| 1. |
- Baker, Jennifer L, et al.
(författare)
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Breastfeeding reduces postpartum weight retention
- 2009
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Ingår i: American Journal of Clinical Nutrition. - : Elsevier BV. - 1938-3207 .- 0002-9165. ; 88:6, s. 1543-51
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Weight gained during pregnancy and not lost postpartum may contribute to obesity in women of childbearing age. OBJECTIVE: We aimed to determine whether breastfeeding reduces postpartum weight retention (PPWR) in a population among which full breastfeeding is common and breastfeeding duration is long. DESIGN: We selected women from the Danish National Birth Cohort who ever breastfed (>98%), and we conducted the interviews at 6 (n = 36 030) and 18 (n = 26 846) mo postpartum. We used regression analyses to investigate whether breastfeeding (scored to account for duration and intensity) reduced PPWR at 6 and 18 mo after adjustment for maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG). RESULTS: GWG was positively (P < 0.0001) associated with PPWR at both 6 and 18 mo postpartum. Breastfeeding was negatively associated with PPWR in all women but those in the heaviest category of prepregnancy BMI at 6 (P < 0.0001) and 18 (P < 0.05) mo postpartum. When modeled together with adjustment for possible confounding, these associations were marginally attenuated. We calculated that, if women exclusively breastfed for 6 mo as recommended, PPWR could be eliminated by that time in women with GWG values of approximately 12 kg, and that the possibility of major weight gain (>or=5 kg) could be reduced in all but the heaviest women. CONCLUSION: Breastfeeding was associated with lower PPWR in all categories of prepregnancy BMI. These results suggest that, when combined with GWG values of approximately 12 kg, breastfeeding as recommended could eliminate weight retention by 6 mo postpartum in many women.
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| 2. |
- Lissner, Lauren, 1956, et al.
(författare)
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Monitoring the Obesity Epidemic into the 21st Century - Weighing the Evidence.
- 2013
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Ingår i: Obesity facts. - : S. Karger AG. - 1662-4033 .- 1662-4025. ; 6:6, s. 561-565
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Tidskriftsartikel (refereegranskat)abstract
- According to recent literature the obesity epidemic in adults and particularly in children seems to have stabilized or receded since the end of the 20th century [1,2]. Many of the encouraging trends toward stabilization have occurred simultaneously in different parts of the world. However, there may be some biases in the data being reported that could explain these trends, to which we will draw attention in the sections below. Besides statistical biases and distortions in the data itself, there may be interpretation biases of a less statistical nature. This paper is not intended to systematically review all publications on the course of the epidemic or discuss study-specific biases in detail, but rather intends to highlight the most relevant sources of bias while offering selected examples of such biases from the literature. We will first review several classic sources of bias in survey data describing secular trends in obesity, which have been frequently discussed in terms of how they might affect conclusions regarding the course of the obesity epidemic. In addition, we will describe sources of bias in what we are looking at and how we are looking at it, which may distort conclusions regarding the obesity epidemic.
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| 3. |
- Lissner, Lauren, 1956, et al.
(författare)
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Secular increases in waist-hip ratio among Swedish women
- 1998
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Ingår i: International Journal of Obesity. ; 22, s. 1116-1120
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Tidskriftsartikel (refereegranskat)abstract
- Department of Internal Medicine, Sahlgrenska University Hospital, Göteborg University, Sweden. INTRODUCTION: Secular increases in obesity have been documented in numerous populations. However, little is known about trends in fat distribution. Because men and women with elevated waist-hip ratios (WHR) constitute a high cardiovascular risk group, it is relevant to document secular changes in WHR. This paper compares WHR in three cohorts of women, one cohort recruited in the late 1960s and the others after 12 y and 24 y intervals. SUBJECTS AND METHODS: In 1968-1969, a randomly selected sample of women aged of 38 y and 50 y, was given anthropometric examinations (n = 761, total). The same measurements were taken on representative cohorts aged 38 y and 50 y in 1980-1981 (n = 677) and 1992-1993 (n = 167). All analyses of trends in WHR as a function of time are age-specific and body mass index (BMI)-adjusted. RESULTS: An interesting feature of this population is that BMI was stable from 1968-1969 to 1992-1993. However, WHR increased significantly in those aged 38 y and 50 y, independent of BMI (P = 0.001, both ages). The source of these changes in WHR was a combination of increasing waist circumferences and decreasing hip circumferences. Skinfold measurements, taken only at the first two examinations, also increased significantly. CONCLUSIONS: This female population appears to have experienced some changes in body shape and composition. However, we cannot explain the increasingly centralized fat patterning by changes in BMI, subcutaneous skinfold thickness or those obesity-related aspects of the modern lifestyle that we were able to measure. PMID: 9822951 [PubMed - indexed for MEDLINE]
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| 4. |
- Pedersen, Peder J, et al.
(författare)
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Influence of psychosocial factors on postpartum weight retention
- 2011
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Ingår i: Obesity. - : Wiley. - 1930-7381. ; 19:3, s. 639-646
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Tidskriftsartikel (refereegranskat)abstract
- For some women, pregnancy may increase the risk of future obesity with consequences for health and well-being. Psychosocial factors may be partly responsible for this. The aim of this study was to examine the association between psychosocial factors during pregnancy and postpartum weight retention (PPWR) at 6 and 18 months. A total of 37,127 women in The Danish National Birth Cohort (DNBC; 1996-2002) participated in four telephone interviews before and after delivery. They gave information about their experience of distress, depression and anxiety, social support, and psychosocial burdens during pregnancy. PPWR was defined as retention >/=5 kg at 6 and 18 months postpartum according to a woman's prepregnancy weight. The associations were examined by use of logistic regression and presented as odds radios with 95% confidence intervals. Women who were more likely to feel depressed/anxious or distressed during pregnancy had a higher risk of PPWR at 6 months (1.35 (1.27; 1.44) and 1.30 (1.22; 1.38)) and 18 months (1.34 (1.24; 1.45) and 1.32 (1.23; 1.42)). Likewise, women who felt burdened by their economy or working situation had a higher risk of PPWR as did women with the lowest incomes or less education. Women who reported a high level of distress or depression/anxiety both during pregnancy and in the first 6 months of motherhood had the highest risk of PPWR 18 months postpartum (1.54 (1.39; 1.71) and 1.49 (1.32; 1.69), respectively). Feeling distressed, depressed, or anxious during pregnancy was associated with higher PPWR as was personal and economical burdens. Adverse psychosocial characteristics may be a common determinant of weight retention after childbirth.
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| 5. |
- Doring, Nora, et al.
(författare)
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Primary prevention of childhood obesity through counselling sessions at Swedish child health centres : design, methods and baseline sample characteristics of the PRIMROSE cluster-randomised trial
- 2014
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 14:335
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Tidskriftsartikel (refereegranskat)abstract
- Background: Childhood obesity is a growing concern in Sweden. Children with overweight and obesity run a high risk of becoming obese as adults, and are likely to develop comorbidities. Despite the immense demand, there is still a lack of evidence-based comprehensive prevention programmes targeting pre-school children and their families in primary health care settings. The aims are to describe the design and methodology of the PRIMROSE cluster-randomised controlled trial, assess the relative validity of a food frequency questionnaire, and describe the baseline characteristics of the eligible young children and their mothers. Methods/Design: The PRIMROSE trial targets first-time parents and their children at Swedish child health centres (CHC) in eight counties in Sweden. Randomisation is conducted at the CHC unit level. CHC nurses employed at the participating CHC received training in carrying out the intervention alongside their provision of regular services. The intervention programme, starting when the child is 8-9 months of age and ending at age 4, is based on social cognitive theory and employs motivational interviewing. Primary outcomes are children's body mass index and waist circumference at four years. Secondary outcomes are children's and mothers' eating habits (assessed by a food frequency questionnaire), and children's and mothers' physical activity (measured by accelerometer and a validated questionnaire), and mothers' body mass index and waist circumference. Discussion: The on-going population-based PRIMROSE trial, which targets childhood obesity, is embedded in the regular national (routine) preventive child health services that are available free-of-charge to all young families in Sweden. Of the participants (n = 1369), 489 intervention and 550 control mothers (75.9%) responded to the validated physical activity and food frequency questionnaire at baseline (i.e., before the first intervention session, or, for children in the control group, before they reached 10 months of age). The food frequency questionnaire showed acceptable relative validity when compared with an 8-day food diary. We are not aware of any previous RCT, concerned with the primary prevention of childhood obesity through sessions at CHC that addresses healthy eating habits and physical activity in the context of a routine child health services programme.
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| 6. |
- Hansson, Lena M., et al.
(författare)
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Associations Between Swedish Mothers' and 3-and 5-Year-Old Children's Food Intake
- 2016
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Ingår i: Journal of nutrition education and behavior. - : Elsevier BV. - 1499-4046 .- 1878-2620. ; 48:8, s. 520-529.e1
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate associations between mothers' and children's food intake. Design: Cross-sectional study. Background variables collected through self-reports and from the register of the total population. Mothers recorded their own and their children's food intake in a diary during 2 4-day periods. Setting: Eight counties in mid Sweden. Participants: Three-and 5-year-old children and their mothers were randomly selected from the register of the total population. A total of 2,045 families were invited, 355 of whom accepted. Mothers who accepted were older and to a larger extent born in Sweden. The final sample of mother-child pairs with complete food records was 189. Main Outcome Measures: Mothers' and children's food intake (16 food items). Analysis: Spearman rank-order correlation with 95% confidence intervals (2-sided). Moderation was investigated using generalized estimation equations with robust variance. Results: The strongest correlations between mothers' and children's food intake were found for pizza and oily fish (r = .70-.80). The weakest correlations were found for sugared drinks and fruit and berries (r = .24-.26). Children's age moderated the relationship between mothers' and children's intake of savoury snacks, as did place of residence for pizza intake. Conclusions and Implications: There were substantial correlations between children's and mothers' intake of various foods. Modeling of mothers' intake might be more effective in influencing young children's intake of certain foods, whereas other strategies, such as encouraging parents to influence food availability (eg, gatekeeping), might be more useful for some foods.
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| 7. |
- Heitmann, Berit L, et al.
(författare)
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Can adverse effects of dietary fat intake be overestimated as a consequence of dietary fat underreporting?
- 2005
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Ingår i: Public Health Nutrition. ; 8, s. 1332-1337
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Tidskriftsartikel (refereegranskat)abstract
- Research Unit for Dietary Studies and Danish Epidemiology Science Centre, Institute of Preventive Medicine, Copenhagen University Hospital, DK-1399 Copenhagen K, Denmark. blh@ipm.hosp.dk OBJECTIVE: To describe the consequences of systematic reporting bias by the obese for diet-disease relationships. DESIGN: The present report used 24-hour urinary nitrogen and estimates of 24-hour energy expenditure to assess error in diet reporting, and examined the consequence of accounting for this error for associations between dietary fat intake and serum low-density lipoprotein (LDL)-cholesterol. SETTING: Sub-study to the Danish MONICA (Monitoring Trends and Determinants in Cardiovascular Disease) project, carried out in 1987-1988. SUBJECTS: A random sub-sample of the adult Danish male population (n = 152). RESULTS: Correcting dietary fat for underreporting error weakened, rather than strengthened, the association between dietary fat intake and LDL-cholesterol by reducing the slope of the regression from beta = 3.4, P = 0.02 to beta = 2.7, P = 0.04. CONCLUSION: This example illustrates that systematic underreporting of dietary fat by high-risk groups such as the obese may produce an overestimated association. These results imply that previous epidemiological studies showing a positive association between percentage of energy from fat and other health outcomes, e.g. cancer and heart disease, may have overestimated the negative effects of a high-fat diet. If we were able to correctly assess dietary fat intake in general populations, recommendations for fat intake may be more liberal than the 30% suggested today. Improved assessment of fat intake in epidemiological studies is necessary for future development of evidence-based recommendations for diet and health . PMID: 16372929 [PubMed - indexed for MEDLINE]
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| 8. |
- Heitmann, Berit L, et al.
(författare)
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Childhood obesity: successes and failures of preventive interventions
- 2009
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Ingår i: Nutrition Reviews. - 1753-4887. ; 67:Suppl 1, s. 89-93
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Tidskriftsartikel (refereegranskat)abstract
- Despite progress toward assuring the health of today's young population, the 21(st) century began with an epidemic of childhood obesity. There is general agreement that the situation must be addressed by means of primary prevention, but relatively little is known about how to intervene effectively. The evidence behind the assumption that childhood obesity can be prevented was discussed critically in this roundtable symposium. Overall, there was general agreement that action is needed and that the worldwide epidemic itself is sufficient evidence for action. As the poet, writer, and scholar Wittner Bynner (1881-1968) wrote, "The biggest problem in the world could have been solved when it was small".
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| 9. |
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| 10. |
- Heitmann, Berit L, et al.
(författare)
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Dietary underreporting by obese individuals--is it specific or non-specific?
- 1995
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Ingår i: British Medical Journal. ; 311, s. 986-989
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Tidskriftsartikel (refereegranskat)abstract
- Danish Epidemiology Science Centre, Institute of Preventive Medicine, Copenhagen, Denmark. OBJECTIVE--To examine the distribution of patterns of macronutrient density in relation to obesity. DESIGN--Cross sectional. SETTING--Denmark. SUBJECTS--323 men and women aged 35-65 years, selected randomly from a larger population sample of Danish adults. MAIN OUTCOME MEASURE--Bias in dietary reporting of energy and protein intake in relation to percentage body fat, assessed by comparison of data from an interview on dietary intake with data estimated from 24 hour nitrogen output, validated by administering p-aminobenzoic acid, and estimated 24 hour energy expenditure. RESULTS--Degree of obesity was positively associated with underreporting of total energy and protein, whereas compared with total energy reported, protein was overreported by the obese subjects. CONCLUSION--Errors in dietary reporting of protein seem to occur disproportionately with respect to total energy, suggesting a differential reporting pattern of different foods. Although, on average, all subjects showed a greater underreporting of energy than of protein, this was most common in the obese subjects. Snack-type foods may be preferentially forgotten when obese people omit food items in dietary reporting. These results seem to agree with the general assumption that obese people tend to underreport fatty foods and foods rich in carbohydrates rather than underreport their total dietary intake. These results may have implications for the interpretation of studies of diet and comorbidities related to obesity. PMID: 7580640 [PubMed - indexed for MEDLINE]
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| 11. |
- Heitmann, Berit L, et al.
(författare)
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Do we eat less fat, or just report so?
- 2000
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Ingår i: International Journal of Obesity and Related Metabolic Disorders. ; 24, s. 435-442
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Tidskriftsartikel (refereegranskat)abstract
- Department of Medicine CF, Glostrup University Hospital, Denmark. BeHe@Glostruphosp.KbhAmt.dk OBJECTIVE: To examine secular trends in diet reporting error. METHODS: Dietary information was obtained from 228 Danish men and women in 1987-88, and from 122 men and women in 1993-94. RESULTS: Bias in dietary reporting of energy and protein intake was assessed by comparing reported intake with intake data, estimated from 24 h nitrogen output, validated by administering P-aminobenzoic acid, and estimated 24 h energy expenditure. Total energy was under-reported more than energy from protein at both surveys, suggesting that energy from other nutrients, like fat and/or carbohydrate, must have been under-reported too. There was a greater under-reporting for energy than for protein in 1993-94 (29%) than in 1987-88 (15%). Obesity was positively associated with under-reporting, both in 1987-88 and in 1993-94. CONCLUSION: The higher macro-nutrient specific error in 1993-94 compared to 1987-88 may reflect a trend to increasingly omitting fat and/or carbohydrate-rich foods in dietary reporting. This may be a consequence of increased awareness of diet intake, which, in turn, may be related to intensified public health campaigns to reduce intake of fat and/or simple carbohydrate. These results may have consequences for our understanding of the apparent decline in dietary fat and associated health benefits. PMID: 10805500 [PubMed - indexed for MEDLINE]
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| 12. |
- Heitmann, Berit L, et al.
(författare)
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Fat in the diet and obesity
- 2001
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Ingår i: International Textbook of Obesity. ; , s. 137-143
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 13. |
- Heitmann, Berit L, et al.
(författare)
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Genetic effects on weight change and food intake in Swedish adult twins
- 1999
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Ingår i: American Journal of Clinical Nutrition. ; 69, s. 597-602
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Tidskriftsartikel (refereegranskat)abstract
- Danish Epidemiology Science Centre at the Institute of Preventive Medicine, Copenhagen Hospital Corporation, Municipal Hospital of Copenhagen. bette@glostruphosp.kbhamt.dk BACKGROUND: Obesity is influenced by genetic and environmental factors. Additionally, synergistic effects of genes and environments may be important in the development of obesity. OBJECTIVE: The aim of this study was to test for genetic effects on food consumption frequency, food preferences, and their interaction with subsequent weight gain. DESIGN: Complete data on the frequencies of consumption of 11 foods typical of the Swedish diet were available for 98 monozygotic and 176 dizygotic twin pairs aged 25-59 y who are part of the Swedish Twin Registry. The data were collected in 1973 as part of a questionnaire study. Body mass index was measured in 1973 and again in 1984. RESULTS: There was some evidence that genetic effects influenced the frequency of intake of some foods. Similarity among monozygotic twins exceeded that among dizygotic twins for intake of flour and grain products and fruit in men and women, intake of milk in men, and intake of vegetables and rice in women, suggesting that genes influence preferences for these foods. Analyses conducted for twins reared together and apart also suggested greater monozygotic than dizygotic correlations, but cross-twin, cross-trait correlations were all insignificant, suggesting that the genes that affect consumption frequencies are not responsible for mediating the relation between the frequency of intake and weight change. CONCLUSIONS: Genetic effects and the frequency of intake are independently related to change in body mass index. However, there was no suggestion of differential genetic effects on weight gain that were dependent on the consumption frequency of the foods studied. PMID: 10197559 [PubMed - indexed for MEDLINE]
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| 14. |
- Heitmann, Berit L, et al.
(författare)
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Hip circumference and cardiovascular morbidity and mortality in men and women
- 2004
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Ingår i: Obesity Research. ; 12, s. 482-487
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Tidskriftsartikel (refereegranskat)abstract
- Research Unit for Dietary Studies and the Danish Epidemiology Science Centre, Institute of Preventive Medicine, Copenhagen, Denmark. BLH@ipm.hosp.dk OBJECTIVE: It has recently been demonstrated that, in middle-aged women, a wide hip circumference is a protective factor for a number of health endpoints in later years. The effect seems to be independent of both overweight and waist circumference. This paper aims to replicate this finding in another population-based sample consisting of women and men. RESEARCH METHODS AND PROCEDURES: This was a prospective observational study consisting of a random subset of adult Danes. A total of 2987 subjects born in 1922, 1932, 1942, or 1952 and 35, 45, 55, or 65 years of age (at examination in 1987 to 1988) participated in the Danish MONICA (MONItoring trends and determinants of CArdiovascular disease) project, with measurements of height, weight, and hip and waist circumference taken. Through personal identification numbers, incidence of coronary heart disease (CHD) and cardiovascular disease (CVD) until the end of 1998 and all causes of death until 2001 were retrieved from the National Registers of Hospital Discharge. There was an average of 10 years of follow-up for incidence of CVD and CHD and 13 years of follow-up for total mortality. RESULTS: Large hip circumference, relative to body size and waist circumference, predicted less incidence of CVD, CHD, and total death in women. This was not the case in men; BMI and waist circumference were the strongest independent predictors. DISCUSSION: A large hip circumference seems to have independent and positive effects on CVD and CHD morbidity and mortality in women, but no protective effect on cardiovascular health in men. However, a borderline significant protective effect on total mortality was observed. PMID: 15044665 [PubMed - indexed for MEDLINE]
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| 15. |
- Heitmann, Berit L, et al.
(författare)
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Hip Hip Hurrah! Hip size inversely related to heart disease and total mortality
- 2011
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Ingår i: Obesity Reviews. - 1467-7881. ; 12:6, s. 478-481
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Tidskriftsartikel (refereegranskat)abstract
- During the past decade a series of published reports have examined the value of studying the relation between hip circumferences and cardiovascular end points. Specifically, in a series of recent studies the independent effects of hip circumference have been studied after adjustment for general obesity and/or waist circumference. These studies have been remarkable in terms of their consistency, and in the unexpected finding of an adverse effect of small hip size, after statistically correcting for differences in general and abdominal size. The hazard related to a small hip size may be stronger for women than men, but is evident in both genders. In this ‘viewpoint’, we wish to draw attention to the emerging body of evidence and to encourage researchers to continue collecting measures of lower body size in their surveys.
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| 16. |
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| 17. |
- Hvidtfeldt, Ulla A., et al.
(författare)
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Alcohol Intake and Risk of Coronary Heart Disease in Younger, Middle-Aged, and Older Adults
- 2010
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Ingår i: Circulation. - : LIPPINCOTT WILLIAMS & WILKINS. - 0009-7322 .- 1524-4539. ; 121:14, s. 1589-1597
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Tidskriftsartikel (refereegranskat)abstract
- Background-Light to moderate alcohol consumption is associated with a reduced risk of coronary heart disease. This protective effect of alcohol, however, may be confined to middle-aged or older individuals. Coronary heart disease incidence is low in men <40 years of age and in women <50 years of age; for this reason, study cohorts rarely have the power to investigate the effects of alcohol on coronary heart disease risk in younger adults. This study examined whether the beneficial effect of alcohol on coronary heart disease depends on age. Methods and Results-In this pooled analysis of 8 prospective studies from North America and Europe including 192 067 women and 74 919 men free of cardiovascular diseases, diabetes, and cancers at baseline, average daily alcohol intake was assessed at baseline with a food frequency or diet history questionnaire. An inverse association between alcohol and risk of coronary heart disease was observed in all age groups; hazard ratios among moderately drinking men (5.0 to 29.9 g/d) 39 to 50, 50 to 59, and >= 60 years of age were 0.58 (95% confidence interval [CI], 0.36 to 0.93), 0.72 (95% CI, 0.60 to 0.86), and 0.85 (95% CI, 0.75 to 0.97) compared with abstainers. However, the analyses indicated a smaller incidence rate difference between abstainers and moderate consumers in younger adults (incidence rate difference, 45 per 100 000; 90% CI, 8 to 84) than in middle-aged (incidence rate difference, 64 per 100 000; 90% CI, 24 to 102) and older (incidence rate difference, 89 per 100 000; 90% CI, 44 to 140) adults. Similar results were observed in women. Conclusion-Alcohol is also associated with a decreased risk of coronary heart disease in younger adults; however, the absolute risk was small compared with middle-aged and older adults. (Circulation. 2010; 121: 1589-1597.)
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| 18. |
- Jakobsen, Marianne U, et al.
(författare)
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Major types of dietary fat and risk of coronary heart disease : a pooled analysis of 11 cohort studies.
- 2009
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Ingår i: American Journal of Clinical Nutrition. - : Elsevier BV. - 0002-9165 .- 1938-3207. ; 89:5, s. 1425-1432
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Saturated fatty acid (SFA) intake increases plasma LDL-cholesterol concentrations; therefore, intake should be reduced to prevent coronary heart disease (CHD). Lower habitual intakes of SFAs, however, require substitution of other macronutrients to maintain energy balance. OBJECTIVE: We investigated associations between energy intake from monounsaturated fatty acids (MUFAs), polyunsaturated fatty acids (PUFAs), and carbohydrates and risk of CHD while assessing the potential effect-modifying role of sex and age. Using substitution models, our aim was to clarify whether energy from unsaturated fatty acids or carbohydrates should replace energy from SFAs to prevent CHD. DESIGN: This was a follow-up study in which data from 11 American and European cohort studies were pooled. The outcome measure was incident CHD. RESULTS: During 4-10 y of follow-up, 5249 coronary events and 2155 coronary deaths occurred among 344,696 persons. For a 5% lower energy intake from SFAs and a concomitant higher energy intake from PUFAs, there was a significant inverse association between PUFAs and risk of coronary events (hazard ratio: 0.87; 95% CI: 0.77, 0.97); the hazard ratio for coronary deaths was 0.74 (95% CI: 0.61, 0.89). For a 5% lower energy intake from SFAs and a concomitant higher energy intake from carbohydrates, there was a modest significant direct association between carbohydrates and coronary events (hazard ratio: 1.07; 95% CI: 1.01, 1.14); the hazard ratio for coronary deaths was 0.96 (95% CI: 0.82, 1.13). MUFA intake was not associated with CHD. No effect modification by sex or age was found. CONCLUSION: The associations suggest that replacing SFAs with PUFAs rather than MUFAs or carbohydrates prevents CHD over a wide range of intakes.
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| 19. |
- Klingberg, Sofia, 1979, et al.
(författare)
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Increase in waist circumference over 6 years predicts subsequent cardiovascular disease and total mortality in nordic women.
- 2015
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Ingår i: Obesity (Silver Spring, Md.). - : Wiley. - 1930-739X .- 1930-7381. ; 23:10, s. 2123-30
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Tidskriftsartikel (refereegranskat)abstract
- Despite solid evidence of an association between centralized body fatness and subsequent disease risk, little is known about the consequences of changes in body fat distribution. Recently it was shown that large hip circumference (HC), measured once, was protective against total and cardiovascular disease (CVD) mortality in women but that gain or loss in HC was unrelated to these outcomes. This study examines whether a 6-year change in waist circumference (WC) predicts mortality and CVD in the same study sample.
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| 20. |
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| 21. |
- Lissner, Lauren, 1956, et al.
(författare)
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Dietary fat and obesity: evidence from epidemiology
- 1995
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Ingår i: European Journal of Clinical Nutrition. ; 49 (2), s. 79-90
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Tidskriftsartikel (refereegranskat)abstract
- Department of Internal Medicine, Göteborg University, Sweden. The epidemiological evidence that a high-fat diet promotes the development of obesity is considered suggestive but not definitive. The purpose of this paper is to provide a review of various epidemiological methods that have been used to address this issue as well as an updated summary of the existing evidence. Ecological studies describing dietary fat intake and obesity at the population level provide mixed results and are likely to be biased by both confounding and unknown data quality factors that differ systematically across the populations studied. Cross-sectional studies are generally in agreement that the concentration of fat in the diet is positively associated with relative weight. Prospective studies of diet in relation to subsequent weight change give inconsistent results. This may be due to behavioural factors such as dieting in response to weight gain; in addition, this type of study rarely takes into account the possible interaction between genetic predisposition and dietary fat in promoting weight gain. Finally, intervention studies in free-living subjects are considered, providing evidence of a consistent but short-lived period of active weight loss on low-fat diets. The experimental evidence on this relationship is more conclusive than the epidemiological evidence, although biological mechanisms remain controversial. Some areas for future epidemiological research involve: longitudinal studies of dietary fat intake as a predictor of growth in children; observational studies relating total dietary fat and specific types of fat to overall as well as regional adiposity; and randomized intervention studies of the effect of low-fat diets with particular emphasis on and familial predisposition to obesity and other possible modifying factors. PMID: 7743988 [PubMed - indexed for MEDLINE]
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| 22. |
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| 23. |
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| 24. |
- Lissner, Lauren, 1956, et al.
(författare)
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Low-fat diets may prevent weight gain in sedentary women: prospective observations from the population study of women in Gothenburg, Sweden
- 1997
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Ingår i: Obesity Research. ; 5, s. 43-48
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Tidskriftsartikel (refereegranskat)abstract
- Department of Primary Health Care, Göteborg University, Sweden. The Population Study of Women in Gothenburg, Sweden is an ongoing prospective study of female residents who were recruited from the local registry in 1968-1969 when they were 38-60 years old. The data presented here were collected from 361 healthy women who underwent a baseline physical examination including a supplementary dietary history interview and returned for a second general health examination 6 years later. This report identifies a subgroup of 57 women who were sedentary during their leisure time and appear to have been particularly susceptible to gaining weight as a function of the fat content of their diets. Specifically, longitudinal analysis of body weights in the whole sample revealed a statistical interaction between leisure-time physical activity and habitual dietary fat intake (energy%), as reported at the baseline examination, in the prediction of subsequent weight change. Further stratified analysis suggested that weight changes were significantly dependent on dietary fat intake among the sedentary women only. High energy intake also predicted weight gain in the sedentary group, although the predictive value for a high-fat diet was of marginal significance after adjusting for total energy consumption. These results suggest that sedentary recreational activity plus a low-fat diet may have a combined contribution to weight change that is not equivalent to the sum of the separate effects. Such a synergy between two modifiable lifestyle factors seems highly relevant for prevention of obesity. PMID: 9061715 [PubMed - indexed for MEDLINE]
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| 25. |
- Lissner, Lauren, 1956, et al.
(författare)
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Measuring intake in free-living human subjects: a question of bias
- 1998
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Ingår i: Proceedings of the Nutrition Society. ; 57, s. 333-339
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Department of Internal Medicine, Göteborg University, Sweden. lauren.lissner@medfak.gu.se PMID: 9656337 [PubMed - indexed for MEDLINE]
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| 26. |
- Lissner, Lauren, 1956, et al.
(författare)
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OPEN about obesity: recovery biomarkers, dietary reporting errors and BMI
- 2007
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Ingår i: International Journal of Obesity. ; 31, s. 956-961
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Tidskriftsartikel (refereegranskat)abstract
- Department of Public Health and Community Medicine, Sahlgrenska Academy at Göteborg University, Sweden, and Research Unit for Dietary Studies at Institute of Preventive Medicine, Copenhagen University Hospital, Denmark. Lauren.lissner@medfak.gu.se OBJECTIVE: Obesity-related under-reporting of usual dietary intake is one of the most persistent sources of bias in nutrition research. The aim of this paper is to characterize obese and non-obese individuals with respect to reporting errors observed with two common dietary instruments, using energy and protein recovery biomarkers as reference measures. POPULATION AND METHODS: This report employs data from the Observing Protein and Energy Nutrition (OPEN) study. Analyses are based on stratified samples of 211 (57 obese) men and 179 (50 obese) women who completed 24-h recalls (24HR), food frequency questionnaires (FFQ), doubly labelled water (DLW) and urinary nitrogen (UN) assessments. RESULTS: In obese and non-obese subgroups, FFQ yielded lower energy and protein intake estimates than 24HR, although biomarker-based information indicated under-reporting with both dietary instruments. Gender differences in obesity-related bias were noted. Among women, the DLW-based energy requirement was 378 kcal greater in obese than in non-obese groups; the FFQ was able to detect a statistically significant portion of this extra energy, while the 24HR was not. Among men, the DLW-based energy requirement was 485 kcal greater in the obese group; however, neither FFQ nor 24HR detected this difference in energy requirement. Combining protein and energy estimates, obese men significantly over-reported the proportion of energy from protein using the 24HR, but not with the FFQ. In obese women, no significant reporting error for energy percent protein was observed by either method. At the individual level, correlations between energy expenditure and reported energy intake tended to be weaker in obese than non-obese groups, particularly with the 24HR. Correlations between true and reported protein density were consistently higher than for protein or energy alone, and did not vary significantly with obesity. CONCLUSION: This work adds to existing evidence that neither of these commonly used dietary reporting methods adequately measures energy or protein intake in obese groups. The 24HR, while capturing more realistic energy distributions for usual intake, may be particularly problematic in the obese. PMID: 17299385 [PubMed - indexed for MEDLINE]
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| 27. |
- Lissner, Lauren, 1956, et al.
(författare)
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Population studies of diet and obesity
- 2000
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Ingår i: British Journal of Nutrition. ; 83
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Department of Internal Medicine, Göteborg University, Vasa Hospital, Gothenburg, Sweden. lauren.lissner@medfak.gu.se Population-based research on diet, obesity and the metabolic syndrome is faced with accumulating evidence of biases that may profoundly affect results. One potential source of bias, which is often neglected in nutritional epidemiology, arises from self-selected study populations. Subjects who agree to participate in surveys may be at less risk of metabolic syndrome than those who refuse. Analogous to observations in adult populations, studies of schoolchildren have also yielded clear evidence of self-selection. Whether such selection patterns influence analytical results depends on how the biases relate to the dependent and independent variables being studied. Systematic dietary reporting error is another source of bias in studies of nutritional risk factors for disease. While obesity-related under-reporting bias is now well documented, less is known about whether specific foods and nutrients are disproportionately affected. However, two studies employing biomarkers for protein have suggested that obese subjects under-reported the proportion of energy from fat plus carbohydrate. This should alert epidemiologists to the possibility that a dual reporting bias may be present in studies of diet and disease: general under-reporting among obese subjects compounded by food-specific errors. In summary, biases due to self-selection and selective dietary under-reporting may produce consequences in epidemiological studies that are both unpredictable and complex. We conclude this review with recent findings involving dietary fat intake and regional adiposity in a population-based study of women. These preliminary results may have etiological relevance to the development of metabolic syndrome, but multiple biases of the type described previously may also be operating. PMID: 10889788 [PubMed - indexed for MEDLINE]
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| 28. |
- Lissner, Lauren, 1956, et al.
(författare)
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The dietary fat: carbohydrate ratio in relation to body weight
- 1995
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Ingår i: Current Opinion in Lipidology. ; 6, s. 8-13
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Department of Internal Medicine, University of Göteborg, Sweden. A review of the contemporary dietary surveys indicates that the percentage of energy derived from fat is, in general, positively associated with total energy consumption and obesity. However, dietary carbohydrate tends to show the opposite trend. Epidemiological and experimental evidence suggest that the fat: carbohydrate ratio affects body weight through energy surfeits facilitated by the high energy density and palatability of fat. Biological mechanisms for an effect of this dietary ratio on the regulation of body weight have been the topic of much recent research. In this context the fat: carbohydrate ratio might be of particular importance in individuals with an inherited susceptibility to obesity. PMID: 7735719 [PubMed - indexed for MEDLINE]
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| 29. |
- Neumann, Tim, et al.
(författare)
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Gold standard program for heavy smokers in a real-life setting.
- 2013
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601. ; 10:9, s. 4186-4199
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Tidskriftsartikel (refereegranskat)abstract
- Background: High-intensity smoking cessation programs generally lead to more continuous abstinence, however, lower rates of success have been reported among heavy smokers. The aim was to evaluate continuous abstinence among heavy smokers during the intensive 6-week Gold Standard Program (GSP) and to identify modifiable factors associated with continuous abstinence. Methods: In this nationwide clinical study based on 36,550 smokers attending an intensive cessation program in Denmark. Heavy smoking was defined as ≥7 points in the Fagerström Nicotine Dependency Test, smoking ≥20 cigarettes daily or ≥20 pack-years. Results: Overall, 28% had a Fagerström score ≥7 points, 58% smoked ≥20 cigarettes daily and 68% smoked ≥20 pack-years. Continuous abstinence was 33% in responders (6-months response rate: 78%); however, abstinence was approximately 1-6% lower in the heavy smokers than the overall population. Attending GSP with an individual format (vs. group/other, OR 1.23-1.44); in a hospital setting (vs. pharmacy/municipality services, OR 1.05-1.11); and being compliant (attending the planned meetings OR 4.36-4.89) were associated with abstinence. Abstinence decreased in a dose-dependent manner with increasing smoking severity. Conclusions: Abstinence after GSP was 1-6% lower in the heavy smokers than in the overall study population. Modifiable factors may be used for small improvements in continued abstinence. However attempts to improve compliance seemed especially promising.
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| 30. |
- Neumann, Tim, et al.
(författare)
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The Gold Standard Programme: smoking cessation interventions for disadvantaged smokers are effective in a real-life setting
- 2013
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Ingår i: Tobacco Control. - : BMJ. - 1468-3318 .- 0964-4563. ; 22:6, s. 9-9
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To evaluate the real-life effect of an evidence-based Gold Standard Programme (GSP) for smoking cessation interventions in disadvantaged patients and to identify modifiable factors that consistently produce the highest abstinence rates. Design Observational prospective cohort study. Setting GSPs in pharmacies, hospitals and communities in Denmark, reporting to the national Smoking Cessation Database. Participants Disadvantaged patients, defined as patients with a lower level of education and those receiving unemployment benefits. Interventions 6-week manualised GSP smoking cessation interventions performed by certified staff. Main outcome measures 6months of continuous abstinence, response rate: 80%. Results Continuous abstinence of the 16?377 responders was 34% (of all 20?588 smokers: 27%). Continuous abstinence was lower in 5738 smokers with a lower educational level (30% of responders and 23% of all) and in 840 unemployed (27% of responders and 19% of all). In respect to modifiable factors, continuous abstinence was found more often after programmes in one-on-one formats (vs group formats) among patients with a lower educational level, 34% (vs 25%, p=0.037), or among unemployed, 35% (vs 24%, p=0.099). The variable format' stayed in the final model of multivariable analyses in patients with a lower educational level, OR=1.31 (95% CI 1.05 to 1.63). Conclusions Although continuous abstinence was lower among disadvantaged smokers, the absolute difference was small. If the programme had been as effective in disadvantaged as in non-disadvantaged groups, there would have been an extra 46 or 8 quitters annually, respectively. Promoting individual interventions among those with a low education may increase the effectiveness of GSP.
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| 31. |
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| 32. |
- Tognon, Gianluca, 1976, et al.
(författare)
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The Mediterranean diet in relation to mortality and CVD: a Danish cohort study
- 2014
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Ingår i: British Journal of Nutrition. - 0007-1145 .- 1475-2662. ; 111:1, s. 151-159
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to determine whether the Mediterranean Diet Score (MDS) is associated with reduced total mortality, cardiovascular incidence and mortality in a Danish population. Analyses were performed on 1849 men and women sampled during the 1982-83 Danish MONICA (MONItoring trends and determinants of Cardiovascular disease) population study, whose diet was assessed by means of a validated 7d food record. The adherence to a Mediterranean dietary pattern was calculated by three different scores: one based on a classification excluding ingredients from mixed dishes and recipes (score 1); another based on a classification including ingredients (score 2); the last one based on a variant of the latter including wine instead of alcohol intake (score 3). The association between these scores and, respectively, total mortality, cardiovascular incidence and mortality was tested by a Cox proportional hazards model adjusted for several potential confounders of the association. Generally, all three scores were inversely associated with the endpoints, although associations with score 1 did not reach statistical significance. Score 2 was inversely associated with total mortality (hazard ratio 0·94; 95% CI 0·88, 0·99). This association was confirmed for total cardiovascular as well as myocardial infarction (MI) incidence and mortality, but not for stroke. Score 3 was slightly more associated with the same outcomes. All associations were also resistant to adjustment for covariates related to potential CVD pathways, such as blood lipids, blood pressure and weight change after 11 years of follow-up. In a Danish cohort, the MDS was inversely associated with total mortality and with cardiovascular and MI incidence and mortality, but not with stroke incidence or mortality.
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| 33. |
- Tolstrup, Janne S, et al.
(författare)
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Smoking and risk of coronary heart disease in younger, middle-aged, and older adults
- 2014
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Ingår i: American Journal of Public Health. - : AMER PUBLIC HEALTH ASSOC INC. - 0090-0036 .- 1541-0048. ; 104:1, s. 96-102
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. We investigated associations of smoking and coronary heart disease (CHD) by age. Methods. Data came from the Pooling Project on Diet and Coronary Heart Disease (8 prospective studies, 1974-1996; n = 192 067 women and 74 720 men, aged 40-89 years). Results. During follow-up, 4326 cases of CHD were reported. Relative to never smokers, CHD risk among current smokers was highest in the youngest and lowest in the oldest participants. For example, among women aged 40 to 49 years the hazard ratio was 8.5 (95% confidence interval [CI] = 5.0, 14) and 3.1 (95% CI = 2.0, 4.9) among those aged 70 years or older. The largest absolute risk differences between current smokers and never smokers were observed among the oldest participants. Finally, the majority of CHD cases among smokers were attributable to smoking. For example, attributable proportions of CHD by age group were 88% (40-49 years), 81% (50-59 years), 71% for (60-69 years), and 68% (70+ years) among women who smoked. Conclusions. Among smokers, the majority of CHD cases are attributable to smoking in all age groups. Smoking prevention is important, irrespective of age.
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| 34. |
- van Vught, Anneke J. A. H., et al.
(författare)
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Association between dietary protein and change in body composition among children (EYHS)
- 2009
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Ingår i: Clinical Nutrition. - : Churchill Livingstone. - 0261-5614 .- 1532-1983. ; 28:6, s. 684-688
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND & AIMS: Growth hormone (GH) affects body composition by a relatively reduced fat mass and increased fat free mass. The intake of protein as well as the specific amino acids arginine and lysine potently stimulate GH secretion. This study investigated associations between intakes of protein, arginine, lysine and subsequent 6-year change in body composition among 8-10-year-old children.METHODS: Data of 364 children were collected from Odense, Denmark, during 1997-1998 and 6-year later as part of the European Youth Heart Study. Body mass index among children was subdivided by fat free mass index (FFMI) and fat mass index (FMI), based on skinfold measurements. Dietary intake was estimated via 24h recall. Associations between intakes of protein as well as arginine, lysine and change in FFMI and FMI were analysed by multiple linear regressions, adjusted for social economic status, puberty stage and physical activity level.RESULTS: Among lean girls inverse associations were found between protein as well as arginine and lysine intake and change in fat mass index (beta=-1.12+/-0.56, p=0.03, beta=-1.10+/-0.53, p=0.04, beta=-1.13+/-0.51, p=0.03 respectively). Furthermore among girls with a body mass index in the 5th quintile, protein intake was associated with DeltaFFMI (p=0.04), and more specific when LYS intake was high, ARG intake was associated with DeltaFFMI (p=0.04).CONCLUSION: Among girls high protein intakes may decrease body fat gain and increase fat free mass gain, depending on the available amounts and combinations of arginine and lysine.
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| 35. |
- van Vught, Anneke J. A. H., et al.
(författare)
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Association between intake of dietary protein and 3-year-change in body growth among normal and overweight 6-year-old boys and girls (CoSCIS)
- 2010
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Ingår i: Public Health Nutrition. - Cambridge United Kingdom : Cambridge University Press. - 1368-9800 .- 1475-2727. ; 13:5, s. 647-653
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Growth hormone (GH) affects linear growth and body composition, by increasing the secretion of insulin-like growth factor-I (IGF-I), muscle protein synthesis and lipolysis. The intake of protein (PROT) as well as the specific amino acids arginine (ARG) and lysine (LYS) stimulates GH/IGF-I secretion. The present paper aimed to investigate associations between PROT intake as well as intake of the specific amino acids ARG and LYS, and subsequent 3-year-change in linear growth and body composition among 6-year-old children.Design: Children's data were collected from Copenhagen (Denmark), during 2001-2002, and again 3 years later. Boys and girls were separated into normal weight and overweight, based on BMI quintiles. Fat-free mass index (FFMI) and fat mass index (FMI) were calculated. Associations between change (Delta) in height, FMI and FFMI, respectively, and habitual PROT intake as well as ARG and LYS were analysed by multiple linear regressions, adjusted for baseline height, FMI or FFMI and energy intake, age, physical activity and socio-economic status.Setting: Eighteen schools in two suburban communities in the Copenhagen (Denmark) area participated in the study. SUBJECTS: In all, 223 children's data were collected for the present study.Results: High ARG intake was associated with linear growth (beta = 1.09 (se 0.54), P = 0.05) among girls. Furthermore, in girls, DeltaFMI had a stronger inverse association with high ARG intake, if it was combined with high LYS intake, instead of low LYS intake (P = 0.03). No associations were found in boys.Conclusion: In prepubertal girls, linear growth may be influenced by habitual ARG intake and body fat gain may be relatively prevented over time by the intake of the amino acids ARG and LYS.
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| 36. |
- Vedtofte, Mia Sadowa, et al.
(författare)
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Association between the intake of alpha-linolenic acid and the risk of CHD
- 2014
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Ingår i: British Journal of Nutrition. - 0007-1145 .- 1475-2662. ; 112:5, s. 735-743
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Tidskriftsartikel (refereegranskat)abstract
- The intake of the mainly plant-derived n-3 PUFA alpha-linolenic acid (ALA) has been reported to be associated with a lower risk of CHD. However, the results have been inconsistent. Therefore, the objective of the present study was to examine the association between the intake of ALA and the risk of CHD. Potential effect modification by the intake of long-chain n-3 PUFA (n-3 LCPUFA) was also investigated. Data from eight American and European prospective cohort studies including 148 675 women and 80 368 men were used. The outcome measure was incident CHD (CHD event and death). During 4-10 years of follow-up, 4493 CHD events and 1751 CHD deaths occurred. Among men, an inverse association (not significant) between the intake of ALA and the risk of CHD events and deaths was observed. For each additional gram of ALA consumed, a 15% lower risk of CHD events (hazard ratios (HR) 0.85, 95% CI 0.72, 1.01) and a 23% lower risk of CHD deaths (HR 0.77, 95% CI 0.58, 1.01) were observed. No consistent association was observed among women. No effect modification by the intake of n-3 LCPUFA was observed.
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