| 1. |
- Bertz, Fredrik, et al.
(författare)
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Diet and exercise weight-loss trial in lactating overweight and obese women
- 2012
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Ingår i: American Journal of Clinical Nutrition. - : Elsevier BV. - 0002-9165. ; 96:4, s. 698-705
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Tidskriftsartikel (refereegranskat)abstract
- Background: Current evidence suggests a combined treatment of postpartum weight loss of diet and exercise. However, to our knowledge, neither their separate and interactive effects nor long-term outcomes have been evaluated. Objective: We evaluated whether a 12-wk dietary behavior modification (D) treatment to decrease energy intake, physical exercise behavior modification (E) treatment to implement moderate aerobic exercise, or combined dietary and physical exercise behavior modification (DE) treatment compared with control (usual care) (C) reduces body weight in lactating women measured at the end of treatment and at a 1-y follow-up 9 mo after treatment termination. Design: At 10-14 wk postpartum, 68 lactating Swedish women with a prepregnancy BMI (in kg/m(2)) of 25-35 were randomly assigned to D, E, DE, or C groups. Measurements were made at baseline, after the intervention, and again at a 1-y follow-up 9 mo later. A 2 x 2 factorial approach was used to analyze main and interaction effects of treatments. Results: Weight changes after the intervention and 1-y follow-up were -8.3 +/- 4.2 and -10.2 +/- 5.7 kg, respectively, in the D group; -2.4 +/- 3.2 and -2.7 +/- 5.9 kg, respectively, in the E group; -6.9 +/- 3.0 and -7.3 +/- 6.3 kg, respectively, in the DE group; and -0.8 +/- 3.0 and -0.9 +/- 6.6 kg, respectively, in the C group. The main effects of D treatment, but not of E treatment, on weight were significant at both times (P < 0.001). Conclusions: Dietary treatment provided clinically relevant weight loss in lactating postpartum women, which was sustained at 9 mo after treatment. The combined treatment did not yield significant weight or body-composition changes beyond those of dietary treatment alone. This trial was registered at clinicaltrials.gov as NCT01343238. Am J Clin Nutr 2012;96:698-705.
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| 2. |
- Bertz, Fredrik, et al.
(författare)
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Sustainable Weight Loss among Overweight and Obese Lactating Women Is Achieved with an Energy-Reduced Diet in Line with Dietary Recommendations: Results from the LEVA Randomized Controlled Trial.
- 2015
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Ingår i: Journal of the Academy of Nutrition and Dietetics. - : Elsevier BV. - 2212-2672. ; 115:1, s. 78-86
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate dietary changes during and after a dietary treatment shown to result in significant and sustained weight loss among lactating overweight and obese women. This is crucial before clinical implementation. Data were collected from the LEVA (in Swedish: Livsstil för Effektiv Viktminskning under Amning [Lifestyle for Effective Weight Loss During Lactation]) randomized controlled factorial trial with a 12-week intervention and a 1-year follow up. At 10 to 14 weeks postpartum, 68 lactating Swedish women with a prepregnancy body mass index (calculated as kg/m(2)) of 25 to 35 were randomized to structured dietary treatment, physical exercise treatment, combined treatment, or usual care (controls) for a 12-week intervention, with a 1-year follow-up. Dietary intake was assessed with 4-day weighed dietary records. Recruitment took place between 2007 and 2010. The main outcome measures were changes in macro- and micronutrient intake from baseline to 12 weeks and 1 year. Main and interaction effects of the treatments were analyzed by a 2×2 factorial approach using a General Linear Model adjusted for relevant covariates (baseline intake and estimated underreporting). It was found that at baseline, the women had an intake of fat and sucrose above, and an intake of total carbohydrates and fiber below, recommended levels. At 12 weeks and 1 year, the dietary treatment led to reduced intake of energy (P<0.001 and P=0.005, respectively), fat (both P values <0.001), and sucrose (P<0.001 and P=0.050). At 12 weeks, total carbohydrates were reduced (P<0.001). Amajority of women in all groups reported low intakes of vitamin D, folate, and/or iron. In conclusion, a novel dietary treatment led to reduced intake of fat and carbohydrates. Diet composition changed to decreased proportions of fat and sucrose, and increased proportions of complex carbohydrates, protein and fiber. Weight loss through dietary treatment was achieved with a diet in line with macronutrient recommendations.
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| 3. |
- Brekke, Hilde Kristin, 1972, et al.
(författare)
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Attitudes and barriers to dietary advice aimed at reducing risk of type 2 diabetes in first-degree relatives of patients with type 2 diabetes.
- 2004
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Ingår i: Journal of Human Nutrition and Dietetics. - 0952-3871. ; 17:6, s. 513-21
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate the attitudes to and adoption of dietary advice in nondiabetic first-degree relatives of patients with type 2 diabetes and to examine barriers to adherence. DESIGN: One-year controlled intervention study, where treatment group (n=73) received lifestyle education. Attitudes towards dietary advice, change in dietary habits and importance of potential barriers to adherence were evaluated by questionnaires. Nondiabetic relatives (25-55 years; males and females) of individuals with type 2 diabetes were recruited. Education was based on current nutrition recommendations and aimed at improving dietary fat quality, increasing intake of fruit and vegetables, with additional advice to reduce dietary glycaemic index (GI). MAIN OUTCOME MEASURES: Attitudes and importance of barriers were classified by the intervened subjects into four categories ranging from 'No problem' to 'Yes, definitely a problem'. Dietary adherence was monitored by food frequency questionnaire at baseline and after 1 year. RESULTS: Participants were generally in favour of advice aimed at improving dietary fat quality. Attitudes towards advice to reduce GI varied widely. Food selection changed in accordance with predefined dietary goals. 'Forgetfulness', 'low availability in lunch restaurant' and 'lack of ideas for cooking' were barriers to adherence. CONCLUSIONS: Dietary advice aimed at reducing risk of type 2 diabetes was generally positively received and adopted in subjects with heredity for the disease. The most prevalent barriers reported are potentially modifiable.
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| 4. |
- Brekke, Hilde Kristin, 1972, et al.
(författare)
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Breastfeeding and introduction of solid foods in Swedish infants: the All Babies in Southeast Sweden study.
- 2005
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Ingår i: The British journal of nutrition. - 0007-1145 .- 1475-2662. ; 94:3, s. 377-82
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this report is to describe breastfeeding duration and introduction of foods in Swedish infants born 1997-9, in relation to current recommendations. A secondary aim is to examine breastfeeding duration and introduction of certain allergenic foods in allergy-risk families (for whom allergy-preventive advice has been issued). Out of 21,700 invited infants, screening questionnaires were completed for 16,070 infants after delivery. Parents to 11,081 infants completed a follow-up questionnaire regarding breastfeeding and introduction of foods and 9849 handed in detailed food diaries at 1 year of age. The percentages of infants who were exclusively breast-fed at 3, 6 and >or=9 months of age were 78.4, 10.1 and 3.9, respectively. The corresponding percentages for partial breastfeeding were 87.8, 68.9 and 43.6. Gluten-containing foods were introduced to 66% of infants between 4 and 6 months, as recommended at the time of the study, and one-quarter had stopped breastfeeding when gluten was introduced. More than 90% of parents introduced the first sample of solid food during months 4-6, as recommended. Fish and eggs had been introduced during the first year in 43% and 29%, respectively, of infants with atopic heredity. Exclusive breastfeeding duration and time of introduction of solid foods, including gluten, seemed to have been in line with Swedish recommendations at the time, although gluten was often introduced late, and not during ongoing breastfeeding as recommended. The adherence to allergy-preventive advice was less than optimal in infants with atopic heredity.
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| 5. |
- Brekke, Hilde Kristin, 1972, et al.
(författare)
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Daily vegetable intake during pregnancy negatively associated to islet autoimmunity in the offspring-The ABIS study
- 2010
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Ingår i: PEDIATRIC DIABETES. - : Blackwell Publishing Ltd. - 1399-543X .- 1399-5448. ; 11:4, s. 244-250
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate if maternal diet during pregnancy is associated with occurrence of islet autoimmunity (IA) in the offspring. Methods: Of 21 700 infants invited to the All Babies in South-east Sweden (ABIS) study, 16 004 screening questionnaires, including a 22-item food frequency questionnaire (FFQ) regarding the mothers diet during pregnancy, were completed after delivery. Follow-up of the children (questionnaires and blood sampling) was performed at 1, 2.5 and 5 yr of age. IA was defined as being positive (above the 95th percentile for healthy children) in two or more measurements of autoantibodies [glutamic acid decarboxylase (GADA); tyrosine phosphatase (IA-2A), insulin autoantibodies (IAA)] analysed at the three time points or being diagnosed with type 1 diabetes during the 5-yr follow-up period. The 5 724 children in whom we carried out two to three possible blood samplings were included in the study. Logistic regression analysis was used to identify variables predicting IA. Results: Of 5 724 children,191 (3.3%) were considered positive for IA. In a univariate analysis, less than daily consumption of vegetables (3-5 times/week) in the mothers diet was associated with increased risk of IA (OR 1.71, 95% CI:1.24-2.35, p = 0.001) compared to daily consumption (p for trend = 0.004). The association was strengthened when adjusting for known IA-risk factors (p for trend andlt; 0.001). Conclusions: Daily consumption of vegetables in the mothers diet during pregnancy was associated with a decreased risk of IA in the offspring.
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| 6. |
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| 7. |
- Brekke, Hilde Kristin, 1972, et al.
(författare)
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Lifestyle changes can be achieved through counseling and follow-up in first-degree relatives of patients with type 2 diabetes.
- 2003
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Ingår i: Journal of the American Dietetic Association. - 0002-8223. ; 103:7, s. 835-43
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe two lifestyle prevention strategies tested in first-degree relatives of patients with type 2 diabetes and to present the short-term effects of these strategies on nutrient intake, physical activity pattern, and body weight. DESIGN: In this 16-week controlled intervention trial, subjects were assigned to one of three treatment conditions: diet group (D) (n=25), diet and exercise group (DE) (n=30), or control group (C) (n=22). Subjects/setting Non-diabetic relatives of individuals with diabetes were recruited (n=77; men and women; age 25 to 55 years). INTERVENTION: Intervention groups received group counseling on two occasions and follow-up through unannounced telephone interviews every 10 days. Counseling regarding diet and physical activity was based on the Nordic Nutrition Recommendations. In addition, increased intake of fatty fish and low glycemic index foods were recommended. Main outcome measures Changes in diet (assessed by food frequency questionnaires), leisure time physical activity (assessed through interviews), fatty acid composition of erythrocyte membrane, and body weight. Statistical analysis One-way analysis of variance and Mann-Whitney U test were used to compare changes among groups. RESULTS: Compared with the control group, both intervention groups decreased intake of saturated fatty acids (percent of energy), increased intake of dietary fiber, and reduced average glycemic index of the diet. The ratio of n-6:n-3 fatty acids of the erythrocyte membranes decreased, confirming increased intake of fatty fish. Body weight decreased 1.7 kg (2.1%, P=.030) in group DE, and physical activity increased in the least-active subjects (+70 min/week, P<.01 within group). Applications/Conclusions Healthy individuals with heredity for type 2 diabetes can achieve desired changes in lifestyle factors associated with increased risk for the disease.
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| 8. |
- Brekke, Hilde Kristin, 1972
(författare)
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Lifestyle intervention in first-degree relatives of patients with type 2 diabetes
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Type 2 diabetes is increasing worldwide, mainly due to unfavorable changes in diet and physical activity. Prevention strategies to slow this development are urgently needed. First-degree relatives of type 2 diabetic patients (FDR) have an increased risk of developing the disease. Lifestyle intervention in these and other high-risk individuals is one way of addressing the problem. Intervention strategies should not only be effective but also keep resource needs to a minimum. The aim of this study was to assess the feasibility and short- and long-term effects of an intervention program for implementing lifestyle change in non-diabetic FDR. One hundred FDR, recruited from the Göteborg area of West Sweden were screened. Seventy-seven non-diabetic men and women (aged 25-55 years) were included in the study and allocated to one of three arms: Diet group (D), Diet + Exercise (DE) group and Control group. The program s goals for diet and physical activity were based on The Nordic Nutrition Recommendations. Intervention groups received group counseling on two occasions and follow-up through unannounced telephone interviews. Effects of intervention were studied after 16 weeks, 1 year and 2 years. Changes in dietary intake and physical activity were monitored by questionnaires. Fatty acid composition of the erythrocyte membrane was used as an objective measure of polyunsaturated fatty acids intake. Treatment effects were measured by body weight, waist circumference, sagittal diameter, oral glucose tolerance test, insulin sensitivity, fasting insulin, fasting blood glucose and blood lipids. Compared to Controls, short-term results (16 weeks) in intervention groups showed improvements in diet and erythrocyte membrane composition. Physical activity increased, but only in persons initially inactive . Further, the Diet group showed a reduction in LDL cholesterol and Apolipoprotein B values, while body weight and waist circumference decreased in group DE. At 1-year follow-up the ratio of LDL/HDL cholesterol was significantly decreased in group D compared to Control as was the body weight in group DE. Two-year follow-up (no Controls) showed that dietary changes were sustained to a large degree, confirmed by fatty acid composition of the erythrocyte membrane. The inactive maintained their increased physical activity. Reductions from baseline were seen in LDL cholesterol in group D and in body weight and fasting insulin in group DE. Evaluation of attitudes to dietary changes, performed after 1 year of intervention, showed that advice was generally well perceived and adopted, especially advice aimed to improve dietary fat quality. In conclusion, the intervention program gave short- and long-term effects on lifestyle and metabolic variables that may lead to reduced risk for type 2 diabetes, and was well received in this high-risk population.
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| 9. |
- Brekke, Hilde Kristin, 1972, et al.
(författare)
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Lifestyle modification improves risk factors in type 2 diabetes relatives.
- 2005
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Ingår i: Diabetes research and clinical practice. - : Elsevier BV. - 0168-8227. ; 68:1, s. 18-28
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To investigate the short-term (16 weeks) effect of lifestyle intervention on insulin sensitivity, anthropometric and metabolic variables in non-diabetic first-degree relatives of type 2 diabetic patients (FDR). METHODS: Seventy-seven (49 male, 28 female) FDR were allocated to one of three groups, diet (D-group; n = 25), diet and exercise (DE-group; n = 30) or control group (C-group; n = 22). Lifestyle counselling was based on current nutrition recommendations, including increased intake of fatty fish and low glycaemic index foods. Group counselling was given on two occasions with follow-up through telephone interviews every 10 days. Assessments included insulin sensitivity index (Si), anthropometry, lipid parameters, circulating leptin and adiponectin levels. RESULTS: The D-group reduced total cholesterol (-0.31 mmol/l, P = 0.024), LDL cholesterol (-0.22 mmol/l, P = 0.021) and apolipoprotein B (-9.5 mg/dl, P = 0.009) levels, whereas the DE-group decreased body weight (-2.1%, P = 0.030) and waist circumference (-3.0 cm, P < 0.001) versus controls. A 13% reduction in fasting insulin was observed in the DE-group, but no significant improvement in Si in D-group or DE-group was observed. A subgroup, adherent to diet and who increased exercise, significantly improved Si and lipid profile. CONCLUSIONS: The improved metabolic risk profile in FDR suggests that lifestyle changes can be effective in individuals at high risk to develop type 2 diabetes and cardiovascular disease.
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| 10. |
- Brekke, Hilde Kristin, 1972, et al.
(författare)
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Long-term (1- and 2-year) effects of lifestyle intervention in type 2 diabetes relatives.
- 2005
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Ingår i: Diabetes research and clinical practice. - : Elsevier BV. - 0168-8227. ; 70:3, s. 225-34
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To study the long-term (1- and 2-year) effect of a lifestyle intervention on non-diabetic first-degree relatives of type 2 diabetic patients, i.e., the 1-year effect of diet versus diet and exercise in relation to a control group and the 2-year sustainability of these treatment effects. METHOD: Seventy-seven healthy first-degree relatives (men and women) between the ages of 25 and 55 were allocated to one of three groups: diet group (D), diet and exercise group (DE) and control group (C). For ethical reasons, after 1 year the control group began the intervention and were followed for another 2 years. Diet and physical activity counselling was based on current nutrition recommendations, including increased intake of fatty fish and low glycaemic index foods. The fatty acid composition of the erythrocyte membrane was studied as an objective measure of dietary change. Assessments included fasting insulin, 2-h insulin, oral glucose tolerance test (OGTT), anthropometry and blood lipid measurements. Groups D and DE received intensive follow-up through unannounced telephone interviews during the first 4 months. RESULTS: Dietary changes were significant at 1 year, and to a large degree sustained at 2 years. Adherence to advice regarding fat quality was confirmed through changes in the fatty acid composition of the erythrocyte membrane. The least active subjects in DE increased their physical activity (PA). At 1 year, group D showed a reduction in the ratio of LDL to HDL cholesterol (p=0.028) while group DE decreased their body weight by 2.7% (p<0.029) and increased HDL (p<0.037) versus controls. At 2 years, cholesterol levels (total, LDL and the ratio LDL/HDL) were reduced within group D and when compared to DE (p=0.022, 0.009, 0.035, respectively). Fasting insulin was reduced within group DE and when compared to group D (p=0.025). CONCLUSIONS: Positive changes in lifestyle, blood lipids and fasting insulin can be achieved and maintained in a non-diabetic population at risk of type 2 diabetes after 2 years.
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| 11. |
- Brekke, Hilde Kristin, 1972, et al.
(författare)
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Predictors and dietary consequences of frequent intake of high-sugar, low-nutrient foods in 1-year-old children participating in the ABIS study.
- 2007
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Ingår i: The British journal of nutrition. - 0007-1145 .- 1475-2662. ; 97:1, s. 176-81
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Tidskriftsartikel (refereegranskat)abstract
- Foods rich in sugar have been suggested to contribute to the increasing prevalence of obesity in children. The aim of this report is to investigate the dietary pattern in 1-year-old children who frequently receive foods rich in sugar but low in nutrients and to study associated demographic and parental factors. During 1977-9, 21,700 infants were invited to participate in this prospective, population-based, longitudinal cohort study. Screening questionnaires were completed for 16,070 infants after delivery. Follow-up questionnaires from 10,762 children at 1 year of age are included in the analysis. It was found that 24% of the children received sweets/pastries more often than one or two times per week. They had a higher intake of French fries, potato crisps and cream as well as a lower intake of fruit and vegetables. A frequent intake of sugar-rich, low-nutrient foods was significantly associated with several maternal factors (high intake of sweets/pastries during pregnancy, young age, mother living alone) as well as presence of older siblings. Maternal smoking during pregnancy and maternal overweight were of borderline significance. Parental education level was inversely associated with the frequency of intake of sweets/pastries in the child. Children who frequently receive sweets/pastries also have an otherwise unfavourable dietary pattern. Several parental and demographic factors were associated with this feeding pattern, especially high intake of sweets/pastries during pregnancy. Screening of pregnant women for risk predictors like consumption of sweets/pastries, young age and smoking could be possible ways of identifying children at future risk for low dietary quality.
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| 12. |
- Brekke, Hilde Kristin, 1972, et al.
(författare)
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Unannounced telephone interviews: A useful and positively received tool in the reinforcement of lifestyle intervention
- 2009
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Ingår i: Patient Preference and Adherence. - 1177-889X. ; 2009:3, s. 357-362
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Reinforcement is critical in dietary counseling, but is also time demanding. We evaluated the acceptability of frequent telephone interviews, including a 24-hour dietary recall, as a means of reinforcement after lifestyle intervention in healthy subjects at risk of diabetes. The aim of this report is to assess the following questions: Was the chosen frequency and duration of telephone reinforcement appropriate? What were the positive and negative aspects of receiving telephone interviews? Methods: Seventy-seven nondiabetic relatives of patients with type 2 diabetes were included in a randomized controlled intervention study in which they received dietary education. Unannounced telephone calls were placed to follow adherence and for encouragement and support. After two years of intervention, the perceived appropriateness of the different aspects of receiving telephone interviews were evaluated by postal questionnaire. Results: Telephone reinforcement was positively received by the participants. Relatively frequent telephone calls, as many as three times per month, were not considered disturbing or time consuming. Participants became aware of their own dietary habits through the interviews, which they appreciated. They found duration of follow-up between one and five years appropriate. Conclusions: Telephone interviews can be applied in lifestyle intervention programs in healthy at-risk individuals in which time constraints may otherwise prevent active persons from participating.
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| 13. |
- Brekke, Hilde Kristin, 1972, et al.
(författare)
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Vitamin D supplementation and diabetes-related autoimmunity in the ABIS study.
- 2007
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Ingår i: Pediatric Diabetes. - 1399-5448. ; 8:1, s. 11-4
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Tidskriftsartikel (refereegranskat)abstract
- Supplementation with vitamin D during infancy, as well as intake of vitamin D during pregnancy, has been associated with decreased risk of type 1 diabetes or diabetes-related autoantibodies in children. The primary aim of this report was to investigate whether vitamin D supplementation during infancy is associated with diabetes-related autoimmunity at 1 and 2.5 yr in the children. Second, we examined whether consumption of vitamin-D-containing supplements during pregnancy is related to risk of autoimmunity in the offspring. Screening questionnaires were completed for 16,070 infants after delivery, including a food-frequency questionnaire regarding the mother's use of dietary supplements during pregnancy. Parents of 11,081 and 8805 infants completed a follow-up questionnaire regarding the use of vitamin supplementation at 1 and 2.5 yr, respectively. Autoantibodies against glutamic acid decarboxylase and islet antigen-2 (IA-2) were analyzed in whole blood from 8694 children at 1 yr and 7766 children at 2.5 yr. Supplementation with AD-drops was not associated with autoantibodies at 1 or 2.5 yr. Use of vitamin-D-containing supplements during pregnancy was associated with reduced diabetes-related autoimmunity at 1 yr (adjusted odds ratio: 0.707, confidence interval: 0.520-0.962, p = 0.028) but not at 2.5 yr. In conclusion, no association was found between an intermediate dose of vitamin D supplementation during infancy and development of diabetes-related autoantibodies at 1 and 2.5 yr. Use of vitamin-D-containing supplements during pregnancy was associated with reduced development of glutamic acid decarboxylase autoantibodies or IA-2A in the offspring at 1 yr, but not at 2.5 yr.
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| 14. |
- Bärebring, Linnea, et al.
(författare)
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Food intake and gestational weight gain in Swedish women
- 2016
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Ingår i: Springerplus. - : Springer Science and Business Media LLC. - 2193-1801. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Background: The objective of this study was to investigate if food intake (dairy, snacks, caloric beverages, bread, cheese, margarine/butter, potato/rice/pasta/grains, red meat, fish and fruit/berries/vegetables) is associated with gestational weight gain (GWG) in Swedish women. Methods: Four day food records from 95 pregnant Swedish women were collected in the last trimester. GWG was calculated as weighed body weight in the last trimester (median gestational week 36) minus self-reported pre-pregnancy body weight. Excessive GWG was defined according to the guidelines by the Institute of Medicine. Food groups tested for association with GWG were dairy (milk, yoghurt and sour milk), snacks (sweets, crisps, popcorn, ice cream and cookies, but not nuts and seeds), caloric beverages (soft drinks, juice, lemonade and non-alcoholic beer), bread, cheese, margarine/butter, potato/rice/pasta/grains, red meat, fish and fruit/berries/vegetables. Results: Median (lower-upper quartiles) GWG was 12.1 kg (10.0-15.3). In total, 28 % had an excessive GWG. Excessive GWG was most common among pre-pregnancy overweight and obese women, where 69 % had an excessive GWG. Median daily intake of fruits and vegetables was 352 g (212-453), caloric beverages was 238 g (100-420) and snacks was 111 g (69-115). Multivariable linear regression analysis showed that intake of caloric beverages, snacks, fish, bread and dairy in the last trimester of pregnancy were positively related to GWG (R-2 = 0.32). Multivariable logistic regression analysis showed that intake of caloric beverages, snacks, fish, and bread was associated with higher odds ratios for excessive GWG. Conclusion: Intake of caloric beverages, snacks, fish and bread were positively related to excessive GWG. Thus, these results indicate that maternal dietary intake should be given higher attention in the antenatal care.
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| 15. |
- Ellegård, Lars, 1958, et al.
(författare)
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Body composition in overweight and obese women postpartum: bioimpedance methods validated by dual energy X-ray absorptiometry and doubly labeled water
- 2016
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Ingår i: European Journal of Clinical Nutrition. - : Springer Science and Business Media LLC. - 0954-3007 .- 1476-5640. ; 70, s. 1181-1188
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Tidskriftsartikel (refereegranskat)abstract
- © 2016 Macmillan Publishers LimitedBackground/Objectives:Obesity, pregnancy and lactation all affect body composition. Simple methods to estimate body composition are useful in clinical practice and to evaluate interventions. In overweight and obese lactating women, such methods are not fully validated. The objective of this study was to validate the accuracy and precision of bioimpedance spectroscopy (BIS) by Xitron 4200 and 8-electrode multifrequency impedance (multifrequency bioimpedance analysis, MFBIA) by Tanita MC180MA with the reference methods dual energy X-ray absorptiometry (DXA) and doubly labeled water (DLW) for the assessment of body composition in 70 overweight and obese women postpartum.Subjects/Methods:The LEVA-study (Lifestyle for Effective Weight loss during lactation) consisted of an intervention and follow-up with three assessments at 3, 6 and 15 months postpartum, which made possible the validation of both accuracy and precision. Mean differences between methods were tested by a paired t-test and Bland–Altman plots for systematic bias.Results:At baseline, BIS and MFBIA underestimated fat mass (FM) by 2.6±2.8 and 8.0±4.2kg compared with DXA (P<0.001) but without systematic bias. BIS and MFBIA overestimated total body water (TBW) by 2.4±2.2 and 4.4±3.2kg (P<0.001) compared with DLW, with slight systematic bias by BIS. BIS correctly estimated muscle mass without systematic bias (P>0.05). BIS overestimated changes in TBW (P=0.01) without systematic bias, whereas MFBIA varied greatly and with systematic bias.Conclusions:BIS underestimates mean FM compared with DXA but can detect mean changes in body composition, although with large limits of agreement. BIS both accurately and precisely estimates muscle mass in overweight and obese women postpartum. MFBIA underestimates FM and overestimates TBW by proprietary equations compared with DXA and DLW.European Journal of Clinical Nutrition advance online publication, 30 March 2016; doi:10.1038/ejcn.2016.50.
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| 16. |
- Fredriksson, Ellinor, et al.
(författare)
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Dietary intake in Swedish medical students during 2007-2012
- 2016
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 44:1, s. 77-83
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Tidskriftsartikel (refereegranskat)abstract
- Background: The dietary intake in Swedish medical students has been reported for the periods 1987-1993 and 1994-2006. Objective: To analyse dietary intake in medical students between 2007 and 2012, in relation to Nordic Nutrition Recommendations, to previous surveys and to a contemporary Swedish population. Design: Nutrient intake was calculated from 3-day food records conducted by 698 medical students. The differences between surveys were evaluated using a t-test and the changes over time by linear regression. Results: The energy intake in valid female and male reporters was 8.7 and 11.9 MJ respectively. The intake of protein, fat and alcohol, as proportions of energy (E%) and dietary fibre, was within recommendations. The intake of most micronutrients was above recommendations, except for vitamin D, and in women, iron and folate. In women, E% fat increased between 2007 and 2012, while E% carbohydrate decreased. Compared to the 1994-2006 period, medical students in the present survey consumed less carbohydrates and more fat, more folate and more vitamin E. The students were more compliant with the dietary recommendations than the same age group of the Swedish population. Conclusions: Energy intake in medical students, and dietary intake with some exceptions, remained stable during 1987-2012, and close to the Nordic Nutrition Recommendations for most nutrients. Between 2007 and 2012, fat intake increased and carbohydrate intake decreased significantly in women and also tended to do so in men. Similar trends were seen in the Swedish population, possibly indicating the impact of diet trends such as the Low-Carb/High-Fat diet.
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| 17. |
- Fredriksson, Ellinor, et al.
(författare)
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Validation of four questions on food habits from the Swedish board of health and social welfare by 3-day food records in medical and nursing students
- 2014
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Ingår i: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 58
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Swedish board for health and social welfare (SoS) has presented four questions on dietary habits as indicators of adherence to dietary recommendations. However, these questions have not been evaluated. Objective: To evaluate if four questions on dietary habits correlate with dietary intake assessed by food records. Design: A total of 279 medical and nursing students, 170 women and 109 men, completed four questions on usual consumption frequency of vegetables, fruits, fish, and sweets. Depending on scoring from 0 to 12 points, subjects were classified as having low (0-4 points), average (5-8 points), or high (9-12 points) adherence to dietary recommendations as proposed by SoS. Nutrient intake was calculated from 3-day food records. Mean dietary intake, expressed per 10 MJ of fibre, ascorbic acid, folate, vitamin D, sucrose, fish, and fruits and vegetables, was analysed for each group and differences assessed by ANOVA. Results: Energy intake was 11.8 +/- 3.0 MJ in male and 8.5 +/- 2.2 MJ in female students. Most students, 64%, were classified as average adherers to dietary recommendations, whereas only 6% were classified as low and 30% as high. Dietary intake of fibre, ascorbic acid, and folate was significantly higher in the high adherence group compared to both the other groups (p < 0.01), but vitamin D significantly so only compared to the average group (p < 0.002). Intake of fruits and vegetables was significantly different between all groups (p < 0.003), with increasing amounts with increasing adherence. The low adherence group had higher intake of sucrose than the other groups (p < 0.005). Median fish intake was nil in the low and average adherence groups, with significant difference between high and average adherence groups (p-0.001). Conclusions: Four questions on the consumption frequency of vegetables, fruits, fish, and sweets correlate well with the dietary intake of fibre, ascorbic acid, folate, vitamin D, fish, sucrose, and fruits and vegetables as assessed by 3-day food records in health-conscious medical and nursing students.
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| 18. |
- Granfors, Maria, et al.
(författare)
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No association between use of multivitamin supplement containing vitamin D during pregnancy and risk of Type 1 Diabetes in the child
- 2016
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Ingår i: Pediatric Diabetes. - : Wiley-Blackwell. - 1399-543X .- 1399-5448. ; 17:7, s. 525-530
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Sweden has the second highest incidence of type 1 diabetes in the world. Nutritional aspects in utero and in infancy affect the development. We conducted a survey to determine whether reported maternal use of vitamin D-containing micronutrient supplements during pregnancy was associated with the risk of developing type 1 diabetes in the child.METHODS:This report was based on data from the ABIS (All Babies In Southeast Sweden) study, with questionnaire data on 16 339 mother and infant pairs at birth and at 1-yr of age (n = 10 879), of whom 108 children were registered with type 1 diabetes before 14-16 yr of age. The questions 'during pregnancy, did you take any vitamin/mineral supplements?' and 'if yes, which? (open answer)' in addition to other lifestyle questions were answered. Logistic regression was performed with onset of type 1 diabetes as the dependent variable and vitamin D supplementation use as the independent variable, adjusted for relevant factors.RESULTS:Vitamin D supplementation during pregnancy was consumed by 9.3% of mothers whose children later got type1 diabetes and among 11.3% of those mothers whose children did not get type 1 diabetes (p = 0.532). No significant association was found between reported supplement intake of vitamin D during pregnancy and risk of type 1 diabetes, even when adjusting for factors which could influence the association.CONCLUSION:Maternal use of vitamin D-containing multivitamin supplements during pregnancy was not related to the risk of developing type 1 diabetes in children before 14-16 yr of age in Southeast of Sweden.
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| 19. |
- Hagberg, Lars A., 1956-, et al.
(författare)
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Cost-utility analysis of a randomized controlled weight loss trial among lactating overweight/obese women
- 2014
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Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Background: Overweight and obesity among young, adult women are increasing problems in Sweden as in many other countries. The postpartum period may be a good opportunity to improve eating habits and lose weight in a sustainable manner. The aim was to make a cost-utility analysis of a dietary behavior modification treatment alongside usual care, compared to usual care alone, among lactating overweight and obese women.Methods: This study was a cost-utility analysis based on a randomized controlled and longitudinal clinical diet intervention. Between 2007-2010, 68 women living in Sweden were, after baseline measurement at 8-12 weeks postpartum, randomly assigned to a 12-week dietary behavior modification treatment or control group.Inclusion criteria were: self-reported pre-pregnancy body mass index (BMI) 25-35 kg/m(2), non-smoker, singleton term delivery, birth weight > 2500 g, intention to breastfeed for 6 mo and no diseases (mother and child). The women in the intervention group received 1.5 hour of individual counseling at study start and 1 hour at follow-up home visits after 6 weeks of intervention, with support through cell phone text messages every two wk. Dietary intervention aimed to reduce dietary intake by 500 kcal/day. The control group received usual care. Weight results have previously been reported. Here we report on analyses carried out during 2012-2013 of cost per quality adjusted life years (QALY), based on the changes in quality of life measured by EQ-5D-3 L and SF-6D. Likelihood of cost-effectiveness was calculated using Net Monetary Benefit method.Results: Based on conservative assumptions of no remaining effect after 1 year follow-up, the diet intervention was cost-effective. Costs per gained QALY were 8 643 - 9 758 USD. The likelihood for cost-effectiveness, considering a willingness to pay 50 000 USD for a QALY, was 87-93%.Conclusions: The diet intervention is cost-effective.
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| 20. |
- Hagberg, Lars, 1956-, et al.
(författare)
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Cost-effectiveness and quality of life of a diet intervention postpartum: 2-year results from a randomized controlled trial
- 2019
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPregnancy has been identified as a contributor to obesity. We have shown that a diet intervention postpartum produced a 2-y weight loss of 8%. Here, we present the impact of the diet intervention on cost-effectiveness and explore changes in quality of life (QOL).MethodsA total of 110 postpartum women with overweight/obesity were randomly assigned to diet (D-group) or control (C-group). D-group received a 12-wk diet intervention within primary health care followed by monthly emails up to the 1-y follow-up. C-group received a brochure. Changes in QOL were measured using the 36-item Short Form Health Survey and EQ-5D. The analysis of cost-effectiveness was a cost-utility analysis with a health care perspective and included costs of intervention for stakeholder, quality-adjusted life-years (QALYs) gained and savings in health care. The likelihood of cost-effectiveness was examined using the net monetary benefit method.ResultsThe D-group increased their QOL more than the C-group at 12 wk. and 1 y, with pronounced differences for the dimensions general health and mental health, and the mental component summary score (all p<0.05). Cost per gained QALY was 1704-7889 USD. The likelihood for cost-effectiveness, based on a willingness to pay 50,000 USD per QALY, was 0.77-1.00.ConclusionsA diet intervention that produced clinically relevant postpartum weight loss also resulted in increased QOL and was cost-effective.Trial registrationClinical trials, NCT01949558, 2013-09-24
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| 21. |
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| 22. |
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| 23. |
- Huseinovic, Ena, et al.
(författare)
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Dietary assessment among women with overweight and obesity in early postpartum
- 2016
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Ingår i: Journal of Human Nutrition and Dietetics. - : Wiley. - 0952-3871 .- 1365-277X. ; 29:4, s. 411-417
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe present study aimed to assess dietary intake and evaluate the degree of agreement of group-level dietary intake as measured by 24-h recall against a 4-day diet record among postpartum women with overweight and obesity. MethodsA cross-sectional study was conducted of 110 Swedish women with a body mass index of 27 kg m(-2) at 6-15 weeks postpartum who were recruited to a weight loss trial and randomised to diet intervention or control. One 24-h recall was conducted among all women prior to randomisation. In addition, women subsequently randomised to diet intervention also conducted a 4-day diet record before receiving dietary treatment (n = 54). Paired tests were used to evaluate agreement of group-level dietary intake as measured by 24-h recall against 4-day diet record among women randomised to diet intervention. ResultsWomen reported a median (25th and 75th percentiles) energy intake of 9.1 (6.9, 11.7) MJ day(-1) and an intake of fibre, vitamin D, folate and iron below the recommended intake as assessed by 24-h recall prior to randomisation (n = 110). Group-level median intakes of energy (9.9 versus 10.0 MJ day(-1)), fibre (21.9 versus 21.3 g day(-1)), vitamin D (4.8 versus 6.5 g day(-1)), folate (296 versus 287 g day(-1)), iron (11.0 versus 11.3 mg day(-1)) and calcium (915 versus 968 mg day(-1)) did not differ significantly between the methods; however, the record captured a higher energy-adjusted intake of fat, saturated fat and alcohol, as well as a lower intake of carbohydrates, compared to the recall (n = 54). ConclusionsWe found no difference in group-level estimates of energy or micronutrients between the recall and the record; however, there were some differences for macronutrients.
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| 24. |
- Huseinovic, Ena, et al.
(författare)
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Does diet intervention in line with nutrition recommendations affect dietary carbon footprint? Results from a weight loss trial among lactating women
- 2017
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Ingår i: European Journal of Clinical Nutrition. - : Springer Science and Business Media LLC. - 0954-3007 .- 1476-5640. ; 71:10, s. 1241-1245
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND/OBJECTIVES: Results from studies evaluating the sustainability of diets combining environmental and nutritional aspects have been diverse; thus, greenhouse gas emissions (that is, carbon footprint (CF)) of diets in line with dietary recommendations in free-living individuals warrants further examination. Here, changes in dietary CF related to changes in food choice during a weight loss trial among lactating women who received a 12-week diet intervention based on the Nordic Nutrition Recommendations (NNR) 2004 were analyzed. The objective of this study was to examine if a diet intervention based on NNR 2004 results in reduced dietary CF. SUBJECTS/METHODS: Changes in dietary CF were analyzed among 61 lactating women participating in a weight loss trial. Food intake data from 4-day weighed diet records and results from life cycle analyses were used to examine changes in dietary CF across eight food groups during the intervention, specified in the unit carbon dioxide equivalent (CO(2)eq/day). Differences in changes in dietary CF between women receiving diet treatment (D-group) and women not receiving it (ND-group) were compared. RESULTS: There was no difference in change in dietary CF of the overall diet between D-and ND-group (P > 0.05). As for the eight food groups, D-group increased their dietary CF from fruit and vegetables (+0.06 +/- 0.13 kg CO(2)eq/day) compared with a decrease in ND-group (-0.01 +/- 0.01 kg CO(2)eq/day) during the intervention, P = 0.01. CONCLUSIONS: A diet intervention in line with NNR 2004 produced clinically relevant weight loss, but did not reduce dietary CF among lactating women with overweight and obesity. Dietary interventions especially designed to decrease dietary CF and their coherence with dietary recommendations need further exploration.
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| 25. |
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| 26. |
- Huseinovic, Ena, et al.
(författare)
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Effectiveness of a weight loss intervention in postpartum women: results from a randomized controlled trial in primary health care
- 2016
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Ingår i: American Journal of Clinical Nutrition. - : Elsevier BV. - 0002-9165. ; 104:2, s. 362-370
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Tidskriftsartikel (refereegranskat)abstract
- Background: Reproduction has been identified as an important factor for long-term weight gain among women. A previous efficacy trial has successfully produced postpartum weight loss; however, the effectiveness of this intervention needs to be established. Objective: This study was designed to evaluate the short-and long-term effectiveness of a diet behavior modification treatment to produce weight loss in postpartum women within the primary health care setting in Sweden. Design: During 2011-2014, 110 women with a self-reported body mass index (BMI; in kg/m(2)) of >= 27 at 6-15 wk postpartum were randomly assigned to the diet behavior modification group (D group) or the control group (C group). Women randomly assigned to the D group (n = 54) received a structured 12-wk diet behavior modification treatment by a dietitian and were instructed to gradually implement a diet plan based on the Nordic Nutrition Recommendations and to self-weigh >= 3 times/wk. Women randomly assigned to the C group (n = 56) were given a brochure on healthy eating. The primary outcome was change in body weight after 12 wk and 1 y. The retention rate was 91% and 85% at 12 wk and 1 y, respectively. Results: At baseline, women had a median (1st, 3rd quartile) BMI of 31.0 (28.8, 33.6), and 84% were breastfeeding. After 12 wk, median weight change in the D group was -6.1 kg (-8.4, -3.2 kg) compared with -1.6 kg (-3.5, -0.4 kg) in the C group (P < 0.001). The difference was maintained at the 1-y follow-up for the D group, -10.0 kg (-11.7, -5.9 kg) compared with 24.3 kg (-10.2, -1.0 kg) in the C group (P = 0.004). In addition, the D group reduced BMI, waist circumference, hip circumference, and body fat percentage more than did the C group at both 12 wk and 1 y (all P < 0.05). Conclusion: A low-intensity diet treatment delivered by a dietitian within the primary health care setting can produce clinically relevant and sustainable weight loss in postpartum women with overweight and obesity.
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| 27. |
- Huseinovic, Ena, et al.
(författare)
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Two-year follow-up of a postpartum weight loss intervention: Results from a randomized controlled trial
- 2018
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Ingår i: Maternal and Child Nutrition. - : Wiley. - 1740-8695 .- 1740-8709. ; 14:2
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Tidskriftsartikel (refereegranskat)abstract
- We recently reported that a 12-week diet intervention among postpartum women produced a weight loss of 12% after 1year, compared to 5% in controls. Here, we present 2-year results after 1year of unsupervised follow-up. In total, 110 women with a self-reported body mass index of ≥27kg/m2 at 6–15-week postpartum were randomized to diet group (D-group) or control group (C-group). D-group received a 12-week diet intervention by a dietitian followed by monthly e-mails up to the 1-year follow-up. C-group received a brochure on healthy eating. No contact was provided from 1 to 2years to either group. Eighty-nine women (81%) completed the 2-year follow-up. Median (1st; 3rd quartile) weight change from 0 to 2years was −6.9 (−11.0; −2.2) kg in D-group and −4.3 (−8.7; −0.2) kg in C-group. There was no group by time interaction at 2years (p=.082); however, when women with a new pregnancy between 1 and 2years were excluded, the interaction became significant (−8.2 vs. −4.6kg, p=.038). From 1 to 2years, women in D- and C-group gained 2.5±5.0kg and 1.1±4.4kg, respectively (p=.186). Women who gained weight from 1 to 2years reported a decrease in self-weighing frequency compared to women who maintained or lost weight (p=.008). Both groups achieved clinically relevant 2-year weight loss, but the significant between-group-difference observed at 1year was not maintained at 2years in the main analysis. However, when women with a new pregnancy between 1 and 2years were excluded, a significant weight loss effect was observed also at 2years. © 2017 John Wiley & Sons Ltd
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| 28. |
- Huus, Karina, 1968-, et al.
(författare)
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Relationship of food frequencies as reported by parents to overweight and obesity at 5 years
- 2009
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 98:1, s. 139-143
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To investigate if food frequencies are related to overweight/obesity in 5-year-old children.METHODS: During 1997-1999, 21 700 infants were invited to participate in ABIS (All Babies in Southeast Sweden), a prospective, cohort study. Participants were followed from birth (n = 16 058) to 5 years (n = 7356). Food frequencies reported by parents at 2.5 and 5 years were studied in the relation to overweight/obesity at 5 years using multiple logistic regressions. A p-value < 0.01 was considered statistically significant.RESULTS: At 2.5 years frequencies of intake of cheese were positively associated with overweight/obesity at 5 years while porridge, fried potatoes/french fries and cream/crème fraiche showed a negative association. When adjusting for known risk factors, porridge and fried potatoes/french fries remained negatively associated with overweight/obesity. At 5 years, chocolate and lemonade were positively associated with overweight/obesity whereas cream/crème fraiche, pastries and candy were negatively associated. Candy remained negatively associated to overweight/obesity after adjustment for potential confounders.CONCLUSION: Food frequencies do not offer any simple explanation for overweight/obesity. Porridge at 2.5 years may protect against overweight/obesity at 5 years, while lemonade may contribute to overweight. Our finding that fried potatoes/french fries may protect against overweight/obesity is unexpected and must be interpreted with caution. These findings should be confirmed by prospective studies using objective recordings.
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| 29. |
- Jonsson, Karin, 1982, et al.
(författare)
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Diet in 1-year-old farm and control children and allergy development: results from the FARMFLORA birth cohort
- 2016
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Ingår i: Food and Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 60, s. 32721-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:A farming environment confers strong protection against allergy development. We have previously shown that farming mothers consume more full-fat dairy than control mothers, who instead consume more low-fat dairy, margarine, and oils; margarine and oil intake was associated with increased risk of allergy development in their children.OBJECTIVES:The aims of this study were to investigate the differences in diet between children in farming and control families at 1 year of age, to investigate the relation between the diets of the mothers and their children, and to relate the children's diet to allergy development.DESIGN:The diet of 1-year-old children from dairy farming families (n=28) and from control families in the same rural area (n=37) was assessed by 24-h dietary recalls, followed by 24-h food diaries. Allergy was diagnosed by pediatricians at 3 years of age using strict predefined criteria.RESULTS:Farm children had a higher intake of farm milk, whole cream, cholesterol, saturated fat, and fat in total and tended to eat more butter, while controls consumed more carbohydrates and poultry and tended to eat more margarine. Farm children also had higher intakes of homemade porridge/gruel, oily fish, and iodine. The intake of butter and whole milk in children and mothers correlated significantly in farm families but not in controls. A weak negative association was found between seafood intake and allergy development, while allergy was positively associated with the intake of pork as well as zinc in the control group; these intakes also correlated with each other.CONCLUSIONS:Consistent with mothers in farming families, the children consumed more full-fat dairy and saturated fat than did controls, but this could not be linked to the low risk of allergy in the farming group. Seafood intake might protect against allergy development, in accordance with earlier findings.
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| 30. |
- Jonsson, Karin, 1982, et al.
(författare)
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Diet in 1-year-old farm and control children and allergy development: results from the FARMFLORA birth cohort : Diet in 1-year-old farm and control children
- 2016
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Ingår i: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 60:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A farming environment confers strong protection against allergy development. We have previously shown that farming mothers consume more full-fat dairy than control mothers, who instead consume more low-fat dairy, margarine, and oils; margarine and oil intake was associated with increased risk of allergy development in their children. OBJECTIVES: The aims of this study were to investigate the differences in diet between children in farming and control families at 1 year of age, to investigate the relation between the diets of the mothers and their children, and to relate the children's diet to allergy development. DESIGN: The diet of 1-year-old children from dairy farming families (n=28) and from control families in the same rural area (n=37) was assessed by 24-h dietary recalls, followed by 24-h food diaries. Allergy was diagnosed by pediatricians at 3 years of age using strict predefined criteria. RESULTS: Farm children had a higher intake of farm milk, whole cream, cholesterol, saturated fat, and fat in total and tended to eat more butter, while controls consumed more carbohydrates and poultry and tended to eat more margarine. Farm children also had higher intakes of homemade porridge/gruel, oily fish, and iodine. The intake of butter and whole milk in children and mothers correlated significantly in farm families but not in controls. A weak negative association was found between seafood intake and allergy development, while allergy was positively associated with the intake of pork as well as zinc in the control group; these intakes also correlated with each other. CONCLUSIONS: Consistent with mothers in farming families, the children consumed more full-fat dairy and saturated fat than did controls, but this could not be linked to the low risk of allergy in the farming group. Seafood intake might protect against allergy development, in accordance with earlier findings.
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| 31. |
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| 32. |
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| 33. |
- Jonsson, Karin, 1982, et al.
(författare)
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Late introduction of fish and eggs is associated with increased risk of allergy development - results from the FARMFLORA birth cohort
- 2017
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Ingår i: Food and Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 61:1
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Tidskriftsartikel (refereegranskat)abstract
- The prevalence of allergy is markedly low in children growing up on farms. An increasing number of studies indicate that the timing of food introduction may affect allergy development. We aimed to investigate if protection against allergy in farm environments may be mediated through differences in food-introduction practices between farm and non-farm families, using an explorative approach. Twenty-eight farm and 37 non-farm children were included in the FARMFLORA birth cohort. Practices of breastfeeding and introduction of formulas and complementary foods were collected by questionnaires at 6, 12, and 18 months of age. Allergy was diagnosed by pediatricians at 3 years of age. The only difference in food-introduction practices observed between farm and non-farm children was an earlier introduction of nuts in farmers (median month: 11 [IQR: 8-6] in farmers, 15 [12-19] in non-farmers). One farm child (4%) and 10 non-farm children (27%) were allergic at 3 years of age. Lower risk of allergy development was associated with early exclusive breastfeeding (continuous variable; OR = 0.59, 95% CI: 0.39-0.89), but also having received eggs (OR = 0.08, 95% CI: 0.13-0.54) and fish (logistic regression not applicable, P = 0.01 in likelihood ratio testing [chi(2)]) at 10 months of age or earlier compared to later. Our results were not affected by reverse causation, as judged by a questionnaire sent to the families in retrospect. Timing of introduction of complementary foods is unlikely to contribute to the lower risk of allergy among farm children. Although early exclusive breastfeeding was associated with a lower rate of allergy development, postponed introduction of complementary foods might increase the risk of developing allergy. Owing to the limited sample size, our results are only indicative, but support prior findings.
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| 34. |
- Jonsson, Karin, 1982, et al.
(författare)
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Serum fatty acids in infants, reflecting family fish consumption, were inversely associated with allergy development but not related to farm residence. : Serum fatty acids and allergy in farm and control children
- 2016
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - : Wiley. - 1651-2227 .- 0803-5253. ; 105:12, s. 1462-1471
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Tidskriftsartikel (refereegranskat)abstract
- AIM: In this study, differences in serum fatty acid patterns between farm and non-farm infants were investigated and related to subsequent allergy development. We also related allergy-related serum fatty acids to maternal diet and breast milk fatty acids. METHODS: The FARMFLORA birth cohort included 28 farm and 37 non-farm infants. Serum was obtained from 21 farm infants and 29 controls at four months postpartum and analysed for phospholipid fatty acids. Allergy was diagnosed by paediatricians at three years of age. RESULTS: Serum fatty acid patterns were similar in farm and control infants, although farm infants had lower 18:1 omega-7 proportions. Serum proportions of eicosapentaenoic acid (EPA) were unrelated to farming status, but lower in children who subsequently developed allergy, with an odds ratio of 0.47 and 95% confidence interval of 0.27-0.83 (p=0.01) for every 0.1% EPA increase. The infants' serum EPA proportions correlated with breast milk EPA proportions, which, in turn, correlated with maternal oily fish intake during lactation. CONCLUSION: The allergy protective effect of farming was not linked to infant serum fatty acid composition. However, healthy infants had higher proportions of EPA in their sera, probably reflecting a family diet rich in fish, compared to subsequently allergic children.
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| 35. |
- Jonsson, Karin, 1982, et al.
(författare)
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Serum fatty acids in infants, reflecting family fish consumption, were inversely associated with allergy development but not related to farm residence.
- 2016
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Ingår i: Acta Paediatrica, International Journal of Paediatrics. - : Wiley. - 0803-5253 .- 1651-2227. ; 105:12, s. 1462-1471
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Tidskriftsartikel (refereegranskat)abstract
- AIM:In this study, differences in serum fatty acid patterns between farm and non-farm infants were investigated and related to subsequent allergy development. We also related allergy-related serum fatty acids to maternal diet and breast milk fatty acids.METHODS:The FARMFLORA birth cohort included 28 farm and 37 non-farm infants. Serum was obtained from 21 farm infants and 29 controls at four months postpartum and analysed for phospholipid fatty acids. Allergy was diagnosed by paediatricians at three years of age.RESULTS:Serum fatty acid patterns were similar in farm and control infants, although farm infants had lower 18:1 omega-7 proportions. Serum proportions of eicosapentaenoic acid (EPA) were unrelated to farming status, but lower in children who subsequently developed allergy, with an odds ratio of 0.47 and 95% confidence interval of 0.27-0.83 (p=0.01) for every 0.1% EPA increase. The infants' serum EPA proportions correlated with breast milk EPA proportions, which, in turn, correlated with maternal oily fish intake during lactation.CONCLUSION:The allergy protective effect of farming was not linked to infant serum fatty acid composition. However, healthy infants had higher proportions of EPA in their sera, probably reflecting a family diet rich in fish, compared to subsequently allergic children.
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| 36. |
- Klingberg, Sofia, 1979, et al.
(författare)
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Introduction of complementary foods in Sweden and impact of maternal education on feeding practices.
- 2017
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Ingår i: Public Health Nutrition. - : John Wiley & Sons. - 1368-9800 .- 1475-2727. ; 20:6, s. 1054-1062
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe the introduction of complementary foods in a population-based cohort in relation to recommendations and explore the possible impact of maternal education on infant feeding practices.DESIGN: Prospective data from the All Babies in Southeast Sweden (ABIS) cohort study were used. The ABIS study invited all infants born in south-east Sweden during October 1997-October 1999 (n 21 700) to participate. A questionnaire was completed for 16 022 infants. During the infants' first year parents continuously filed in a diary covering introduction of foods.SETTING: Sweden.SUBJECTS: Infants (n 9727) with completed food diaries.RESULTS: Potatoes, vegetables, fruits/berries and porridge were the foods first introduced, with a median introduction between 19 and 22 weeks, followed by introduction of meat, cow's milk, follow-on formula and sour milk/yoghurt between 24 and 27 weeks. Early introduction of any food, before 16 weeks, occurred for 27 % of the infants and was more common in infants of mothers with low education. Overall, potatoes (14·7 %), vegetables (11·1 %), fruits/berries (8·5 %), porridge (7·4 %) and follow-on formula (2·7 %) were the foods most frequently introduced early. The majority of infants (≥70 %) were introduced to potatoes, vegetables, fruits/berries and porridge during concurrent breast-feeding, but introduction during concurrent breast-feeding was less common in infants of mothers with low education.CONCLUSIONS: Most infants were introduced to complementary foods timely in relation to recommendations. Low maternal education was associated with earlier introduction of complementary foods and less introduction during concurrent breast-feeding. Still, the results indicated exposure to fewer foods at 12 months in infants of mothers with low education.
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| 37. |
- Klingberg, Sofia, 1979, et al.
(författare)
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Parity, weight change, and maternal risk of cardiovascular events
- 2017
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Ingår i: American Journal of Obstetrics and Gynecology. - : Elsevier BV. - 0002-9378 .- 1097-6868. ; 216:2, s. 1-172
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Tidskriftsartikel (refereegranskat)abstract
- Background High parity has been suggested to increase risk of maternal cardiovascular disease independent of body mass index measured after childbearing. Pregnancy is, however, associated with persistent weight gain and metabolic changes that, independent of parity, increase the risk of cardiovascular disease. It could therefore be questioned if high parity independently increases the risk of cardiovascular disease or if this association may be confounded, mediated, or modified by other parity-related factors. Objective We sought to investigate the association between parity and risk of cardiovascular disease, and secondary outcomes in terms of myocardial infarction and cerebral infarction, with particular focus on potential mediation by anthropometric measures and effect modification by lactation. Study Design We used data from 16,515 female participants (age 44.5-73.6 years) of the population-based Malmö Diet and Cancer Study with baseline examination from 1991 through 1996. The Malmö Diet and Cancer Study was followed up throughout 2010, with a median follow-up of 15.8 years. We used Cox proportional hazards model to examine the association between parity and cardiovascular disease. Results Adjusted for age and other potential confounders, grand multiparous women (≥5 children) had an increased risk of cardiovascular disease (hazard ratio, 1.60; 95% confidence interval, 1.20–2.14), myocardial infarction (hazard ratio, 1.68; 95% confidence interval, 1.15–2.45), and cerebral infarction (hazard ratio, 1.74; 95% confidence interval, 1.18–2.58) compared to women with 2 children. Additional adjustment for baseline body mass index and weight change since age 20 years attenuated the risk, but the increased risk for cardiovascular disease (hazard ratio, 1.38; 95% confidence interval, 1.02–1.87) and myocardial infarction (hazard ratio, 1.53; 95% confidence interval, 1.04–2.26) in grand multiparous women remained significant. Models stratified by lactation time showed that risk was only raised in grand multiparous women who had a mean lactation time of <4 mo/child. In sensitivity analyses excluding women with a history of diabetes at baseline, risk estimates for grand multiparous women became nonsignificant in the full model. Conclusion Part of the increased risk of cardiovascular disease and myocardial infarction in grand multiparous women seems to be mediated by weight gain and potentially by higher likelihood of type 2 diabetes mellitus. Lactation may modify the increased risk of grand multiparity in that longer duration might offset the cardiovascular disease risk.
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| 38. |
- Lignell, S., et al.
(författare)
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Environmental organic pollutants in human milk before and after weight loss
- 2016
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Ingår i: Chemosphere. - : Elsevier BV. - 0045-6535 .- 1879-1298. ; 159, s. 96-102
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Tidskriftsartikel (refereegranskat)abstract
- © 2016 Elsevier Ltd.Many persistent organic pollutants (POPs) are banned because they accumulate in organisms and are toxic. Lipophilic POPs are stored in maternal adipose tissue and concentrations in human milk (HM) may increase during weight loss. Our aim was to examine associations between weight loss and concentrations of chlorinated POPs in HM in lactating women participating in a weight loss study. We analysed POPs (PCB 28, PCB 153, HCB, DDE) in HM at 12 and 24 weeks postpartum from 32 women who participated in a randomized, 2 × 2 factorial trial of diet and exercise for postpartum weight loss. Participants donated milk before and after the intervention period. We examined associations between weight loss and change in POP concentrations and estimated the intake of POPs by their breastfed infants. Most (n = 27) women lost weight during intervention, 0.45 ± 0.30 kg/week (mean ± SD). Among these women, the concentration of PCB 153 in HM was significantly (p = 0.04) higher at follow-up than at baseline. Weight loss was significantly positively associated with changes in concentrations of all studied POPs (2.0-2.4% increase per percent weight loss). Estimated mean intakes of POPs (ng/day) remained stable because infant milk consumption decreased during the study period. As infants gained weight, estimated mean intakes per kg body weight decreased 17-22%. Changes in concentrations of POPs in HM correlated positively with maternal weight loss, but it is unlikely that the balance between the benefits and risks of breastfeeding will change if the weight loss is restricted to 0.5 kg per week.
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| 39. |
- Ljungkrona-Falk, Lena, et al.
(författare)
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Swedish nurses encounter barriers when promoting healthy habits in children.
- 2014
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Ingår i: Health promotion international. - Oxford : Oxford University Press (OUP). - 1460-2245 .- 0957-4824. ; 29:4, s. 730-738
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Tidskriftsartikel (refereegranskat)abstract
- To increase the understanding of difficulties in promoting healthy habits to parents, we explore barriers in health-care provision. The aim of this study is to describe nurses' perceived barriers when discussing with parents regarding healthy food habits, physical activity and their child's body weight. A mixed method approach was chosen. Nurses (n = 76) working at 29 different Child Health Care Centers' in an area in west Sweden were included in the study. Three focus group interviews were conducted and 17 nurses were selected according to maximum variation. Data were categorized and qualitative content analysis was the chosen analysis method. In the second method, data were obtained from a questionnaire distributed to all 76 nurses. The latent content was formulated into a theme: even with encouragement and support, the nurses perceive barriers of both an external and internal nature. The results identified four main barriers: experienced barriers in the workplace-internal and external; the nurse's own fear and uncertainty; perceived obstacles in nurse-parent interactions and modern society impedes parents' ability to promote healthy habits. The nurses' perceived barriers were confirmed by the results from 62 of the nurses who completed the questionnaire. Despite education and professional support, the health professionals perceived both external and internal barriers in promoting healthy habits to parents when implementing a new method of health promotion in primary care. Further qualitative studies are needed to gain deeper understanding of the perceived barriers when promoting healthy habits to parents.
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| 40. |
- Nesse, S. H., et al.
(författare)
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Predictive equations for estimating resting energy expenditure in women with overweight and obesity at three postpartum stages
- 2020
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Ingår i: Journal of Nutritional Science. - : Cambridge University Press (CUP). - 2048-6790. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- The objective was to investigate which predictive equations provide the best estimates of resting energy expenditure (REE) in postpartum women with overweight and obesity. Lactating women with overweight or obesity underwent REE measurement by indirect calorimetry, and fat-free mass (FFM) was assessed by dual-energy X-ray absorptiometry at three postpartum stages. Predictive equations based on body weight and FFM were obtained from the literature. Performance of the predictive equations were analysed as the percentage of women whose REE was accurately predicted, defined as a predicted REE within +/- 10 % of measured REE. REE data were available for women at 10 weeks (n71), 24 weeks (n64) and 15 months (n57) postpartum. Thirty-six predictive equations (twenty-five weight-based and eleven FFM-based) were validated. REE was accurately predicted in >= 80 % of women at all postpartum visits by six predictive equations (two weight-based and four FFM-based). The weight-based equation with the highest performance was that of Henry (weight, height, age 30-60 years) (Henry(WH30-60)), with an overall mean of 83 % accurate predictions. The Henry(WH30-60)equation was highly suitable for predicting REE at all postpartum visits (irrespective of the women's actual age), and the performance was sustained across changes in weight and lactation status. No FFM-based equation was remarkably superior to Henry(WH30-60)for the total postpartum period.
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| 41. |
- Ohman, E. A., et al.
(författare)
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Effects of dietary and exercise treatments on HDL subclasses in lactating women with overweight and obesity: a secondary analysis of a randomised controlled trial
- 2022
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Ingår i: British Journal of Nutrition. - : Cambridge University Press (CUP). - 0007-1145 .- 1475-2662. ; 128:11, s. 2105-2114
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Tidskriftsartikel (refereegranskat)abstract
- Childbearing decreases HDL-cholesterol, potentially contributing to the increased risk of CVD in parous women. Large HDL particles (HDL-P) are associated with lower risk of CVD. In this secondary analysis of a randomised controlled trial, we investigated the effects of 12-week dietary and exercise treatments on HDL-P subclass concentration, size and apoA1 in lactating women with overweight/obesity. At 10-14 weeks postpartum, 68 women with pre-pregnant BMI 25-35 kg/m(2) were randomised to four groups using 2 x 2 factorial design: (1) dietary treatment for weight loss; (2) exercise treatment; (3) both treatments and (4) no treatment. Lipoprotein subclass profiling by NMR spectroscopy was performed in serum at randomisation and after 3 and 12 months, and the results analysed with two-way ANCOVA. Lipid concentrations decline naturally postpartum. At 3 months (5-6 months postpartum), both diet (P = 0 center dot 003) and exercise (P = 0 center dot 008) reduced small HDL-P concentration. Concurrently, exercise limited the decline in very large HDL-P (P = 0 center dot 002) and the effect was still significant at 12 months (15 months postpartum) (P = 0 center dot 041). At 12 months, diet limited the decline in very large HDL-P (P = 0 center dot 005), large HDL-P (P = 0 center dot 001) and apoA1 (P = 0 center dot 002) as well as HDL size (P = 0 center dot 002). The dietary treatment for weight loss and the exercise treatment both showed effects on HDL-P subclasses in lactating women with overweight and obesity possibly associated with lower CVD risk. The dietary treatment had more effects than the exercise treatment at 12 months, likely associated with a 10 % weight loss.
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| 42. |
- Slinde, Frode, 1973, et al.
(författare)
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Energy Expenditure by Multisensor Armband in Overweight and Obese Lactating Women Validated by Doubly Labeled Water
- 2013
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Ingår i: Obesity. - : Wiley. - 1930-7381. ; 21:11, s. 2231-2235
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To validate total energy expenditure (TEE) and activity energy expenditure (AEE) from the portable SenseWear armband (SWA) Pro 2 (TEESWA and AEE(SWA); InnerView software versions SWA 5.1 and SWA 6.1) against TEE from doubly labeled water (DLW) and AEE from DLW and indirect calorimetry (TEEDLW and AEE(DLW)) in overweight/obese lactating women at 10 weeks postpartum. Design and Methods: TEE was measured simultaneously with DLW (14 days) and SWA (first 7 days). Lactating women (n = 62), non-smoking, with a BMI > 25 kg/m(2) and wearing time SWA >= 90% were included. Results: Mean TEESWA5.1 was overestimated with 85 kcal/day compared to TEEDLW (P = 0.040), while mean TEESWA6.1 was underestimated with 241 kcal/day compared to TEEDLW (P < 0.001). Mean AEE(SWA5.1) was similar to mean AEE(DLW) (P = 0.818), while mean AEE(SWA6.1) was underestimated with 581 kcal/day compared to AEE(DLW) (P < 0.001). TEESWA6.1 and AEE(SWA6.1) were systematically underestimated at higher levels of energy expenditure and BMI while only AEE(SWA5.1) was systematically overestimated at higher levels of energy expenditure. Conclusions: TEESWA5.1 and AEE(SWA5.1) were fairly estimated on a group level while TEESWA6.1 and AEE(SWA6.1) were significantly and systematically underestimated. Both SWA software versions showed large individual variation in agreement with TEEDLW and AEE(DLW), limiting the validity on individual level.
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| 43. |
- Winkvist, Anna, 1962, et al.
(författare)
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Metabolic Risk Profile among Overweight and Obese Lactating Women in Sweden
- 2013
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Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 8:5
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Tidskriftsartikel (refereegranskat)abstract
- Background: Obesity and cardiovascular diseases are increasing globally and any association between reproduction and these conditions is of concern. Unfortunately, little is known about normal levels of metabolic risk factors in women of different body mass index throughout the reproductive cycle. This study is one of the first to describe the metabolic risk profile of lactating overweight or obese women at 8-12 weeks postpartum. Methods: During 2007-2009, 66 overweight or obese Swedish lactating women without known diseases underwent detailed measurements of their metabolic profiles, dietary intake and general health before entering a lifestyle intervention trial. Baseline measurements took place between 8-12 wk postpartum. Almost all women were exclusively breastfeeding their term infants. Results: The women were regarded as healthy, as reflected in the absence of diagnosed diseases, their own perceptions and in normal hemoglobin, albumin and fasting plasma glucose values. Four women were diagnosed with metabolic syndrome. In these cases, underlying conditions included large waist circumference, low HDL cholesterol values, high triglyceride values and relatively high blood pressure. The metabolic profile differed between overweight and obese women; obese women had significantly higher levels of fasting insulin (p = 0.017), borderline higher HOMA values (p = 0.057) and significantly higher triglyceride values (p = 0.029), as well as larger waist and hip circumferences (p<0.001 and p<0.001). However, no significant differences between overweight and obese women were detected for LDL or total cholesterol levels. Overweight and obese women reported similar total energy and macronutrient intakes, but obese women tended to be less physically active (p = 0.081). Conclusions: Among generally healthy lactating women, obesity as compared to overweight is associated with increased metabolic risk. This cut-off is thus important also in the early postpartum period, and obesity among these women should warrant proper health investigation. Macronutrient intake did not differ between the groups and, hence, cannot explain these differences.
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