| 1. |
- Baker, Jennifer L, et al.
(författare)
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Breastfeeding reduces postpartum weight retention
- 2009
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Ingår i: American Journal of Clinical Nutrition. - : Elsevier BV. - 1938-3207 .- 0002-9165. ; 88:6, s. 1543-51
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Weight gained during pregnancy and not lost postpartum may contribute to obesity in women of childbearing age. OBJECTIVE: We aimed to determine whether breastfeeding reduces postpartum weight retention (PPWR) in a population among which full breastfeeding is common and breastfeeding duration is long. DESIGN: We selected women from the Danish National Birth Cohort who ever breastfed (>98%), and we conducted the interviews at 6 (n = 36 030) and 18 (n = 26 846) mo postpartum. We used regression analyses to investigate whether breastfeeding (scored to account for duration and intensity) reduced PPWR at 6 and 18 mo after adjustment for maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG). RESULTS: GWG was positively (P < 0.0001) associated with PPWR at both 6 and 18 mo postpartum. Breastfeeding was negatively associated with PPWR in all women but those in the heaviest category of prepregnancy BMI at 6 (P < 0.0001) and 18 (P < 0.05) mo postpartum. When modeled together with adjustment for possible confounding, these associations were marginally attenuated. We calculated that, if women exclusively breastfed for 6 mo as recommended, PPWR could be eliminated by that time in women with GWG values of approximately 12 kg, and that the possibility of major weight gain (>or=5 kg) could be reduced in all but the heaviest women. CONCLUSION: Breastfeeding was associated with lower PPWR in all categories of prepregnancy BMI. These results suggest that, when combined with GWG values of approximately 12 kg, breastfeeding as recommended could eliminate weight retention by 6 mo postpartum in many women.
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| 2. |
- Lissner, Lauren, 1956, et al.
(författare)
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Monitoring the Obesity Epidemic into the 21st Century - Weighing the Evidence.
- 2013
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Ingår i: Obesity facts. - : S. Karger AG. - 1662-4033 .- 1662-4025. ; 6:6, s. 561-565
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Tidskriftsartikel (refereegranskat)abstract
- According to recent literature the obesity epidemic in adults and particularly in children seems to have stabilized or receded since the end of the 20th century [1,2]. Many of the encouraging trends toward stabilization have occurred simultaneously in different parts of the world. However, there may be some biases in the data being reported that could explain these trends, to which we will draw attention in the sections below. Besides statistical biases and distortions in the data itself, there may be interpretation biases of a less statistical nature. This paper is not intended to systematically review all publications on the course of the epidemic or discuss study-specific biases in detail, but rather intends to highlight the most relevant sources of bias while offering selected examples of such biases from the literature. We will first review several classic sources of bias in survey data describing secular trends in obesity, which have been frequently discussed in terms of how they might affect conclusions regarding the course of the obesity epidemic. In addition, we will describe sources of bias in what we are looking at and how we are looking at it, which may distort conclusions regarding the obesity epidemic.
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| 3. |
- Lissner, Lauren, 1956, et al.
(författare)
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Secular increases in waist-hip ratio among Swedish women
- 1998
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Ingår i: International Journal of Obesity. ; 22, s. 1116-1120
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Tidskriftsartikel (refereegranskat)abstract
- Department of Internal Medicine, Sahlgrenska University Hospital, Göteborg University, Sweden. INTRODUCTION: Secular increases in obesity have been documented in numerous populations. However, little is known about trends in fat distribution. Because men and women with elevated waist-hip ratios (WHR) constitute a high cardiovascular risk group, it is relevant to document secular changes in WHR. This paper compares WHR in three cohorts of women, one cohort recruited in the late 1960s and the others after 12 y and 24 y intervals. SUBJECTS AND METHODS: In 1968-1969, a randomly selected sample of women aged of 38 y and 50 y, was given anthropometric examinations (n = 761, total). The same measurements were taken on representative cohorts aged 38 y and 50 y in 1980-1981 (n = 677) and 1992-1993 (n = 167). All analyses of trends in WHR as a function of time are age-specific and body mass index (BMI)-adjusted. RESULTS: An interesting feature of this population is that BMI was stable from 1968-1969 to 1992-1993. However, WHR increased significantly in those aged 38 y and 50 y, independent of BMI (P = 0.001, both ages). The source of these changes in WHR was a combination of increasing waist circumferences and decreasing hip circumferences. Skinfold measurements, taken only at the first two examinations, also increased significantly. CONCLUSIONS: This female population appears to have experienced some changes in body shape and composition. However, we cannot explain the increasingly centralized fat patterning by changes in BMI, subcutaneous skinfold thickness or those obesity-related aspects of the modern lifestyle that we were able to measure. PMID: 9822951 [PubMed - indexed for MEDLINE]
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| 4. |
- Pedersen, Peder J, et al.
(författare)
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Influence of psychosocial factors on postpartum weight retention
- 2011
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Ingår i: Obesity. - : Wiley. - 1930-7381. ; 19:3, s. 639-646
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Tidskriftsartikel (refereegranskat)abstract
- For some women, pregnancy may increase the risk of future obesity with consequences for health and well-being. Psychosocial factors may be partly responsible for this. The aim of this study was to examine the association between psychosocial factors during pregnancy and postpartum weight retention (PPWR) at 6 and 18 months. A total of 37,127 women in The Danish National Birth Cohort (DNBC; 1996-2002) participated in four telephone interviews before and after delivery. They gave information about their experience of distress, depression and anxiety, social support, and psychosocial burdens during pregnancy. PPWR was defined as retention >/=5 kg at 6 and 18 months postpartum according to a woman's prepregnancy weight. The associations were examined by use of logistic regression and presented as odds radios with 95% confidence intervals. Women who were more likely to feel depressed/anxious or distressed during pregnancy had a higher risk of PPWR at 6 months (1.35 (1.27; 1.44) and 1.30 (1.22; 1.38)) and 18 months (1.34 (1.24; 1.45) and 1.32 (1.23; 1.42)). Likewise, women who felt burdened by their economy or working situation had a higher risk of PPWR as did women with the lowest incomes or less education. Women who reported a high level of distress or depression/anxiety both during pregnancy and in the first 6 months of motherhood had the highest risk of PPWR 18 months postpartum (1.54 (1.39; 1.71) and 1.49 (1.32; 1.69), respectively). Feeling distressed, depressed, or anxious during pregnancy was associated with higher PPWR as was personal and economical burdens. Adverse psychosocial characteristics may be a common determinant of weight retention after childbirth.
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| 5. |
- Doring, Nora, et al.
(författare)
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Primary prevention of childhood obesity through counselling sessions at Swedish child health centres : design, methods and baseline sample characteristics of the PRIMROSE cluster-randomised trial
- 2014
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 14:335
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Tidskriftsartikel (refereegranskat)abstract
- Background: Childhood obesity is a growing concern in Sweden. Children with overweight and obesity run a high risk of becoming obese as adults, and are likely to develop comorbidities. Despite the immense demand, there is still a lack of evidence-based comprehensive prevention programmes targeting pre-school children and their families in primary health care settings. The aims are to describe the design and methodology of the PRIMROSE cluster-randomised controlled trial, assess the relative validity of a food frequency questionnaire, and describe the baseline characteristics of the eligible young children and their mothers. Methods/Design: The PRIMROSE trial targets first-time parents and their children at Swedish child health centres (CHC) in eight counties in Sweden. Randomisation is conducted at the CHC unit level. CHC nurses employed at the participating CHC received training in carrying out the intervention alongside their provision of regular services. The intervention programme, starting when the child is 8-9 months of age and ending at age 4, is based on social cognitive theory and employs motivational interviewing. Primary outcomes are children's body mass index and waist circumference at four years. Secondary outcomes are children's and mothers' eating habits (assessed by a food frequency questionnaire), and children's and mothers' physical activity (measured by accelerometer and a validated questionnaire), and mothers' body mass index and waist circumference. Discussion: The on-going population-based PRIMROSE trial, which targets childhood obesity, is embedded in the regular national (routine) preventive child health services that are available free-of-charge to all young families in Sweden. Of the participants (n = 1369), 489 intervention and 550 control mothers (75.9%) responded to the validated physical activity and food frequency questionnaire at baseline (i.e., before the first intervention session, or, for children in the control group, before they reached 10 months of age). The food frequency questionnaire showed acceptable relative validity when compared with an 8-day food diary. We are not aware of any previous RCT, concerned with the primary prevention of childhood obesity through sessions at CHC that addresses healthy eating habits and physical activity in the context of a routine child health services programme.
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| 6. |
- Hansson, Lena M., et al.
(författare)
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Associations Between Swedish Mothers' and 3-and 5-Year-Old Children's Food Intake
- 2016
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Ingår i: Journal of nutrition education and behavior. - : Elsevier BV. - 1499-4046 .- 1878-2620. ; 48:8, s. 520-529.e1
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate associations between mothers' and children's food intake. Design: Cross-sectional study. Background variables collected through self-reports and from the register of the total population. Mothers recorded their own and their children's food intake in a diary during 2 4-day periods. Setting: Eight counties in mid Sweden. Participants: Three-and 5-year-old children and their mothers were randomly selected from the register of the total population. A total of 2,045 families were invited, 355 of whom accepted. Mothers who accepted were older and to a larger extent born in Sweden. The final sample of mother-child pairs with complete food records was 189. Main Outcome Measures: Mothers' and children's food intake (16 food items). Analysis: Spearman rank-order correlation with 95% confidence intervals (2-sided). Moderation was investigated using generalized estimation equations with robust variance. Results: The strongest correlations between mothers' and children's food intake were found for pizza and oily fish (r = .70-.80). The weakest correlations were found for sugared drinks and fruit and berries (r = .24-.26). Children's age moderated the relationship between mothers' and children's intake of savoury snacks, as did place of residence for pizza intake. Conclusions and Implications: There were substantial correlations between children's and mothers' intake of various foods. Modeling of mothers' intake might be more effective in influencing young children's intake of certain foods, whereas other strategies, such as encouraging parents to influence food availability (eg, gatekeeping), might be more useful for some foods.
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| 7. |
- Heitmann, Berit L, et al.
(författare)
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Can adverse effects of dietary fat intake be overestimated as a consequence of dietary fat underreporting?
- 2005
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Ingår i: Public Health Nutrition. ; 8, s. 1332-1337
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Tidskriftsartikel (refereegranskat)abstract
- Research Unit for Dietary Studies and Danish Epidemiology Science Centre, Institute of Preventive Medicine, Copenhagen University Hospital, DK-1399 Copenhagen K, Denmark. blh@ipm.hosp.dk OBJECTIVE: To describe the consequences of systematic reporting bias by the obese for diet-disease relationships. DESIGN: The present report used 24-hour urinary nitrogen and estimates of 24-hour energy expenditure to assess error in diet reporting, and examined the consequence of accounting for this error for associations between dietary fat intake and serum low-density lipoprotein (LDL)-cholesterol. SETTING: Sub-study to the Danish MONICA (Monitoring Trends and Determinants in Cardiovascular Disease) project, carried out in 1987-1988. SUBJECTS: A random sub-sample of the adult Danish male population (n = 152). RESULTS: Correcting dietary fat for underreporting error weakened, rather than strengthened, the association between dietary fat intake and LDL-cholesterol by reducing the slope of the regression from beta = 3.4, P = 0.02 to beta = 2.7, P = 0.04. CONCLUSION: This example illustrates that systematic underreporting of dietary fat by high-risk groups such as the obese may produce an overestimated association. These results imply that previous epidemiological studies showing a positive association between percentage of energy from fat and other health outcomes, e.g. cancer and heart disease, may have overestimated the negative effects of a high-fat diet. If we were able to correctly assess dietary fat intake in general populations, recommendations for fat intake may be more liberal than the 30% suggested today. Improved assessment of fat intake in epidemiological studies is necessary for future development of evidence-based recommendations for diet and health . PMID: 16372929 [PubMed - indexed for MEDLINE]
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| 8. |
- Heitmann, Berit L, et al.
(författare)
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Childhood obesity: successes and failures of preventive interventions
- 2009
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Ingår i: Nutrition Reviews. - 1753-4887. ; 67:Suppl 1, s. 89-93
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Tidskriftsartikel (refereegranskat)abstract
- Despite progress toward assuring the health of today's young population, the 21(st) century began with an epidemic of childhood obesity. There is general agreement that the situation must be addressed by means of primary prevention, but relatively little is known about how to intervene effectively. The evidence behind the assumption that childhood obesity can be prevented was discussed critically in this roundtable symposium. Overall, there was general agreement that action is needed and that the worldwide epidemic itself is sufficient evidence for action. As the poet, writer, and scholar Wittner Bynner (1881-1968) wrote, "The biggest problem in the world could have been solved when it was small".
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| 9. |
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| 10. |
- Heitmann, Berit L, et al.
(författare)
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Dietary underreporting by obese individuals--is it specific or non-specific?
- 1995
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Ingår i: British Medical Journal. ; 311, s. 986-989
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Tidskriftsartikel (refereegranskat)abstract
- Danish Epidemiology Science Centre, Institute of Preventive Medicine, Copenhagen, Denmark. OBJECTIVE--To examine the distribution of patterns of macronutrient density in relation to obesity. DESIGN--Cross sectional. SETTING--Denmark. SUBJECTS--323 men and women aged 35-65 years, selected randomly from a larger population sample of Danish adults. MAIN OUTCOME MEASURE--Bias in dietary reporting of energy and protein intake in relation to percentage body fat, assessed by comparison of data from an interview on dietary intake with data estimated from 24 hour nitrogen output, validated by administering p-aminobenzoic acid, and estimated 24 hour energy expenditure. RESULTS--Degree of obesity was positively associated with underreporting of total energy and protein, whereas compared with total energy reported, protein was overreported by the obese subjects. CONCLUSION--Errors in dietary reporting of protein seem to occur disproportionately with respect to total energy, suggesting a differential reporting pattern of different foods. Although, on average, all subjects showed a greater underreporting of energy than of protein, this was most common in the obese subjects. Snack-type foods may be preferentially forgotten when obese people omit food items in dietary reporting. These results seem to agree with the general assumption that obese people tend to underreport fatty foods and foods rich in carbohydrates rather than underreport their total dietary intake. These results may have implications for the interpretation of studies of diet and comorbidities related to obesity. PMID: 7580640 [PubMed - indexed for MEDLINE]
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