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- Axelsen, Mette, 1965, et al.
(författare)
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Breakfast glycaemic response in patients with type 2 diabetes: effects of bedtime dietary carbohydrates.
- 1999
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Ingår i: European journal of clinical nutrition. - 0954-3007. ; 53:9, s. 706-10
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Bedtime carbohydrate (CHO) intake in patients with type-2 diabetes may improve glucose tolerance at breakfast the next morning. We examined the 'overnight second-meal effect' of bedtime supplements containing 'rapid' or 'slow' CHOs. DESIGN: Randomized cross-over study with three test-periods, each consisting of two days on a standardized diet, followed by a breakfast tolerance test on the third morning. SETTING: The Lundberg Laboratory for Diabetes Research, Sahlgrenska University Hospital, Göteborg, Sweden. SUBJECTS: Sixteen patients with type 2 diabetes on oral agents and/or diet. INTERVENTIONS: Two different bedtime (22.00 h) CHO supplements (0.46 g available CHO/kg body weight) were compared to a starch-free placebo ('normal' food regimen). The CHOs were provided as uncooked cornstarch (slow-release CHOs) or white bread (rapid CHOs). RESULTS: On the mornings after different bedtime meals we found similar fasting glucose, insulin, free fatty acid and lactate levels. However, the glycaemic response after breakfast was 21% less after uncooked cornstarch compared to placebo ingestion at bedtime (406 +/- 46 vs 511 +/- 61 mmol min l(-1), P < 0.01). In contrast, it did not differ when the evening meal consisted of white bread (451 +/- 57 mmol min l(-1)) compared to placebo. According to an in vitro analysis, uncooked cornstarch contained approximately 4 times more slowly digestible starch as compared to white bread. CONCLUSIONS: A bedtime meal providing uncooked cornstarch improved breakfast tolerance the next morning while, in contrast, this was not found following a bedtime meal of white bread. The results are consistent, therefore, with the concept that an increased intake of slowly digestible carbohydrates exert an overnight second-meal effect in patients with type 2 diabetes.
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- Berg, Christina, 1963, et al.
(författare)
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Sources of bias in a dietary survey of children.
- 1998
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Ingår i: European journal of clinical nutrition. - 0954-3007. ; 52:9, s. 663-7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare non-responders and responders to a dietary survey with respect to demographic variables and intention to choose selected breakfast foods, and to examine if there was any systematic change in number of food items reported during a 7 d recording period. DESIGN: Cross-sectional survey. SETTING: Mölndal, Sweden. SUBJECTS: All pupils in 5th, 7th and 9th grades in the municipality were asked to complete a questionnaire during school hours. All those present (n = 1584, 92% of total) answered questions about lifestyle factors and about intentions, attitudes and beliefs concerning high-fibre bread and milk with varying fat content. All subjects in the initial sample were asked to fill in a 7 d record of food consumed. Acceptable food records were completed by 69% of the initial participants. RESULTS: Subjects not completing the food record differed significantly from participants with respect to demographic, lifestyle and dietary factors. Dropout was more common among those who reported not usually eating breakfast and among those intending to drink whole milk for breakfast. A decline in reported food items during the recording period was also observed. CONCLUSIONS: Two sources of bias were observed here, one indicating significant differences between non-participants and participants, the other suggesting the presence of a time-dependent trend in number of recorded foods. It is likely such biases are present in other dietary surveys involving schoolchildren, and should be taken into consideration in the design, analysis and interpretation of such studies.
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- Bratteby, L E, et al.
(författare)
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A 7-day activity diary for assessment of daily energy expenditure validated by the doubly labelled water method in adolescents.
- 1997
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Ingår i: European Journal of Clinical Nutrition. - 0954-3007 .- 1476-5640. ; 51:9, s. 585-91
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To validate the use of an activity diary and predicted BMR for assessment of daily total energy expenditure (TEE) and physical activity level (PAL = TEE/BMR) in adolescents.DESIGN: TEE and PAL estimated from activity diary records kept for seven days and BMR predicted from age, gender and body weight were compared with the results of doubly labelled water (DLW) measurements and indirect calorimetry performed during the same time period.SETTING: The Unit of paediatric Physiology of the Department of Clinical Physiology, University Hospital, Uppsala, Sweden.SUBJECTS: Fifty randomly selected 15 y old adolescents (25 boys and 25 girls).RESULTS: The mean difference between TEE estimated in all adolescents by the activity diary and by DLW methods was 1.2%. The limits of agreement (mean difference 2 s.d.) were -3.47 and 3.77 MD/d, equivalent to a coefficient of variation of 15%. The mean difference between PAL assessed by activity diary records and by DLW measurements was 0.001, and the limits of agreement between the two methods were 0.54.CONCLUSIONS: The results imply that the activity diary method provides a close estimate of TEE and PAL in population groups.
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- Bratteby, L E, et al.
(författare)
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Daily energy expenditure and physical activity assessed by an activity diary in 374 randomly selected 15-year-old adolescents.
- 1997
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Ingår i: European Journal of Clinical Nutrition. - 0954-3007 .- 1476-5640. ; 51:9, s. 592-600
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To assess the average daily levels of physical activity, energy expenditure and the time and energy spent a different activities in two cohorts of Swedish adolescents.DESIGN: Total energy expenditure (TEE) and physical activity level (PAL = TEE/basal metabolic rate (BMR)) were estimated in 374 randomly selected healthy adolescents living with two different regions of Sweden on the basis of a seven-day activity diary (AD) and predicted BMR. A validation of the estimates from the AD with the doubly labelled water (DLW) method in a randomly selected subsample of 50 of these subjects is presented elsewhere.SETTING: The Unit of Paediatric of the Department of Clinical Physiology, University Hospital, Uppsala and the Department of Paediatrics, Northern Alvsborg Hospital, Trollhättan, Sweden.RESULTS: No significant differences in TEE and PAL were found between the adolescents of the two regions. High levels of TEE (14.2 and 10.9 MJ/d in boys and girls, respectively) and PAL (1.95 and 1.80) were observed. There was a close association between the PAL and the adolescents and their reported time spent sitting. Those with the lowest PAL values spent 3-6 h longer each day sitting compared to those with the highest PAL values. The results also indicate that everyday activities such as walking and bicycling have a crucial impact on the PAL values.CONCLUSIONS: In the 15 y old adolescents of the two studied regions of Sweden, high and concordant levels of energy expenditure and physical activity were found.
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- De Graaf, Cees, et al.
(författare)
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Stages of dietary change among nationally-representative samples of adults in the European Union
- 1997
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Ingår i: European Journal of Clinical Nutrition. - 0954-3007 .- 1476-5640. ; 51:Suppl. 2, s. S47-S56
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the distribution across the different stages of change for each of the 15 participating European countries, and the effect of socio-demographic variables such as sex and education on this distribution. Also to assess the relationships between stages of change and influences of food choice, and other variables. Design: A cross-sectional study in which quota-controlled, nationally-representative samples of approximately 1000 adults from each country completed a face-to-face interview-assisted questionnaire. Setting: The survey was conducted between October 1995 and February 1996 in the 15 member states of the European Union. Subjects: 14,331 subjects (aged 15 y upwards) completed the questionnaire. Data were weighted by population size for each country and by sex, age and regional distribution within each member state. Subjects were divided into five different categories according to their attitudes towards 'changing their eating habits in order to eat healthier': (1) Precontemplation; do not consider any changes, (2) Contemplation; consider changes, (3) Decision; make plans to change, (4) Action; carry out the changes, and (5) Maintenance; maintained changes for more than six months. Results: 52% of the subjects were in the precontemplation stage, whereas 31% of the subjects were in the maintenance stage. Two, one, and seven percent of subjects were in the contemplation, decision and action stage, respectively. In the Mediterranean countries, and in Germany, there were more people (55-64%) in the precontemplation stage, whereas in the Scandinavian countries there were less people in precontemplation stage (20-38%). The opposite was true for the maintenance stage, whereas women and people with a higher education level tended to be more in the maintenance stage. With respect to influences on food choice, subjects in precontemplation stage found that taste was more important, whereas people in maintenance stage found that health was more important. Conclusions: The stages of change model makes a useful distinction between people with different attitudes towards nutrition and health. Nutrition education can benefit from this distinction.
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- Elmståhl, Sölve, et al.
(författare)
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Fermented milk products are associated to ulcer disease. Results from a cross-sectional population study
- 1998
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Ingår i: European Journal of Clinical Nutrition. - : Springer Science and Business Media LLC. - 0954-3007 .- 1476-5640. ; 52:9, s. 668-674
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Tidskriftsartikel (refereegranskat)abstract
- Background: Prevalence of peptic ulcer disease has been associated to diet. Some dietary factors seem to have bactericidal effect which may modify the risk of peptic ulcer disease. The objective was to analyze associations between dietary habits and peptic ulcers. Design: A cross sectional population study. Subjects: One thousand, one hundred and thirty-five subjects out of 11,700 randomly invited men and women, aged 46-67 y, participating in a diet and disease study during 1991-1993. The study population comprised of 764 cases with reported peptic ulcer, 142 with dyspeptic symptoms and 229 randomly selected controls. Methods: X-ray examinations and endoscopies were reviewed and 332 out of 764 peptic ulcer cases were verified. Mean daily intake of foods and nutrients were assessed with a combined 7 d menu book and a quantitative food frequency questionnaire, including dietary supplements. Results: Subjects with verified ulcer had lower intake of fermented milk products and vegetables and higher intake of milk, meal and bread than controls. Intake of total fat, saturated and monounsaturated fatty acids and linolenic acid were higher in the ulcer group. Higher intake of fermented milk products, by quintiles showed a decreased ulcer risk; odds ratio 0.82 (0.71-0.95), adjusted for covariates below. Higher intake of milk, by quintiles, was associated with an increased risk of ulcer; odds ratio 1.17 (1.03-1.32). Smoking, foreign ethnicity and being unmarried or divorced were covariates associated to ulcer. Conclusion: This study indicates the multifactorial etiology of peptic ulcer including dietary factors. High intake of fermented milk products was associated with decreased risk for ulcer, whereas increased risk was noted for high milk intake.
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| 10. |
- Elmståhl, S., et al.
(författare)
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The Malmö food study : The relative validity of a modified diet history method and an extensive food frequency questionnaire for measuring food intake
- 1996
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Ingår i: European Journal of Clinical Nutrition. - 0954-3007. ; 50:3, s. 143-151
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To assess the relative validity of two diet assessment methods, an extensive quantitative food frequency questionnaire (method A) and a novel shorter quantitative food frequency questionnaire with a 14 day food record (method B). Design: A randomized prospective cohort study. Setting: General community. Subjects: 206 residents of the town of Malmö, aged between 50-69 years, 101 men and 105 women who completed the methods during one year. Methods: Both diet methods were designed to cover the whole diet and portion sizes were estimated using a booklet with 120 photographs; method A comprised 250 items and method B combined a two-week food record measuring lunch and dinner meals and a shorter 130 item quantitative food frequency questionnaire for average consumption of foods, snacks and beverages during the past year. An 18 day dietary record comprising six 3-day weighed records evenly distributed over one year served as a reference method. Results: Pearson's correlation coefficients varied from 0.25 for fat intake to 0.84 for milk products for method A and from 0.32 for fish to 0.88 for meat for method B. Correlations for most food groups ranged between 0.50-0.80, and were higher for method B. Only small changes were noted after adjustment for energy intake. On average for most food groups categorization of subjects into quartiles, 55% of subjects belonging to the lowest quartile, and 57-59% of those belonging to the highest quartile for method A and B were correctly classified. Conclusion: A combined food record with a quantitative food frequency questionnaire is a better tool for food assessment than an extensive food frequency questionnaire. Sponsorship: This study was supported by the Swedish Medical Research Council (K84-19X-7010-01) and the International Agency for Research on Cancer (Collaborative Research Agreement DEB/85/43).
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