| 1. |
|
|
| 2. |
- Melin, Anna K., Assistant Professor, 1965-, et al.
(författare)
-
Energy availability and the female athlete triad in elite endurance athletes
- 2015
-
Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : Wiley-Blackwell. - 0905-7188 .- 1600-0838. ; 25:5, s. 610-622
-
Tidskriftsartikel (refereegranskat)abstract
- The female athlete triad (Triad), links low energy availability (EA), with menstrual dysfunction (MD), and impaired bone health. The aims of this study were to examine associations between EA/MD and energy metabolism and the prevalence of Triad-associated conditions in endurance athletes. Forty women [26.2 +/- 5.5 years, body mass index (BMI) 20.6 +/- 2.0 kg/m(2), body fat 20.0 +/- 3.0%], exercising 11.4 +/- 4.5 h/week, were recruited from national teams and competitive clubs. Protocol included gynecological examination; assessment of bone health; indirect respiratory calorimetry; diet and exercise measured 7 days to assess EA; eating disorder (ED) examination; blood analysis. Subjects with low/reduced EA (< 45 kcal/kg FFM/day), had lower resting metabolic rate (RMR) compared with those with optimal EA [28.4 +/- 2.0 kcal/kg fat-free mass (FFM)/day vs 30.5 +/- 2.2 kcal/kg FFM/day, P < 0.01], as did subjects with MD compared with eumenorrheic subjects (28.6 +/- 2.4 kcal/kg FFM/day vs 30.2 +/- 1.8 kcal/kg FFM/day, P < 0.05). 63% had low/reduced EA, 25% ED, 60% MD, 45% impaired bone health, and 23% had all three Triad conditions. 53% had low RMR, 25% hypercholesterolemia, and 38% hypoglycemia. Conclusively, athletes with low/reduced EA and/or MD had lowered RMR. Triad-associated conditions were common in this group of athletes, despite a normal BMI range. The high prevalence of ED, MD, and impaired bone health emphasizes the importance of prevention, early detection, and treatment of energy deficiency.
|
|
| 3. |
- Melin, Anna K., Assistant Professor, 1965-, et al.
(författare)
-
Low-energy density and high fiber intake are dietary concerns in female endurance athletes
- 2016
-
Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : Wiley-Blackwell. - 0905-7188 .- 1600-0838. ; 26:9, s. 1060-1071
-
Tidskriftsartikel (refereegranskat)abstract
- Low or reduced energy availability (LEA) is linked to functional hypothalamic oligomenorrhea/amenorrhea (FHA), which is frequently reported in weight-sensitive sports. This makes LEA a major nutritional concern for female athletes. The aim of this study was to describe dietary characteristics of athletes with LEA and/or FHA. Endurance athletes (n=45) were recruited from national teams and competitive clubs. Protocols included gynecological examination, body composition, eating disorder evaluation, and 7-day dietary intake and EA assessment. Athletes with disordered eating behavior/eating disorders (n=11), menstrual dysfunction other than FHA (n=5), and low dietary record validity (n=4) were excluded. Remaining subjects (n=25) were characterized by EA [optimal:45kcal (188kJ)/kg fat-free mass (FFM)/day (n=11), LEA:<45kcal (188kJ)/kg FFM/day (n=14)] and reproductive function [eumenorrhea (EUM; n=10), FHA (n=15)]. There was no difference in EA between FHA and EUM subjects. However, FHA and LEA subjects shared the same dietary characteristics of lower energy density (ED) [(P=0.012; P=0.020), respectively], and fat content [(P=0.047; P=0.027), respectively]. Furthermore, FHA subjects had a lower intake of carbohydrate-rich foods (P=0.019), higher fiber content (P<0.001), and drive for thinness score (P=0.003). Conclusively, low ED together with high fiber content may constitute targets for dietary intervention in order to prevent and treat LEA and FHA in female athletes.
|
|
| 4. |
|
|
| 5. |
- Andersen, SB, et al.
(författare)
-
Measuring the burden of interval cancers in long-standing screening mammography programmes
- 2015
-
Ingår i: Journal of medical screening. - : SAGE Publications. - 1475-5793 .- 0969-1413. ; 22:2, s. 83-92
-
Tidskriftsartikel (refereegranskat)abstract
- Mammography screening programme sensitivity is evaluated by comparing the interval cancer rate (ICR) with the expected breast cancer incidence without screening, ie. the proportional interval cancer rate (PICR). The PICR is usually found by extrapolating pre-screening incidence rates, whereas ICR is calculated from data available in the screening programmes. As there is no consensus regarding estimation of background incidence, we seek to validate the ICR measure against the PICR. Methods Screening data from the three mammography screening programmes of Stockholm, Copenhagen, and Funen in the period 1989-2011 provided data to calculate the ICR. The most commonly described methods of extrapolating pre-screening incidence rates to calculate the PICR were illustrated and PICRs were calculated by year and programme using these different methods and compared with the ICRs. Results PICRs varied greatly, reaching a difference of 32–34% in Stockholm, 79% in Copenhagen, and 100–106% in Funen between the highest and the lowest value, depending on which method was applied. PICRs exhibited large variations yearly and from programme to programme. ICRs did not vary to the same extent, ranging on average from 0.100 to 0.136 in the first 12-months and between 0.201 and 0.225 in the last 12-months of the two-year period after a negative screen across the three programmes. Conclusion The value of the PICR is hugely influenced by which method is applied, whereas the ICR is calculated purely on data available within programmes. We find that the PICR, the establishing indicator for sensitivity, could preferably be replaced by the ICR.
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
|
|
| 9. |
- Blom, J, et al.
(författare)
-
Gender-specific cut-offs in colorectal cancer screening with FIT: Increased compliance and equal positivity rate
- 2019
-
Ingår i: Journal of medical screening. - : SAGE Publications. - 1475-5793 .- 0969-1413. ; 26:2, s. 92-97
-
Tidskriftsartikel (refereegranskat)abstract
- Using quantitative Faecal Immunochemical Test (FIT) in colorectal cancer screening enables adjustment of the cut-off for a positive test. As men have higher stool blood levels and higher prevalence of colorectal neoplasia, different cut-off levels can be chosen for men and women. We evaluated participation and positivity rates switching from guaiac-based faecal occult blood test (gFOBT) (Hemoccult®) to FIT (OC-Sensor), using gender-specific cut-offs. Methods The colorectal cancer screening programme of Stockholm-Gotland, Sweden, started in 2008 and invited individuals aged 60–69 to biennial testing using gFOBT. From 1 October 2015 the test was switched to FIT, with positivity cut-offs of 40 (200) and 80 (400) µg Hb/g (ng/mL) faeces for women and men, respectively. The first year was evaluated for compliance and positivity, number of reminders and incorrect/inadequate tests, compared with gFOBT in the preceding 12-month period. Results There were 127,030 and 87,269 individuals invited to screening with gFOBT and FIT, respectively. The change of test increased overall participation by 11.9% (95% confidence interval 11.5%–12.3%) from 56.5% to 68.4% ( p < 0.001). The increase was larger in men (14.3%) than women (9.7%), and in those aged 60–64 (14.2%) than those aged 65–69 (8.7%). The positivity rate was 2.6% in women and 2.5% in men. There was a lower rate of reminders and incorrect/inadequate tests with FIT. Conclusions Within a well-organised colorectal cancer screening programme, changing the test from gFOBT to FIT markedly increased participation, especially among men, and in the younger age group. With a lower cut-off in women than men, the positivity rate was similar.
|
|
| 10. |
- Blom, J, et al.
(författare)
-
Interval cancers in a guaiac-based colorectal cancer screening programme: Consequences on sensitivity
- 2017
-
Ingår i: Journal of medical screening. - : SAGE Publications. - 1475-5793 .- 0969-1413. ; 24:3, s. 146-152
-
Tidskriftsartikel (refereegranskat)abstract
- To evaluate interval cancers in the population-based colorectal cancer screening programme of Stockholm/Gotland, Sweden. Methods From 2008, individuals aged 60–69 were invited to colorectal cancer screening using biennial guaiac-based faecal occult blood test (Hemoccult®). Interval cancers, defined as colorectal cancer among participants not diagnosed by the screening programme but registered in the Swedish cancer register, were evaluated by cross-checking the screening histories for all cancers in the region 2008–2012. Results Of 203,848 individuals from nine different birth cohorts who participated (∼60%), 4530 (2.2%) tested positive. All invited individuals were followed up for 24 months after invitation. The cancer register reported 557 colorectal cancer, 219 (39.3%) screen-detected cancers and 338 (60.7%) interval cancers, generating both test- and episode sensitivities of approximately 40% and an interval cancer-rate of 17.1/10,000 tests. Among individuals with positive tests without colorectal cancer diagnosed at work-up colonoscopy, 37 interval cancers (10.9%) occurred. There was statistically significant lower sensitivity in women, ranging 22.4–32.2%, compared with 43.2–52.0% in men. Age-group and tumour location were not strongly correlated to screen-detected cancer rates. The programme sensitivity increased by year (20.3–25.0%), with successively more colorectal cancers diagnosed within the expanding programme (11.6–16.2%). Conclusion Interval cancer is a quality indicator of a screening programme. As the interval cancer-rate determined in a well-organized population-based screening programme was actually higher than the screen-detected cancer rate, a change to a more sensitive screening test is indicated. The lower screen-detected cancers among women, and compliance and quality of work-up colonoscopies also need attention.
|
|
