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  • Amundadottir, Laufey T., et al. (författare)
  • A common variant associated with prostate cancer in European and African populations
  • 2006
  • Ingår i: Nature Genetics. - 1061-4036. ; 38:6, s. 652-658
  • Tidskriftsartikel (refereegranskat)abstract
    • With the increasing incidence of prostate cancer, identifying common genetic variants that confer risk of the disease is important. Here we report such a variant on chromosome 8q24, a region initially identified through a study of Icelandic families. Allele -8 of the microsatellite DG8S737 was associated with prostate cancer in three case-control series of European ancestry from Iceland, Sweden and the US. The estimated odds ratio (OR) of the allele is 1.62 (P = 2.7 x 10(-11)). About 19% of affected men and 13% of the general population carry at least one copy, yielding a population attributable risk (PAR) of approximately 8%. The association was also replicated in an African American case-control group with a similar OR, in which 41% of affected individuals and 30% of the population are carriers. This leads to a greater estimated PAR (16%) that may contribute to higher incidence of prostate cancer in African American men than in men of European ancestry.
  • Bälter, Olle, 1962-, et al. (författare)
  • Demands on web survey tools for epidemiological research
  • 2005
  • Ingår i: European Journal of Epidemiology. - 0393-2990. ; 20:2, s. 137-139
  • Tidskriftsartikel (refereegranskat)abstract
    • In countries where the Internet access is high, a web-based questionnaire could save time and money compared to printed questionnaires, mainly by eliminating the two steps of transferring answers from printed to a digital data set and manually completing missing and impossible answers. However, many of the features wanted for conducting large epidemiological studies are not available in many web survey systems. Here we describe design issues the investigator needs to be aware of when using web-based questionnaires in epidemiological research.
  • Bälter, Olle, 1962-, et al. (författare)
  • Feedback in web-based questionnaires as incentive to increase compliance in studies on lifestyle factors
  • 2012
  • Ingår i: Public Health Nutrition. - Cambridge University Press. - 1368-9800. ; 15:6, s. 982-988
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: We explored the use of feedback in interactive web-based questionnaires for collecting data on lifestyle factors in epidemiological studies.Design: Here we report from a cohort study on lifestyle factors and upper respiratory tract infections among 1805 men and women. We introduced interactivity in the form of personalized feedback and feedback on a group level regarding dietary intake, physical activity and incidence of infections in web- based questionnaires as incentives for the respondents to continue answering questions and stay in the study.Setting: The study was performed in Sweden.Subjects: All participants were randomly selected from the population registry.Results: Personalized feedback was offered in the baseline questionnaire and feedback on a group level in the five follow-up questionnaires. In total, 88 % of the participants actively chose to get personalized feedback at least once in the baseline questionnaire. The follow-up questionnaires were sent by email and the overall compliance at each follow-up was 83–84 %, despite only one reminder. In total, 74 % completed all five follow-ups. However, the compliance was higher among those who chose feedback in the baseline questionnaire compared with those who did not choose feedback.Conclusions: The results show that it is possible to use feedback in web ques- tionnaires and that it has the potential to increase compliance. The majority of the participants actively chose to take part in the personalized feedback in the baseline questionnaire and future research should focus on improving the design of the feedback, which may ultimately result in even higher compliance in research studies.
  • Christensen, S. E., et al. (författare)
  • Relative Validity of Micronutrient and Fiber Intake Assessed With Two New Interactive Meal- and Web-Based Food Frequency Questionnaires
  • 2014
  • Ingår i: Journal of Medical Internet Research. - 1438-8871. ; 16:2
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The meal-and Web-based food frequency questionnaires, Meal-Q and MiniMeal-Q, were developed for cost-efficient assessment of dietary intake in epidemiological studies. Objective: The objective of this study was to evaluate the relative validity of micronutrient and fiber intake assessed with Meal-Q and MiniMeal-Q. The reproducibility of Meal-Q was also evaluated. Methods: A total of 163 volunteer men and women aged between 20 and 63 years were recruited from Stockholm County, Sweden. Assessment of micronutrient and fiber intake with the 174-item Meal-Q was compared to a Web-based 7-day weighed food record (WFR). Two administered Meal-Q questionnaires were compared for reproducibility. The 126-item MiniMeal-Q, developed after the validation study, was evaluated in a simulated validation by using truncated Meal-Q data. Results: The study population consisted of approximately 80% women (129/163) with a mean age of 33 years (SD 12) who were highly educated (130/163, 80% with >12 years of education) on average. Cross-classification of quartiles with the WFR placed 69% to 90% in the same/adjacent quartile for Meal-Q and 67% to 89% for MiniMeal-Q. Bland-Altman plots with the WFR and the questionnaires showed large variances and a trend of increasing underestimation with increasing intakes. Deattenuated and energy-adjusted Spearman rank correlations between the questionnaires and the WFR were in the range rho=.25-.69, excluding sodium that was not statistically significant. Cross-classifications of quartiles of the 2 Meal-Q administrations placed 86% to 97% in the same/adjacent quartile. Intraclass correlation coefficients for energy-adjusted intakes were in the range of .50-.76. Conclusions: With the exception of sodium, this validation study demonstrates Meal-Q and MiniMeal-Q to be useful methods for ranking micronutrient and fiber intake in epidemiological studies with Web-based data collection.
  • Christensen, S. E., et al. (författare)
  • Two New Meal- and Web-Based Interactive Food Frequency Questionnaires: Validation of Energy and Macronutrient Intake
  • 2013
  • Ingår i: Journal of Medical Internet Research. - 1438-8871. ; 15:6
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Meal-Q and its shorter version, MiniMeal-Q, are 2 new Web-based food frequency questionnaires. Their meal-based and interactive format was designed to promote ease of use and to minimize answering time, desirable improvements in large epidemiological studies. Objective: We evaluated the validity of energy and macronutrient intake assessed with Meal-Q and MiniMeal-Q as well as the reproducibility of Meal-Q. Methods: Healthy volunteers aged 20-63 years recruited from Stockholm County filled out the 174-item Meal-Q. The questionnaire was compared to 7-day weighed food records (WFR; n=163), for energy and macronutrient intake, and to doubly labeled water (DLW; n=39), for total energy expenditure. In addition, the 126-item MiniMeal-Q was evaluated in a simulated validation using truncated Meal-Q data. We also assessed the answering time and ease of use of both questionnaires. Results: Bland-Altman plots showed a varying bias within the intake range for all validity comparisons. Cross-classification of quartiles placed 70%-86% in the same/adjacent quartile with WFR and 77% with DLW. Deattenuated and energy-adjusted Pearson correlation coefficients with the WFR ranged from r=0.33-0.74 for macronutrients and was r=0.18 for energy. Correlations with DLW were r=0.42 for Meal-Q and r=0.38 for MiniMeal-Q. Intraclass correlations for Meal-Q ranged from r=0.57-0.90. Median answering time was 17 minutes for Meal-Q and 7 minutes for MiniMeal-Q, and participants rated both questionnaires as easy to use. Conclusions: Meal-Q and MiniMeal-Q are easy to use and have short answering times. The ranking agreement is good for most of the nutrients for both questionnaires and Meal-Q shows fair reproducibility.
  • Fondell, Elinor, et al. (författare)
  • Adherence to the Nordic Nutrition Recommendations as a measure of a healthy diet and upper respiratory tract infection
  • 2011
  • Ingår i: Public Health Nutrition. - CAMBRIDGE UNIV PRESS. - 1368-9800. ; 14:5, s. 860-869
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: The Nordic countries have published joint dietary recommendations, the Nordic Nutrition Recommendations (NNR), since 1980. We evaluated adherence to the NNR as a measure of a healthy diet and its potential association with self-reported upper respiratory tract infection (URTI). Design: A prospective, population-based study with a follow-up period of 4 months. Dietary intake was assessed using a semi-quantitative FFQ with ninety-six items, along with other lifestyle factors, at baseline. URTI was assessed every three weeks. A Poisson regression model was used to control for age, sex and other confounding factors. Setting: A middle-sized county in northern Sweden. Subjects: Swedish men and women (n 1509) aged 20-60 years. Results: The NNR include recommendations on macronutrient proportions, physical activity and intake of micronutrients, sodium, fibre and alcohol. We found that overall adherence to the NNR was moderately good. In addition, we found that high adherence to the NNR (>5.5 adherence points) was not associated with a lower risk of URTI (incidence rate ratio (IRR) 0.89, 95% CI 0.73, 1.08) compared with low adherence (<4.5 adherence points). When investigating individual components of the NNR, only high physical activity was associated with lower URTI risk (IRR=0.82, 95% CI 0.69, 0.97) whereas none of the dietary components were associated with risk of URTI. Conclusions: Overall adherence to the NNR was moderately good. Overall adherence to the NNR was not associated with URTI risk in our study. However, when investigating individual components of the NNR, we found that high physical activity was associated with lower URTI risk.
  • Fondell, Elinor, et al. (författare)
  • Dietary Intake and Supplement Use of Vitamins C and E and Upper Respiratory Tract Infection
  • 2011
  • Ingår i: Journal of the American College of Nutrition (Print). - ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD. - 0731-5724. ; 30:4, s. 248-258
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: Antioxidants are regulators of immune function and may play a role in upper respiratory tract infections (URTI). We investigated the potential effects of dietary intake from food and supplement use of vitamins C and E on the risk of self-reported URTI. Methods: We conducted a population-based cohort study of 1509 Swedish men and women ages 20 to 60 with a follow-up period of 4 months. Participants reported a total of 1181 occurrences of URTI. Poisson regression model was used to control for age, sex, and other confounding factors. Results: Among women, we found that the incidence rate ratio (IRR) for high intake of vitamin C (>200 mg/d) from food was 0.69 (95% CI 0.49-0.98) compared with low intake (<100 mg/d). This association was not seen among men, for whom the IRR was 1.16 (95% CI 0.79-1.70) for high intake of vitamin C (>150 mg/d) compared with low intake (<50 mg/d). We saw no protective effect of vitamin E from food among either men or women, but a possible protective effect of vitamin C and E supplement use among men (vitamin C, 0.69 [95% CI 0.47-1.02]; vitamin E, 0.56 [95% CI 0.33-0.95]), although not among women. Conclusion: The present study is the first observational study to suggest that intake of vitamin C from food is sufficient to lower the risk of URTI among women. In addition, it appears that supplement use of vitamin E and vitamin C may reduce the risk of URTI among men, who overall had a lower intake of vitamin C from food than women.
  • Fondell, Elinor, et al. (författare)
  • Physical Activity, Stress, and Self-Reported Upper Respiratory Tract Infection
  • 2011
  • Ingår i: Medicine & Science in Sports & Exercise. - LIPPINCOTT WILLIAMS & WILKINS. - 0195-9131. ; 43:2, s. 272-279
  • Tidskriftsartikel (refereegranskat)abstract
    • FONDELL, E., Y. T. LAGERROS, C. J. SUNDBERG, M. LEKANDER, O. BALTER, K. J. ROTHMAN, and K. BALTER. Physical Activity, Stress, and Self-Reported Upper Respiratory Tract Infection. Med. Sci. Sports Exerc., Vol. 43, No. 2, pp. 272-279, 2011. Purpose: Upper respiratory tract infection (URTI) is the most common reason for seeking primary care in many countries. Still, little is known about potential strategies to reduce susceptibility. We investigated the relationships between physical activity level, perceived stress, and incidence of self-reported URTI. Methods: We conducted a population-based prospective cohort study of 1509 Swedish men and women aged 20-60 yr with a follow-up period of 4 months. We used a Web-based questionnaire to assess disease status and lifestyle factors at the start of the study. We assessed physical activity and inactivity as total MET-hours (MET task) per day and perceived stress by the 14-item Perceived Stress Scale. Participants were contacted every 3 wk via e-mail to assess incidence of URTI. They reported a total of 1181 occurrences of URTI. We used Poisson regression models to control for age, sex, and other potential confounding factors. Results: We found that high levels of physical activity (>= 55 MET.h.d(-1)) were associated with an 18% reduced risk (incidence rate ratio (IRR) = 0.82, 95% confidence interval (CI) = 0.69-0.98) of self-reporting URTI compared with low levels of physical activity (< 45 MET.h.d(-1)). This association was stronger among those reporting high levels of stress (IRR = 0.58, 95% CI = 0.43-0.78), especially among men (IRR = 0.37, 95% CI = 0.24-0.59), but absent in the group with low levels of stress. Conclusions: We found that high physical activity was associated with a lower risk of contracting URTI for both men and women. In addition, we found that highly stressed people, particularly men, appear to benefit more from physical activity than those with lower stress levels.
  • Henriksson, Hanna, et al. (författare)
  • A New Mobile Phone-Based Tool for Assessing Energy and Certain Food Intakes in Young Children A Validation Study
  • 2015
  • Ingår i: JMIR mhealth and uhealth. - JMIR publications. ; 3:2
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Childhood obesity is an increasing health problem globally. Obesity may be established already at pre-school age. Further research in this area requires accurate and easy-to-use methods for assessing the intake of energy and foods. Traditional methods have limited accuracy, and place large demands on the study participants and researchers. Mobile phones offer possibilities for methodological advancements in this area since they are readily available, enable instant digitalization of collected data, and also contain a camera to photograph pre- and post-meal food items. We have recently developed a new tool for assessing energy and food intake in children using mobile phones called the Tool for Energy Balance in Children (TECH). Objective: The main aims of our study are to (1) compare energy intake by means of TECH with total energy expenditure (TEE) measured using a criterion method, the doubly labeled water (DLW) method, and (2) to compare intakes of fruits and berries, vegetables, juice, and sweetened beverages assessed by means of TECH with intakes obtained using a Web-based food frequency questionnaire (KidMeal-Q) in 3 year olds. Methods: In this study, 30 Swedish 3 year olds were included. Energy intake using TECH was compared to TEE measured using the DLW method. Intakes of vegetables, fruits and berries, juice, as well as sweetened beverages were assessed using TECH and compared to the corresponding intakes assessed using KidMeal-Q. Wilcoxon matched pairs test, Spearman rank order correlations, and the Bland-Altman procedure were applied. Results: The mean energy intake, assessed by TECH, was 5400 kJ/24h (SD 1500). This value was not significantly different (P=.23) from TEE (5070 kJ/24h, SD 600). However, the limits of agreement (2 standard deviations) in the Bland-Altman plot for energy intake estimated using TECH compared to TEE were wide (2990 kJ/24h), and TECH overestimated high and underestimated low energy intakes. The Bland-Altman plots for foods showed similar patterns. The mean intakes of vegetables, fruits and berries, juice, and sweetened beverages estimated using TECH were not significantly different from the corresponding intakes estimated using KidMeal-Q. Moderate but statistically significant correlations (ρ=.42-.46, P=.01-.02) between TECH and KidMeal-Q were observed for intakes of vegetables, fruits and berries, and juice, but not for sweetened beverages. Conclusion: We found that one day of recordings using TECH was not able to accurately estimate intakes of energy or certain foods in 3 year old children.
  • Raposo, S. E., et al. (författare)
  • Intake of vitamin C, vitamin E, selenium, zinc and polyunsaturated fatty acids and upper respiratory tract infection-a prospective cohort study
  • 2017
  • Ingår i: European Journal of Clinical Nutrition. - NATURE PUBLISHING GROUP. - 0954-3007. ; 71:4, s. 450-457
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND/OBJECTIVES: Antioxidants and polyunsaturated fatty acids (PUFAs) have a role in the human immune defense and may affect the susceptibility to upper respiratory tract infection (URTI). To examine dietary intake of vitamin C, vitamin E, selenium, zinc and PUFAs in relation to URTI incidence in a prospective cohort study. SUBJECTS/METHODS: A total of 1533 Swedish women and men aged 25-64 years were followed for nine months during 2011-2012. Information on dietary intake was assessed through a web-based food frequency questionnaire, and events of URTI were self-reported prospectively as they occurred. Cox proportional hazards regression was applied to obtain incidence rate ratios with 95% confidence intervals. RESULTS: The mean number of URTI events was 0.9 among all participants, 1.0 among women and 0.7 among men. In women, the incidence rate ratios ( 95% confidence interval) for high compared with low intake were 0.69 (0.55-0.88) for vitamin C, 0.77 (0.62-0.96) for vitamin E, 0.57 (0.39-0.83) for docosahexaenoic acid (DHA) and 0.80 (0.65-0.99) for arachidonic acid ( AA). No association was found for selenium or zinc among women. In men, an increased URTI incidence was seen with medium vitamin E intake (1.42 (1.09-1.85)) and high zinc intake (1.50 (1.04-2.16)). No association was found for vitamin C, selenium or PUFAs among men. CONCLUSIONS: We found an inverse association of URTI incidence among women for vitamin C, vitamin E, DHA and AA intake and a positive association among men for vitamin E and zinc intake. The observed gender differences warrant further investigation.
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