| 1. |
- Nordén, J., et al.
(författare)
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Nutrition impact symptoms and body composition in patients with COPD
- 2015
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Ingår i: European Journal of Clinical Nutrition. - : Nature Publishing Group. - 0954-3007 .- 1476-5640. ; 69:2, s. 256-261
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Tidskriftsartikel (refereegranskat)abstract
- Background/Objectives:Anorexia or lack of appetite is common in chronic obstructive pulmonary disease (COPD) and may be caused or augmented by several symptoms affecting appetite and eating. We aimed to investigate and quantify the extent of nutrition impact symptoms (NIS) in patients with COPD and to explore relationships between NIS and fat-free mass depletion.Subjects/Methods:The results in this cross-sectional study are based on 169 COPD patients (62% female subjects). Body composition was assessed using bioelectrical impedance spectroscopy and the patients reported NIS by two newly developed questionnaires: the Eating Symptoms Questionnaire (ESQ) and the Disease-Related Appetite Questionnaire (DRAQ).Results:Symptoms with the highest prevalence were dry mouth (71%), stomach ache (39%), pain or aches affecting appetite (36%) and constipation (35%). Problems with diarrhoea and feeling affected by smells were more severe among women compared with men (P<0.05). Thirty-six percent of the patients were depleted (fat-free mass index (FFMI) <15 kg/m(2) for women and FFMI<16 kg/m(2) for men). Depleted patients had more NIS (P<0.05) and also rated appetite and taste of food as worse compared with non-depleted patients (P<0.05).Conclusions:NIS are common in patients with COPD, and depleted patients have more severe symptoms. To investigate how these symptoms are best prevented and/or managed and whether NIS prevention/treatment can affect development of malnutrition in patients with COPD is a challenge for the future.
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| 2. |
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| 3. |
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| 4. |
- Andersson, Ingalill, et al.
(författare)
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Vitamin and mineral status in elderly patients with chronic obstructive pulmonary disease
- 2007
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Ingår i: Clinical Respiratory Journal. - : Blackwell Publishing. - 1752-6981 .- 1752-699X. ; 1:1, s. 23-29
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Eating problems are common in patients with chronic obstructive pulmonary disease (COPD), and intake of micronutrients might be lower than recommended. Objective: To study dietary intake, serum and urinary concentration of trace elements and vitamins in elderly underweight patients with established severe COPD. Methods: Outpatients at a university clinic for lung medicine, with COPD, 70-85 years old, with no other serious disease, and with a body mass index (BMI) of similar to 20 kg/m(2) and an FEV(1) of < 50 % predicted were recruited. Body composition and bone density were evaluated with dual energy X-ray absorptiometry. Dietary intake was studied by a trained dietitian using diet-history interview. Blood and urine samples were analysed for various vitamins and trace elements. Results: Seventeen of 30 recruited patients took part. Osteoporosis or osteopaenia was found in 16 patients. Dietary intake of energy and macronutrients was in line with recommendations for healthy individuals. Intake of protein did not meet recommendations for COPD patients. Intake of polyunsaturated fatty acids was lower than recommended and intake of saturated fatty acids was higher than recommended. Mean intake of vitamin D and folic acid was far below recommendations. Serum concentrations for folic acid and methylmalonate and plasma concentrations for homocysteine were below normal in several patients. Conclusion: Intake of vitamin D and calcium is often low in older COPD patients, which might contribute to osteoporosis. Low intake of folic acid might also be a problem. The results support prophylaxis with calcium, vitamin D and folic acid.
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| 5. |
- Andersson, Mikael, et al.
(författare)
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Physical activity level and its clinical correlates in chronic obstructive pulmonary disease : a cross-sectional study
- 2013
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Ingår i: Respiratory Research. - : Springer Science and Business Media LLC. - 1465-9921 .- 1465-993X. ; 14, s. 128-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Decreased physical activity is associated with higher mortality in subjects with COPD. The aim of this study was to assess clinical characteristics and physical activity levels (PALs) in subjects with COPD. Methods: Seventy-three subjects with COPD (67 +/- 7 yrs, 44 female) with one-second forced expiratory volume percentage (FEV1%) predicted values of 43 +/- 16 were included. The ratio of total energy expenditure (TEE) and resting metabolic rate (RMR) was used to define the physical activity level (PAL) (PAL = TEE/RMR). TEE was assessed with an activity monitor (ActiReg), and RMR was measured by indirect calorimetry. Walking speed (measured over 30-meters), maximal quadriceps muscle strength, fat-free mass and systemic inflammation were measured as clinical characteristics. Hierarchical linear regression was applied to investigate the explanatory values of the clinical correlates to PAL. Results: The mean PAL was 1.47 +/- 0.19, and 92% of subjects were classified as physically very inactive or sedentary. The walking speed was 1.02 +/- 0.23 m/s, the quadriceps strength was 31.3 +/- 11.2 kg, and the fat-free mass index (FFMI) was 15.7 +/- 2.3 kg/m(2), identifying 42% of subjects as slow walkers, 21% as muscle-weak and 49% as FFM-depleted. The regression model explained 45.5% (p < 0.001) of the variance in PAL. The FEV1% predicted explained the largest proportion (22.5%), with further improvements in the model from walking speed (10.1%), muscle strength (7.0%) and FFMI (3.0%). Neither age, gender nor systemic inflammation contributed to the model. Conclusions: Apart from lung function, walking speed and muscle strength are important correlates of physical activity. Further explorations of the longitudinal effects of the factors characterizing the most inactive subjects are warranted.
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| 6. |
- Arvidsson, Daniel, 1974, et al.
(författare)
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Energy Cost in Children Assessed by Multisensor Activity Monitors
- 2009
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Ingår i: Medicine & Science in Sports & Exercise. - : American College of Sports Medicine. - 0195-9131 .- 1530-0315. ; 41:3, s. 603-611
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The SenseWear Pro2 Armband (SWA; BodyMedia, Inc., Pittsburg, PA), the Intelligent Device for Energy Expenditure and Activity (IDEEA; Minisun LLC, Fresno, CA), and the ActiReg (AR; PreMed AS, Oslo, Norway) were compared with indirect calorimetry to determine the ability of these devices to assess energy cost in children during resting and different physical activities. Methods: Fourteen children, 11–13 yr old, wore the SWA, the IDEEA, and the AR during resting, sitting, stationary bicycling, jumping on a trampoline, playing basketball, stair walking, and walking/running along a 50-m track. The Oxycon Mobile portable metabolic system (VIASYS Healthcare, Conshohocken, PA) was used as the criterion method for energy cost. Results: For resting and sitting, the three activity monitors showed comparable results, but none of them accurately assessed energy cost for stationary bicycling, jumping on a trampoline, or playing basketball. The IDEEA was the only activity monitor that accurately assessed energy cost for stair walking. Also, the IDEEA showed a close estimate of energy cost across the walking and the running intensities, whereas the SWA accurately assessed energy cost for slow to normal walking but showed increased underestimation of energy cost with increasing speed. The AR overestimated energy cost during walking and during slow running but did not respond to increasing running speed. Conclusions: To be able to capture children’s physical activity, all three activity monitors need to be further developed. Overall, the IDEEA showed the highest ability to assess energy cost in this study, but SWA may be more feasible for use in children under free-living conditions.
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| 7. |
- Arvidsson, Daniel, 1974, et al.
(författare)
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Energy cost of physical activities in children : Validation of SenseWear Armband
- 2007
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Ingår i: Medicine & Science in Sports & Exercise. - : American College of Sports Medicine. - 0195-9131 .- 1530-0315. ; 39:11, s. 2076-2084
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To examine the validity of SenseWear Pro2 Armband in assessing energy cost of physical activities in children, and to contribute with values of energy costs in an overview of physical activities in children. METHODS: Energy cost was assessed by SenseWear Pro2 Armband in 20 healthy children, 11-13 yr, while lying down resting, sitting playing games on mobile phone, stepping up and down on a step board, bicycling on a stationary bike, jumping on a trampoline, playing basketball, and walking/running on a treadmill at the speeds 2, 3, 4, 5, 6, 7, 8, and 10 km x h(-1). During these activities, energy cost was also assessed from VO2 and VCO2 measured by Oxycon Mobile portable metabolic system, which was used as criterion method. RESULTS: The difference in energy cost between SenseWear Pro2 Armband and Oxycon Mobile was -0.7 (0.5) (P < 0.001) for resting, -2.0 (0.9) (P < 0.001) for playing games on mobile phone, -6.6 (2.3) (P < 0.001) for stepping on the step board, -12.0 (3.7) (P < 0.001) for bicycling, -2.7 (11.9) (P = 0.34) for jumping on the trampoline, and -14.8 (6.4) kJ x min(-1) (P < 0.001) for playing basketball. The difference in energy cost between SenseWear Pro2 Armband and Oxycon Mobile for increasing treadmill speed was 1.3 (3.1) (P = 0.048), 0.1 (2.9) (P = 0.82), -1.2 (2.6) (P = 0.049), -1.6 (3.2) (P = 0.044), -3.1 (3.7) (P = 0.0013), -4.9 (3.7) (P < 0.001), -5.3 (3.7) (P < 0.001), and -11.1 (3.5) kJ x min(-1) (P < 0.001). CONCLUSIONS: SenseWear Pro2 Armband underestimated energy cost of most activities in this study, an underestimation that increased with increased physical activity intensity. A table of energy costs (MET values) of physical activities in children measured by indirect calorimetry is presented as an initiation of the creation of a compendium of physical activities in children
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| 8. |
- Arvidsson, Daniel, 1974, et al.
(författare)
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Free-living energy expenditure in children using multi-sensor activity monitors.
- 2009
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Ingår i: Clinical nutrition (Edinburgh, Scotland). - : Elsevier BV. - 1532-1983 .- 0261-5614. ; 28:3, s. 305-12
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To improve the energy expenditure algorithm of the activity monitor ActiReg, and to validate ActiReg and the activity monitor SenseWear in free-living children. METHODS: The development of the ActiReg algorithm was performed in 20 healthy 11-13 years old children on treadmill walking and running with indirect calorimetry as reference. The original and new ActiReg algorithms and SenseWear using software versions InnerView 5.1 and 6.1 were validated in 20 healthy 14-15 years old children against doubly labelled water. RESULTS: The new ActiReg algorithm improved the assessment of energy expenditure during walking and running, but the response from the monitor levelled off after 7 km h(-1). The new algorithm and InnerView 6.1 decreased the mean (sd) difference to doubly labelled water from 11 (25) (P<0.05) to 0 (22) kJ kg(-1) d(-1) for ActiReg, and from 17 (20) (P<0.01) to -10 (21) (P<0.05) kJ kg(-1) d(-1) for SenseWear. However, the correlations between energy expenditure and the individual error for the new ActiReg algorithm and InnerView 6.1 were r= -0.50 (P<0.05) and r= -0.73 (P<0.01). CONCLUSIONS: The new ActiReg algorithm and InnerView 6.1 improved the activity monitors at group level, but the error was dependent on physical activity level. Both activity monitors need further developments for use in children.
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| 9. |
- Arvidsson, Daniel, 1974, et al.
(författare)
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Physical activity questionnaire for adolescents validated against doubly labelled water
- 2005
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Ingår i: Eur J Clin Nutr. ; 59:3, s. 376-83
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To validate a physical activity questionnaire for adolescents (PAQA) adapted from the International Physical Activity Questionnaire (IPAQ). DESIGN: Energy expenditure was measured during a 14-day period with doubly labelled water (DLW). PAQA was administered as an interview at the end of the period, asking for physical activity in school, during transportation and leisure-time, during a habitual week. Energy expenditure (EE(PAQA)) was calculated as the product of total physical activity + sleep and predicted resting metabolic rate, and was compared to energy expenditure from DLW (EE(DLW)), thermic effect of feeding excluded. SETTING: Participants were recruited from grade 9 in a compulsory school in Goteborg, Sweden. All data were collected at school, and distribution of DLW and measuring of resting metabolic rate were performed at Sahlgrenska University Hospital. SUBJECTS: A total of 33 adolescents (16 girls, 17 boys) 15.7 (0.4) y performed all measurements. RESULTS:: For the whole group, PAQA underestimated energy expenditure by 3.8 (1.7) MJ (P<0.001). There was a strong correlation (r = 0.62, P<0.001) between EE(PAQA) and EE(DLW), but not for boys (r = 0.42, P = 0.090) and girls (r = 0.33, P = 0.22) separately. CONCLUSIONS: PAQA is not able to predict energy expenditure in Swedish adolescents, largely explained by the amount of unreported time. The ability to rank adolescents energy expenditure is questioned because of the gender effect, although we found a strong correlation for the whole group.
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| 10. |
- Arvidsson, Daniel, 1974, et al.
(författare)
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Physical activity, sports participation and aerobic fitness in children who have undergone surgery for congenital heart defects.
- 2009
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - : Wiley. - 1651-2227 .- 0803-5253. ; 98:9, s. 1475-82
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To investigate physical activity, sports participation and aerobic fitness in children who have undergone surgery for congenital heart defects. SUBJECTS AND METHODS: Children who had undergone surgery for congenital heart defects and healthy controls in the Gothenburg area were invited to participate in the study. All participants were aged 9-11 or 14-16 years. The activity monitor ActiReg was used to assess physical activity. Participants were interviewed about their participation in sports and performed a maximal exercise test on a bicycle with measured oxygen uptake. RESULTS: A total of 32 and 25 patients, and 61 and 45 controls, in the two age-groups were included, respectively. The patients had a wide range of severity of congenital heart defects. The physical activity level was similar in the patients and the controls. The rate of sports participation was high for both patients and controls; 80-94% of all participants took part in sports at least once a week. The majority of the patients were considered to have at least a moderate level of aerobic fitness. CONCLUSIONS: Although children who have undergone surgery for congenital heart defects have a similar level of physical activity compared with that of healthy children, some of them may require support to participate in exercise and vigorous physical activity.
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| 11. |
- Arvidsson, Daniel, 1974, et al.
(författare)
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Validity of the ActiReg system in assessing energy requirement in chronic obstructive pulmonary disease patients
- 2006
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Ingår i: Clin Nutr. ; 25:1, s. 68-74
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND & AIMS: Malnutrition and weight loss are common in patients with chronic obstructive pulmonary disease (COPD) and effective nutritional support relies on accurate assessment of energy requirement. This could only be performed by measuring energy expenditure using objective methods. The aim of this study was to examine the validity of the ActiReg system in assessing energy requirement in non-hospitalized patients with severe COPD, using doubly labelled water (DLW) as criterion method. METHODS: Total energy expenditure (TEE) was assessed from 14 days DLW analysis in 13 patients. During the first 7 days TEE was simultaneously assessed using the ActiReg system, combining measured resting energy expenditure (REE) with physical activity monitoring. RESULTS: A difference of -88 (782) kJ d(-1) (P = 0.69) was observed between the ActiReg system and DLW. REE explained 52% of the variation in TEE from DLW. Adding physical activity energy expenditure from the ActiReg system (PAEE(AR) = TEE(AR)-REE) increased the explained variation in TEE from DLW with 16%. CONCLUSIONS: The ActiReg system is valid in assessing energy requirement in non-hospitalized patients with severe COPD. The unique feature of being able to discriminate within both the low intensity activity range and moderate-to-high intensity activity range makes the ActiReg system a valuable tool in clinical nutritional support.
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| 12. |
- Carlsson, Ebba, et al.
(författare)
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Resting energy expenditure is not influenced by classical music
- 2005
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Ingår i: J Negat Results Biomed. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- Obesity shows an increasing prevalence worldwide and a decrease in energy expenditure has been suggested to be one of the risk factors for developing obesity. An increase in resting energy expenditure would have a great impact on total energy expenditure. This study shows that classical music do not influence resting energy expenditure compared to complete silence. Further studies should be performed including other genres of music and other types of stress-inductors than music.
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| 13. |
- Carlsson, Maine, 1955-
(författare)
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Nutritional status, body composition and physical activity among older people living in residential care facilities
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The main purpose of this thesis was to study, whether drinkable yoghurt enriched with probiotic bacteria could have any effect on constipation and body weight (BW) among older people with dementia. Further, it concerns poor nutritional status among older people with physical and cognitive impairments and its relationship with factors commonly occur in older people living in residential care facilities. It also discusses how body composition changes with ageing and the associations between changes in muscle mass and functional balance after a high-intensity weight-bearing exercise program (the HIFE program) and the ingestion of an additional milk-based protein-enriched energy supplement. A six-month feasibility study that included a probiotic drink was performed among 15 old people who were living in special units for people with dementia and who all had constipation. The effects of the probiotic drink on stool habits, and BW were studied. The outcome measures were followed daily for bowel movements and at three and six months for BW. The staff found the study easy to carry out and that the drink was well accepted by the participants. No convincing beneficial effects on stool habits were observed. In addition, a mean BW loss of 0.65 kg/month was registered. A poor nutritional intake, low physical activity level, and an over-night fast of almost 15 hours, 4 hours longer than recommended were also observed. As a part of the FOPANU Study (Frail Older People-Activity and Nutrition Study), a randomized controlled trial was carried out in Umeå - the associations between nutritional status and factors common among old people with physical and cognitive impairments living in residential care facilities was studied. Assessments were made of nutritional status using the Mini Nutritional Assessment (MNA) scale, fat-free mass (FFM) and fat mass (FM) using both bioelectrical impedance spectroscopy (BIS) and skinfold thickness measurements. The effects of a high- intensity functional exercise program with an additional protein-enriched milk drink on ability to build muscle mass were evaluated. Analyses were made to investigate whether nutritional status, assessed using the MNA scale, was associated with medical conditions, drugs, activities of daily living (Barthel ADL index), cognitive impairment (Mini Mental State Examination (MMSE)), and depressive symptoms (Geriatric Depression Scale (GDS)) at baseline. The associations were assessed with multiple linear regression analyses with additional interaction analyses. An independent association was found between poor nutritional status and having had a urinary tract infection (UTI) during the preceding year and being dependent in feeding for both women and men, and having lower MMSE scores for women. A large proportion of the participants, were at risk of malnutrition or were already malnourished. Women, but not men, had significantly lower Fat-Free Mass Index (FFMI) and Fat Mass Index (FMI) with age. Bioelectrical impedance spectroscopy results correlated with skinfold thickness measurements, but on different levels on value for FM%. Despite the high-intensity exercise had long-term effects (at six months, three months after the exercise) on functional balance, walking ability and leg strength. No effects on muscle mass and no additional effects from the protein-enriched drink could be observed after the three months of high intensity exercise. A negative, long-term effect on the amount of muscle mass and BW was revealed at six months (three months after the intervention had ended). The effects from the exercise did not differ for participants who were malnourished. No statistical interactions were observed between sex, depression, dementia disorder, and nutritional status, and the level of functional balance capacity on the outcome at three or six months. In summary, the majority of the included older people with dementia had a low dietary intake, low physical activity level, and lost BW despite receiving a probiotic drink supplement every day for six months. The supplementation had no detectable effect on constipation. Among the participants in the FOPANU Study, UTI during the preceding year was independently associated with poor nutritional status. Being dependent in feeding was associated with poor nutritional status as were lower MMSE scores for women but not for men. Despite the high-intensity exercise program had long-term effects on the fysical function was no effect on the amount of muscle mass at three months observed. The FFM and FM expressed as indexes of body height were inversely related to age for women, but not for men. A high-intensity exercise program did not have any effect on the amount of muscle mass. The ingestion of a protein-enriched drink immediately after exercise produced no additional effect on the outcome and the results did not differ for participants who were malnourished. The negative long-term effect on amount of muscle mass, and BW, indicate that it is necessary to compensate for increased energy demands during a high-intensity exercise program. High age, female sex, depression, mild to moderate dementia syndrome, malnutrition, and severe physical impairment do not seem to have a negative impact on the effect of a high-intensity functional weight-bearing exercise program. Consequently, people with these characteristics in residential care facilities should not be excluded from training and rehabilitation including nutrition. More research is needed in large randomized controlled trials to further explore the association between energy balance and malnutrition among frail old people, with a special focus on UTI and constipation, but also to study how physical exercise affects older people’s nutritional status.
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| 14. |
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| 15. |
- Elam Edwén, Cecilia, 1970, et al.
(författare)
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Stretch-shortening cycle muscle power in women and men aged 18-81 years: Influence of age and gender
- 2014
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Ingår i: Scandinavian Journal of Medicine & Science in Sports. - : Wiley. - 0905-7188. ; 24:4, s. 717-726
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Tidskriftsartikel (refereegranskat)abstract
- This study explored the age-related deterioration in stretch-shortening cycle (SSC) muscle power and concurrent force-velocity properties in women and men across the adult life span. A total of 315 participants (women: n = 188; men: n = 127) aged 18-81 years performed maximal countermovement jumps on an instrumented force plate. Maximal SSC leg extension power expressed per kg body mass (Ppeak) was greater in men than in women across the adult age span (P < 0.001); however, this gender difference was progressively reduced with increasing age, because men showed an similar to 50% faster rate of decline in SSC power than women (P < 0.001). Velocity at peak power (VPpeak) was greater in men than in women (P < 0.001) but declined at a greater rate in men than in women (P = 0.002). Vertical ground reaction force at peak power (FPpeak) was higher in men than in women in younger adults only (P < 0.001) and the age-related decline was steeper in men than in women (P < 0.001). Men demonstrated a steeper rate of decline in Ppeak than women with progressive aging. This novel finding emerged as a result of greater age-related losses in men for both force and velocity. Consequently, maximal SSC power production was observed to converge between genders when approaching old age.
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| 16. |
- Farooqi, Nighat, et al.
(författare)
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Assessment of energy intake in women with chronic obstructive pulmonary disease: A doubly labeled water method study
- 2015
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Ingår i: Journal of Nutrition Health & Aging. - : Springer Science and Business Media LLC. - 1279-7707 .- 1760-4788. ; 19:5, s. 518-524
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Tidskriftsartikel (refereegranskat)abstract
- To maintain energy balance, reliable methods for assessing energy intake and expenditure should be used in patients with chronic obstructive pulmonary disease (COPD). The purpose of this study was to validate the diet history and 7-day food diary methods of assessing energy intake (EI) using total energy expenditure (TEE) with the doubly labeled water (DLW) method (TEEDLW) as the criterion method in outpatient women with COPD. EI was assessed by diet history (EIDH) and a 7-day food diary (EIFD) in 19 women with COPD, using TEEDLW as the criterion method. The three methods were compared using intra-class correlation coefficients (ICC) and Bland-Altman analyses. The participants were classified according to their reporting status (EI/TEE) as valid-reporters 0.79-1.21, under-reporters < 0.79 or over-reporters > 1.21. Diet history underestimated reported EI by 28%, and 7-day food diary underestimated EI by approximately 20% compared with TEEDLW. The ICC analysis showed weak agreement between TEEDLW and EIDH (ICC=-0.01; 95%CI-0.10 to 0.17) and between TEEDLW and EIFD (ICC=0.11; 95%CI -0.16 to 0.44). The Bland-Altman plots revealed a slight systematic bias for both methods. For diet history, six women (32%) were identified as valid-reporters, and for the 7-day food diary, twelve women (63%) were identified as valid-reporters. The accuracy of reported EI was only related to BMI. The diet history and 7-day food diary methods underestimated energy intake in women with COPD compared with the DLW method. Individuals with higher BMIs are prone to underreporting. Seven-day food diaries should be used with caution in assessing EI in women with COPD.
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| 17. |
- Farooqi, Nighat, 1969-, et al.
(författare)
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Energy expenditure in women and men with COPD
- 2018
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Ingår i: Clinical Nutrition Espen. - : Elsevier BV. - 2405-4577. ; 28, s. 171-178
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Tidskriftsartikel (refereegranskat)abstract
- Background: Many patients with chronic obstructive pulmonary disease (COPD) lose weight. Successful nutritional intervention is vital, thus assessment of energy requirement is required. The aim of this study was to present an improved possibility to assess energy requirement in patients with COPD. Methods: Pub Med search was conducted for all the studies reporting total energy expenditure (TEE) measured by doubly labeled water (DLW) method in patients with COPD. Four studies were identified, whereof three were conducted in Sweden. The present analysis is based on these three studies of which the data was acquired. Results: There was a large variation in resting metabolic rate (RMR) and TEE. Body mass index decreased significantly with increase in disease severity (p < .001), and correlated significantly to forced expiratory volume in 1 s (FEV1) % predicted (r = .627, p < .001). FEV1% predicted had a significant correlation with RMR/kg body weight (BW)/day (r = -.503, p = .001), RMR/kg fat-free mass (FFM)/day (r = .338, p = .031), and TEE/kg FFM/day (r = .671, p < .001). Compared to men, women had a lower RMR and TEE/kg BW/day (p < .001 respectively p = .002), and higher RMR and TEE/kg FFM/day (p = .080 respectively p = .005). The correlates of: RMR/kg BW were gender and FEV1% predicted; of TEE/kg BW the correlates were age and gender, and of TEE/kg FFM the correlates were age and FEV1% predicted. Conclusion: In this study, we have presented a possibility to assess energy requirement per kg BW/day and per kg FFM/day in patients with COPD in clinical settings. However, gender, age, and disease severity must be considered. (C) 2018 The Authors. Published by Elsevier Ltd on behalf of European Society for Clinical Nutrition and Metabolism.
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| 18. |
- Farooqi, Nighat, 1969-
(författare)
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Nutrition and energy expenditure in women with chronic obstructive pulmonary disease
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- AimThe overall objective of this thesis was to increase the knowledge and validate methods for assessment of total daily energy expenditure (TEE), energy requirement and energy intake (EI) in women with COPD. We also investigated the relationship of BMI with clinical characteristics of COPD in a population-based study. Due to the substantial and increasing morbidity in women with COPD, special attention was given to this group.MethodsResting metabolic rate (RMR) was measured by indirect calorimetry (IC). TEE was measured by criterion method, doubly labeled water (DLW) (Paper I-III) during a 14-day period. TEE was simultaneously assessed by SenseWear Armband, software version 5.1 and 6.1 (SWA5 respectively SWA6), and ActiHeart (paper I). EI was assessed by diet history interview and 7-day food diary (paper II), and energy requirement was predicted using pedometer-determined physical activity level (paper III). Energy requirement data was also acquired from studies concerning TEE measured by DLW in patients with COPD (paper IV). BMI and other characteristics in subjects with COPD were compared with non-COPD subjects in a population-based study, Obstructive Lung disease in Norrbotten study (OLIN) (paper V).ResultsThere was a large variation in RMR and TEE measured by DLW in this group of women with COPD. The results of energy expenditure study showed that the SWA5 assessed TEE with good accuracy over a 14-day period in free-living women with COPD. However, the SWA6 and ActiHeart methods tend to underestimate TEE. A higher proportion of women were within ± 5% of the TEE individually measured with the DLW method using SWA5 than SWA6 and AH (63%, 47%, 37% respectively). The agreement between the TEE measured by DLW and SWA5 was strong, and with SWA6 and ActiHeart it was lesser. Bland-Altman plots revealed no systematic bias for TEE. The reported EI was underestimated by 28% respectively 20 % when assessed by diet, and the 7-day food diary compared with the criterion method, DLW. More women were identified as valid-reporters based on their 7- day food diaries than on their diet histories (63% vs 32%). The accuracy of reported EI was only related to BMI. The agreement between the DLW and the EI methods was weak. The Bland-Altman plots revealed a slight systematic bias for both methods. The energy requirement predicted by pedometer-determined PAL multiplied by six different RMR equations was within a reasonable accuracy (±10%) of the measured TEE for all equations except one. The agreement between the DLW and four of six predicted TEE methods was strong. The Bland– Altman plots revealed no systematic bias for predicted energy requirement except for one. Estimated PAL from the pedometer was lower by 14 % than the measured criterion PAL. The energy requirement calculation based on available TEE data measured by DLW varied by BW and FFM. Compared to men, women had a lower RMR and TEE/kg BW/day, and higher RMR and TEE/kg FFM/day. The correlates of RMR/kg BW were gender and forced expiratory volume in 1st second (FEV1) % of predicted value, of TEE/ kg BW the correlates were age and gender, and of TEE/kg FFM were age and FEV1 % predicted. BMI decreased significantly with increase in disease severity and correlated significantly to forced expiratory volume in 1st second % predicted. In the population-based study (OLIN), subjects with COPD had lower BMI and a higher prevalence of underweight than in non-COPD, and its sub-groups namely, normal lung function and restrictive spirometry pattern subjects. There was an independent association between COPD and low BMI. Fewer COPD subjects were obese than in the non-COPD, normal lung function and restrictive spirometry pattern groups. Among the subjects with COPD, women had a lower mean BMI and a higher proportion were under-weight than men. In COPD women with under-weight, FEV1 % predicted values increased with an increase in BMI.ConclusionCompared with the gold standard DLW method, the total daily energy expenditure can be assessed reliably by SenseWear Armband 5 in women with COPD, while other devices underestimated TEE. The energy intake was underestimated by diet history and 7-day food diary methods, and energy requirement was predicted with reasonable accuracy using pedometer-determined PAL and common RMR equations, compared with DLW. Furthermore, the energy requirement was determined per kg BW/day and per kg FFM/day, using DLW based TEE data in patients with COPD. In the population-based study (OLIN), subjects with COPD had lower BMI and higher prevalence of under-weight than subjects without COPD. There was a gender difference, which was particularly significant in COPD, for women to have lower mean BMI and a higher prevalence of under-weight. The present findings indicate that low BMI is common in COPD and needs to be intervened. For a successful nutritional treatment, it is imperative to assess the patient’s ener
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| 19. |
- Farooqi, N., et al.
(författare)
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Predicting energy requirement with pedometer-determined physical-activity level in women with chronic obstructive pulmonary disease
- 2015
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Ingår i: International Journal of Chronic Obstructive Pulmonary Disease. - : Informa UK Limited. - 1178-2005. ; 10:1, s. 1129-1137
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Tidskriftsartikel (refereegranskat)abstract
- Background: In clinical practice, in the absence of objective measures, simple methods to predict energy requirement in patients with chronic obstructive pulmonary disease (COPD) needs to be evaluated. The aim of the present study was to evaluate predicted energy requirement in females with COPD using pedometer-determined physical activity level (PAL) multiplied by resting metabolic rate (RMR) equations. Methods: Energy requirement was predicted in 18 women with COPD using pedometer-determined PAL multiplied by six different RMR equations (Harris-Benedict; Schofield; World Health Organization; Moore; Nordic Nutrition Recommendations; Nordenson). Total energy expenditure (TEE) was measured by the criterion method: doubly labeled water. The predicted energy requirement was compared with measured TEE using intraclass correlation coefficient (ICC) and Bland-Altman analyses. Results: The energy requirement predicted by pedometer-determined PAL multiplied by six different RMR equations was within a reasonable accuracy (+/- 10%) of the measured TEE for all equations except one (Nordenson equation). The ICC values between the criterion method (TEE) and predicted energy requirement were: Harris-Benedict, ICC =0.70, 95% confidence interval (CI) 0.23-0.89; Schofield, ICC =0.71, 95% CI 0.21-0.89; World Health Organization, ICC =0.74, 95% CI 0.33-0.90; Moore, ICC =0.69, 95% CI 0.21-0.88; Nordic Nutrition Recommendations, ICC =0.70, 95% CI 0.17-0.89; and Nordenson, ICC =0.40, 95% CI -0.19 to 0.77. Bland-Altman plots revealed no systematic bias for predicted energy requirement except for Nordenson estimates. Conclusion: For clinical purposes, in absence of objective methods such as doubly labeled water method and motion sensors, energy requirement can be predicted using pedometer-determined PAL and common RMR equations. However, for assessment of nutritional status and for the purpose of giving nutritional treatment, a clinical judgment is important regarding when to accept a predicted energy requirement both at individual and group levels.
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| 20. |
- Farooqi, Nighat, et al.
(författare)
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Predicting energy requirement with pedometer-determined physical-activity level in women with chronic obstructive pulmonary disease
- 2015
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Ingår i: The International Journal of Chronic Obstructive Pulmonary Disease. - 1176-9106 .- 1178-2005. ; 10, s. 1129-1137
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Tidskriftsartikel (refereegranskat)abstract
- Background: In clinical practice, in the absence of objective measures, simple methods to predict energy requirement in patients with chronic obstructive pulmonary disease (COPD) needs to be evaluated. The aim of the present study was to evaluate predicted energy requirement in females with COPD using pedometer-determined physical activity level (PAL) multiplied by resting metabolic rate (RMR) equations. Methods: Energy requirement was predicted in 18 women with COPD using pedometer-determined PAL multiplied by six different RMR equations (Harris-Benedict; Schofield; World Health Organization; Moore; Nordic Nutrition Recommendations; Nordenson). Total energy expenditure (TEE) was measured by the criterion method: doubly labeled water. The predicted energy requirement was compared with measured TEE using intraclass correlation coefficient (ICC) and Bland-Altman analyses. Results: The energy requirement predicted by pedometer-determined PAL multiplied by six different RMR equations was within a reasonable accuracy (+/- 10%) of the measured TEE for all equations except one (Nordenson equation). The ICC values between the criterion method (TEE) and predicted energy requirement were: Harris-Benedict, ICC =0.70, 95% confidence interval (CI) 0.23-0.89; Schofield, ICC =0.71, 95% CI 0.21-0.89; World Health Organization, ICC =0.74, 95% CI 0.33-0.90; Moore, ICC =0.69, 95% CI 0.21-0.88; Nordic Nutrition Recommendations, ICC =0.70, 95% CI 0.17-0.89; and Nordenson, ICC =0.40, 95% CI -0.19 to 0.77. Bland-Altman plots revealed no systematic bias for predicted energy requirement except for Nordenson estimates. Conclusion: For clinical purposes, in absence of objective methods such as doubly labeled water method and motion sensors, energy requirement can be predicted using pedometer-determined PAL and common RMR equations. However, for assessment of nutritional status and for the purpose of giving nutritional treatment, a clinical judgment is important regarding when to accept a predicted energy requirement both at individual and group levels.
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| 21. |
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| 22. |
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| 23. |
- Farooqi, Nighat, et al.
(författare)
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Validation of SenseWear Armband and ActiHeart monitors for assessments of daily energy expenditure in free-living women with chronic obstructive pulmonary disease
- 2013
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Ingår i: Physiological Reports. - : The American Physiological Society. - 2051-817X. ; 1:6
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Tidskriftsartikel (refereegranskat)abstract
- To provide individually adapted nutritional support to patients with chronic obstructive pulmonary disease (COPD), objective and reliable methods must be used to assess patient energy requirements. The aim of this study was to validate the use of SenseWear Armband (SWA) and ActiHeart (AH) monitors for assessing total daily energy expenditure (TEE) and activity energy expenditure (AEE) and compare these techniques with the doubly labeled water (DLW) method in free‐living women with COPD. TEE and AEE were measured in 19 women with COPD for 14 days using SWAs with software version 5.1 (TEESWA5, AEESWA5) or 6.1 (TEESWA6, AEESWA6) and AH monitors (TEEAH, AEEAH), using DLW (TEEDLW) as the criterion method. The three methods were compared using intraclass correlation coefficient (ICC) and Bland–Altman analyses. The mean TEE did not significantly differ between the DLW and SWA5.1 methods (−21 ± 726 kJ/day; P = 0.9), but it did significantly differ between the DLW and SWA6.1 (709 ± 667 kJ/day) (P < 0.001) and the DLW and AH methods (709 ± 786 kJ/day) (P < 0.001). Strong agreement was observed between the DLW and TEESWA5 methods (ICC = 0.76; 95% CI 0.47–0.90), with moderate agreements between the DLW and TEESWA6 (ICC = 0.66; 95% CI 0.02–0.88) and the DLW and TEEAH methods (ICC = 0.61; 95% CI 0.05–0.85). Compared with the DLW method, the SWA5.1 underestimated AEE by 12% (P = 0.03), whereas the SWA6.1 and AH monitors underestimated AEE by 35% (P < 0.001). Bland–Altman plots revealed no systematic bias for TEE or AEE. The SWA5.1 can reliably assess TEE in women with COPD. However, the SWA6.1 and AH monitors underestimate TEE. The SWA and AH monitors underestimate AEE.
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| 24. |
- Grönberg, Anne Marie, 1951, et al.
(författare)
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Behandling av undernutritionstillstånd vid KOL
- 2014
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Ingår i: KOL - kroniskt obstruktiv lungdjukdom. - Lund : Studentlitteratur. - 9789144078175 ; , s. 641-648
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 25. |
- Grönberg, Anne Marie, 1951, et al.
(författare)
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Dietary problems in patients with severe chronic obstructive pulmonary disease
- 2005
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Ingår i: J Hum Nutr Diet. ; 18:6, s. 445-52
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Low body weight and low fat-free mass-index (FFMI) are common in patients with severe chronic obstructive pulmonary disease (COPD). Several factors seem to contribute. The aims of the present observational study were to investigate dietary problems in patients with severe COPD and to compare dietary problems to nutritional status, energy intake and smoking habits. METHODS: Nutritional status was assessed in 73 stable outpatients using body mass index and FFMI by single-frequency bioelectrical impedance. Lung function, smoking habits, energy intake and dietary problems were also assessed. RESULTS: The most frequently reported dietary problems were 'anorexia', 'dyspeptic symptoms other than diarrhoea', 'slimming', 'fear of gaining weight', 'dyspnoea', 'diarrhoea', 'depression, anxiety, solitude'. Smoking habits and gender had impact on the kind of dietary problems reported. Reporting two dietary problems correlated to low FFMI, whereas reporting one or more dietary problems correlated to decreased energy intake. CONCLUSION: Dietary problems are common in the group studied and related to smoking habits and gender. Dietary problems affect energy intake and FFMI negatively. It is important to recognize dietary problems and to offer intervention of the dietary problems as a part of the dietary intervention.
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| 26. |
- Grönberg, Anne Marie, 1951, et al.
(författare)
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Individually adapted nutritional intervention reduces dietary problems and improves physical function in chronic obstructive pulmonary disease patients.
- 2012
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Ingår i: Journal of Aging Research & Clinical Practice (JARCP). - 2258-8094. ; 1:1, s. 98-100
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Tidskriftsartikel (refereegranskat)abstract
- Dietary problems are common in patients with severe chronic obstructive pulmonary disease (COPD) and affect energy intake and nutritional status. The aim was to investigate effects of dietary counselling on dietary problems during a 12-month rehabilitation programme for patients with COPD. In 73 subjects with severe COPD, nutritional status was assessed by body mass index (BMI) and fat free mass index (FFMI) by single frequency bioelectrical impedance. Energy intake was calculated. The subjects were asked to describe any dietary problem they experienced. A six-minute walking test (6MWT) was performed to assess physical function. After 12 months of individually adapted nutritional intervention, 67 subjects were assessed by the same parameters. The number of dietary problems was reduced from 98 to 68. A significantly smaller group reported ” Fear of gaining weight” and ”Diarrhoea” (p<0.05). The patients succeeding in reducing their dietary problems also improved physical function indicated by significant improvements in 6MWT (mean 29.4 meters) after 12 months compared to baseline (p=0.023). Individually adapted dietary counselling can reduce the number of dietary problems. The results underline the importance of identifying dietary problems specific to the individuals as a means for improving nutritional status and physical function.
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| 27. |
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| 28. |
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| 29. |
- Gustafsson, Susanne, 1963, et al.
(författare)
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Health-Promoting Interventions for Persons 80 Years and Over are Successful in the Short Term – Results from the Randomized and Three-Armed Study Elderly Persons in the Risk Zone
- 2012
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Ingår i: Journal of the American Geriatrics Society. - : Wiley. - 0002-8614 .- 1532-5415. ; 60:3, s. 447-454
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The study Elderly Persons in the Risk Zone was designed to evaluate if it is possible to delay deterioration if a health-promoting intervention is made when the older adults (80+) are at risk of becoming frail, and if a multi-professional group intervention is more effective in delaying deterioration than a single preventive home visit. This paper examined the outcome with regard to frailty, self-rated health, and Activities of Daily Living (ADL) at the three-month follow-up. DESIGN: A randomized, three-armed, single-blind, and controlled trial performed between November 2007 and May 2011. SETTING: Two municipalities of Gothenburg, Sweden. PARTICIPANTS: A total of 459 older adults were included. They were 80 years or older, living in their ordinary housing, and not dependent on the municipal home help service. INTERVENTION: A preventive home visit or four weekly multi-professional senior group meetings with one follow-up home visit. MEASUREMENTS: The change in frailty, self-rated health, and ADL between baseline and the three-month follow-up. RESULTS: Both interventions delayed deterioration of self-rated health (OR=1.99, 95% CI=1.12 to 3.54). As regards postponing dependence in ADL, senior meetings were found to be the most beneficial intervention (OR=1.95, 95% CI=1.14 to 3.33). No effect on frailty could be demonstrated. CONCLUSION: Health-promoting interventions, made when older adults are at risk of becoming frail, can delay deterioration of self-rated health and ADL in the short term. Also, a multi-professional group intervention such as the senior meetings described seems to have a greater impact on delaying deterioration in ADL than a single preventive home visit. Further research is needed to examine the outcome in the long term, and in different contexts.
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| 30. |
- Gustafsson, Susanne, et al.
(författare)
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Health-promoting interventions for persons aged 80 and older are successful in the short term : results from the randomized and three-armed Elderly Persons in the Risk Zone study
- 2012
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Ingår i: Journal of The American Geriatrics Society. - 0002-8614 .- 1532-5415. ; 60:3, s. 447-454
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To examine the outcomes of the Elderly Persons in the Risk Zone study, which was designed to evaluate whether it is possible to delay deterioration if a health-promoting intervention is made when an older adult (≥80) is at risk of becoming frail and whether a multiprofessional group intervention is more effective in delaying deterioration than a single preventive home visit with regard to frailty, self-rated health, and activities of daily living (ADLs) at 3-month follow-up.DESIGN: Randomized, three-armed, single-blind, controlled trial performed between November 2007 and May 2011.SETTING: Two urban districts of Gothenburg, Sweden.PARTICIPANTS: Four hundred fifty-nine community-living adults aged 80 and older not dependent on the municipal home help service.INTERVENTION: A preventive home visit or four weekly multiprofessional senior group meetings with one follow-up home visit.MEASUREMENTS: Change in frailty, self-rated health, and ADLs between baseline and 3-month follow-up.RESULTS: Both interventions delayed deterioration of self-rated health (odds ratio (OR) = 1.99, 95% confidence interval (CI) = 1.12-3.54). Senior meetings were the most beneficial intervention for postponing dependence in ADLs (OR = 1.95, 95% CI = 1.14-3.33). No effect on frailty could be demonstrated.CONCLUSION: Health-promoting interventions made when older adults are at risk of becoming frail can delay deterioration in self-rated health and ADLs in the short term. A multiprofessional group intervention such as the senior meetings described seems to have a greater effect on delaying deterioration in ADLs than a single preventive home visit. Further research is needed to examine the outcome in the long term and in different contexts.
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| 31. |
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| 32. |
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| 33. |
- Hallin, Runa, 1952-
(författare)
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Nutritional Depletion in Chronic Obstructive Pulmonary Disease (COPD) : Effect on Morbidity, Mortality and Physical Capacity
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this work was to examine the effects of depleted nutritional status on some aspects of Chronic Obstructive Pulmonary Disease (COPD).Morbidity. In paper І, we found that energy intake was lower than the calculated energy demand for all patients. A low body mass index (BMI) at inclusion and weight loss, during the one year follow-up period were independent risk factors for having a new exacerbation (p = 0.003 and 0.006, respectively).Mortality. Nineteen percent of the patients in paper ІІ, where underweight (BMI<20). A significant positive correlation was found between BMI and FEV1, and this correlation remained significant after adjustment for age, sex and pack years (p<0.0001). Being underweight was related to increased overall mortality and respiratory mortality but not to mortality of other causes, 19% of the patients had died within 2 years. The lowest mortality was found among the overweight patients (BMI 25-30 kg/m).Physical capacity and effect of training. In paper ІІІ we investigated baseline characteristics of patients that were starting physical training. We found that peak working capacity was positively related to BMI (r=0.35, p=0.02) and fat free mass index (FFMI) (r=0.49, p=0.004) and negatively related to S-Fibrinogen and serum C reactive protein (S-CRP). BMI and FFMI were significantly related to the 12 minutes walking distance when adjusted for body weight. Fifty to 76% of the variation in physical capacity was accounted for when age, gender, FEV1, FFMI and CRP were combined in a multiple regression model.In Paper ІV the median change in fat free mass (FFM), after 4 months of physical training was 0.5 kg. Old age, low FEV1 and high level of dyspnoea were independent negative predictors of FFM increase after the training period.In conclusion nutritional status is an important determinant of morbidity, mortality and physical capacity in COPD. Low FEV1 and high level of dyspnea are negative predictors for increased FFM after physical training.
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| 34. |
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| 35. |
- Hallin, Runa, et al.
(författare)
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Relation between physical capacity, nutritional status and systemic inflammation in COPD
- 2011
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Ingår i: Clinical Respiratory Journal. - 1752-6981 .- 1752-699X. ; 5:3, s. 136-142
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Tidskriftsartikel (refereegranskat)abstract
- Background: Decreased physical capacity, weight loss, fat-free mass depletion and systemic inflammation are frequently observed in patients with chronic obstructive pulmonary disease (COPD).Objective: Our aim was to examine relations between physical capacity, nutritional status, systemic inflammation and disease severity in COPD.Method: Forty nine patients with moderate to severe COPD were included in the study. Spirometry was preformed. Physical capacity was determined by a progressive symptom limited cycle ergo meter test, incremental shuttle walking test, 12-minute walk distance and hand grip strength test. Nutritional status was investigated by anthropometric measurements, (weight, height, arm and leg circumferences and skinfold thickness) and bioelectrical impedance assessment was performed. Blood samples were analyzed for C-reactive protein (CRP) and fibrinogen.Result: Working capacity was positively related to forced expiratory volume in 1 s (FEV(1)) (p < 0.001), body mass index and fat free mass index (p = 0.01) and negatively related to CRP (p = 0.02) and fibrinogen (p = 0.03). Incremental shuttle walk test was positively related to FEV(1) (p < 0.001) and negatively to CRP (p = 0.048). Hand grip strength was positively related to fat free mass index, and arm and leg circumferences. Fifty to 76% of the variation in physical capacity was accounted for when age, gender, FEV(1), fat free mass index and CRP were combined in a multiple regression model.Conclusion: Physical capacity in chronic obstructive pulmonary disease is related to lung function, body composition and systemic inflammation. A depiction of all three aspects of the disease might be important when targeting interventions in chronic obstructive pulmonary disease.
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| 36. |
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| 37. |
- Johannesson, Julie, et al.
(författare)
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Exploring meal frequency and vegetable intake among immigrants 70 years or older in Sweden : Secondary analysis of data from the Promoting Aging Migrants Capabilities study
- 2021
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Ingår i: Journal of Ethnic Foods. - : Springer Science and Business Media LLC. - 2352-6181 .- 2352-619X. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Earlier research regarding immigrants has shown that lifestyle and environmental factors are of importance for the risk of developing certain diseases. Food habits are one of these factors. As there is little research concerning immigrants and food habits, the aim of the present paper was to explore food habits operationalised as meal frequency and vegetable intake among a group of older immigrants in Sweden. Specifically, the following questions were explored: changes in food habits when migrating, missing food from the native country, gender differences in food habits and association between food habits and self-rated health and well-being. Method: A total of 131 persons from the health-promoting study “Promoting Aging Migrants’ Capabilities” (PAMC) conducted in Gothenburg, Sweden, 2011–2014, were included in this exploratory secondary analysis of questionnaire data. Participants were 70 years or older, cognitively intact, and living in ordinary housing. They had all migrated to Sweden from Finland or the Western Balkan Region (Bosnia-Herzegovina, Croatia, Montenegro and Serbia). Descriptive statistics as well as binary logistic regression were used to answer the research questions. Results: Forty-eight percent of the participants in PAMC reported that they had changed their food habits when migrating, and 17% considered that they missed certain foods from their native country. Most of the participants migrated to Sweden more than 20 years ago. There was a significant difference in self-rated health in favour of the male participants (p = 0.02), but food habits, operationalised as meal frequency and vegetable intake, were not associated with self-rated health or life satisfaction. Conclusion: Men rated their health as better than women did, but food habits operationalised as meal frequency or vegetable intake, were not associated with self-rated health or life satisfaction. Results from this secondary analysis were affected by methodological shortcomings. Further studies to understand the role of food habits in relation to health in a migration context are desired. Trial registration: NCT01841853, Registered April 29, 2013. Retrospectively registered.
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| 38. |
- Johannesson, Julie, et al.
(författare)
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Meal frequency and vegetable intake does not predict the development of frailty in older adults
- 2019
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Ingår i: Nutrition and Health. - : Sage Publications. - 0260-1060 .- 2047-945X. ; 25:1, s. 21-28
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Tidskriftsartikel (refereegranskat)abstract
- Background: Frailty is considered highly prevalent among the aging population. Fruit and vegetable intake is associated with positive health outcomes across the life-span; however, the relationship with health benefits among older adults has received little attention. Aim: The aim was to examine if a relationship exists between meal frequency or frequency of vegetable intake and the development of frailty in a population of older adults. Methods: A total of 371 individuals, 80 years or older, from the study ‘Elderly Persons in the Risk Zone’ were included. Data was collected in the participants’ home by face-to-face interviews up to 24 months after the intervention. Baseline data were calculated using Chi2-test; statistical significance was accepted at the 5% level. Binary logistic regression was used for the relationship between meal frequency or vegetable intake and frailty. Results: Mean meal frequency was 4.2 ± 0.9 meals per day; women seem to have a somewhat higher meal frequency than men (p=0.02); 57% of the participants had vegetables with at least one meal per day. No significant relationship was found between meal frequency or vegetable intake and frailty at 12 or 24 months follow-ups. Conclusions: Among this group of older adults (80+), meal frequency was slightly higher among women than men, and just over half of the participants had vegetables with at least one meal a day. The risk of developing frailty was not associated with meal frequency or vegetable intake. The questions in this study were meant as indicators for healthy food habits.
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| 39. |
- Johansson, Patrik, et al.
(författare)
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Accelerometry combined with heart rate telemetry in the assessment of total energy expenditure
- 2006
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Ingår i: Br J Nutr. ; 95:3, s. 631-9
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was: (1) to develop a new method for total energy expenditure (TEE) assessment, using accelerometry (ACC) and heart rate (HR) telemetry in combination; (2) to validate the new method against the criterion measure (DLW) and to compare with two of the most common methods, FLEX-HR and ACC alone. In the first part of the study VO(2), HR and ACC counts were measured in twenty-seven subjects during walking and running on a treadmill. Considering the advantages and disadvantages of the HR and ACC methods an analysis model was developed, using ACC at intensities of low and medium levels and HR at higher intensities. During periods of inactivity, RMR is used. A formula for determining TEE from ACC, HR and RMR was developed: TEE = 1.1x(EQ(HR) x TT(HR) + EQ(ACC1) x TT(ACC1) + EQ(ACC2) x TTACC2 + RMR x TT(RMR)). In the validation part of the study a sub-sample of eight subjects wore an accelerometer, HR was logged and TEE was measured for 14 d with the DLW method. Analysis of the Bland-Altman plots with 95 % CI indicates that there are no significant differences in TEE estimated with HR-ACC and ACC alone compared with TEE measured with DLW. It is concluded that the HR-ACC combination as well as ACC alone has potential as a method for assessment of TEE during free-living activities as compared with DLW.
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| 40. |
- Knudsen, A. W., et al.
(författare)
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Nutrition impact symptoms, handgrip strength and nutritional risk in hospitalized patients with gastroenterological and liver diseases
- 2015
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Ingår i: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 0036-5521 .- 1502-7708. ; 50:10, s. 1191-1198
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Tidskriftsartikel (refereegranskat)abstract
- Objective. Malnutrition is common among patients with diseases of the liver and gastrointestinal tract. Nutritional intake may be negatively affected by nutrition impact symptoms (NIS). Therefore, the aims were to assess: 1) the prevalence of NIS in this group of patients and 2) the relationship between NIS and nutritional status as well as nutritional risk. Material and methods. We performed a cross-sectional study among patients with liver disease, inflammatory bowel disease, cancer or pancreatitis. Nutritional risk was assessed by the NRS-2002. Nutritional status was assessed by body mass index (BMI) and handgrip strength (HGS), which were both measured within 5 days after admission. NIS were assessed by the Eating Symptoms Questionnaire (ESQ) and the Disease-Related Appetite Questionnaire (DRAQ). Results. In total, 126 patients were included (women 39%) with a mean BMI of 24 +/- 5 kg/m(2). The prevalence of low HGS was 38%, and the prevalence of those at nutritional risk was 58%. The number of NIS reported by 50% of the patients were 4 or more in the ESQ and 5 or more in the DRAQ. Patients who were both at nutritional risk and had a low HGS more frequently reported difficulties swallowing, poor appetite, feeling full after having one-fourth of the meal and food tasting bad. Conclusions. NIS that preclude food intake are very frequent among patients with diseases of the liver and gastrointestinal tract. Specific NIS are associated with low HGS, weight loss and being at nutritional risk.
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| 41. |
- Larsson, Sven, et al.
(författare)
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A gender difference in circulating neutrophils in malnourished patients with COPD.
- 2011
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Ingår i: International journal of chronic obstructive pulmonary disease. - 1178-2005. ; 6, s. 83-8
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Tidskriftsartikel (refereegranskat)abstract
- Circulating markers of inflammation in chronic obstructive pulmonary disease (COPD) may correlate to disease progression and extrapulmonary complications such as malnourishment. However, surprisingly little is known about gender-related differences for circulating inflammatory markers in COPD.
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| 42. |
- Lindqvist, Catarina, et al.
(författare)
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Energy expenditure early after liver transplantation: better measured than predicted.
- 2020
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Ingår i: Nutrition. - : Elsevier BV. - 0899-9007 .- 1873-1244. ; 79-80
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Tidskriftsartikel (refereegranskat)abstract
- There is no consensus on how to estimate energy requirements after liver transplantation (LT). The aim of this study was to compare measured resting energy expenditure (REE) with predictive equations and fixed factors, and evaluate whether clinical variables were associated with REE.During the period of 2011 through 2018, REE measured with indirect calorimetry and predicted by the Harris and Benedict (HB) equation was compared in patients during the first 30 postoperative days after LT. The fixed factors 25 kcal/kg, 30 kcal/kg, or 35 kcal/kg were used to calculate energy requirements. The accuracy of HB and fixed factors were evaluated with a Bland-Altman analysis and Lin's concordance correlation coefficient. The associations of pre- and postoperative clinical variables with REE were evaluated in a multivariate regression analysis.A total of 143 patients were evaluated and had indirect calorimetry performed on postoperative day 6 (interquartile range: 3) in median. The mean measured REE was 1950 ± 461 kcal (range, 720-3309 kcal) or 24.5 ± 6.1 kcal/kg body weight. Large limits of agreements were observed in the Bland-Altman analyses for both HB and fixed factors. HB was closer than fixed factors with a positive concordance (concordance correlation: 0.350; 95% confidence interval, 0.248-0.445) and Pearsons r2 = 0.261. Measured REE was significantly associated (P < 0.05) with age, sex, Model for End-Stage Liver Disease score before LT, surgery time, and graft cold ischemia time according to the multiple regression analysis.The low accuracy of HB and fixed factors suggests risks of both under- and overfeeding of individual patients if energy requirement is only based on calculation. REE measurement is recommended after LT to secure accurate and safe nutritional therapy.
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| 43. |
- Lindqvist, Catarina, et al.
(författare)
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Nutrition impact symptoms are related to malnutrition and quality of life - A cross-sectional study of patients with chronic liver disease.
- 2020
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Ingår i: Clinical nutrition. - : Elsevier BV. - 1532-1983 .- 0261-5614. ; 39:6, s. 1840-1848
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Tidskriftsartikel (refereegranskat)abstract
- Patients with chronic liver disease often experience symptoms that affect their ability to eat. These symptoms can contribute to weight loss and malnutrition. We aimed to examine the prevalence of nutrition impact symptoms (NIS) in patients with chronic liver disease, and to investigate the relationships between NIS, malnutrition and health-related quality of life.In a cross-sectional study on adult patients with chronic liver disease under evaluation for liver transplantation, we studied NIS with two questionnaires: the Eating Symptoms Questionnaire and the Disease-Related Appetite Questionnaire. Malnutrition was primarily assessed with the Global Leadership Initiative on Malnutrition (GLIM) criteria. Health-related quality of life (HRQOL) was assessed with the Chronic Liver Disease Questionnaire.Among the 133 included patients, 90% reported one or more NIS and 51% reported four or more NIS. The most common symptoms were dry mouth (61%), abdominal pain (58%), diarrhoea (45%) and nausea (41%). Malnutrition was present in 32% according to GLIM criteria. Malnourished patients reported more NIS (p=0.004) and had lower HRQOL (p<0.001). Certain NIS, such as pain, poor appetite, changes in taste and early satiety, were predictors for malnutrition.NIS are common in patients with chronic liver disease and are associated with malnutrition and worse HRQOL. NIS should therefore be systematically assessed in patients with chronic liver disease. Whether identification and proper management of NIS can prevent malnutrition and improve quality of life deserves further exploration.
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| 44. |
- Lindström, Rebecca, et al.
(författare)
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Swedish translation and cultural adaptation of the scored Patient-Generated Subjective Global Assessment (PG-SGA©) : A validated tool for screening and assessing malnutrition in clinical practice and research
- 2024
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley-Blackwell Publishing Ltd. - 0283-9318 .- 1471-6712.
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION : The scored Patient-Generated Subjective Global Assessment (PG-SGA©) is a validated tool for the screening, assessment and monitoring of malnutrition, and triaging of interventions. It contains a patient-generated component and a healthcare professional (HCP)-generated component. AIM : To translate the PG-SGA into Swedish, assess the linguistic and content validity of the Swedish version, and ensure conceptional, semantic and operational equivalence to the original English PG-SGA. METHODS : In line with the methodology used in previously translated and culturally adapted versions, the standardised 10-step process suggested by the International Society for Health Economics and Outcomes Research (ISPOR) was followed. In step 7, a cross-sectional study targeting patients n = 51 and HCPs n = 52 was performed at a university hospital in Sweden. Using separate questionnaires, patients assessed the patient component and HCPs, the professional component regarding perceived comprehensibility and difficulty (linguistic validity). The HCPs also assessed perceived relevance (content validity) of all items on the PG-SGA. Item indices for comprehensibility (I-CI), difficulty (I-DI) and content validity (I-CVI) were calculated and averaged into scale indices (S-CI, S-DI and S-CVI). Cut-off standards for item and scale indices were used as reference. RESULTS : The Swedish version of the PG-SGA rated excellent for comprehensibility (S-CI 0.96) and difficulty (S-DI 0.93) for the patient component. The professional component rated acceptable for comprehensibility (S-CI 0.89) and below acceptable for difficulty (S-DI 0.70), with the physical examination rated most difficult (I-DI 0.39 to 0.69). Content validity for the full Swedish PG-SGA was rated excellent (S-CVI 0.94). CONCLUSION : The patient component was considered clear and easy to complete. The full Swedish PG-SGA was considered relevant by HCPs for screening and assessment of malnutrition. Due to perceived difficulty with the physical examination, training of Swedish HCPs in using the PG-SGA is essential before implementing the professional component into clinical practice or research.
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| 45. |
- Lindström, Rebecca, et al.
(författare)
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Swedish translation and cultural adaptation of the scored Patient-Generated Subjective Global Assessment (PG-SGA©)—A validated tool for screening and assessing malnutrition in clinical practice and research
- 2024
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712.
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: The scored Patient-Generated Subjective Global Assessment (PG-SGA©) is a validated tool for the screening, assessment and monitoring of malnutrition, and triaging of interventions. It contains a patient-generated component and a healthcare professional (HCP)-generated component. Aim: To translate the PG-SGA into Swedish, assess the linguistic and content validity of the Swedish version, and ensure conceptional, semantic and operational equivalence to the original English PG-SGA. Methods: In line with the methodology used in previously translated and culturally adapted versions, the standardised 10-step process suggested by the International Society for Health Economics and Outcomes Research (ISPOR) was followed. In step 7, a cross-sectional study targeting patients n = 51 and HCPs n = 52 was performed at a university hospital in Sweden. Using separate questionnaires, patients assessed the patient component and HCPs, the professional component regarding perceived comprehensibility and difficulty (linguistic validity). The HCPs also assessed perceived relevance (content validity) of all items on the PG-SGA. Item indices for comprehensibility (I-CI), difficulty (I-DI) and content validity (I-CVI) were calculated and averaged into scale indices (S-CI, S-DI and S-CVI). Cut-off standards for item and scale indices were used as reference. Results: The Swedish version of the PG-SGA rated excellent for comprehensibility (S-CI 0.96) and difficulty (S-DI 0.93) for the patient component. The professional component rated acceptable for comprehensibility (S-CI 0.89) and below acceptable for difficulty (S-DI 0.70), with the physical examination rated most difficult (I-DI 0.39 to 0.69). Content validity for the full Swedish PG-SGA was rated excellent (S-CVI 0.94). Conclusion: The patient component was considered clear and easy to complete. The full Swedish PG-SGA was considered relevant by HCPs for screening and assessment of malnutrition. Due to perceived difficulty with the physical examination, training of Swedish HCPs in using the PG-SGA is essential before implementing the professional component into clinical practice or research.
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| 46. |
- Måhlin, Carolina, et al.
(författare)
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Vitamin D status and dietary intake in a Swedish COPD population.
- 2014
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Ingår i: The clinical respiratory journal. - : Wiley. - 1752-699X .- 1752-6981. ; 8:1, s. 24-32
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Tidskriftsartikel (refereegranskat)abstract
- Emerging evidence indicates that patients with chronic obstructive pulmonary disease (COPD) have a poorer vitamin D status than the general population, possibly affecting several comorbidities. In northern latitudes, these problems could be even more accentuated wintertime because of the low ultraviolet B radiation.
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| 47. |
- Nordén, Johanna, et al.
(författare)
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Nutrition impact symptoms and body composition in patients with COPD
- 2014
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Konferensbidrag (refereegranskat)abstract
- RATIONALE: Anorexia or lack of appetite is common in chronic obstructive pulmonary disease (COPD) and may be caused or augmented by several symptoms affecting appetite and eating. We aimed to investigate and quantify the extent of nutrition impact symptoms (NIS) in patients with COPD and to explore relationships between NIS and fat free mass depletion.METHODS: The results in this cross-sectional study are based on 169 COPD patients (62 % females). Body composition was assessed using bioelectrical impedance spectroscopy and the patients reported NIS by two newly developed questionnaires; Eating Symptoms Questionnaire (ESQ) and Disease Related Appetite Questionnaire (DRAQ).RESULTS: Symptoms with the highest prevalence were dry mouth (71%), stomach ache (39%), pain or aches affecting appetite (36%) and constipation (35%). Problems with diarrhoea and feeling affected by smells were more severe among women compared to men (p<0.05). Thirty-six percent of the patients were depleted (FFMI < 15 kg/m² for women and FFMI < 16 kg/m² for men). Depleted patients had more NIS (p<0.05), and also rated appetite and taste of food as worse compared to non-depleted (p < 0.05).CONCLUSION: Nutrition impact symptoms are common in patients with COPD and depleted patients have more severe symptoms. To investigate how these symptoms are best prevented and/or managed and if NIS prevention/treatment can affect development of malnutrition in patients with COPD is a challenge for the future.
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| 48. |
- Norden, J., et al.
(författare)
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Nutrition impact symptoms and body composition in patients with COPD
- 2015
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Ingår i: European Journal of Clinical Nutrition. - : Nature Publishing Group. - 0954-3007 .- 1476-5640. ; 69:2, s. 256-261
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND/OBJECTIVES: Anorexia or lack of appetite is common in chronic obstructive pulmonary disease (COPD) and may be caused or augmented by several symptoms affecting appetite and eating. We aimed to investigate and quantify the extent of nutrition impact symptoms (NIS) in patients with COPD and to explore relationships between NIS and fat-free mass depletion.SUBJECTS/METHODS: The results in this cross-sectional study are based on 169 COPD patients (62% female subjects). Body composition was assessed using bioelectrical impedance spectroscopy and the patients reported NIS by two newly developed questionnaires: the Eating Symptoms Questionnaire (ESQ) and the Disease-Related Appetite Questionnaire (DRAQ).RESULTS: Symptoms with the highest prevalence were dry mouth (71%), stomach ache (39%), pain or aches affecting appetite (36%) and constipation (35%). Problems with diarrhoea and feeling affected by smells were more severe among women compared with men (P < 0.05). Thirty-six percent of the patients were depleted (fat-free mass index (FFMI) < 15 kg/m(2) for women and FFMI < 16 kg/m(2) for men). Depleted patients had more NIS (P < 0.05) and also rated appetite and taste of food as worse compared with non-depleted patients (P < 0.05).CONCLUSIONS: NIS are common in patients with COPD, and depleted patients have more severe symptoms. To investigate how these symptoms are best prevented and/or managed and whether NIS prevention/treatment can affect development of malnutrition in patients with COPD is a challenge for the future.
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| 49. |
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| 50. |
- Nordenson, Anita, 1957, et al.
(författare)
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A validated disease specific prediction equation for resting metabolic rate in underweight patients with COPD.
- 2010
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Ingår i: International journal of chronic obstructive pulmonary disease. - 1178-2005. ; 5, s. 271-276
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Tidskriftsartikel (refereegranskat)abstract
- Malnutrition is a serious condition in chronic obstructive pulmonary disease (COPD). Successful dietary intervention calls for calculations of resting metabolic rate (RMR). One disease-specific prediction equation for RMR exists based on mainly male patients. To construct a disease-specific equation for RMR based on measurements in underweight or weight-losing women and men with COPD, RMR was measured by indirect calorimetry in 30 women and 11 men with a diagnosis of COPD and body mass index <21 kg/m(2). The following variables, possibly influencing RMR were measured: length, weight, middle upper arm circumference, triceps skinfold, body composition by dual energy x-ray absorptiometry and bioelectrical impedance, lung function, and markers of inflammation. Relations between RMR and measured variables were studied using univariate analysis according to Pearson. Gender and variables that were associated with RMR with a P value <0.15 were included in a forward multiple regression analysis. The best-fit multiple regression equation included only fat-free mass (FFM): RMR (kJ/day) = 1856 + 76.0 FFM (kg). To conclude, FFM is the dominating factor influencing RMR. The developed equation can be used for prediction of RMR in underweight COPD patients.
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