| 1. |
- Bälter, Katarina, et al.
(författare)
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The effect of dietary guidelines on cancer risk and mortality
- 2012
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Ingår i: Current Opinion in Oncology. - : LIPPINCOTT WILLIAMS & WILKINS. - 1040-8746 .- 1531-703X. ; 24:1, s. 90-102
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Forskningsöversikt (refereegranskat)abstract
- Purpose of review Dietary guidelines are important tools for educating the general public and helping health professionals promote good health and prevent chronic diet-related diseases. However, it is of major public health relevance that the effect of the guidelines per se is evaluated to make sure that they serve their purpose. The aim of this article is to review the current research on dietary guidelines and their effect on cancer risk and mortality. Recent findings Since the last 30-40 years, most industrialized countries have had dietary guidelines. The guidelines are based on thorough reviews of the current scientific evidence regarding dietary intake and health. Potential health benefits associated with good adherence to the guidelines have been evaluated in observational studies during the last 15 years, with an increase in the number of studies during the most recent years. Summary Available data on the potential association between dietary guidelines and cancer are limited and inconclusive. A meta-analysis of studies on overall cancer risk shows no protective effect for good adherence to the dietary guidelines as compared with poor adherence. However, good adherence was associated with a 21% reduced risk of colorectal cancer, and 22% reduced cancer-specific mortality.
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| 2. |
- Bälter, Olle, 1962-, et al.
(författare)
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Feedback in web-based questionnaires as incentive to increase compliance in studies on lifestyle factors
- 2012
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Ingår i: Public Health Nutrition. - : Cambridge University Press. - 1368-9800 .- 1475-2727. ; 15:6, s. 982-988
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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.
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| 3. |
- Fondell, Elinor, et al.
(författare)
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Adherence to the Nordic Nutrition Recommendations as a measure of a healthy diet and upper respiratory tract infection
- 2011
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Ingår i: Public Health Nutrition. - : CAMBRIDGE UNIV PRESS. - 1368-9800 .- 1475-2727. ; 14:5, s. 860-869
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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.
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| 4. |
- Fondell, Elinor, et al.
(författare)
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Physical Activity, Stress, and Self-Reported Upper Respiratory Tract Infection
- 2011
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Ingår i: Medicine & Science in Sports & Exercise. - : LIPPINCOTT WILLIAMS & WILKINS. - 0195-9131 .- 1530-0315. ; 43:2, s. 272-279
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Tidskriftsartikel (refereegranskat)abstract
- 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.
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| 5. |
- Fondell, Elinor, et al.
(författare)
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Short natural sleep is associated with higher T cell and lower NK cell activities
- 2011
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Ingår i: Brain, behavior, and immunity. - : Elsevier BV. - 0889-1591 .- 1090-2139. ; 25:7, s. 1367-1375
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Tidskriftsartikel (refereegranskat)abstract
- Short sleep duration increases the risk of several diseases, possibly involving compromised immune function. However, most previous studies are based on experimentally induced sleep deprivation, and only a few have studied natural variations in sleep duration. Thus our aim was to study how natural variations in sleep duration affect immune function. In total, 36 healthy men and women, aged 20-54, donated blood; 29 on three consecutive mornings, and seven on one morning. Each morning, participants self-reported sleep duration the night prior to blood draw. General sleep patterns, physical activity and stress were also assessed. A flow-cytometric assay was used to measure natural killer cell activity (NKCA), T cell function (in response to PHA, influenza, and SEA+B), and B cell function (in response to PWM) per volume whole blood. Short sleep duration prior to blood draw (<7h) was associated with 49% higher PHA-induced T cell function (95% CI 7/109%) and 30% lower NKCA compared with normal prior sleep (7-9h) (95% CI -46/-8%). In addition, high perceived stress was associated with 39% higher PHA-induced T cell function (95% CI 0/94%). High general physical activity was associated with 47% increased numbers of B cells and 28% increased numbers of T cells, but not with immune function. Our results suggest strong relationships between short sleep duration and T- and NK-cell functions. The stability of the findings as well as the clinical consequences of the link between short sleep and immune function should be explored in future studies.
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| 6. |
- Fondell, Elinor
(författare)
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Web-based studies of lifestyle factors and immune function
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Upper respiratory tract infection (URTI), is estimated to cost $40 billion per year in the US, not including the cost of influenza, and is the most common reason for seeking primary care in many countries. Despite this, little is known about how to decrease susceptibility. Lifestyle factors such as physical activity, stress, sleep, and diet are important modulators of immune function and in this thesis, five papers evaluating the use of Internet for data collection, and the association of lifestyle factors to URTI and immune function in blood, are described. In Paper I, the feasibility of using Web questionnaires compared with traditional paper questionnaires in a population-based setting was investigated. The use of interactive Web-based questionnaires resulted in lower initial response rate but similar total response-rates on follow-up questionnaires. Based on these findings, we conducted a population-based Web cohort study of 1509 Swedish men and women aged 20-60 with a follow-up period of four months (Papers II-IV). Participants reported a total of 1181 occurrences of URTI. In Paper II, results show that high levels of physical activity (≥55 MET-hours/d, MET, metabolic equivalent task) were associated with an 18% reduced risk of self-reporting URTI compared with low levels of physical activity (<45 MET-hours/d) (IRR 0.82, 95% CI 0.69-0.98). In addition, highly stressed people, particularly men, appeared to benefit more from physical activity than those reporting lower stress levels. When studying intake of antioxidants and URTI risk in Paper III, we found that a high intake of vitamin C from food (>200 mg/d) was associated with a 31% lower risk of URTI compared with a low intake (<100 mg/d) (IRR 0.69, 95% CI 0.49-0.98) among women. This association was not seen among men, who overall had a lower intake of vitamin C than women. In Paper IV, we assessed adherence to the Nordic Nutrition Recommendations (NNR) as a measure of an overall healthy diet. The NNR include recommendations on macronutrients (e.g. saturated fat), micronutrients (vitamins and minerals), fiber, sodium, alcohol, and physical activity. Good adherence versus poor adherence to the NNR was not associated with risk of URTI in this study. In Paper V the natural variations of sleep duration, stress, physical activity, leukocyte numbers, and their function was examined in 36 men and women, aged 20-54. Results show that short sleep duration (<7h) prior to blood draw was associated with a 49% higher T cell function (95% CI 7/109%) in response to phytohemagglutinin (PHA) and 30% lower natural killer cell activity (NKCA) (95% CI -46/-8%) compared with normal prior sleep (7-9h). Results also indicate that high general perceived stress was associated with a 39% higher T cell function in response to PHA (95% CI 0/94%), and that high general physical activity was associated with an increased number of B cells and T cells, but general physical activity was not clearly associated with immune cell function. In conclusion, we found that Web questionnaires can be useful for research purposes in populations with high proportion of Internet users, especially when multiple follow-ups are needed. Paper II and III conclude that lifestyle factors such as physical activity, stress, and diet are associated with risk of self-reported URTI. However, no association was seen between good adherence to the NNR and URTI, which may be explained by the fact that the participants were generally very well-nourished and with a limited variation in the NNR score (Paper IV). In Paper V, we found that lifestyle factors were related to immunological markers in blood. Natural short sleep duration was associated with lower NKCA, which might impair ability to fight infections.
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