppm) concentrations and five plant extracts were tested at three low (5, 10, and 20 ppm) concentrations over time. In the high concentration sets, summer savory freeze-dried powder, beetroot leaves extracted with 50% ethanol, and an olive polyphenol powder extracted from wastewater, inhibited oxidation the most effectively. After two weeks and at 200 ppm concentration, oxidation was reduced to 17.2%, 16.6% and 13.5% of the blank sample with no added antioxidants respectively. In the low concentration set, spray dried rhubarb juice inhibited oxidation the most after two weeks at 5 ppm where oxidation was reduced to 68.3% of the blank sample with no added antioxidants.
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| 10. |
- Burri, Stina, et al.
(författare)
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Processed meat products with added plant antioxidants affect the microbiota and immune response in C57BL/6JRj mice with cyclically induced chronic inflammation
- 2021
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Ingår i: Biomedicine and Pharmacotherapy. - : Elsevier BV. - 1950-6007 .- 0753-3322. ; 135
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Tidskriftsartikel (refereegranskat)abstract
- Epidemiological studies have found that there is a correlation between red and processed meat consumption and an increased risk of colorectal cancer. There are numerous existing hypotheses on what underlying mechanisms are causative to this correlation, but the results remain unclear. A common hypothesis is that lipid oxidation, which occurs in endogenous lipids and phospholipids in consumed food, are catalyzed by the heme iron in meat. In this study, five pre-selected plant antioxidant preparations (sea buckthorn leaves and sprouts, summer savory leaves, olive polyphenols, onion skin and lyophilized black currant leaves) were added to a meatball type prone to oxidize (pork meat, 20 % fat, 2% salt, deep-fried and after 2 weeks of storage). Pro-inflammatory markers, neutrophil infiltration and microbiota composition were studied after four months in a chronic inflammation model in C57BL6/J female mice. We found that the bacterial diversity index was affected, as well as initial immunological reactions.
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