| 11. |
- Ericson Sjöström, Monica, et al.
(författare)
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GP and patient predictions of sick-listing duration: How well do they correspond? A prospective observational study
- 2014
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 32:2, s. 73-77
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To explore how well physicians and patients predict sick-listing duration and the correspondence between their respective predictions. To study possible gender differences concerning prediction accuracy. Design. Prospective observational study. Setting. Two medium-sized primary care centres (PCC) in western Sweden. Subjects. GPs at the PCCs and attending patients sick-listed for > 14 days. Main outcome measures. Sick-listing duration; patients' and GPs' predictions of the total duration of the individual patient's sick-listing. Results. A total of 127 patients (93 women, 34 men, mean age 45 years) and 10 GPs participated in the study. Neither the GPs nor the patients were able to predict the interval until return to work with high accuracy. The GPs' and the patients' perceptions concurred in only 26% of cases. There was a significant difference in the correspondence between the GPs' and patients' respective predictions of sick-listing duration compared with the actual duration. GPs' predictions were more accurate for medium-length duration (1.5-6 months), while patients' predictions were more accurate for long-duration (> 6 months) sick-listing. Patients with less education predicted long duration of sick-listing more accurately than those with more education. There was no significant difference between male and female patients' accuracy of prediction, or between GPs' accuracy of prediction of male vs. female patients' sick-listing duration. Conclusions. Prediction of total sick-listing duration was hard for both GP and patient; their respective predictions corresponded in only one-quarter of the cases. No gender differences were observed in the accuracy of prediction.
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| 12. |
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| 13. |
- Gustavsson, Jaana, 1974, et al.
(författare)
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Interaction of apolipoprotein E genotype with smoking and physical inactivity on coronary heart disease risk in men and women.
- 2012
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Ingår i: Atherosclerosis. - : Elsevier BV. - 1879-1484 .- 0021-9150. ; 220:2, s. 486-492
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Apolipoprotein E genotype (APOE) polymorphism affects lipid levels and coronary heart disease (CHD) risk. However, these associations may be modified by lifestyle factors. Therefore, we studied whether smoking, physical inactivity or overweight interact with APOE on cholesterol levels and CHD risk. METHODS: Combining two Swedish case-control studies yielded 1735 CHD cases and 4654 population controls (3747 men, 2642 women). Self-reported questionnaire lifestyle data included smoking (ever [current or former regular] or never) and physical inactivity (mainly sitting leisure time). We obtained LDL cholesterol levels and APOE genotypes. CHD risk was modelled using logistic regression to obtain odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for relevant covariates. RESULTS: Smoking interacted with APOE on CHD risk; adjusted ORs for ever versus never smoking were 1.45 (95% CI 1.00-2.10) in ɛ2 carriers, 2.25 (95% CI 1.90-2.68) in ɛ3 homozygotes and 2.37 (95% CI 1.85-3.04) in ɛ4 carriers. Female ɛ4 carriers had OR 3.62 (95% CI 2.32-5.63). The adjusted ORs for physical inactivity were 1.09 (95% CI 0.73-1.61), 1.34 (95% CI 1.12-1.61), and 1.79 (95% CI 1.38-2.30) in ɛ2, ɛ3ɛ3 and ɛ4 groups, respectively. No interaction was seen between overweight and APOE for CHD risk, or between any lifestyle factor and APOE for LDL cholesterol levels. CONCLUSION: The APOE ɛ2 allele counteracted CHD risk from smoking in both genders, while the ɛ4 allele was seen to potentiate this risk mainly in women. Similar ɛ2 protection and ɛ4 potentiation was suggested for CHD risk from physical inactivity.
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| 14. |
- Mehlig, Kirsten, 1964, et al.
(författare)
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CETP TaqIB genotype modifies the association between alcohol and coronary heart disease: The INTERGENE case-control study
- 2014
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Ingår i: Alcohol. - : Elsevier BV. - 0741-8329. ; 48:7, s. 695-700
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Tidskriftsartikel (refereegranskat)abstract
- Alcohol consumption at moderate levels has been associated with decreased risk of coronary heart disease (CHD). However, the cardio-protective effect of alcohol may be restricted to subjects with a particular genotype of the cholesteryl ester transfer protein (CETP) polymorphism. There is evidence for this from one study in men, but the finding has not been confirmed since. The present study specifically re-examines the potential modification of the association between alcohol consumption and CHD by the CETP TaqIB (rs708272) polymorphism in a sample including both men and women. The INTERGENE case-control study consists of 618 patients with CHD and 2921 control subjects, of whom 19% were homozygous for the CETP TaqIB B2 allele. Alcohol consumption was categorized into sex-specific tertiles of ethanol intake, with non-drinkers constituting a separate category. Logistic regression was used to determine the association between CHD with genotype, ethanol intake, and their interaction. Participants with intermediate ethanol intake (2nd tertile) had lower risk of CHD than those with low ethanol intake (odds ratio [OR] = 0.65; 95% confidence interval [Cl] 0.50-0.85). The strongest protective association was seen in the CETP TaqIB B2 homozygotes for intermediate vs. low ethanol intake (odds ratio OR = 0.21; 95% CI 0.10-0.44). The interaction between ethanol intake and genotype was statistically significant (p = 0.008), and of similar size in men and women though significant only in men (p = 0.01). The effect modification could not be explained by differences in lifestyle, socioeconomics, or alcohol-related biological variables such as HDL-cholesterol. Our study is the first to replicate previous findings of an effect modification in men. It gives only suggestive results for women, possibly due to the small number of female cases (n = 165). The prevented fraction for the favorable combination of genotype and alcohol consumption is about 6%, a value suggesting that the cardio-protective effect of moderate alcohol consumption applies only to a small segment of the general population. (C) 2014 The Authors. Published by Elsevier Inc.
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| 15. |
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| 16. |
- Mehlig, Kirsten, 1964, et al.
(författare)
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The association between plasma homocysteine and coronary heart disease is modified by the MTHFR 677C>T polymorphism.
- 2013
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Ingår i: Heart (British Cardiac Society). - : BMJ. - 1468-201X .- 1355-6037. ; 99:23, s. 1761-1765
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Tidskriftsartikel (refereegranskat)abstract
- An elevated level of total plasma homocysteine (tHcy) has been associated with risk of coronary heart disease (CHD). The level of tHcy is affected by lifestyle, in addition to genetic predisposition. The methylene tetrahydrofolate reductase (MTHFR) 677C>T polymorphism (rs1801133) is among the strongest genetic predictors of tHcy. We examined whether the association between tHcy and CHD is modified by the MTHFR 677C>T polymorphism.
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| 17. |
- Persson, Christina, 1985, et al.
(författare)
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Cardiovascular risk factors in relation to dietary patterns in 50-year-old men and women: a feasibility study of a short FFQ
- 2019
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Ingår i: Public Health Nutrition. - : Cambridge University Press. - 1475-2727 .- 1368-9800. ; 22:4, s. 645-653
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: We aimed to assess the feasibility of a simple new fifteen-item FFQ as a tool for screening risk of poor dietary patterns in a healthy middle-aged population and to investigate how the results of the FFQ correlated with cardiovascular risk factors and socio-economic factors. DESIGN: A randomized population-based cross-sectional study. Metabolic measurements for cardiovascular risk factors and information about lifestyle were collected. A fifteen-item FFQ was created to obtain information about dietary patterns. From the FFQ, a healthy eating index was created with three dietary groups: good, average and poor. Multivariate logistic regression was used to assess relationships between dietary patterns and cardiovascular risk factors. SETTING: Sweden. SUBJECTS: Men and women aged 50 years and living in Gothenburg, Sweden. RESULTS: In total, 521 middle-aged adults (257 men, 264 women) were examined. With good dietary pattern as the reference, there was a gradient association of having obesity, hypertension and high serum TAG in those with average and poor dietary patterns. After adjustment for education and lifestyle factors, individuals with a poor dietary pattern still had significantly higher risk (OR; 95 % CI) of obesity (2.33; 1.10, 4.94), hypertension (2.73; 1.44, 5.20) and high serum TAG (2.62; 1.33, 5.14) compared with those with a good dietary pattern. CONCLUSIONS: Baseline data collected by a short FFQ can predict cardiovascular risk factors in middle-aged Swedish men and women. The FFQ could be a useful tool in health-care settings, when screening for risk of poor dietary patterns.
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| 18. |
- Rothenberg, E., et al.
(författare)
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Relative Validity of a Short 15-Item Food Frequency Questionnaire Measuring Dietary Quality, by the Diet History Method
- 2021
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Ingår i: Nutrients. - : MDPI AG. - 2072-6643. ; 13:11
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Tidskriftsartikel (refereegranskat)abstract
- Food frequency questionnaires (FFQ) are commonly used dietary assessment tools. The aim was to assess the relative validity of a 15-item FFQ, designed for the screening of poor dietary patterns with a validated diet history (DH). The study population was derived from the Gothenburg H70 Birth Cohort Studies. The DH registrations were harmonized in accordance with the FFQ frequencies. The agreement was assessed by Cohen's kappa with corresponding confidence intervals (CI) for the frequency and categorical variables. Bland-Altman plots were used for the numeric variables. The study comprised data from 848 individuals (55.2% women). Overall, there was high agreement between the methods, with the exact and adjacent level of agreement over 80% for eight variables. The proportion attributed to the opposite frequency was fairly low for most of the frequency variables. Most of the kappa values were in fair or moderate agreement. The highest kappa values were calculated for the type of cooking fat (k = 0.68, CI = 0.63-0.72) and sandwich spread (k = 0.55, CI = 0.49-0.53), and the lowest for type of bread (0.13, CI = 0.07-0.20) and sweets (0.22 CI = 0.18-0.27). In conclusion, the FFQ showed overall good agreement compared with the DH. We, therefore, think it, with some improvements, could serve as a simple screening tool for poor dietary patterns.
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| 19. |
- Strandhagen, Elisabeth, 1960
(författare)
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Coffee and gene interaction. The effect on methionine and lipid metabolism
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Different dietary factors influence the risk of coronary heart disease (CHD), most likely in an interaction with genetic polymorphisms. The knowledge about such interactions is insufficient. Some observational studies have shown an association between coffee and CHD, others have not. Coffee consumption affects some CHD risk factors, e.g. plasma total homocysteine (tHcy) and serum total cholesterol. tHcy is negatively associated with folic acid, pyridoxine (vitamin B6) and vitamin B12, and is also influenced by the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism. Serum cholesterol is affected by the APOE 2/ 3/ 4 polymorphism.Aims: To investigate if a supplement of 200 µg folic acid or 40 mg pyridoxine would decrease or eliminate the tHcy enhancing effect of coffee, and if the effect was dependent of the MTHFR C677T polymorphism. The study also gave the opportunity to study the serum cholesterol raising effect of filtered coffee and if the effect was influenced by APOE 2/ 3/ 4 polymorphisms.Method: The participants were 121 healthy non-smoking men (22%) and women (78%), 29-65 years old, not on blood lipid lowering drugs or vitamin B supplementation. The effect of coffee was studied in a prospective, controlled, double blind trial with four consecutive periods: 1. three weeks of coffee abstention (wash-out) 2. 4 cups (600 mL) coffee/day and 200 g folic acid/day or placebo for 4 weeks3. three weeks of coffee abstention (wash-out) 4. 4 cups (600 mL) coffee/day and 40 mg pyridoxine/day or placebo for 4 weeks.Results: Three weeks of coffee abstention resulted in a tHcy decrease of 1.04 mol/L for the whole group (95% CI -1.45, -0.62). During the subsequent coffee consumption period there was a further decrease of 0.17 mol/L in the folic acid group. In the placebo group there was a tHcy increase of 1.26 mol/L, the difference was 1.43 mol/L (95% CI 0.80, 2.07). Pyridoxine supplementation had no significant effect on the tHcy level.The homocysteine increasing effect of coffee was mainly seen in individuals homozygous for the MTHFR 677T genotype. Folic acid supplement reduced the tHcy increase in these individuals. The two coffee abstention periods resulted in a significant serum cholesterol decrease of 0.22 mmol/L and 0.36 mmol/L, respectively. Consumption of 4 cups filter brewed coffee/day resulted in a significant serum cholesterol increase of 0.25 mmol/L and 0.15 mmol/L, respectively. APOE e2 positive individuals had lower serum cholesterol at baseline than APOE e2 negative individuals, but the APOE polymorphism had no influence on the serum cholesterol increasing effect of coffee.Discussion: The results are consistent with earlier intervention studies on the association between coffee and tHcy. Individuals with hyperhomocysteinemia, often homozygous for the MTHFR 677T allele, should have an adequate intake of folic acid to limit the homocysteine raising effect of coffee. The magnitude of the serum cholesterol enhancing effect of filter-brewed coffee was surprising, and has been shown in only two earlier intervention studies. Individuals with high serum cholesterol should limit their coffee consumption regardless of their APOE genotype.
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| 20. |
- Strandhagen, Elisabeth, 1960, et al.
(författare)
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Filtered coffee raises serum cholesterol: results from a controlled study.
- 2003
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Ingår i: European journal of clinical nutrition. - : Springer Science and Business Media LLC. - 0954-3007 .- 1476-5640. ; 57:9, s. 1164-8
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Earlier studies and trials have shown a serum cholesterol raising effect of unfiltered coffee, which is reduced by about 80% in filtered coffee. Recent cross-sectional studies and trials, however, have indicated that filtered coffee may have a more pronounced serum cholesterol raising effect than previously anticipated. The objective of this controlled study was to assess the effects of the intake and abstention of filtered brewed coffee on blood lipids. DESIGN: A prospective, controlled study with four consecutive trial periods. The first and third periods were 3 weeks of total coffee abstention. The second and fourth periods consisted of 4 weeks with the subjects consuming 600 ml filter brewed coffee/day. SETTING: Free-living population. Volunteers. SUBJECTS: A total of 121 healthy, nonsmoking men and women aged 29-65 y. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Serum total cholesterol, serum HDL cholesterol, serum triglycerides, serum lipoprotein (a) (Lp(a)), blood pressure and heart rate. RESULTS: The two coffee abstention periods were associated with a decline in serum cholesterol of 0.22 mmol/l (95% CI -0.31, -0.13) and 0.36 mmol/l (95% CI -0.46, -0.26), respectively. Filtered coffee/day 600 ml increased serum cholesterol by 0.25 mmol/l (95% CI 0.15, 0.36) and 0.15 mmol/l (95% CI 0.04, 0.26) during the two coffee drinking periods. CONCLUSIONS: Coffee abstention for 3 weeks decreased total serum cholesterol by 0.22-0.36 mmol/l. A volume of 600 ml (about four cups) of filtered coffee/day during 4 weeks raised total serum cholesterol by 0.15-0.25 mmol/l.
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