| 1. |
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| 2. |
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| 3. |
- Klingberg, Sofia, 1979, et al.
(författare)
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Inverse relation between dietary intake of naturally occurring plant sterols and serum cholesterol in northern Sweden
- 2008
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Ingår i: American Journal of Clinical Nutrition. - New York, N.Y. : American Society for Clinical Nutrition. - 0002-9165 .- 1938-3207. ; 87:4, s. 993-1001
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Tidskriftsartikel (refereegranskat)abstract
- Background: Plant sterols are bioactive compounds, found in all vegetable foods, which inhibit cholesterol absorption. Little is known about the effect of habitual natural dietary intake of plant sterols. Objective: We investigated the relation between plant sterol density (in mg/MJ) and serum concentrations of cholesterol in men and women in northern Sweden. Design: The analysis included 37 150 men and 40 502 women aged 29–61 y, all participants in the Västerbotten Intervention Program. Results: Higher plant sterol density was associated with lower serum total cholesterol in both sexes and with lower LDL cholesterol in women. After adjustment for age, body mass index (in kg/m2), and (in women) menopausal status, men with high plant sterol density (quintile 5) had 0.15 mmol/L (2.6%) lower total serum cholesterol (P for trend = 0.001) and 0.13 mmol/L (3.1%) lower LDL cholesterol (P = 0.062) than did men with low plant sterol density (quintile 1). The corresponding figures for women were 0.20 mmol/L (3.5%) lower total serum cholesterol (P for trend < 0.001) and 0.13 mmol/L (3.2%) lower LDL cholesterol (Pfor trend = 0.001). Conclusions: The present study is the second epidemiologic study to show a significant inverse relation between naturally occurring dietary plant sterols and serum cholesterol. To the extent that the associations found truly mirror plant sterol intake and not merely a diet high in vegetable fat and fiber, it highlights the importance of considering the plant sterol content of foods both in primary prevention of cardiovascular disease and in the dietary advice incorporated into nutritional treatment of patients with hyperlipidemia.
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| 4. |
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| 8. |
- Axelsson, Mette, et al.
(författare)
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Mat vid diabetes. : En systematisk översikt med utvärdering av effekter samt hälsoekonomiska och etiska aspekter.
- 2022
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- SlutsatserTyp 1- och typ 2-diabetes Det finns ett samband mellan att äta medelhavskost och lägre risk att dö i förtid oavsett orsak (måttlig tillförlitlighet). Det finns ett samband mellan att äta en större andel2 fibrer eller baljväxter och lägre risk att dö i förtid oavsett orsak (måttlig tillförlitlighet). Det kan även finnas ett samband mellan att äta en större andel nötter och lägre risk att dö i förtid oavsett orsak (låg tillförlitlighet) samt lägre risk att insjukna i hjärt- och kärlsjukdom (låg tillförlitlighet). Det finns ett samband mellan att dricka mer2 kaffe och lägre risk att dö i förtid oavsett orsak och lägre risk att dö i förtid i kranskärlssjukdom (måttlig tillförlitlighet) samt möjligen en lägre risk att dö i förtid i hjärt- och kärlsjukdom (låg tillförlitlighet). Det råder generell brist på studier med lång uppföljningstid som jämför inverkan av olika slags kostråd på överlevnad, diabeteskomplikationer, diabetesremission3, livskvalitet och biverkningar. Tillförlitligheten av befintliga resultat är dessutom mycket låg för de flesta koster, kostbehandlingar, livsmedel och näringsämnen som har utvärderats. Effekter på hälsa och relaterade mått kan i dessa fall inte bedömas.2. Begreppet ”större andel” eller ”mer” avser inte nödvändigtvis att äta eller dricka mer totalt utan att öka mängden av ett visst livsmedel genom att byta ut annan mat eller dryck.Typ 2-diabetes Det kan finnas ett samband mellan att äta en större andel mättat fett och högre risk för att dö i förtid av hjärt- och kärlsjukdom (låg tillförlitlighet). Det kan även finnas ett samband mellan att äta en större andel enkelomättat fett och lägre risk att dö i förtid oavsett orsak (låg tillförlitlighet). En behandling med en initial period av kraftigt minskat energiintag med hjälp av lågenergipulver (VLED) med efterföljande övergång till mat för viktstabilitet jämfört med vanlig kostbehandling har gynnsamma effekter på livskvalitet (enligt EQ-5D), långtidsblodsocker (HbA1c) och vikt upp till 12 månader (måttlig tillförlitlighet)4. Vidare kan metoder där VLED ingår ha gynnsamma effekter på diabetesremission5 och midjeomfång upp till 12 månader (låg tillförlitlighet) och långtidsblodsocker (HbA1c) upp till 24 månader (låg tillförlitlighet). Intensiv livsstilsbehandling därlågfettkost kombineras med fysisk aktivitet och minskat energiintag har gynnsamma effekter jämfört med vanlig kostbehandling på långtidsblodsocker (HbA1c), vikt, kroppsmasseindex (BMI), midjeomfång och vissa blodfetter upp till 12 månader (måttlig tillförlitlighet)3. Viktminskningen kan kvarstå upp till omkring 10 år (låg tillförlitlighet). Behandlingen kan leda till bättre fysisk livskvalitet upp till 8 år (låg tillförlitlighet) medan effektskillnaden i psykisk livskvalitet under samma tid kan vara obefintlig eller försumbar (låg tillförlitlighet). Jämförelsen påvisar ingen förändrad risk att dö i förtid oavsett orsak eller att dö eller insjukna av kardiovaskulära orsaker efter omkring 10 år (låg tillförlitlighet). I det hälsoekonomiska perspektivet är intensiv livsstilsbehandling mer resurskrävande än vanlig kostbehandling, och beräkningar visar små eller inga vinster i kvalitetsjusterade levnadsår (QALYs) på individnivå. Energirestriktion i samband med intensiv livsstilsbehandling med ketogen kost eller med högproteinkost (20 E%) i kombination med fysisk aktivitet jämfört med vanlig kostbehandling kan ge en viktminskning upp till 11 månader (låg tillförlitlighet) men det saknas studier som kan visa om vikten kan bibehållas på längre sikt. Det saknas studier som undersökt kliniskt viktiga utfall som dödlighet, kardiovaskulära sjukdomar, livskvalitet och diabetesremission.3. Gäller endast vid typ 2-diabetes.4. Utgår från individer med en medelkroppsvikt på cirka 100 kg och medel-HbA1c på 60 mmol/mol.5. Resultaten för utfallet diabetesremission (att uppnå normala blodsockervärden) gäller när en diabetesdiagnos sattes för mindre än 6 år sedan eller för mindre än 3 år sedan. Definitionen för diabetesremission var ett HbA1c på mindre än 48 mmol/mol och att samtidigt vara fri från blodsockersänkande läkemedel.Graviditetsdiabetes Det saknas studier om kost vid graviditetsdiabetes med tillräcklig tillförlitlighet för att kunna bedöma effekterna.
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| 9. |
- Banach, Maciej, et al.
(författare)
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The role of red yeast rice (RYR) supplementation in plasma cholesterol control: A review and expert opinion
- 2019
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Ingår i: Atherosclerosis Supplements. - : Elsevier BV. - 1567-5688 .- 1878-5050. ; 39
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Tidskriftsartikel (refereegranskat)abstract
- Hypercholesterolemia is a major risk factor for atherosclerotic cardiovascular disease (ASCVD) [1]. Increased levels of low density lipoprotein cholesterol (LDL-C) are associated with an increased risk of coronary heart disease (CHD) and many clinical trials have shown that reducing LDL-C levels significantly reduced the CHD and CVD risk [2–5]. Thus LDL-C-lowering is the main approach for the management of cardiovascular disease. Current guidelines suggest LDL-C levels targets based on the individual CV risk; such targets can be achieved by several means, which include both lifestyle changes and pharmacological approaches [6], with statins being the cornerstone of cardiovascular prevention.
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| 10. |
- Bartusch, Cajsa, 1965-
(författare)
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Boosting behavioral change in residential electricity consumption : demand response programs and feedback
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- As part of realizing national and European climate ambitions, it is imperative to bring about increased energy efficiency and consumption flexibility in the residential sector of the Swedish power market. In addition to governmental policy instruments to this end, market-based measures play an important role in making behavioral change in domestic electricity use happen. In light of the prevailing lack of incentives for residential consumers to save electricity and cut peak demand at times of physical and financial market constraints, the research studies that form the basis of this thesis have the aim of adding to the body of knowledge on policy instruments for the purpose of boosting behavioral change in residential electricity consumption. The research has accordingly contributed to the general statistics on residential electricity consumption, which constitute the starting point for policy instrument development, and augmented knowledge on the merits of residential demand response programs involving hourly settlements in power trading and demand-based, time-of-use tariffs in power distribution as well as graphic feedback on individual households’ electricity use by means of a statistics service provided over the Internet. The overall results have shown that household behavior, together with physical factors such as heating systems, help explain the sizeable differences in electricity consumption among homeowners. Statistical analysis of variance has in this context proven to be an effective method for identifying key indicators of policy development. Power suppliers and electricity consumers as well as society as a whole have been found to gain substantially from hourly settlements in retail. To suppliers, the greatest benefits are associated with risk management, while the major advantage to customers is that they are provided with an opportunity to reduce their electricity costs. It has also been empirically demonstrated that electricity users are willing to adjust their consumption to a demand-based, time-varying distribution tariff. Households generally have a favorable attitude towards this type of distribution tariff, seeing as they indirectly have a positive impact on the environment. Providing households with feedback over the Internet on their individual electricity use and demand has been shown to contribute to an increased awareness and lead to energy efficiency in homes. Easy accessibility and simplicity have proven to be key success factors in this context. Combining conventional bar charts, color symbolism and historic feedback is expedient in this respect.
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| 11. |
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| 12. |
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| 13. |
- 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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| 14. |
- Bosaeus, Ingvar, 1950, et al.
(författare)
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Enteral och parenteral nutrition
- 2008
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Ingår i: Medicinska mag-tarmsjukdomar, redaktör Henry Nyhlin. - Lund : Studentlitteratur. - 9789144017112 ; , s. 425-437
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 15. |
- Bosaeus, Ingvar, 1950, et al.
(författare)
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Vårdprogram vid tarmsvikt
- 2010
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Ingår i: Svensk Förening för Gastroenterologi.
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 16. |
- Bosaeus, Marja, et al.
(författare)
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A randomized longitudinal dietary intervention study during pregnancy: effects on fish intake, phospholipids, and body composition
- 2015
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Ingår i: Nutrition Journal. - : Springer Science and Business Media LLC. - 1475-2891. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Fish and meat intake may affect gestational weight gain, body composition and serum fatty acids. We aimed to determine whether a longitudinal dietary intervention during pregnancy could increase fish intake, affect serum phospholipid fatty acids, gestational weight gain and body composition changes during pregnancy in women of normal weight participating in the Pregnancy Obesity Nutrition and Child Health study. A second aim was to study possible effects in early pregnancy of fish intake and meat intake, respectively, on serum phospholipid fatty acids, gestational weight gain, and body composition changes during pregnancy. Methods In this prospective, randomized controlled study, women were allocated to a control group or to a dietary counseling group that focused on increasing fish intake. Fat mass and fat-free mass were measured by air-displacement plethysmography. Reported intake of fish and meat was collected from a baseline population and from a subgroup of women who participated in each trimester of their pregnancies. Serum levels of phospholipid arachidonic acid (s-ARA), eicosapentaenoic acid (s-EPA), and docosahexaenoic acid (s-DHA) were measured during each trimester. Results Weekly fish intake increased only in the intervention group (n=18) from the first to the second trimester (median difference 113 g, p=0.03) and from the first to the third trimester (median difference 75 g, p=0.01). In the first trimester, fish intake correlated with s-EPA (r=0.36, p=0.002, n=69) and s-DHA (r=0.34, p=0.005, n=69), and meat intake correlated with s-ARA (r=0.28, p=0.02, n=69). Fat-free mass gain correlated with reported meat intake in the first trimester (r=0.39, p=0.01, n=45). Conclusions Dietary counseling throughout pregnancy could help women increase their fish intake. Intake of meat in early pregnancy may increase the gain in fat-free mass during pregnancy.
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| 17. |
- Bosaeus, Marja, et al.
(författare)
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Accuracy of quantitative magnetic resonance and eight-electrode bioelectrical impedance analysis in normal weight and obese women.
- 2014
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Ingår i: Clinical Nutrition. - : Elsevier BV. - 0261-5614. ; 33:3, s. 471-477
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Tidskriftsartikel (refereegranskat)abstract
- Background & aims Quantitative magnetic resonance (QMR) has previously been shown to both overestimate and underestimate average fat mass (FM) in humans. Eight-electrode bioelectrical impedance analysis (BIA) has previously been found biased as well as successfully validated. We report cross-sectional accuracy of QMR and eight-electrode BIA evaluated with air displacement plethysmography (ADP) as reference method. Methods Fat mass and fat free mass (FFM) by QMR and eight-electrode BIA were evaluated against ADP as reference in 38 normal weight and 30 obese women. Total body water estimates by QMR and eight-electrode BIA were compared. Results Fat mass was overestimated by QMR (1 ± 2 kg, p < 0.001) and was underestimated by eight-electrode BIA (1 ± 3 kg, p = 0.03, Bonferroni adjusted p = 0.29) in normal weight women. Fat mass was underestimated by both QMR (2 ± 2 kg, p < 0.001) and eight-electrode BIA (9 ± 3 kg, p < 0.001) in obese women. Fat free mass biases were of similar magnitude but in opposite direction to FM biases. Total body water estimates were larger by eight-electrode BIA compared to QMR (1–10 kg). Conclusions Fat mass and FFM by QMR were both biased but in opposite directions in both normal weight and obese women. Eight-electrode BIA FM and FFM estimates were imprecise and biased in obese women. Thus, QMR is more precise and more accurate than eight-electrode BIA for estimating body composition in women, but is not accurate enough to be used for individual single assessment of body composition.
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| 18. |
- Bosaeus, Marja, et al.
(författare)
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Body Composition During Pregnancy: Longitudinal Changes and Method Comparisons
- 2020
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Ingår i: Reproductive Sciences. - : Springer Science and Business Media LLC. - 1933-7191 .- 1933-7205. ; :27, s. 1477-1489
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Tidskriftsartikel (refereegranskat)abstract
- The Pregnancy Obesity Nutrition and Child Health study is a longitudinal study of reproductive health. Here we analyzed body composition of normal-weight and obese Swedish women by three methods during each trimester of pregnancy. Cross-sectional and longitudinal fat mass estimates using quantitative magnetic resonance (QMR) and bioelectrical impedance analysis (BIA) (Tanita MC-180MA-III) were compared with fat mass determined by air displacement plethysmography (ADP) in pregnancy weeks 8-12, 24-26, and 35-37 in normal-weight women (n = 122, BMI = 22.1 +/- 1.6 kg/m(2)) and obese women (n = 29, BMI = 34.6 +/- 3.6 kg/m(2)). ADP results were calculated from pregnancy-adjusted fat-free mass densities. Mean fat mass by QMR and ADP were similar in obese women, although with wide limits of agreement. In normal-weight women, QMR overestimated mean fat mass in all trimesters, with systematic overestimation at low fat mass values in trimesters 1 and 3. In obese women, fat mass by BIA was grossly underestimated and imprecise in all trimesters, especially at higher values in trimester 2. In normal-weight women, fat mass by BIA was moderately lower than by ADP in trimester 1, similar in trimester 2, and moderately higher in trimester 3. QMR and ADP assessed fat mass changes similarly in obese women, whereas BIA overestimated fat mass changes in normal-weight women. Mean fat mass and fat mass changes by QMR and pregnancy-adjusted ADP were similar in pregnant obese women. Mean fat mass by QMR and fat mass changes by BIA were higher than corresponding values determined by pregnancy-adjusted ADP in normal-weight women.
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| 19. |
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| 20. |
- Buendia, Ruben, 1982, et al.
(författare)
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Estimation of body fluids with bioimpedance spectroscopy: state of the art methods and proposal of novel methods
- 2015
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Ingår i: Physiological Measurement. - : IOP Publishing. - 0967-3334 .- 1361-6579. ; 36:10
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Tidskriftsartikel (refereegranskat)abstract
- Determination of body fluids is a useful common practice in determination of disease mechanisms and treatments. Bioimpedance spectroscopy (BIS) methods are non-invasive, inexpensive and rapid alternatives to reference methods such as tracer dilution. However, they are indirect and their robustness and validity are unclear. In this article, state of the art methods are reviewed, their drawbacks identified and new methods are proposed. All methods were tested on a clinical database of patients receiving growth hormone replacement therapy. Results indicated that most BIS methods are similarly accurate (e.g. < 0.5 +/- 3.0% mean percentage difference for total body water) for estimation of body fluids. A new model for calculation is proposed that performs equally well for all fluid compartments (total body water, extra-and intracellular water). It is suggested that the main source of error in extracellular water estimation is due to anisotropy, in total body water estimation to the uncertainty associated with intracellular resistivity and in determination of intracellular water a combination of both.
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| 21. |
- Buendia, Rubén, et al.
(författare)
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Robustness study of the different immittance spectra and frequency ranges in bioimpedance spectroscopy analysis for assessment of total body composition.
- 2014
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Ingår i: Physiological measurement. - : IOP Publishing. - 1361-6579 .- 0967-3334. ; 35:7, s. 1373-95
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Tidskriftsartikel (refereegranskat)abstract
- The estimation of body fluids is a useful and common practice for assessment of disease status and therapy outcomes. Electrical bioimpedance spectroscopy (EBIS) methods are noninvasive, inexpensive and efficient alternatives for determination of body fluids. One of the main source of errors in EBIS measurements in the estimation of body fluids is capacitive coupling. In this paper an analysis of capacitive coupling in EBIS measurements was performed and the robustness of the different immittance spectra against it tested. On simulations the conductance (G) spectrum presented the smallest overall error, among all immittance spectra, in the estimation of the impedance parameters used to estimate body fluids. Afterwards the frequency range of 10-500kHz showed to be the most robust band of the G spectrum. The accuracy of body fluid estimations from the resulting parameters that utilized G spectrum and parameters provided by the measuring device were tested on EBIS clinical measurements from growth hormone replacement therapy patients against estimations performed with dilution methods. Regarding extracellular fluid, the correlation between each EBIS method and dilution was 0.93 with limits of agreement of 1.06 ± 2.95 l for the device, 1.10 ± 2.94 l for G [10-500kHz] and 1.04 ± 2.94 l for G [5-1000kHz]. Regarding intracellular fluid, the correlation between dilution and the device was 0.91, same as for G [10-500kHz] and 0.92 for G [5-1000kHz]. Limits of agreement were 0.12 ± 4.46 l for the device, 0.09 ± 4.45 for G [10-500kHz] and 0.04 ± 4.58 for G [5-1000kHz]. Such close results between the EBIS methods validate the proposed approach of using G spectrum for initial Cole characterization and posterior clinical estimation of body fluids status.
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| 22. |
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| 23. |
- Cederholm, Tommy, et al.
(författare)
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SBU-rapport "missar" övertygande evidensläge : Kosttillägg förlänger livet på undernärda äldre
- 2014
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 111:51-52, s. 2299-2300
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Tidskriftsartikel (refereegranskat)abstract
- Tvärtemot slutsatserna i en ny SBU-rapport anser Tommy Cederholm och medförfattare att det finns övertygande evidens för att kosttillägg är gynnsamt för undernärda äldre. Ordination ska dock ske först efter utredning, göras patientsäkert, dokumenteras och utvärderas individuellt.
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| 24. |
- Cloetens, Lieselotte, et al.
(författare)
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Energy - a scoping review for the Nordic Nutrition Recommendations 2023 project
- 2023
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Ingår i: FOOD & NUTRITION RESEARCH. - 1654-6628 .- 1654-661X. ; 67
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Tidskriftsartikel (refereegranskat)abstract
- We need energy intake to provide energy and nutrients to our cells. The amount of daily energy intake should aim for energy balance, which results in good health. Under- or overconsumption of total daily energy over a longer period leads to increased risk of diseases. In this scoping review, the components of daily energy requirement are defined. Several methods to estimate energy requirements and the amount of total daily energy intake (kJ) related to health are also discussed. Reference values for energy intake in children, adults and pregnant and postpartum women, and older adults are evaluated.Results show that it is challenging to set reference values for energy intake since existing methods are not accurate and precise, and there are several factors that influence the estimated amount of energy. Energy requirement is increased during growth as in childhood, pregnancy and lactation. We conclude that more research in this area is needed, and that new high-quality studies in both Nordic and Baltic countries are needed to obtain new recommendation numbers for energy intake.
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| 25. |
- Copland, Lotta, 1969, et al.
(författare)
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Muscle mass and exercise capacity in cancer patients after major upper gastrointestinal surgery.
- 2010
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Ingår i: e-SPEN, the European e-journal of Clinical Nutrition and Metabolism. - 1751-4991. ; 5:6
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Tidskriftsartikel (refereegranskat)abstract
- Background & aims Nutritional therapy has traditionally been evaluated by changes in weight and in food intake, while body composition and function may be of greater clinical significance. We investigated relationships between total body skeletal muscle mass (TBSMM), energy balance and exercise capacity in 41 patients before, 6 and 12 months after curatively intended major upper gastrointestinal surgery. Methods TBSMM and body energy content were assessed by DXA. Exercise capacity was measured on a treadmill. Energy balance was defined as the difference in body energy content at two points in time. Results During the first postoperative year average weight loss was 7% although 1 our of 3 patients remained weight stable (WS). Average TBSMM decreased significantly at 6 months (0.9 kg, p < 0.01), but was regained at 12 months, as was exercise capacity. 72% of weight losing patients (WL) lost TBSMM compared to 17% of WS patients, p < 0.01. Both TBSMM and changes in TBSMM, but not changes in energy content, were correlated to exercise capacity, r2 = 0.49, p < 0.001 and r2 = 0.15, p < 0.05 respectively. Conclusions TBSMM and exercise capacity were clearly related in cancer patients after major upper gastrointestinal surgery, as were changes in TBSMM and exercise capacity. Energy balance was not directly correlated to exercise capacity, but more WS than WL patients increased their TBSMM indicating a possible influence by energy balance.
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| 26. |
- Copland, Lotta, 1969, et al.
(författare)
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Validity of the ActiReg system and a physical activity interview in assessing total energy expenditure in long-term survivors after total gastrectomy.
- 2008
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Ingår i: Clinical nutrition (Edinburgh, Scotland). - : Elsevier BV. - 1532-1983 .- 0261-5614. ; 27:6, s. 842-8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND & AIMS: Malnutrition is common after total gastrectomy. There is a need for clinically useful methods to assess energy requirements. We aimed to validate measurements of energy expenditure by an activity monitor (ActiReg) and a physical activity interview (HPAQ(modified)), in long-term survivors after gastrectomy for gastric carcinoma, using doubly labelled water as reference method. METHODS: Total energy expenditure (TEE) was estimated by DLW (14 days), ActiReg (3 days) and HPAQ(modified) (7 days) in 15 patients. Measurements were repeated after 12 months. Basal metabolic rate was measured with indirect calorimetry. RESULTS: ActiReg and HPAQ(modified) both underestimated TEE by 180 (+/-254 SD) and 130 (+/-326 SD)kcalday(-1), i.e. 14% vs. 12%, respectively. However, this was evident only at higher levels of physical activity (PAL(DLW)> or =1.65), whereas at lower levels (PAL<1.65) no difference was found. There were no changes in TEE over time independent of the method used. DLW and ActiReg had approximately the same width of the 95% confidence interval of this estimate, while it was 2.4 times larger by HPAQ(modified). CONCLUSION: Both simple methods underestimated total energy expenditure at higher, but not at lower physical activity levels. The ActiReg method appears useful to estimate changes in TEE over time.
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| 27. |
- Cuerda, C., et al.
(författare)
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Original article Nutrition education in medical schools (NEMS) project: Joining ESPEN and university point of view
- 2021
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Ingår i: Clinical Nutrition. - : Elsevier BV. - 0261-5614. ; 40:5, s. 2754-2761
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Tidskriftsartikel (refereegranskat)abstract
- Background & aims: Nutrition education is not well represented in the medical curriculum. The aim of this original paper was to describe the Nutrition Education in Medical Schools (NEMS) Project of the European Society for Clinical Nutrition and Metabolism (ESPEN). Methods: On 19 January 2020, a meeting was held on this topic that was attended by 51 delegates (27 council members) from 34 countries, and 13 European University representatives. Results: This article includes the contents of the meeting that concluded with the signing of the Manifesto for the Implementation of Nutrition Education in the Undergraduate Medical Curriculum. Conclusion: The meeting represented a significant step forward, moved towards implementation of nutrition education in medical education in general and in clinical practice in particular, in compliance with the aims of the ESPEN Nutrition Education Study Group (NESG). 0 2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
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| 28. |
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| 29. |
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| 30. |
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| 31. |
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| 32. |
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| 33. |
- Ellegård, Kajsa, 1951, et al.
(författare)
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Reflective Production in the Final Assembly of Motor Vehicles - An Emerging Swedish Challenge
- 1992
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Ingår i: International Journal of Operations and Production Management. - 1758-6593 .- 0144-3577. ; 12:7/8, s. 117-133
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Tidskriftsartikel (refereegranskat)abstract
- Presents some theoretical principles and empirical evidence relating to the new Swedish production systems for final assembly of motor vehicles. Contends that in these production systems it is possible simultaneously to enhance efficiency and quality of working life. Briefly sketches three production forms as they apply to the final assembly of automobiles and discusses the societal environments in which these different forms of production have evolved. It focuses on Volvo Uddevalla plant as one of the main examples so far of a reflective production system for final assembly of automobiles. Amplifies the analysis of different production flow patterns for final assembly and in particular addresses the issue of semi‐parallel mechanistic production flow and parallel organic production flow as alternatives to serial flow on a conventional line assembly. A comment: This publication is authored together with e.g. senior research competencies (1) within vocational learning and training as well as (2) within time-geography with whom Engström have had long time cooperation procedures. But also personal at our department/research group (Mats Johansson) well as our knowledgeable contact person (Bertil Johansson) within Volvo contributed (he has really helped us out for decades and was responsible for the continuous contacts with Volvo in most any matter).
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| 34. |
- Ellegård, Kajsa, 1951, et al.
(författare)
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Reflektiv produktion – Industriell verksamhet i förnyelse
- 1992
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- This book, a sort of summarization of the authors' insights and experiences regarding group work as well as alternatives to assembly line work from their own scientific perspective, which was made available in 1992. That is, in the (very specific) period of time (or turbulence) while the assembly plants in Uddevalla and Kalmar were closed down (the former assembly plant was closed down first, while the other was shut down approximate a year later). This book has been published by Volvo (AB Volvo Media, ISBN-number: 91 9761 604). It has been published by Arbetslivsutveckling with the editors Lars Cambert and Glenn Carlsson at this department. Moreover, the content has been validated by a number of Volvo experts and discussed at a seminary (among other things, each of these experts had to provide written comments to the two editors etc.). A comment: This publication is authored together with e.g. senior research competencies (1) within vocational learning and training as well as (2) within time-geography with whom Engström have had long time cooperation procedures. But also personal at our department/research group (Mats Johansson) well as our knowledgeable contact person (Bertil Johansson) within Volvo contributed. A comment: This publication is authored together with e.g. senior research competencies (1) within vocational learning and training as well as (2) within time-geography with whom Engström have had long time cooperation procedures. But, as our knowledgeable contact person (Bertil Johansson) within Volvo has contributed (he was helping us out for decades).
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| 35. |
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| 36. |
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| 37. |
- Ellegård, Lars, 1958, et al.
(författare)
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Biochemical indices to evaluate nutritional support for malignant disease.
- 2008
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Ingår i: Clinica chimica acta; international journal of clinical chemistry. - : Elsevier BV. - 0009-8981. ; 390:1-2, s. 23-7
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Forskningsöversikt (refereegranskat)abstract
- Malignant diseases are often complicated by malnutrition, and nutritional support is often indicated. Nutritional support should be evaluated primarily by improved clinical outcome. During nutritional support as artificial nutrition, monitoring is of paramount importance. Several biochemical markers are frequently used to monitor nutritional status. Most widely used are serum levels of albumin, transferrin, and transthyretin which are subnormal in malnutrition. Unfortunately, monitoring nutritional support by biochemical indices in malignant disease is complicated by the pathophysiology of cancer related malnutrition. Systemic inflammation is central in this context as it perturbs most of the traditional biochemical indices, and is inversely correlated to survival. In addition, systemic inflammation explains variations in body composition. Thus, the most important biochemical index to be measured in malignant disease is the assessment of systemic inflammatory response, preferably by high-resolution CRP, and if normal, common biochemical indices such as albumin, transferrin or transthyretin might be used. Preferentially, indices with high turnover should be used. IGF-1 is an index well suited for assessing nutrition support in conventional malnutrition, but its use in malignant disease is still unproved. If APPR is prevalent, methods detecting changes in body composition, performance or physical activity might offer better options to evaluate nutritional support.
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| 38. |
- Ellegård, Lars, 1958, et al.
(författare)
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Bioelectric impedance spectroscopy underestimates fat-free mass compared to dual energy X-ray absorptiometry in incurable cancer patients.
- 2009
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Ingår i: European journal of clinical nutrition. - : Springer Science and Business Media LLC. - 0954-3007 .- 1476-5640. ; 63:6, s. 794-801
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Tidskriftsartikel (refereegranskat)abstract
- Background/Objectives:Weight loss is frequently seen in advanced cancer. Bioelectrical impedance spectroscopy (BIS) is a convenient method for estimating body composition. We examined in a prospective, comparative study if BIS could accurately estimate fat-free mass (FFM) in cancer patients compared to dual-energy X-ray absorptiometry (DXA).Subjects/Methods:The study was based on 132 consecutive incurable cancer patients with solid tumours in a University hospital outpatient clinic. Comparison of FFM from DXA and BIS with standard and revised equations. Bland-Altman plots, t-tests and linear regression analysis were used to evaluate agreement and differences between methods.Results:BIS significantly underestimated mean FFM with 7.6+/-4.7 kg compared to DXA (P<0.001). Bias was significantly correlated to % weight loss (r=0.32), systemic inflammation as measured by C-reactive protein (r=0.29), malnutrition as assessed by low insulin-like growth factor-1 (r=-0.23) and inversely to the per cent body fat estimated by DXA (P=-0.61) and body mass index (BMI; r=-0.30). Revised BIS equations taking BMI into account reduced bias significantly but still with great individual variation.Conclusions:BIS by standard equations grossly underestimates FFM compared to DXA in cancer patients. This bias is related to weight loss, malnutrition and systemic inflammation. Revised equations improved FFM estimates, but with large individual variation. Thus, BIS with standard equations is not suitable to estimate FFM in patients with cachexia, inflammation and malnutrition.European Journal of Clinical Nutrition advance online publication, 14 May 2008; doi:10.1038/ejcn.2008.35.
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| 39. |
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| 40. |
- 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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| 41. |
- 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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| 42. |
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| 43. |
- Ellegård, Lars, 1958
(författare)
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D-vitamin efter tarmoperation
- 2012
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Ingår i: ILCO-bladet. - 0345-4908. ; :2
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 44. |
- Ellegård, Lars, 1958, et al.
(författare)
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Dietary plant sterols and cholesterol metabolism
- 2007
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Ingår i: Nutrition Reviews. - 0029-6643. ; 65:1, s. 39-45
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Forskningsöversikt (refereegranskat)abstract
- Plant sterols, naturally occurring in foods of plant origin, reduce cholesterol absorption. Experimental studies show plant sterols to be an important part of the serum-cholesterol lowering effect of certain diets and dietary components. Epidemiological data show that individuals with higher intakes of plant sterols from their habitual diets have lower serum-cholesterol levels. To date, the role of naturally occurring plant sterols for lowering serum cholesterol has probably been underestimated. The consumption of dietary plant sterols should be a part of dietary advice to patients with hypercholesterolemia and the general public for the prevention and management of coronary heart disease.
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| 45. |
- Ellegård, Lars, 1958, et al.
(författare)
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Distinguishing vegan-, vegetarian-, and omnivorous diets by hair isotopic analysis.
- 2019
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Ingår i: Clinical nutrition. - : Elsevier BV. - 1532-1983 .- 0261-5614. ; 38:6, s. 2949-2951
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Tidskriftsartikel (refereegranskat)abstract
- Dietary risks contribute heavily to disability-adjusted life years (DALYs), being more important than hypertension, obesity, or smoking. To measure dietary exposure remains a challenge in nutrition research.The aim of the present study was to test the hypothesis that isotope ratios of 15N and 13C in human hair could distinguish between subjects adhering to different habitual diets.20 male and 29 female subjects average 31 years old (range 19-53), with stable dietary habits volunteered. Diets were vegan, vegetarian and omnivorous. Hair samples were processed on an elemental analyser coupled to isotope-ratio mass spectrometry.δ15N differed between vegan, vegetarian and omnivorous diets, p<0.05 for all. δ13C differed between vegan and omnivorous diets, p<0.05, but neither of these diets were separated from the vegetarian diet.Elemental Analysis of δ13C and especially δ15N with isotope ratio mass spectrometry seems to be a promising, non-invasive and objective way to distinguish groups of subjects on different habitual diets, at least if n=>10.
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| 46. |
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| 47. |
- Ellegård, Lars, 1958
(författare)
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Nutrition vid tarmsvikt efter tarmischemi.
- 2012
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Ingår i: Läkartidningen. - 0023-7205. ; 109:49-50, s. 2294-2295
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Tidskriftsartikel (refereegranskat)abstract
- Patienter med tarmischemi drabbas akut av tarmsvikt, som oftast blir kronisk. Vid ileocekal resektion krävs livslång substitution med vitamin B12. Vid stomiflöden överstigande 1–2 l/dygn ökar risken för dehydrering och natriumbrist, vilket bäst diagnostiseras via lågt urin-Na, och magnesiumbrist som ger kramper. Om >1 meter tunntarm plus kolon återstår kan patienten vanligen klara sig med peroralt intag, som kompenserar de ökade förlusterna. För optimal rehabilitering bör samlad kompetens inom kirurgi, nutrition och stomivård erbjudas. Det ger goda möjligheter till kateterinläggning, kuratorskontakt och bestämning av bentäthet och kroppssammansättning.
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| 48. |
- Ellegård, Lars, 1958, et al.
(författare)
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Oat bran rapidly increases bile acid excretion and bile acid synthesis – an ileostomy study.
- 2007
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Ingår i: European Journal of Clinical Nutrition. - : Springer Science and Business Media LLC. - 0954-3007 .- 1476-5640. ; 61, s. 938-945
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study whether oat bran with native beta-glucans increases bile acid excretion and bile acid synthesis as measured by serum concentrations of 7alpha-hydroxy-4-cholesten-3-one (7alpha-HC). DESIGN: Short-term interventional crossover study evaluating cholesterol absorption, ileal excretion of cholesterol and bile acids, and serum levels of cholesterol and bile acid metabolites. Differences between diets evaluated with Wilcoxon's signed rank-sum test. SETTING: Outpatients at a metabolic-ward kitchen. SUBJECTS: Nine volunteers with conventional ileostomies. METHODS: Two 3-day-diet periods, with controlled, blinded basal diet including 75 g extruded oat bran breakfast cereal daily, with either 11.6 g native or hydrolysed beta-glucans. RESULTS: Native oat bran increased median excretion of bile acids by 144% (P=0.008). Cholesterol excretion remained unchanged, cholesterol absorption decreased by 19% (P=0.013), whereas the sum of bile acid and cholesterol excretion increased by 40% (P=0.008) compared with hydrolysed oat bran. 7alpha-HC reflecting bile acid synthesis increased by 57% (P=0.008) within 24 h of consumption, whereas serum lathosterol concentration reflecting cholesterol synthesis increased by 12% (P=0.015). CONCLUSIONS: Oat bran with native beta-glucans increases bile acid excretion within 24 h of consumption and this increase can also be detected by rising serum concentrations of 7alpha-HC. Thus, 7alpha-HC could be used for rapid detection of dietary effects on bile acid metabolism. These effects could possibly be explained by entrapment of whole micelles in the gut owing to higher viscosity.
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| 49. |
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| 50. |
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