| 1. |
- Alimoradi, Z., et al.
(författare)
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Prevalence of household food insecurity and its predictive role on the health of mothers with children aged under 60 months
- 2022
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Ingår i: Clinical Nutrition ESPEN. - : Elsevier. - 2405-4577. ; 51, s. 246-252
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Tidskriftsartikel (refereegranskat)abstract
- Background: Food insecurity can have poor physical and mental health consequences for all family members. The present study investigated the prevalence of household food insecurity and its predictive role on the health of mothers of children aged under 60 months in Qazvin (Iran). Methods: A cross-sectional study was carried out between January 2019 and December 2020. Participants included all mothers with children aged under 60 months who referred themselves to comprehensive health centers in Qazvin (N = 1750; mean age 30.61 years). Convenience sampling was performed. Data were collected using a demographic information checklist, the General Health Questionnaire (GHQ) and the Household Food Insecurity Access Scale (HFIAS). Data analysis was performed using independent t-tests, one-way analyses of variance, uni-variable and multivariable linear regression with a significance level of p < 0.05. Results: Two-thirds of the participants had a secure food status (68.4%). Household food security status showed a significant, and inverse relationship with general health subscales. General health subscales of depression (standardized mean difference or SMD: −1.24 [95% CI: −1.36; −1.13]), somatic symptoms (SMD: −0.92 [95% CI: −1.03; −0.81]) and anxiety and insomnia (SMD: −0.72 [95% CI: −0.83; −0.61]) were significantly lower among food secure participants vs. food insecure participants. Social dysfunction was not significantly associated with household food security. The regression models demonstrated that household food security was a significant predictor for the health of mothers with children aged under 60 months: uni-variable (β = −0.38) and multivariable (β = −0.41). Conclusion: Household food security is associated with various aspects of mothers’ health. Since the growth and development of a healthy child depends on having a healthy mother, the food security situation of the family and the general health of mother can be assessed as part of providing health service regarding monitoring growth and development of children. This will help in targeting appropriate interventions if needed.
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| 2. |
- Baban, Bayar, 1973-, et al.
(författare)
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Altered insulin sensitivity and immune function in patients with colorectal cancer
- 2023
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Ingår i: Clinical Nutrition ESPEN. - : Elsevier. - 2405-4577. ; 58, s. 193-200
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Tidskriftsartikel (refereegranskat)abstract
- Background & aims: Insulin resistance and chronic inflammation have been reported in patients with cancer. However, many of the underlying mechanisms and associations are yet to be unveiled. We examined both the level of insulin sensitivity and markers of inflammation in patients with colorectal cancer for comparison to controls.Methods: Clinical exploratory study of patients with colorectal cancer (n = 20) and matched controls (n = 10). Insulin sensitivity was quantified using the hyperinsulinemic normoglycemic clamp and blood samples were taken for quantification of several key, both intra- and extracellular, inflammatory markers. We analysed the differences in these parameters between the two groups.Results: Patients exhibited both insulin resistance (M-value, patients median (Mdn) 4.57 interquartile range (IQR) 3.49-5.75; controls Mdn 5.79 (IQR 5.20-6.81), p = 0.049), as well as increased plasma levels of the pro-inflammatory cytokines IL-1b(patients Mdn 0.48 (IQR 0.33-0.58); controls Mdn 0.36 (IQR 0.29-0.42), p = 0.02) and IL-6 (patients Mdn 3.21 (IQR 2.31-4.93); controls Mdn 2.16 (IQR 1.50-2.65), p = 0.02). The latter is present despite an almost two to three fold decrease (p < 0.01) in caspase-1 activity, a facilitating enzyme of IL-1b production, within circulating immune cells.Conclusion: Patients with colorectal cancer displayed insulin resistance and higher levels of plasma IL-1b and IL-6, in comparison to matched healthy controls. The finding of a seemingly disconnect between inflammasome (caspase-1) activity and plasma levels of key pro-inflammatory cytokines in cancer patients may suggest that, in parallel to dysregulated immune cells, tumour-driven inflammatory pathways also are in effect.
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| 3. |
- Baban, Bayar, 1973-, et al.
(författare)
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Inflammasome activation, colonic cancer and glucose metabolism
- 2016
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Ingår i: Clinical Nutrition ESPEN. - : Elsevier. - 2405-4577. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To study the association between inflammasome activation (a potent initiator of inflammation acting via caspase-1 and maturation of interleukin-1β), colonic cancer and glucose metabolism.Methods: Five patients with colon cancer and ten matched controls without cancer were measured for insulin sensitivity using the hyperinsulinemic euglycemic clamp. For detection of inflammasome activation the caspase-1 activity, determined by detecting FLICA using flow cytometry, was measured in both monocytes and granulocytes at the start of, and at 120 minutes into the clamp. Descriptive and analytical statistics were performed using nonparametric methods by SPSS.Results: There was no difference in levels of insulin sensitivity between the two groups (p=0.09). The cancer patients had significantly lower levels of caspase-1 both in monocytes (p<0.05) and granulocytes (p<0.05) compared with the controls. However both patients and controls had significantly higher levels of both mono- and granulocyte caspase-1 activity at 120 minutes into the clamp as compared to at start (p<0.05). Patients showed an overall higher relative increase in caspase-1 during the clamp, however this finding did not reach statistical significance (monocytes; p=0.27, granulocytes; p=0.22).
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| 4. |
- Brook, M. S., et al.
(författare)
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Omega-3 supplementation during unilateral resistance exercise training in older women : A within subject and double-blind placebo-controlled trial
- 2021
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Ingår i: Clinical Nutrition ESPEN. - : Elsevier. - 2405-4577. ; 46, s. 394-404
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND & AIMS: The skeletal muscle anabolic effects of n-3 polyunsaturated fatty acids (n-3 PUFA) appear favoured towards women; a property that could be exploited in older women who typically exhibit poor muscle growth responses to resistance exercise training (RET). Here we sought to generate novel insights into the efficacy and mechanisms of n-3 PUFA alongside short-term RET in older women.METHODS: We recruited 16 healthy older women (Placebo n = 8 (PLA): 67±1y, n-3 PUFA n = 8: 64±1y) to a randomised double-blind placebo-controlled trial (n-3 PUFA; 3680 mg/day versus PLA) of 6 weeks fully-supervised progressive unilateral RET (i.e. 6 × 8 reps, 75% 1-RM, 3/wk-1). Strength was assessed by knee extensor 1-RM and isokinetic dynamometry ∼ every 10 d. Thigh fat free mass (TFFM) was measured by DXA at 0/3/6 weeks. Bilateral vastus lateralis (VL) biopsies at 0/2/4/6 weeks with deuterium oxide (D2O) dosing were used to determine MPS responses for 0-2 and 4-6 weeks. Further, fibre cross sectional area (CSA), myonuclei number and satellite cell (SC) number were assessed, alongside muscle anabolic/catabolic signalling via immunoblotting.RESULTS: RET increased 1-RM equally in the trained leg of both groups (+23 ± 5% n-3 PUFA vs. +25 ± 5% PLA (both P < 0.01)) with no significant increase in maximum voluntary contraction (MVC) (+10 ± 6% n-3 PUFA vs. +13 ± 5% PLA). Only the n-3 PUFA group increased TFFM (3774 ± 158 g to 3961 ± 151 g n-3 PUFA (P < 0.05) vs. 3406 ± 201 g to 3561 ± 170 PLA) and type II fibre CSA (3097 ± 339 μm2 to 4329 ± 264 μm2 n-3 PUFA (P < 0.05) vs. 2520 ± 316 μm2 to 3467 ± 303 μm2 in PL) with RET. Myonuclei number increased equally in n-3 PUFA and PLA in both type I and type II fibres, with no change in SC number. N-3 PUFA had no added benefit on muscle protein synthesis (MPS), however, during weeks 4-6 of RET, absolute synthesis rates (ASR) displayed a trend to increase with n-3 PUFA only (5.6 ± 0.3 g d-1 to 7.1 ± 0.5 g d-1 n-3 PUFA (P = 0.09) vs. 5.5 ± 0.5 g d-1 to 6.5 ± 0.5 g d-1 PLA). Further, the n-3 PUFA group displayed greater 4EBP1 activation after acute RE at 6 weeks.CONCLUSION: n3-PUFA enhanced RET gains in muscle mass through type II fibre hypertrophy, with data suggesting a role for MPS rather than via SC recruitment. As such, the present study adds to a literature base illustrating the apparent enhancement of muscle hypertrophy with RET in older women fed adjuvant n3-PUFA.
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| 5. |
- Bärebring, Linnea, et al.
(författare)
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A validated screening tool correctly identifies the majority of pregnant women at high risk of vitamin D deficiency
- 2022
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Ingår i: Clinical Nutrition Espen. - : Elsevier BV. - 2405-4577. ; 49, s. 301-306
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Tidskriftsartikel (refereegranskat)abstract
- Background & aim: The objective was to develop and validate a non-invasive screening tool to identify pregnant women at high risk of vitamin D deficiency. Methods: Data from the Swedish prospective cohort GraviD, 2125 pregnant women, were randomly split in halves; one for developing the screening tool, and one for validation. Risk factors of vitamin D deficiency (serum 25-hydroxyvitamin D < 30 nmol/L) were identified using logistic regression analyses and odds ratios were translated into scores. Cutt offs to indicate high risk of vitamin D deficiency were evaluated by receiver operator characteristics. Results: Five variables (season, clothing, eye color, fortified milk intake and vitamin D supplement use) were included in the screening tool. The possible total score was 0-42. Mean (95% CI) area under the curve for classification of vitamin D deficiency was 0.921 (0.893-0.948) (p < 0.001). A score of >15 points had 92% sensitivity and 76% specificity to identify women with 25OHD <30 nmol/L. This cut off had a positive predictive value of 31% and a negative predictive value of 99%. Conclusion: This short non-invasive screening tool is valid as it correctly identified the majority of the vitamin D deficient pregnant women, who may benefit from further investigation for definite diagnosis and subsequent treatment.0 2022 The Author(s). Published by Elsevier Ltd on behalf of European Society for Clinical Nutrition and Metabolism. This is an open access article under the CC BY license (http://creativecommons.org/licenses/ by/4.0/).
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| 6. |
- Bärebring, Linnea, et al.
(författare)
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Use of bioelectrical impedance analysis to monitor changes in fat-free mass during recovery from colorectal cancer– a validation study
- 2020
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Ingår i: Clinical Nutrition ESPEN. - : Elsevier BV. - 2405-4577. ; 40, s. 201-207
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Tidskriftsartikel (refereegranskat)abstract
- Background & aims: Although previous research show high correlation between fat-free mass (FFM) measured by bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA), the validity of BIA to track longitudinal changes in FFM is uncertain. Thus, the aim of this study was to validate the ability of BIA to assess changes in FFM during 6 months of recovery from non-metastatic colorectal cancer (CRC). Methods: A total of 136 women and men (50–80 years) with stage I-III CRC and a wide range of baseline FFM (35.7–73.5 kg) were included in the study. Body composition was measured at study baseline within 2–9 months of surgery and again 6 months later. Whole-body BIA FFM estimates (FFMBIA) were calculated using three different equations (manufacturer's, Schols' and Gray's) before comparison to FFM estimates obtained by DXA (FFMDXA). Results: Correlation between changes in FFMBIA and FFMDXA was intermediate regardless of equation (r ≈ 0.6). The difference in change of FFMBIA was significant compared to FFMDXA, using all three equations and BIA overestimated both loss and gain. However, BIA showed 100% sensitivity and about 90% specificity to identify individuals with ≥5% loss in FFM, using all three equations. Sensitivity of FFMBIA to detect a smaller loss of FFM (60–76%) or a gain in FFM of ≥5% (33–62%) was poor. Conclusion: In a well-nourished population of non-metastatic CRC patients, a single-frequency whole-body BIA device yielded imprecise data on changes in FFM, regardless of equation. BIA is thus not a valid option for quantifying changes in FFM in individuals. However, BIA could be used to identify patients with loss in FFM ≥5% in this population. The validity of BIA to monitor changes in FFM warrants further investigation before implementation in clinical praxis. © 2020 The Author(s)
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| 7. |
- Dimander, Josefin, et al.
(författare)
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Documented nutritional therapy in relation to nutritional guidelines post burn injury : a retrospective observational study
- 2023
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Ingår i: Clinical Nutrition ESPEN. - : Elsevier. - 2405-4577. ; 56, s. 222-229
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Tidskriftsartikel (refereegranskat)abstract
- Background & aims: Intensive nutritional therapy is an essential component of burn care. Regardingpost-minor burn injuries, the literature is lacking. The aim of this study was to evaluate documentednutritional therapy in relation to international guidelines after both minor and major burn injuries. The secondary aim of this study was to evaluate the adequacy of energy and protein intake compared toindividual nutritional goals post-burn injury.Methods: A retrospective observational single-centre study including patients admitted between 2017and 2019 at a burn centre in Sweden was performed. The patients included in the study were >18 years old and in need of hospital care for > 72 h post-burn injury. Information about patients' demographics,nutritional therapy, and clinical characteristics of burn injury was collected. The patients were dividedaccording to total body surface area burnt (TBSA %) into minor burn injuries (TBSA <20%) and major burninjuries (TBSA >20%). Descriptive statistics were used to analyse data. Adherence to guidelines wasestablished by comparing 24 nutritional therapy recommendations to documented treatment. If documented nutritional treatment were in accordance with guidelines, adherence was considered high(>80%), moderate (60-79.9%) or low (<59.9%).Results: One hundred thirty-four patients were included, 90 patients with minor burn injuries and 44patients with major burn injuries. Documented adherence to the nutritional guideline was overall low.After minor burn injury, 8% (2/24) of nutritional therapy recommendations had a high adherence (fatintake <35% of total energy intake and enteral nutrition as prioritized feeding route), 17% (4/24) amoderate adherence, and 75% (18/24) a low adherence. In patients treated after a major burn injury,there were two recommendations with documented high adherence (Vitamin C and Zinc); 25% (6/24)had moderate adherence, and 67% (16/24) had low adherence. In addition, quite a large amount ofmissing data was found.Adequacy of documented nutritional intake, compared to the individual documented goal, was 78%(±23%) for energy and 66% (±22%) for protein after minor burn injury. After major burn injury, the adequacy was 89% (±21%) for energy and 78% (±19%) for protein, respectively.Conclusions: This study revealed low adherence to nutritional guidelines in patients treated for minorand major burn injuries. Compared to major burn injuries, lower documented adequacy for both energyand proteins was found in minor burn injuries. Given the disparity between guidelines and documentednutritional therapy, and the lack of specific guidelines for minor burn injuries, there could be aconsiderable risk of inadequate nutritional therapy post-burn injury.
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| 8. |
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| 9. |
- Einarsson, Sandra, 1981-, et al.
(författare)
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Mapping impact factors leading to the GLIM diagnosis of malnutrition in patients with head and neck cancer
- 2020
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Ingår i: Clinical Nutrition ESPEN. - : Elsevier BV. - 2405-4577. ; 40, s. 149-155
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Tidskriftsartikel (refereegranskat)abstract
- Background & aims: In head and neck cancer, the combination of weight loss and elevated C-reactive protein levels means that patients have malnutrition as defined by the Global Leadership Initiative on Malnutrition (GLIM). This study aimed to identify impact factors for malnutrition as defined by the GLIM criteria among patients with head and neck cancer at the start of treatment and up to 12 months posttreatment.Methods: In a prospective, observational study, patient, tumour, treatment, and nutritional data from 229 patients with head and neck cancer were collected at the start of treatment and at three follow-ups (7 weeks after the start of treatment and at 3 and 12 months after the termination of treatment). These clinical variables were statistically analysed in relation to malnutrition at each follow-up using univariate and multivariate analyses. Malnutrition was defined according to the two GLIM criteria of >5% body weight loss during the last 6 months and C-reactive protein >5 mg/L.Results: The following factors were predictive for malnutrition in the multivariate analysis performed 7 weeks after the start of treatment: moderate or severe mucositis, chemoradiotherapy +/- surgery, and the need for nutritional support (total or partial use of tube feeding/parenteral nutrition). Advanced tumour stage (III-IV) was significant for malnutrition at the start of treatment and at the 7 week and 3 month follow-ups, but not at 12 months.Conclusions: Severe mucositis, chemoradiotherapy +/- surgery, and advanced tumour stage were found to be impact factors for the diagnosis of malnutrition using GLIM at different follow-up times from the start of treatment up to 12 months after the end of treatment. Few patients with head and neck cancer are diagnosed with malnutrition according to the GLIM criteria in a long-term perspective after the termination of treatment. Research on the validity of the GLIM criteria is needed to build a comprehensive evidence base of impact factors for malnutrition in head and neck cancer.
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| 10. |
- Einarsson, Sandra, 1981-, et al.
(författare)
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Mapping the frequency of malnutrition in patients with head and neck cancer using the GLIM Criteria for the Diagnosis of Malnutrition
- 2020
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Ingår i: Clinical Nutrition ESPEN. - : Elsevier. - 2405-4577. ; 37, s. 100-106
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Tidskriftsartikel (refereegranskat)abstract
- Background & aims: Patients with head and neck cancer are defined as high-risk patients for malnutrition, but the inconsistent practice of diagnosing malnutrition is a barrier in comparing studies and in assessing patients in clinical practice. The aim of the study was to describe the frequency of malnutrition over time in patients treated for head and neck cancer using the GLIM Criteria for the Diagnosis of Malnutrition.Methods: Data from a prospective observational study on patients with head and neck cancer were used (n = 210). Patients were assessed for malnutrition using the combination of one phenotypic and one etiologic criterion. The following phenotypic criteria for malnutrition were used: body weight loss (either >5% within the past six months or >10% beyond six months), body mass index (<20 kg/m2 if <70 years or <22 kg/m2 if ≥70 years), and fat free mass index measured by bioelectrical impedance analysis (<17 FFM/m2 for males and <15 FFM/m2 for females). The following etiologic criteria for malnutrition were used: reduced food intake (partial or no food intake with the need for artificial nutrition) and C-reactive protein (>5 mg/L).Results: For all eight possible combinations of GLIM, the frequency of malnutrition reached its highest point at seven weeks after the start of treatment. A total of 32% of the patients fulfilled the criteria for malnutrition using weight loss >5% within the past six months (phenotypic) in combination with C-reactive protein >5 mg/L (etiologic).Conclusions: GLIM Criteria for the Diagnosis of Malnutrition can be used to assess malnutrition in patients with head and neck cancer during treatment. Using the same criteria to define malnutrition in nutritional research will make it possible to produce multiple lines of evidence on malnutrition in head and neck cancer and its adverse effects on treatment, prognosis, and survival.
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| 11. |
- Ellegård, Lars, 1958, et al.
(författare)
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Body composition in patients with primary neuromuscular disease assessed by dual energy X-ray absorptiometry (DXA) and three different bioimpedance devices
- 2019
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Ingår i: Clinical Nutrition Espen. - : Elsevier BV. - 2405-4577. ; 29, s. 142-148
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients with primary neuromuscular disease have reduced muscle mass, and use of body mass index to assess nutritional status and body composition can therefore be questioned. Dual emission X-ray absorptiometry (DXA) can estimate muscle mass, but is not always readily available. Bioimpedance is a simple, portable and "easy to use" method for the assessment of body composition. Objectives: To assess muscle mass by DXA in 143 patients with primary neuromuscular disease and validate three bioimpedance devices; Impedimed SFB7, (BISIMPEDIMED), Xitron4200 (BISXITRON) and Tanita MC180MA (MFBIA(TANITA)). Methods: Body composition was assessed by DXA in 143, by BISIMPEDIMED in 116, by MFBIA(TANITA) in 104 and by BISXITRON in 35 patients. Results: Muscle mass assessed by DXA, and phase angle (PhA) were below reference values in all female and 96% of male patients. BISIMPEDIMED underestimated muscle mass by 6.5 +/- 14.2 kg (p < 0.001), but this could be corrected after exclusion of resistance (Ri) values > 3500 Ohm (p = 0.84). MFBIA(TANITA) over-estimated muscle mass by 30.8 +/- 9.1 kg (p < 0.001) with systematic bias, whereas BISXITRON was in agreement with DXA, and without systematic bias. Muscle mass was strongly correlated to PhA (r(PEARSON) = 0.75, p < 0.01). Conclusion: Patients with primary neuromuscular disease have proportionally more fat and less muscle mass than the population in general, despite normal BMI. Muscle mass can be assessed by bioimpedance in these patients, but performance and bias depends on device. Phase angle by bioimpedance correlates to muscle mass, and could therefore potentially be used a surrogate measure of muscle mass during follow up. (C) 2018 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.
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| 12. |
- Ellegård, L. H., et al.
(författare)
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Longitudinal changes in phase angle by bioimpedance in intensive care patients differ between survivors and non-survivors
- 2018
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Ingår i: Clinical Nutrition ESPEN. - : Elsevier BV. - 2405-4577. ; 24, s. 170-172
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Tidskriftsartikel (refereegranskat)abstract
- Background & Aims: Intensive care (ICU) patients suffer from metabolic stress, creating a catabolic state which might disturb nutritional status and body composition. Alterations in body fluid compartments by disease or massive volume resuscitation could invalidate bioimpedance hydrometry. Still bioimpedance might give other information. Methods: 52 ICU patients (35 male, 17 female, mean age 66 years), BMI 29,2 were assessed by bioimpedance spectroscopy. Phase angle (PhA) at 50 kHz was assessed. Results: On first assessment PhA was 3.7 ± 1.0°. In 26 patients reassessed after median 5 days PhA was not significantly changed, although R 50 kHz and Xc 50 kHz both increased (p = 0.047), indicating diminishing overhydration. Body weight and body cell mass decreased by 1.8 ± 5.7 and 2.8 ± 7.5 kg (p = 0.13). Fat free mass and extracellular water decreased 4.5 ± 8.9 kg (p = 0.032) and 1.5 ± 3.5 kg (p = 0.031), while CRP decreased 63 mg/l (p = 0.002). In 17 survivors PhA increased 0.62 ± 1.24° (NS), while in 9 non-survivors PhA decreased 0.24 ± 0.82° (p = 0.06), with 0.86° difference (p = 0.049) between groups. Conclusion: Phase angle by bioimpedance is very low in ICU patients and positive changes in PhA seems to reflect more favorable outcome. Bioimpedance by Body Scout appears unsuitable for the assessment of fat free mass or overhydration in ICU patients.
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| 13. |
- Engelheart, Stina, 1976-, et al.
(författare)
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Meal patterns in relation to energy and protein intake in older adults in home health care
- 2020
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Ingår i: Clinical Nutrition ESPEN. - : Elsevier BV. - 2405-4577. ; 35, s. 180-187
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Tidskriftsartikel (refereegranskat)abstract
- Background & aims: Inadequate dietary intake is common in frail elderly people, however knowledge of meal patters and their relation to dietary intake is scarce, but is important for planning meals and nutritional prevention and interventions. The aim of this study was to describe meal patterns and the relation to energy and protein intake in elderly people in home health care. Methods: In this cross-sectional study, 69 men and women ≥65 years old with a lasting need for home health care were included. A 24-hour recall was used to analyse meal patterns as well as intake of energy and protein. Meal patterns were analysed in terms of number of eating occasions, time of the first, and the last meal each day, length of the overnight fast, timing of the energy and protein intake, energy content and time for the largest meal of the day, and classification as an early or late eater. Results: In this population, 77% had four or five eating occasions per day. The median length of the overnight fast was 13 h and 87% of participants had an overnight fast of >11 h. Regarding the timing of the energy and protein intake, there were three peaks: in the morning, mid-day and in the evening. The mid-day meal was the most important eating occasion regarding total energy intake; mid-day was also the time of the day when most participants had a protein intake >20 g. The majority (60%) of participants were categorized as early eaters. Neither the number of eating occasions nor the length of the overnight fast was correlated with energy or protein intake; however, a large energy intake from the largest meal of the day was significantly correlated with an increased total energy and protein intake, indicating that daily energy intake is stimulated by at least one large meal per day. Conclusions: This study showed that one large meal a day had more impact on daily energy and protein intake than did several eating occasions or a short overnight fast in elderly people in home health care. Further research is needed to elucidate how to stimulate large energy intake at main meals to stimulate daily energy and protein intake. © 2019 European Society for Clinical Nutrition and Metabolism
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| 14. |
- Engelheart, Stina, 1976-, et al.
(författare)
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Nutritional status in older people - An explorative analysis
- 2021
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Ingår i: Clinical Nutrition ESPEN. - : Elsevier BV. - 2405-4577. ; 46, s. 424-433
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Tidskriftsartikel (refereegranskat)abstract
- Background & aims: The nutritional status is seldom defined in general, but is considered to be important throughout life span, especially in times of diseases and disabilities. We previously proposed a theoretical model of the nutritional status from a functional perspective [1], however without proposing a definition of the nutritional status. The model comprises four domains that might affect the nutritional and functional status in a bidirectional way. These four domains are: Food and nutrition; Health and somatic disorders; Physical function and capacity; and Cognitive, affective, and sensory function. This study contributes to the existing literature and knowledge by empirically analysing patterns and relationships of possible nutritional status indicators within and between the four domains. Methods: This study is based on a sample of 69 men and women; older than 65 years, receiving home health care. They were followed up for three years. A broad set of nutritional status indicators in the participants were assessed in their home yearly. Given the small sample size and large number of variables, we used both correlation and factor analysis to explore patterns of nutritional status indicators within the four domains and relationships between the four domains suggested by the theoretical model of nutritional status which we proposed earlier. Results: At baseline, between 4 and 18 components were extracted from the four domains, separately, using factor analysis. The first three components of each domain (called main components) were correlated (p < 0.05) with at least one of the main components of each of the other three domains (r = -0.34-0.79 at baseline, 0.38-0.74 at year 1, 0.40-0.77 at year 2 and 0.47-0.71 at year 3). At baseline, these main components explained, respectively, 31%, 52%, 57% and 63% of the sample variation in the four domains. This remained stable throughout all three years of follow up. In all four domains, there were statistically significant differences in prevalence of malnutrition, frailty, sarcopenia, and dehydration (all different inadequate nutritional status) between individuals' individual component scores. Conclusions: This study provides empirical evidence for the relationship between nutritional status indicators within and between the four domains suggested by our theoretical model of nutritional status. Components in all four domains were associated with inadequate nutritional status, highlighting that a wide perspective of the nutritional status assessment is necessary to be applied in clinical practice. (C) 2021 The Authors. Published by Elsevier Ltd on behalf of European Society for Clinical Nutrition and Metabolism.
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| 15. |
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| 16. |
- Farooqi, Nighat, 1969-, et al.
(författare)
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Energy expenditure in women and men with COPD
- 2018
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Ingår i: Clinical Nutrition Espen. - : Elsevier BV. - 2405-4577. ; 28, s. 171-178
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Tidskriftsartikel (refereegranskat)abstract
- Background: Many patients with chronic obstructive pulmonary disease (COPD) lose weight. Successful nutritional intervention is vital, thus assessment of energy requirement is required. The aim of this study was to present an improved possibility to assess energy requirement in patients with COPD. Methods: Pub Med search was conducted for all the studies reporting total energy expenditure (TEE) measured by doubly labeled water (DLW) method in patients with COPD. Four studies were identified, whereof three were conducted in Sweden. The present analysis is based on these three studies of which the data was acquired. Results: There was a large variation in resting metabolic rate (RMR) and TEE. Body mass index decreased significantly with increase in disease severity (p < .001), and correlated significantly to forced expiratory volume in 1 s (FEV1) % predicted (r = .627, p < .001). FEV1% predicted had a significant correlation with RMR/kg body weight (BW)/day (r = -.503, p = .001), RMR/kg fat-free mass (FFM)/day (r = .338, p = .031), and TEE/kg FFM/day (r = .671, p < .001). Compared to men, women had a lower RMR and TEE/kg BW/day (p < .001 respectively p = .002), and higher RMR and TEE/kg FFM/day (p = .080 respectively p = .005). The correlates of: RMR/kg BW were gender and FEV1% predicted; of TEE/kg BW the correlates were age and gender, and of TEE/kg FFM the correlates were age and FEV1% predicted. Conclusion: In this study, we have presented a possibility to assess energy requirement per kg BW/day and per kg FFM/day in patients with COPD in clinical settings. However, gender, age, and disease severity must be considered. (C) 2018 The Authors. Published by Elsevier Ltd on behalf of European Society for Clinical Nutrition and Metabolism.
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| 17. |
- Guo, Jie, et al.
(författare)
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Adherence to lifestyle advice and its related cardiovascular disease risk among US adults with high cholesterol
- 2022
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Ingår i: Clinical Nutrition ESPEN. - : Elsevier BV. - 2405-4577. ; 51, s. 267-273
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Tidskriftsartikel (refereegranskat)abstract
- Background & aims: Little is known about adherence to lifestyle advice from health professionals among people with high blood cholesterol, and its relationship with cardiovascular disease (CVD). We aimed to examine the proportion of adherence to lifestyle advice and its effect on lipid profile and CVD among people with high cholesterol. Methods: Within the National Health and Nutrition Examination Survey 1999–2010, the study included adults aged ≥20 years who were recommended to improve lifestyles in diet (N = 6645), bodyweight (N = 4797), or exercise (N = 5594) due to their high cholesterol. Adherent status was self-reported through questionnaires. Lipid measurements were collected from laboratory tests. 10-year Atherosclerotic CVD (ASCVD) risk was estimated by using pooled cohort risk equations for participants aged 40–79 years. CVD mortality up to December 31, 2019 was obtained from the National Death Index. Results: The percentages of adherents were 80.9%, 80.7%, and 72.7% for eating less fat, controlling weight, and increasing exercise, respectively. The percentages of adherents for controlling weight and increasing exercise significantly increased from 1999 to 2000 to 2009–2010 (both P trend <0.05). Adherents had a higher high-density lipoprotein cholesterol (HDL-C) and lower total cholesterol/HDL-C ratio than non-adherents (P for difference <0.05 for all). Participants adhering to increasing exercise had a lower odds ratio of 10-year intermediate-to-high ASCVD risk (Odd ratio 0.73, 95% confidence interval [CI] 0.56–0.95) and a lower CVD mortality (Hazard ratio 0.70, 95% CI 0.51–0.97) than non-adherents. Conclusions: Lifestyle advice from health staff obtained relatively high and increasing acceptability. Given the better lipid profile and lower CVD risk of adherents, health professionals should be encouraged to recommend lifestyle modifications for adults with high cholesterol in clinical practice.
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| 19. |
- Håglin, Lena, 1948-, et al.
(författare)
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Low plasma thiamine and phosphate in male patients with Parkinson's disease is associated with mild cognitive impairment
- 2020
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Ingår i: Clinical Nutrition ESPEN. - : Elsevier. - 2405-4577. ; 37, s. 93-99
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Thiamine deficiency (TD) and phosphate depletion increase the risk for cognitive disturbances. This study investigates whether plasma levels of thiamine (P-THIAM), thiamine-monophosphate (P-TMP), and phosphate (P-PHOS) are associated with mild cognitive decline (MCI) in patients with Parkinson's disease (PD).DESIGN AND STUDY POPULATION: This case-control study includes baseline data from a cohort of newly diagnosed patients identified in the New Parkinsonism in Umeå study (NYPUM) (N = 75) and an age and sex matched control group (n = 24).MEASUREMENTS: Mini Nutritional Assessment (MNA-score) and concentrations of P-THIAM, P-TMP, and P-PHOS at baseline were compared between PD patients with mild cognitive impairment (PD-MCI) and PD patients with normal cognition (PD-NC). Neuropsychological assessments of MCI were performed at time of diagnosis.RESULTS: Compared to patients with NC, patients with MCI had lower levels of P-THIAM and P-TMP as well as lower scores on both the Mini Mental State Examination (MMSE) and MNA-screening test. In addition, patients with MCI were older and had more motor problems. The multiple logistic regressions adjusted for age and sex revealed that higher levels of P-THIAM and the MNA-total score were associated with a lower risk of having MCI. Higher MNA-total score and higher P-THIAM and P-PHOS concentrations decreased the risk of MCI in male patients, but not in female patients. The decreased risk of MCI with higher P-TMP levels was lost after adding age and sex to the model. Bivariate correlations between P-PHOS and P-TMP were shown for the total PD population and controls as well as for males with MCI (r = 0.533; n = 22; p = 0.011), but not for males with NC (r = 0.314; n = 19; p = 0.204). An inverse partial correlation (adjusted for age, sex and UPDRS III) was shown for P-THIAM and MNA-total (r = -0.315,p = 0.009) and -final (part II) (r = -0.395,p = 0.001) score for the PD population (n = 75).CONCLUSIONS: Higher P-THIAM and P-PHOS concentrations and higher MNA-total score were associated with a lower risk of MCI in male PD patients, findings that indicate that nutritional factors may influence cognitive function in males in the early phase of PD.
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| 20. |
- Iversen, Kia Nøhr, et al.
(författare)
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A hypocaloric diet rich in high fiber rye foods causes greater reduction in body weight and body fat than a diet rich in refined wheat : A parallel randomized controlled trial in adults with overweight and obesity (the RyeWeight study)
- 2021
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Ingår i: Clinical Nutrition. - : Elsevier. - 0261-5614 .- 1532-1983 .- 2405-4577. ; 45, s. 155-169
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Tidskriftsartikel (refereegranskat)abstract
- Background and aim: A high intake of whole grain foods is inversely associated with body mass index (BMI) and body fat in observational studies, but mixed results have been found in interventional studies. Among whole grains, rye is the richest source of dietary fiber and meals containing high-fiber rye foods have shown increased satiety up to 8 h, compared to meals containing refined wheat products. The aim of the study was to determine the effect of consuming high fiber rye products, compared to refined wheat products, on body weight and body fat loss in the context of an energy restricted diet.Methods: After a 2-week run-in period, 242 males and females with overweight or obesity (BMI 27-35 kg/m2), aged 30-70 years, were randomized (1:1) to consume high fiber rye products or refined wheat products for 12 weeks, while adhering to a hypocaloric diet. At week 0, week 6 and week 12 body weight and body composition (dual energy x-ray absorptiometry) was measured and fasting blood samples were collected. Subjective appetite was evaluated for 14 h at week 0, 6 and 12.Results: After 12 weeks the participants in the rye group had lost 1.08 kg body weight and 0.54% body fat more than the wheat group (95% confidence interval (CI): 0.36; 1.80, p < 0.01 and 0.05; 1.03, p = 0.03, respectively). C-reactive protein was 28% lower in the rye vs wheat group after 12 weeks of intervention (CI: 7; 53, p < 0.01). There were no consistent group differences on subjective appetite or on other cardiometabolic risk markers.Conclusion: Consumption of high fiber rye products as part of a hypocaloric diet for 12 weeks caused a greater weight loss and body fat loss, as well as reduction in C-reactive protein, compared to refined wheat. The difference in weight loss could not be linked to differences in appetite response
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| 22. |
- Lindqvist, Helen, 1977, et al.
(författare)
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Validity of bioimpedance for assessment of fat-free mass in women with Rheumatoid Arthritis compared to non-rheumatic controls
- 2022
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Ingår i: Clinical Nutrition Espen. - : Elsevier BV. - 2405-4577. ; 47, s. 333-338
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Tidskriftsartikel (refereegranskat)abstract
- Background & aims: The aim was to assess the validity of bioimpedance in the assessment of fat free mass (FFM) among women and to study if the validity differs between women with and without Rheumatoid Arthritis (RA). Methods: 38 women with RA and 24 non-rheumatic controls were included. FFM was measured in the non-fasting state using DXA (Lunar Prodigy), multi-frequency bioelectrical impedance analysis (BIA) (MF-BIA [Tanita MC-180 MA]), single-frequency BIA (SF-BIA) and bioelectrical impedance spectroscopy (BIS) (both Impedimed SFB7). BIS raw data were also used to calculate FFM from equations by Matthie, Jaffrin and Moissl. Results were compared using correlation, Bland Altman analysis, Mann Whitney U test and Wilcoxon Signed Ranks Test. Results: Women with RA had different body water distribution compared to women without RA (p < 0.05). Median bias in FFM assessed by bioimpedance was 0.62-7.87 kg with wide limits of agreement for all methods. Median FFM differed significantly from DXA by all bioimpedance methods except for BIS by Jaffrin. Women with RA had significantly smaller biases compared to non-rheumatic controls using BIS equations by Matthie (p = 0.012) and Moissl (p = 0.025). Correlations between FFM measured by DXA and bioimpedance (r = 0.73-0.85, all p < 0.001) did not differ between groups. The sensitivity of bioimpedance to detect low fat free mass index (FFMI) was 0-47%. Conclusion: The results of this study show that bioimpedance has similar validity in women with RA compared to non-rheumatic controls, despite differences in body water distribution. Agreement with DXA improved when applying specific equations, but the clinical utility of bioimpedance is questionable as all methods failed to identify low FFMI with acceptable precision. (C) 2021 The Authors. Published by Elsevier Ltd on behalf of European Society for Clinical Nutrition and Metabolism.
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| 24. |
- Mc Loughlin, S., et al.
(författare)
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Nausea and vomiting in a colorectal ERAS program : Impact on nutritional recovery and the length of hospital stay
- 2019
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Ingår i: Clinical Nutrition ESPEN. - : Elsevier. - 2405-4577. ; 34, s. 73-80
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Tidskriftsartikel (refereegranskat)abstract
- Background & aims: Postoperative nausea and vomiting (PONV) and its impact on the hospital length of stay (LOS), have been extensively studied. However, most previous publications focused their studies on PONV during the first 24 h, and less is known about this complication during the ensuing days, its impact on nutritional recovery or its relation to other complications and the course of care.Methods: An observational study involving 806 consecutive patients in a colorectal Enhanced Recovery After Surgery (ERAS) programme was performed. The primary objective was to analyse the incidence of early PONV on the day of surgery and the following 2 postoperative days (late PONV). Secondary objectives included evaluation of the influence of late PONV over the LOS and the nutritional recovery adjusted for confounding factors.Results: PONV tended to increase over time (7% vs 7% and 10%, postop days 0, 1 and 2, respectively; p < 0.05). PONV on day 2 was associated in an adjusted analysis with poor oral intake, delayed solid food tolerance and an average increase in LOS of 2 nights. Risk factors for the presence of PONV on day 2 were the use of opioids on the same day, PONV on the day of the surgery and rectal procedures.Conclusions: PONV continues to be frequent after the first 24 h in colorectal surgery despite high compliance to current anti emetic recommendations. PONV during day 2 negatively affects the nutritional postoperative recovery and independently prolongs the hospital stay. The findings of the current study highlight the adverse effects of opioids and the need of further discussion on how to best audit, prevent and treat late PONV in ERAS colorectal programmes.
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