| 1. |
- Adamsson, Viola
(author)
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A Healthy Nordic Diet and Cardiometabolic Risk Factors : Intervention Studies with Special Emphasis on Plasma Lipoproteins
- 2013
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Doctoral thesis (other academic/artistic)abstract
- A healthy diet is important in the prevention of cardiovascular disease (CVD). Several risk factors, modifiable by diet, are involved in the development of CVD, e.g. hyperlipidaemia, hyperglycaemia, insulin resistance, obesity and hypertension. Little data however exist on diets composed of foods originating from the Nordic countries, and their potential to reduce CVD risk.This thesis aimed to investigate whether an ad libitum healthy Nordic diet (ND), either provided as a whole diet, or as a prudent breakfast (PB) alone, could influence CVD risk factors in healthy, mildly hypercholesterolemic men and women. Another aim was to describe the nutrient and food composition of the ND, both by using self-reported data and serum biomarkers of dietary fat quality.The primary clinical outcome measure was LDL-cholesterol, and other cardiometabolic risk factors were secondary outcomes.Two parallel, randomised, controlled intervention studies were conducted in free-living subjects. Clinical and dietary assessments were performed at baseline and at the end of dietary interventions. All foods were provided to subjects randomised to ND, whereas only breakfast items were supplied to subjects randomised to PB. Control groups followed their habitual diet/breakfast.Compared with controls, ND reduced body weight and improved several CVD risk factors including LDL-cholesterol, insulin sensitivity and blood pressure. Several, but not all effects were probably partly mediated by diet-induced weight loss. ND accorded with Nordic nutrition recommendations and was defined as “a plant-based diet, where animal products are used sparingly as side dishes”. Compared with average Swedish diet, ND was high in dietary fibre, but low in sodium, meat, high-fat dairy products, sweets and alcohol. A decreased intake of saturated fat and increased intake of n-3 PUFA during ND was partly reflected in serum lipids. Eating a PB without other dietary changes did not improve lipid or glucose metabolism, but decreased markers of visceral fat and inflammation, without influencing body weight.This thesis suggests that a whole ND, but not PB alone, promotes weight loss and improves multiple CVD risk factors in healthy subjects after 6 weeks. These results suggest that ND could have a potential role in the prevention of cardiometabolic diseases.
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| 2. |
- Al-Adili, Lina, et al.
(author)
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Discrepancy in the evaluation of explicit and implicit nutrition care outcomes for patients at risk of malnutrition : A qualitative study
- 2022
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In: Journal of human nutrition and dietetics. - : John Wiley & Sons. - 0952-3871 .- 1365-277X. ; 35:3, s. 494-503
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Journal article (peer-reviewed)abstract
- BACKGROUND: Nutrition care plays a significant role in the prevention and treatment of malnutrition, although the challenge to establish the precise impact of a nutrition intervention on patient outcomes remains. Malnutrition can be associated with diverse underlying diseases and an increased risk of complications, which increases the difficulty of monitoring and evaluating the nutrition intervention. The aim is to gain an understanding of dietitians' reflections concerning nutrition care outcomes of interventions in patients at risk of malnutrition.METHODS: Six semi-structured audio-recorded focus group discussions with registered dietitians from primary healthcare and hospitals (n = 29) in Sweden were held at the dietitians' place of work or at the University. Focus group transcripts were analysed thematically to reveal patterns in the data and identify themes and subthemes.RESULTS: The dietitians described an approach to nutrition monitoring and evaluation of patients at risk of malnutrition that was categorised into three themes: (i) quantitative explicit outcomes, based on objective measures and described as rigorous; (ii) quantitative estimated outcomes, based on estimates and described as less rigorous and (iii) qualitative implicit outcomes, based on patients' subjective perceptions and experiences of their health and described as difficult to measure.CONCLUSIONS: Findings indicate the need for new strategies to promote systematic and comprehensive nutrition monitoring and evaluation.
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| 3. |
- Al-Adili, Lina, et al.
(author)
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Setting goals with patients at risk of malnutrition : A focus group study with clinical dietitians
- 2022
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In: Patient Education and Counseling. - : Elsevier. - 0738-3991 .- 1873-5134. ; 105:7, s. 2103-2109
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Journal article (peer-reviewed)abstract
- Objective: Setting goals collaboratively with patients is a key aspect in shared decision-making (SDM) in malnutrition interventions. The aim, therefore, was to gain an understanding of clinical dietitians' reflections regarding the process of goal-setting with patients at risk of malnutrition.Methods: Six semi-structured audio-recorded focus group discussions were held with registered dietitians (n = 29) from primary healthcare and hospitals in Sweden. Focus group transcripts were analysed thematically to find patterns in the data and identify themes.Results: Dietitians expressed striving to explore patients' narratives, capabilities, and resources before deciding on goals. They described different strategies in counseling patients and a lack of patient participation in the goal setting. They emphasized the difficulties of setting feasible goals due to discrepancies between their clinically oriented goals and patients' personal goals.Conclusion: Findings highlight a gap in the process of setting goals for patients at risk of malnutrition, where patients' participation was lacking. Education in SDM, and strategies and tools to support dietitians in involving patients in goal-setting, are required to bridge the gap and promote person-centeredness. Practice implications: Findings may be further used to develop tools and strategies, and design studies on the implementation of and education in SDM and goal-setting for malnutrition interventions.
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| 4. |
- Al-Adili, Lina
(author)
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The evaluation process of nutrition interventions for patients at risk of malnutrition : From a person-centred perspective
- 2023
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Doctoral thesis (other academic/artistic)abstract
- This thesis is aimed at exploring the process of evaluating nutrition interventions for patients at risk of malnutrition from a person-centred perspective. An explorative cross-sectional study was conducted based on data from the International Nutrition Care Process and Terminology Implementation Survey (INIS). Associations between the reported documentation of goals and outcomes and the reported implementation of the nutrition care process and its terminology, demographic factors, and factors associated with the workplace were explored. Responses were received from 347 Scandinavian dietitians. Strong associations were found between the implementation of nutrition monitoring and evaluation terminology and the documentation of goals and outcomes. Standardisation may support the documentation of goals and outcomes, and improve nutrition monitoring and evaluation. Focus group interviews were held with Swedish dietitians working in hospital and primary healthcare settings. The dietitians’ reflections on the process of nutrition monitoring and evaluation (Paper II) and the goal-setting process (Paper III) with patients at risk of malnutrition in nutrition intervention were explored. A lack of routine and structure in the process of evaluation and a lack of shared decision-making (SDM) in goal-setting was found. Dietitians described qualitative subjective outcomes as being most important to patients but that these are only implied in the nutrition intervention. They highlighted discrepancies between their clinically oriented goals and the patients’ own goals. The clarification of patients’ perspectives in the evaluation process is necessary to promote person-centredness, improve communication, and support the evidence-informed practice of nutrition intervention.An interview study with patients at risk of malnutrition was conducted. Patients’ experiences, perspectives and needs concerning goals in nutrition intervention were explored. Patients rarely reflected on goals in nutrition interventions, instead they described striving towards increased strength and energy. Goal-setting is part of the dietitian’s structured way of working, while the patient’s life-world is complex and unstructured. Elucidating patients’ goals may counteract the discrepancies between the dietitians’ clinically oriented goals and patients’ perspectives.In summary, this thesis highlights the need for tools and strategies for the improvement of the evaluation process in nutrition intervention. The person-centred practice of the evaluation process is described in this thesis as key to improving this process. This can be achieved through exploring what matters to patients in terms of perspectives, goals, and priorities, creating partnerships through involving patients in goal-setting and communicating feedback, and documenting and evaluating outcomes that are meaningful to patients.
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| 5. |
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| 6. |
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| 7. |
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| 8. |
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| 9. |
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| 10. |
- Becker, Wulf, et al.
(author)
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Precoded food records compared with weighed food records for measuring dietary habits in a population of Swedish adults
- 1998
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In: Scandinavian Journal of Nutrition/Næringsforskning. - : Informa UK Limited. - 1102-6480 .- 1651-2359. ; 42:1, s. 145-149
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Journal article (peer-reviewed)abstract
- In a cross-over design, 82 women and men recorded their food intake by a precoded 7-day record book (PR) including both standard portions in household measures and photographs, and a weighed 7-day record (WR), respectively. Single 24-h urine samples, for determination of nitrogen excretion, were collected for 39 subjects during the WR period. Comparing the PR to the WR method, the mean intake of some foods, as cheese, was higher, and bread and vegetables lower. For energy and nutrients, the fat energy percent (E%) was higher, and protein E%, dietary fibre, iron, thiamin, folate, carotene and α-tocopherol were all lower. Protein intake registered by the PR method was 20% lower compared to 24-h urine samples, and 11% lower for the WR method. The results indicate that some of the standard portion sizes, used by the PR method, contributed to the observed differences in food and nutrient intakes. The subjects found it easier and less time-consuming to record their food intake with the PR than with the WR method. The time spent on processing data was reduced by 50% when using the PR method. The results of the study will be used for improvements in the design of the PR for use in large-scale dietary surveys for monitoring dietary habits.
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| 11. |
- Fielding, R. A., et al.
(author)
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Effect of structured physical activity and nutritional supplementation on physical function in mobility-limited older adults : Results from the VIVE2 randomized trial
- 2017
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In: The Journal of Nutrition, Health & Aging. - : Springer Science and Business Media LLC. - 1279-7707 .- 1760-4788. ; 21:9, s. 936-942
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Journal article (peer-reviewed)abstract
- The interactions between nutritional supplementation and physical activity on changes in physical function among older adults remain unclear. The primary objective of this study was to examine the impact of nutritional supplementation plus structured physical activity on 400M walk capacity in mobility-limited older adults across two sites (Boston, USA and Stockholm, Sweden). All subjects participated in a physical activity program (3x/week for 24 weeks), involving walking, strength, balance, and flexibility exercises. Subjects were randomized to a daily nutritional supplement (150kcal, 20g whey protein, 800 IU vitamin D) or placebo (30kcal, non-nutritive). Participants were recruited from urban communities at 2 field centers in Boston MA USA and Stockholm SWE. Mobility-limited (Short Physical Performance Battery (SPPB) ae9) and vitamin D insufficient (serum 25(OH) D 9 - 24 ng/ml) older adults were recruited for this study. Primary outcome was gait speed assessed by the 400M walk. Results: 149 subjects were randomized into the study (mean age=77.5 +/- 5.4; female=46.3%; mean SPPB= 7.9 +/- 1.2; mean 25(OH)D=18.7 +/- 6.4 ng/ml). Adherence across supplement and placebo groups was similar (86% and 88%, respectively), and was also similar across groups for the physical activity intervention (75% and 72%, respectively). Both groups demonstrated an improvement in gait speed with no significant difference between those who received the nutritional supplement compared to the placebo (0.071 and 0.108 m/s, respectively (p=0.06)). Similar effects in physical function were observed using the SPPB. Serum 25(OH)D increased in supplemented group compared to placebo 7.4 ng/ml versus 1.3 ng/ml respectively. Results suggest improved gait speed following physical activity program with no further improvement with added nutritional supplementation.
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| 12. |
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| 13. |
- Fjellström Christina, Nydahl Margaretha, Sidenvall Birgitta
(author)
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Äldrehushållet inför 2000-talet
- 1997
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In: Livsmedelsteknik 8-9:44.. ; :8-9
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Other publication (other academic/artistic)
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| 14. |
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| 15. |
- Frid, Hanna, et al.
(author)
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Agreement between different methods of measuring height in elderly patients
- 2013
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In: Journal of human nutrition and dietetics. - : Wiley. - 0952-3871 .- 1365-277X. ; 26:5, s. 504-511
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Journal article (peer-reviewed)abstract
- BackgroundThe present study aimed to examine the agreement between measurements of standing height and self-reported height, height measured with a sliding caliper, and height estimated from either demispan or knee height in elderly patients.MethodsFifty-five patients (mean age 79 years) at a Swedish hospital were included in this observational study. The participants' heights were evaluated as the standing height, self-reported height, height measured in a recumbent position with a sliding caliper, and height estimated from the demispan or knee height.ResultsThe measurements made with a sliding caliper in the recumbent position agreed most closely with the standing height. Ninety-five percent of the individuals' differences from standing height were within an interval of +1.1 to −4.8 cm (limits of agreement). Self-reported height and height estimated from knee height differed relatively strongly from standing height. The limits of agreement were +5.2 to −9.8 cm and +9.4 to −6.2 cm, respectively. The widest distribution of differences was found in the height estimated from the demispan, with limits of agreements from +11.2 to −9.3 cm.ConclusionsWhen measuring the height of patients who find it difficult to stand upright, a sliding caliper should be the method of choice, and the second choice should be self-reported height or the height estimated from knee height. Estimating height from the demispan should be the method of last resort.
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| 16. |
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| 17. |
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| 18. |
- Hedman, Sanna, et al.
(author)
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Individually prescribed diet is fundamental to optimize nutritional treatment in geriatric patients
- 2016
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In: Clinical Nutrition. - : Elsevier BV. - 0261-5614 .- 1532-1983. ; 35:3, s. 692-698
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Journal article (peer-reviewed)abstract
- Background & aimsMalnutrition is a well-recognized problem in geriatric patients. Individually prescribed diet is fundamental to optimize nutritional treatment in geriatric patients. The objective of this study was to investigate routines regarding dietary prescriptions and monitoring of food intake in geriatric patients and to see how well the prescribed diet conforms to the patients' nutritional status and ability to eat. A further aim was to identify the most common reasons and factors interacting with patients not finishing a complete meal.MethodsThis study combines two methods using both qualitative and quantitative analysis. Patients (n = 43; 82.5 ± 7.5 yrs; 60% females) at four geriatric wards performed a two-day dietary record, assisted by a dietician. Nurses and assistant nurses at each ward participated in a semi-structured interview regarding prescription of diets and portion size for the patients.ResultsThe prescribed diet differed significantly (P < 0.01) from a diet based upon the patient's nutritional status and ability to eat. Only 30% of the patients were prescribed an energy-enriched diet in contrast to 60% that was in need of it. The most common reason for not finishing the meal was lack of appetite. Diet prescription for the patient was based upon information about eating difficulties identified in the Mini Nutritional Assessment-Short Form (MNA-SF) at admission and the type of diet that was prescribed on a previous ward. Monitoring of the patients' food intake was described as a continuous process discussed daily between the staff.ConclusionPatients' nutritional status and to what extent they were able to eat a complete meal was not routinely considered when prescribing food and monitoring food intake in this study. By making use of this information the diet could be tailored to the patients' needs, thereby improving their nutritional treatment.
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| 19. |
- Holt, Christina, et al.
(author)
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Salt
- 2014. - 2:1
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In: Livsmedelsvetenskap. - Lund : Studentlitteratur AB. - 9789144095677 ; , s. 345-350
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Book chapter (other academic/artistic)
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| 20. |
- Jonsson, Lena, et al.
(author)
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Livsmedelskvalitet
- 2014. - 2:1
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Book (other academic/artistic)
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| 21. |
- Jonsson, Lena, et al.
(author)
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Livsmedelsvetenskap
- 2007. - 1
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Book (other academic/artistic)abstract
- En lärobok som tekniskt och kemiskt förklarar varför man ska tillaga på ett visst sätt. Råvaor belyses från sitt ursprung, via kemisk sammansättning till vad som händer under tillagning. Dessutom belyses närings- och miljöaspekter på respektive råvara.
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| 22. |
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| 23. |
- Kirn, Dylan R., et al.
(author)
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The Vitality, Independence, and Vigor in the Elderly 2 Study (VIVE2) : Design and methods
- 2015
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In: Contemporary Clinical Trials. - : Elsevier BV. - 1551-7144 .- 1559-2030. ; 43, s. 164-171
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Journal article (peer-reviewed)abstract
- Background: Nutritional supplementation may potentiate the increase in skeletal muscle protein synthesis following exercise in healthy older individuals. Whether exercise and nutrition act synergistically to produce sustained changes in physical functioning and body composition has not been well studied, particularly in mobility-limited older adults. Methods: The VIVE2 study was a multi-center, randomized controlled trial, conducted in the United States and Sweden. This study was designed to compare the effects of a 6-month intervention with a once daily, experimental, 4 fl. oz. liquid nutritional supplement providing 150 kcal, whey protein (20 g), and vitamin D (800 IU) (Nestle Health Science, Vevey, Switzerland), to a low calorie placebo drink (30 kcal, non-nutritive; identical format) when combined with group-based exercise in 150 community-dwelling, mobility-limited older adults. All participants participated in a structured exercise program (3 sessions/week for 6 months), which included aerobic, strength, flexibility, and balance exercises. Results: The primary outcome was 6-month change in 400 m walk performance (m/s) between supplement and placebo groups. Secondary outcomes included 6 month change in: body composition, muscle cross-sectional area, leg strength, grip strength, stair climb time, quality of life, physical performance, mood/depressive symptoms and nutritional status. These outcomes were selected based on their applicability to the health and wellbeing of older adults. Conclusions: The results of this study will further define the role of nutritional supplementation on physical functioning and restoration of skeletal muscle mass in older adults. Additionally, these results will help refine the current physical activity and nutritional recommendations for mobility-limited older adults.
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| 24. |
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| 25. |
- Liljeberg, Evelina, 1985-, et al.
(author)
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A qualitative exploration of dietitians' experiences of prescribing oral nutritional supplements to patients with malnutrition : A focus on shared tailoring and behaviour change support
- 2021
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In: Journal of human nutrition and dietetics. - : John Wiley & Sons. - 0952-3871 .- 1365-277X. ; 34:5, s. 858-867
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Journal article (peer-reviewed)abstract
- Background: Oral nutritional supplements (ONS) are commonly prescribed to patients with malnutrition. Dietitians have been suggested as preferred prescribers butgenerally lack ONS prescribing rights. How dietitians with prescribing rights experience their professional practice of prescribing ONS remains understudied. Thus, byexploring dietitians’ experiences of prescribing ONS, the present study aimed to obtain a deeper understanding of specific aspects that are of importance for dietitianswhen providing a nutrition therapy including ONS.Methods: Qualitative individual interviews were conducted with 13 dietitians prescribing ONS to free-living adult outpatients with malnutrition or at nutritional riskin the hospital or primary care setting. Systematic text condensation was used fordata analysis.Results: Two main categories signifying important aspects were identified and labelled: ‘Shared tailoring of the ONS prescription’ and ‘Supporting and facilitatingONS use’. First, the dietitians described tailoring the ONS prescription together withthe patient, having their acceptance as a prerequisite, and being flexible regardingproducts and amounts prescribed. Second, they described performing different communication strategies and organising of practical issues (e.g., ONS delivery and support from others) to support and facilitate patients’ ONS usage.Conclusions: The present study identifies patient involvement and the role of dietitians as behaviour change facilitators as two important aspects when dietitiansprescribe ONS. These findings allow for dietitians’ ideals and strategies on how toprescribe ONS to be made more visible, which can inform both clinical practice andclinical trials for future improvements in nutrition therapy to address malnutrition.
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| 26. |
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| 27. |
- Liljeberg, Evelina, 1985-, et al.
(author)
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'Between foods and medicines' : A qualitative interview study of patient experiences of the meaning and usage of oral nutritional supplements
- 2022
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In: Appetite. - : Elsevier. - 0195-6663 .- 1095-8304. ; 178
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Journal article (peer-reviewed)abstract
- The aim of this study was to deepen the understanding of what oral nutritional supplements mean to patients and how this meaning connects to supplement usage, by exploring patient experiences of such supplements. Qualitative interviews were conducted in June 2019–March 2020 with ten patients with malnutrition or at nutritional risk, prescribed oral nutritional supplements by dietitians. Data were thematically analysed using systematic text condensation. Two final categories were identified: ‘Oral nutritional supplements are a one-dimensional remedy’ and ‘Everyday oral nutritional supplement usage is regulated autonomously’. The patients described the meaning of oral nutritional supplements as nutrition. While the supplements could compensate for nutrients not eaten or be part of a helpful compensation strategy, they could not lessen the burden of altered eating. Supplement usage was described as dependent on the acceptance of taste and the priority given to nutrition in everyday life. Usage was greater when nutrients were perceived as needed, such as when striving for higher bodyweight or disease recovery. Usage was lower when a patient's own goals were not increased nutrient intake or bodyweight or when other activities were perceived as more important. Patient experiences indicated that oral nutritional supplements could serve as a remedy for malnutrition, but not for a situation of altered eating. Supplement usage was described as being regulated autonomously based on patient views on the importance of nutrition. Those views were diverse, highlighting the importance of supplement prescribers discussing treatment goals with each patient. A deeper understanding of the meaning of oral nutritional supplements and reasons for their usage from a patient perspective is crucial in order for healthcare to provide appropriate, effective nutrition therapy for malnutrition.
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| 28. |
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| 29. |
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| 30. |
- Liljeberg, Evelina, 1985-, et al.
(author)
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High adherence to oral nutrition supplements prescribed by dietitians : A cross‐sectional study on hospital outpatients
- 2019
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In: Nutrition in clinical practice. - : John Wiley & Sons. - 0884-5336. ; 34:6, s. 887-898
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Journal article (peer-reviewed)abstract
- Background: This study aimed to assess adherence to oral nutrition supplements (ONS) among hospital outpatients and to assess patient characteristics, experiences of ONS, and the characteristics of ONS prescriptions in clinical practice.Methods: Hospital outpatients aged 18 years and prescribed ONS by a dietitian at a Swedish hospital were referred to the study from September 2016 to February 2017. Data were collected from structured telephone interviews, medical records, and a register of ONS delivered. Adherence to ONS was measured by dividing self-reported intake of ONS (frequency question and 24-hour recall question) by the amount prescribed and using the medication possession ratio (MPR).Results: Of the 96 patients included (mean age 67±13 years), 52% were male. The 2 most frequent medical diagnoses were malignancy and digestive system disease. Mean adherence to ONS was 93% measured by the frequency question, 87% measured by the 24-hour recall question, and 76% according to MPR. The majority of the patients (83%) were prescribed 1–3 bottles of ONS/day. The average number of flavors of ONS delivered was 4.2. Before prescription, 69% of the patients had been allowed to taste the ONS and 92% had chosen the flavors to be prescribed. Over 75% liked the taste of the ONS and considered them to be good for their health.Conclusions: Adherence to ONS was high in this population, which might be explained by the individual tailoring of ONS prescriptions by a dietitian, positive experiences of ONS, and the relatively young mean age of the participants.
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| 31. |
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| 32. |
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| 33. |
- Liljeberg, Evelina, 1985-, et al.
(author)
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Incomplete descriptions of oral nutritional supplement interventions in reports of randomised controlled trials
- 2018
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In: Clinical Nutrition. - : Elsevier. - 0261-5614 .- 1532-1983. ; 37:1, s. 61-71
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Journal article (peer-reviewed)abstract
- Background & aimsThe effects of oral nutritional supplements (ONS) have been evaluated in several clinical trials and more studies have been requested. To facilitate replication, support accurate evaluations of research results and avoid research waste, high quality reporting of interventions in clinical trials is needed. The aim of this study is to assess the quality of reporting of interventions in publications describing randomised controlled trials of ONS in populations with malnutrition or at nutritional risk.MethodsThe PubMed database was searched for articles describing ONS trials published between January 2002 and December 2015. The quality of intervention descriptions was evaluated using the Template for Intervention Description and Replication (TIDieR) checklist and guide, which contains twelve items. Articles published before and after 2011 were compared.ResultsOf 76 articles identified, only 3% reported all TIDieR items in sufficient detail. The most frequently missing elements were descriptions of the intervention procedures (e.g. how the ONS were to be taken and if participants were given a choice of flavours), which were adequately presented in only 26% of the articles. Less than half of the articles included a description of the intervention provider and sufficient information about the location(s) for the intervention. Information about adherence and mode of delivery was reported in 60–65% of the articles. Most frequently reported, in >70% of the articles, were items regarding the brief name of the intervention, the rationale for the intervention and the materials used (i.e. information about the specific ONS product(s) administered). The reporting quality for two of the items (materials and provider) was higher in articles published after 2011.ConclusionsThe quality of reporting of ONS interventions was found to be poor. The descriptions mostly lacked information about intervention procedures, provider and location(s). A moderately higher reporting quality was observed in articles published after 2011. These findings imply that an improvement in the descriptions of ONS interventions is required in future clinical trials of malnutrition treatment.
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| 34. |
- Liljeberg, Evelina, 1985-
(author)
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Oral nutritional supplements within the nutrition therapy : Prescription and adherence from a dietetic practice perspective
- 2021
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Doctoral thesis (other academic/artistic)abstract
- The overall aim of this thesis was to increase knowledge and deepen understanding on prescription of and adherence to oral nutritional supplements (ONS). In Paper I, the reporting quality of interventions with ONS in publications of randomised controlled trials was explored. In Paper II, adherence to ONS prescriptions from dietitians to hospital outpatients in clinical practice was assessed. Further, an evaluation of the population characteristics and ONS prescription characteristics was performed. In Papers III and IV, dietitian and patient experiences of prescribing or being prescribed and using ONS were explored through qualitative interviews.The reporting quality of ONS interventions was found to be incomplete, making it hard to interpret trial findings and replicate them in clinical practice. The articles mainly lacked a description of intervention procedures, provider and location(s), but an improvement was observed in articles published after 2011. Adherence to ONS was found to be high (> 75%) among hospital outpatients prescribed ONS in clinical practice. The population was relatively young (mean age 67 years), and the two most common medical diagnoses were cancer and gastrointestinal disease. The prescriptions were individually tailored by dietitians, usually encompassing several flavours (mean 4.2) and 1–3 bottles/day. In the dietitian interview study, shared tailoring of the ONS prescription and provision of behaviour change support were identified as important aspects when dietitians prescribe ONS. In the patient interview study, ONS were described as a one-dimensional remedy: contributing with nutrients, but unable to resolve the situation of altered eating. Additionally, ONS usage was described as regulated autonomously based on the priority given to nutrition in everyday life.In conclusion, this thesis shows that prescription of and adherence to ONS are complex processes, which tend to be underestimated in the ONS literature. Adherence to ONS was high, which might be explained by population characteristics and the dietitian-tailored prescriptions fulfilling criteria for appropriate ONS prescriptions. The interview studies provided insights into nutrition therapy with ONS from both the dietitian and the patient perspective. The findings indicated that ONS should be prescribed using a person-centred care approach, with patients viewed as an active part in nutrition therapy.
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| 35. |
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| 36. |
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| 37. |
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| 38. |
- Lundmark, Berit, et al.
(author)
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hemmetskokbok.se
- 2007
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Other publication (pop. science, debate, etc.)
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| 39. |
- Marklinder, Ingela, 1959-, et al.
(author)
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A Proposed Theoretical Model for Sustainable and Safe Commensality among Older Adults
- 2021
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In: International Journal of Environmental Research and Public Health. - Basel, Schweiz : MDPI. - 1661-7827 .- 1660-4601. ; 18:3
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Journal article (peer-reviewed)abstract
- Eating together at the same table, i.e., commensality, is an old phenomenon among humans. Today, there is a relatively high number of people living in single households eating most meals on their own. Among adults aged 65+ years, both malnutrition and non-communicable diseases are common. These circumstances, as well as foodborne illnesses, cause health problems for the individual, as well as high societal costs. In older adults, several external factors might impact on commensality, such as living arrangements, health status, and cooking competence. Improved knowledge regarding healthy eating and food handling may improve attitudes and behaviors in relation to food safety and dietary intake. Further, commensality has been shown to influence dietary intake in multiple ways. Community-organized activities, e.g., Food Classes for Older Adults (FCOA), may lead to sustainable commensality. Participating in health-promoting activities can contribute to improved health outcomes and improved social interaction among older adults. The objective of this study was to propose a theoretical model to inspire and create networks for sustainable commensality among older adults. The model could serve as a conceptual framework when implementing FCOA in communities and research. Outcomes could be measured by investigating the frequency of commensality, health effects, and well-being.
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| 40. |
- Marklinder, Ingela, 1959-, et al.
(author)
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CHANCE : a healthy lifestyle in terms of food handling and hygiene
- 2013
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In: British Food Journal. - : Emerald. - 0007-070X .- 1758-4108. ; 115:2-3, s. 223-234
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Journal article (peer-reviewed)abstract
- The purpose of this paper is to identify knowledge gaps in terms of food handling and hygiene among a population in a selected city district. This study is a part of the project Community Health management to Enhance Behaviour (CHANCE), Life Long Learning programme of European Union 2007-2009). A certain vulnerable group, i.e. older people , were addressed. the study population was recruited by convenience sample. A questionnaire was used to collect data among citizens in a selected city district (n=251). The elderly (71-80+; n=123) were interviewed face to face, while the younger (21-70 years; n= 128) filled in their data on their own.One third of the respondents usually measure the temperature in their trefrigerator. However, one third revealed knowledge gaps relating to storage temperature for certain food items. Thirty nine per cent changes dishcloths onece a week. Twenty percent of the elderly usually put raw minced meat into their mouth without reflecting on pathogenic bacteria. There was no significant relation between the fear of food poisioning and tasting minced meat, changing the dishcloth often, or cooling down food properly. These results can be interpreted as a sign of knowledge gaps, indicating a need for imporved health communication.The study population consisted of consumers in a selected city district in Uppsala municipality. Therefore the results should not be generalized for Swedes in general. The collected data and the information of knowledge gaps have been used to perform a local health intervention. The results would reveal relevance for a larger nationwide survey that aims to identify knowledge gaps in terms of food handling and and hygiene among Swedish citizens. Data from the present study would be useful in the attempt to implement simple tools at the local level, in order to promote healthy habits among consumers. An innovative principle in the EU project CHANCE is to work from inside out. Studies of consumers´food handling in private homes are lacking in Sweden. the present study is rather unique as it explores private households in terms of food handling and hygiene.
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| 41. |
- Marklinder, Ingela, 1959-, et al.
(author)
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Cold Food Storage - the 70+ need for Information
- 2008
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In: IAFP´s Fourth European Symposium on Food Safety, Lisbon, Portugal 19-21 November 2008. ; , s. 8-8
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Conference paper (other academic/artistic)abstract
- Older people (70 years plus) represent a risk category concerning complications with food-borne infections. As part of the project CHANCE, taking place in Austria, Germany, Latvia, Romania, Sweden and United Kingdom (Lifelong Learning Programme of European Union 2007-2009) a pilot study was performed in the urban area of Eriksberg, Uppsala municipality, Sweden. The aim was to understand this target group’s need for information about cold food storage and food handling within the context of understanding and perception of health related messages. Methods: Nine individuals aged 72 -93 years were individually asked to purchase certain food items (soft cheese; vacuum-packed, smoked salmon; vacuum-packed, sliced ham) and store them in their own refrigerator using their normal food practices. Subsequently, qualitative interviews were performed. The temperature was then measured in these food items after storage for one night. Data were qualitatively processed.Results: The study group were neither aware of the temperature in their refrigerator nor did they know about temperature differences on different shelves, although they did consider themselves to have a sound knowledge of how to handle and store foods. They expressed confidence in the grocery store and as such did not see the need for information. None of the informants were afraid of food-borne infections and yet a common habit was to taste raw minced meat, thus indicating a risk related optimism. The recorded temperatures of the various foodstuffs also suggested need for extra information.Significance: This group seemed to overestimate their own skills concerning cold food storage. Education about food handling was taught in childhood but arguably a need for information about how to handle food today exists. The trust given to their grocery store might contribute to a decrease in their own responsibility, which might be an obstacle concerning accessing further information.
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- Nydahl, Margaretha, 1953-, et al.
(author)
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A simplified health information model increased the level of knowledge regarding "five a day" and food safety in a city district
- 2012
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In: British Food Journal. - United Kingdom : Emerald Group Publishing Limited. - 0007-070X .- 1758-4108. ; 114:7, s. 910-925
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Journal article (peer-reviewed)abstract
- Purpose – The aim of this paper was to analyze the effect according to knowledge and behavior, respectively, through a simplified health information model launched in a selected city district.Design/methodology/approach – The intervention in this study encompasses information meetings where two educational computer programs highlighting the “five a day” concept, and food hygiene were showcased in conjunction with a group discussion. In total, 92 people living or working in a selected city district participated. The effect of the intervention was determined by means of inquiries (multiple-choice) that were carried out prior to, immediately following, and three weeks after the intervention.Findings – A statistically significant improvement in knowledge of the concepts “five a day”, cross-contamination, and recommended storage temperature (for smoked salmon and raw mince meat) was observed, however, no major change in behavior was reported.Practical implications – The knowledge improvement suggests that the education programs, in conjunction with discussions, are a useful information model for raising awareness about the notion of “five a day” and food safety. The results of the study make it clear that there are difficulties in getting people to change their behavior, let alone getting them to participate in health education offered locally.Originality/value – Intervention projects are a communication tool that may be used in order to increase knowledge and produce behavioral change. The project is working from the inside out, i.e. it examines the needs first and then develops solutions for them.
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- Nydahl, Margaretha
(author)
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Comparison between an optical readable food record and an open-ended weighed record
- 2008
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Conference paper (peer-reviewed)abstract
- Comparison between an optical readable food record and an open-ended weighed record M Nydah1 l , I-B Gustafsson2, R Mohsen3, W Becker4 1 Department of Domestic Sciences, Uppsala university, Uppsala Sweden 2. Department of Restaurant and Culinary Arts, University of Örebro, Örebro, Sweden. 3. Department of Public Health and Caring Sciences/Geriatrics, Uppsala university, Uppsala, Sweden 4 National Food Administration, Uppsala, Sweden Background: A simplified optically readable food record (ORFR) was developed and compared with an open-ended weighed record (WR). Objective: To compare dietary intake data obtained by a 7-day ORFR with those obtained by a 7-day WR. The results were validated against 24-h urinary nitrogen excretion and EI/estimated BMR cut-off values. Design: The study comprised 73 free-living, healthy 70-year-old men from a large cohort study. Dietary data were collected during 7 consecutive days, starting either with WR or ORFR. Results: Average intakes of milk, cheese and other milk products as well as coffee, tea and alcohol were significantly higher by ORFR than by WR, while intakes of vegetables, meat and meat products, fish, bread and cereal products as well as a number of sweet foods were significantly lower by ORFR than WR. Protein intake obtained by ORFR was 31% lower than the values calculated from the 24-h urine nitrogen excretion, and 22% lower than those obtained from WR. Average intakes of energy and several nutrients were significantly lower with ORFR than by WR. However, when adjusted to nutrient density, only a few nutrients were still lower with ORFR. A large proportion of the subjects under-reported their energy intakes, with a higher proportion for ORFR. Conclusion: Adjustments of some portion sizes in ORFR are suggested. In view of the advantages with respect to lower response burden and rapid processing of data these improvements would make ORFR a suitable dietary assessment tool in dietary surveys, especially in larger resource demanding, epidemiological investigations.
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- Nydahl, Margaretha, et al.
(author)
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Comparison between optical readable and open-ended weighed food records
- 2009
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In: Food & Nutrition Research. - : Taylor & Francis. - 1654-6628 .- 1654-661X. ; 53:1, s. 1-8
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Journal article (peer-reviewed)abstract
- Background: A simplified optically readable food record (ORFR) was developed and compared with an openended weighed record (WR). Objective: To compare intake of nutrients and foods using a seven-day ORFR with intake estimated using a seven-day WR. The results from each method were validated against 24-h urine nitrogen excretion and energy intake (EI)/estimated basal metabolic rate (BMR) cut-off values. Design: The study comprised 73 free-living, healthy 70-year-old Swedish men. Dietary data were collected during seven consecutive days, starting either with WR or ORFR. Results: Average intakes of energy and several nutrients were significantly lower when estimated using ORFR than when using WR. However, when adjusted for nutrient density, only a few nutrients were still lower with ORFR. Spearman correlation coefficients between the two methods regarding intakes of energy and energy-yielding nutrients were moderate to high, i.e. 0.4 0.6, while figures for most micro-nutrients were in the range 0.30.5. A large proportion of subjects under-reported their EIs, a higher proportion doing so when using ORFR. Protein intake obtained using ORFR was 31% lower than the values calculated from the 24-h urine nitrogen excretion, and 22% lower than those obtained from WR. Average intakes of milk, cheese and other milk products as well as coffee, tea and alcohol were significantly higher when estimated using ORFR than when using WR, while intakes of vegetables, meat and meat products, fish, bread and cereal products as well as number of sweet foods were significantly lower with ORFR. Conclusions: Based on these results, adjustments of some portion sizes in ORFR are suggested. In view of the advantages of ORFR with respect to lower response burden and rapid processing of data, such adjustments would make ORFR a suitable dietary assessment tool for use in dietary surveys, including larger resourcedemanding epidemiological investigations.
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