| 1. |
- Berg, Christina, 1963, et al.
(författare)
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Eating patterns and portion size associated with obesity in a Swedish population.
- 2009
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Ingår i: Appetite. - : Elsevier BV. - 1095-8304 .- 0195-6663. ; 52:1, s. 21-6
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to describe the association between meal pattern and obesity. The study is based on data from the INTERGENE research programme, and the study population consists of randomly selected women and men, aged 25-74, living in the V?stra G?taland Region in Sweden. A total of 3610 were examined. Participants with measured BMI>/=30 were compared with others (BMI<30) with respect to questionnaire data on habitual meal patterns and intake of energy estimated from food frequencies and standard portions. Odds ratios (OR) with 95% confidence intervals were adjusted for age, sex, smoking and physical activity in logistic regression models. Being obese was significantly associated with omitting breakfast, OR 1.41 (1.05-1.90), omitting lunch OR 1.31 (1.04-1.66) and eating at night OR 1.62 (1.10-2.39). Obesity was also related to significantly larger self-reported portion sizes of main meals. No statistically significant relationship with intake of total energy was revealed. Thus, the results indicate that examination of meal patterns and portion sizes might tell us more about obesogenic food patterns than traditional nutrient analyses of food frequencies. Being obese was associated with a meal pattern shifted to later in the day and significantly larger self-reported portions of main meals.
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| 2. |
- Berg, Christina, 1963, et al.
(författare)
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Food patterns and cardiovascular disease risk factors: the Swedish INTERGENE research program.
- 2008
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Ingår i: The American journal of clinical nutrition. - : Elsevier BV. - 0002-9165 .- 1938-3207. ; 88:2, s. 289-97
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Analyzing the impact of the intake of many foods simultaneously provides additional knowledge about analyses of nutrients and might make it easier to implement recommendations for the public. OBJECTIVE: The objective was to examine food patterns in a Swedish population and determine how they are related to metabolic risk factors for cardiovascular disease. DESIGN: The study is based on data from the INTERGENE population study of women and men aged 25-74 y in western Sweden. Dietary patterns were identified with cluster analysis of 93 food frequencies reported by 3452 participants. Associations with features of the metabolic syndrome, including blood lipids, blood pressure, and anthropometric measures, were analyzed. RESULTS: Five distinct food patterns were identified, of which one was interpreted as a "healthy" reference pattern. This healthy cluster was distinguished by more frequent consumption of high-fiber and low-fat foods and lower consumption of products rich in fat and sugar. The 4 other clusters differed significantly from the reference cluster with respect to prevalence of cardiovascular disease risk factors and the metabolic syndrome. For example, body mass index and waist-to-hip ratio were significantly higher in a cluster characterized by high consumption of energy-dense drinks and white bread and low consumption of fruit and vegetables (P < 0.0001 and P = 0.004, respectively). CONCLUSIONS: It is possible to distinguish food patterns that are related to obesity and obesity-related cardiovascular disease risk factors in contrast with a more healthy pattern conforming with current dietary guidelines. Thus, the results indicate no reason for questioning the current recommendations.
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| 3. |
- Berg, Christina, 1963, et al.
(författare)
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Trends in blood lipid levels, blood pressure, alcohol and smoking habits from 1985 to 2002: results from INTERGENE and GOT-MONICA.
- 2005
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Ingår i: European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology. - 1741-8267. ; 12:2, s. 115-25
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Favourable trends in cardiovascular disease have been observed in Sweden. The aim of this study was to study secular trends in a variety of cardiovascular risk factors. METHODS: Total-, low-density (LDL) and high-density lipoprotein (HDL) serum cholesterol; serum triglycerides; systolic and diastolic blood pressure; self-reported smoking and alcohol consumption were studied in repeated cross-sectional surveys. Data from four population-based samples in Goteborg, Sweden were used-WHO MONICA project 1985, 1990 and 1995, and INTERGENE 2002. A total of 2931 females and 2691 males aged 25-64 consisting of 1021-1624 randomly selected subjects at each survey period participated. RESULTS: Serum cholesterol levels showed downward trends but the decline in both total- and LDL-cholesterol seems to be levelling off from 1995 and onwards. No significant changes were observed in serum triglyceride, HDL-serum cholesterol or blood pressure levels. The majority of the participants had higher total- and LDL-serum cholesterol levels than currently recommended. Antihypertensive medical treatment increased in women and the oldest men. The prevalence of smoking decreased from 39 to 25% in women and 35 to 20% in men respectively from 1985-2002. In contrast, the prevalence of subjects consuming strong beer and wine, respectively, at least once a week almost doubled from 1990-2002. CONCLUSIONS: Cardiovascular risk factor patterns change continuously and need to be monitored. The favourable trends in LDL-serum cholesterol and smoking in the Goteborg surveys were paralleled by less favourable trends in being overweight and alcohol consumption.
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| 4. |
- Berg, Christina, 1963, et al.
(författare)
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Trends in overweight and obesity from 1985 to 2002 in Göteborg, West Sweden.
- 2005
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Ingår i: International journal of obesity (2005). - : Springer Science and Business Media LLC. - 0307-0565 .- 1476-5497. ; 29:8, s. 916-24
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study secular trends in overweight and selected correlates in men and women in Göteborg, Sweden. DESIGN: Cross-sequential population-based surveys. SUBJECTS: A total of 2931 female and 2691 male subjects aged 25-64 y participated in WHO MONICA surveys (1985, 1990, 1995) and the INTERGENE study (2002). MEASUREMENTS: Body mass index (BMI), waist-to-hip ratio (WHR), prevalence of overweight (BMI> or =25 kg/m(2)), and obesity (BMI> or =30 kg/m(2)). RESULTS: Mean body weight increased by 3.3 kg for women and 5 kg for men, with a significant upward trend for BMI in men but not women over the 17-y observation period. The prevalence of overweight and obesity increased significantly in both sexes over the period. The largest increase was observed in men, and in women aged 25-34 y. In 2002, the prevalence of overweight was 38% in women and 58% in men, and the prevalence of obesity was 11% in women and 15% in men. No significant secular trends were observed for WHR, but there was an upward trend in prevalence of WHR>0.85 in women. A decreased prevalence of smoking in both sexes was observed together with an increase in reported leisure time physical activity. No significant secular trends were observed in rates of self-reported diabetes, although the risk of diabetes attributable to obesity was 24%. CONCLUSION: The results indicate that 25-64-y-olds in the recent survey were more overweight and obese than earlier studied MONICA participants. The increase in BMI was more pronounced in men while abdominal obesity increased principally in women. Although obesity and overweight are clearly important risk factors for type 2 diabetes, the number of diabetics remains low and any secular increase is not yet apparent.
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| 5. |
- Berg, Johanna, 1983, et al.
(författare)
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Symptoms of a first acute myocardial infarction in women and men.
- 2009
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Ingår i: Gender medicine : official journal of the Partnership for Gender-Specific Medicine at Columbia University. - : Elsevier BV. - 1878-7398. ; 6:3, s. 454-62
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Many studies have compared women and men for symptoms of acute myocardial infarction (AMI), but findings have been inconsistent, largely because of varying inclusion criteria, different study populations, and different methods. OBJECTIVE: The purpose of this study was to analyze gender differences in symptoms in a well-defined, population-based sample of women and men who experienced a first AMI. METHODS: Information on symptoms was collected from the medical charts of all patients with a first AMI, aged 25 to 74 years, who had taken part in the INTERGENE (Interplay Between Genetic Susceptibility and Environmental Factors for the Risk of Chronic Diseases) study. INTERGENE was a population-based research program on risk factors for cardiovascular disease. Medical charts were reviewed for each patient to determine the symptoms of AMI, and the prevalence of each symptom was compared according to sex. RESULTS: The study included 225 patients with a first AMI: 52 women and 173 men. Chest pain was the most common symptom, affecting 88.5% (46/52) of the women and 94.8% (164/173) of the men, with no statistically significant difference between the sexes. Women had significantly higher rates of 4 symptoms: nausea (53.8% [28/52] vs 29.5% [51/173]; age-adjusted odds ratio [OR] = 2.78; 95% CI, 1.47-5.25), back pain (42.3% [22/52] vs 14.5% [25/173]; OR = 4.29; 95% CI, 2.14-8.62), dizziness (17.3% [9/52] vs 7.5% [13/173]; OR = 2.60; 95% CI, 1.04-6.50), and palpitations (11.5% [6/52] vs 2.9% [5/173]; OR = 3.99; 95% CI, 1.15-13.84). No significant gender differences were found in the proportions of patients experiencing arm or shoulder pain, diaphoresis, dyspnea, fatigue, neck pain, abdominal pain, vomiting, jaw pain, or syncope/lightheadedness. No significant differences were found in the duration, type, or location of chest pain. The medical charts listed numerically more symptoms in women than in men; 73.1% (38/52) of the women but only 48.0% (83/173) of the men reported >3 symptoms (age-adjusted OR = 3.26; 95% CI, 1.62-6.54). CONCLUSIONS: Chest pain is the most common presenting symptom in both women and men with AMI. Nausea, back pain, dizziness, and palpitations were significantly more common in women. Women as a group displayed a greater number of symptoms than did men.
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| 6. |
- Björck, Lena, 1959, et al.
(författare)
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Modelling the decreasing coronary heart disease mortality in Sweden between 1986 and 2002.
- 2009
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Ingår i: European heart journal. - : Oxford University Press (OUP). - 1522-9645 .- 0195-668X. ; 30:9, s. 1046-56
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Coronary heart disease (CHD) mortality rates have been falling in Sweden since the 1980s. We used the previously validated IMPACT CHD model to examine how much of the mortality decrease in Sweden between 1986 and 2002 could be attributed to medical and surgical treatments, and how much to changes in cardiovascular risk factors. METHODS AND RESULTS: The IMPACT mortality model was used to combine and analyse data on uptake and effectiveness of cardiological treatments and risk factor trends in Sweden. The main data sources were official statistics, national quality of care registers, published trials and meta-analyses, and national population surveys. Between 1986 and 2002, CHD mortality rates in Sweden decreased by 53.4% in men and 52.0% in women aged 25-84 years. This resulted in 13 180 fewer deaths in 2002. Approximately 36% of this decrease was attributed to treatments in individuals and 55% to population risk factor reductions. Adverse trends were seen for diabetes and overweight. CONCLUSION: More than half of the substantial CHD mortality decrease in Sweden between 1986 and 2002 was attributable to reductions in major risk factors, mainly a large decrease in total serum cholesterol. These findings emphasize the value of a comprehensive strategy that promotes primary prevention and evidence-based medical treatments, especially secondary prevention.
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| 7. |
- Danesh, John, et al.
(författare)
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Plasma fibrinogen level and the risk of major cardiovascular diseases and nonvascular mortality: an individual participant meta-analysis
- 2005
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Ingår i: JAMA: The Journal of the American Medical Association. - : American Medical Association (AMA). - 1538-3598 .- 0098-7484. ; 294:14, s. 1799-1809
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Forskningsöversikt (refereegranskat)abstract
- CONTEXT: Plasma fibrinogen levels may be associated with the risk of coronary heart disease (CHD) and stroke. OBJECTIVE: To assess the relationships of fibrinogen levels with risk of major vascular and with risk of nonvascular outcomes based on individual participant data. DATA SOURCES: Relevant studies were identified by computer-assisted searches, hand searches of reference lists, and personal communication with relevant investigators. STUDY SELECTION: All identified prospective studies were included with information available on baseline fibrinogen levels and details of subsequent major vascular morbidity and/or cause-specific mortality during at least 1 year of follow-up. Studies were excluded if they recruited participants on the basis of having had a previous history of cardiovascular disease; participants with known preexisting CHD or stroke were excluded. DATA EXTRACTION: Individual records were provided on each of 154,211 participants in 31 prospective studies. During 1.38 million person-years of follow-up, there were 6944 first nonfatal myocardial infarctions or stroke events and 13,210 deaths. Cause-specific mortality was generally available. Analyses involved proportional hazards modeling with adjustment for confounding by known cardiovascular risk factors and for regression dilution bias. DATA SYNTHESIS: Within each age group considered (40-59, 60-69, and > or =70 years), there was an approximately log-linear association with usual fibrinogen level for the risk of any CHD, any stroke, other vascular (eg, non-CHD, nonstroke) mortality, and nonvascular mortality. There was no evidence of a threshold within the range of usual fibrinogen level studied at any age. The age- and sex- adjusted hazard ratio per 1-g/L increase in usual fibrinogen level for CHD was 2.42 (95% confidence interval [CI], 2.24-2.60); stroke, 2.06 (95% CI, 1.83-2.33); other vascular mortality, 2.76 (95% CI, 2.28-3.35); and nonvascular mortality, 2.03 (95% CI, 1.90-2.18). The hazard ratios for CHD and stroke were reduced to about 1.8 after further adjustment for measured values of several established vascular risk factors. In a subset of 7011 participants with available C-reactive protein values, the findings for CHD were essentially unchanged following additional adjustment for C-reactive protein. The associations of fibrinogen level with CHD or stroke did not differ substantially according to sex, smoking, blood pressure, blood lipid levels, or several features of study design. CONCLUSIONS: In this large individual participant meta-analysis, moderately strong associations were found between usual plasma fibrinogen level and the risks of CHD, stroke, other vascular mortality, and nonvascular mortality in a wide range of circumstances in healthy middle-aged adults. Assessment of any causal relevance of elevated fibrinogen levels to disease requires additional research.
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| 8. |
- Dotevall, Annika, 1957, et al.
(författare)
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Considerable disturbances of cardiovascular risk factors in women with diabetes and myocardial infarction
- 2005
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Ingår i: J Diabetes Complications. - : Elsevier BV. - 1056-8727. ; 19:1, s. 26-34
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate to which extent differences in cardiovascular risk factors explain the increased risk of myocardial infarction (MI) and complication rate in women with diabetes mellitus (DM). DESIGN: Case-control study. SUBJECTS: We compared women with diabetes and previous MI (n=29), diabetes but no MI (n=46), prior MI but no diabetes (n=64), and healthy controls (n=125). MEASUREMENTS: Smoking habits, physical activity, blood pressure (BP), body mass index (BMI), waist/hip ratio (WHR), serum lipids, plasma fibrinogen, and serum sex hormones. RESULTS: Despite the fact that diabetic women had similar BMI, those with a past MI, compared to diabetic women without MI, had significantly higher WHR (mean, 95% CI) [0.89 (0.87, 0.92) vs. 0.84 (0.81, 0.86) mmol/l, P=.001] and very high S-triglycerides [3.03 (2.23, 3.83) vs. 1.69, (1.39, 1.99) mmol/l, P=.001] and low HDL-cholesterol [1.09 (0.94, 1.24) vs. 1.56 (1.41, 1.71) mmol/l, P<.001], indicating pronounced metabolic disturbances. Women with MI but no diabetes had intermediate values for WHR, triglycerides, and HDL-cholesterol. Furthermore, women with diabetes and MI had significantly higher p-fibrinogen, were smokers, and lived a more sedentary life than the other women. Over half of all women with prior MI were on lipid-lowering therapy and tended to have nonsignificantly lower S-cholesterol than women without MI. CONCLUSIONS: Women with diabetes who have manifested an MI carry a very substantial cardiovascular risk factor burden, which probably explain their increased morbidity and mortality. In order to improve prognosis, studies targeted at investigating treatment modalities for these abnormalities are needed.
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| 9. |
- Emerging Risk Factors, Collaboration, et al.
(författare)
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The Emerging Risk Factors Collaboration: analysis of individual data on lipid, inflammatory and other markers in over 1.1 million participants in 104 prospective studies of cardiovascular diseases
- 2007
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Ingår i: Eur J Epidemiol. - 0393-2990. ; 22:12, s. 839-69
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Tidskriftsartikel (refereegranskat)abstract
- Many long-term prospective studies have reported on associations of cardiovascular diseases with circulating lipid markers and/or inflammatory markers. Studies have not, however, generally been designed to provide reliable estimates under different circumstances and to correct for within-person variability. The Emerging Risk Factors Collaboration has established a central database on over 1.1 million participants from 104 prospective population-based studies, in which subsets have information on lipid and inflammatory markers, other characteristics, as well as major cardiovascular morbidity and cause-specific mortality. Information on repeat measurements on relevant characteristics has been collected in approximately 340,000 participants to enable estimation of and correction for within-person variability. Re-analysis of individual data will yield up to approximately 69,000 incident fatal or nonfatal first ever major cardiovascular outcomes recorded during about 11.7 million person years at risk. The primary analyses will involve age-specific regression models in people without known baseline cardiovascular disease in relation to fatal or nonfatal first ever coronary heart disease outcomes. This initiative will characterize more precisely and in greater detail than has previously been possible the shape and strength of the age- and sex-specific associations of several lipid and inflammatory markers with incident coronary heart disease outcomes (and, secondarily, with other incident cardiovascular outcomes) under a wide range of circumstances. It will, therefore, help to determine to what extent such associations are independent from possible confounding factors and to what extent such markers (separately and in combination) provide incremental predictive value.
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| 10. |
- Fibrinogen Studies, Collaboration, et al.
(författare)
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Systematically missing confounders in individual participant data meta-analysis of observational cohort studies.
- 2009
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Ingår i: Statistics in medicine. - : Wiley. - 0277-6715 .- 1097-0258. ; 28:8, s. 1218-37
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Tidskriftsartikel (refereegranskat)abstract
- One difficulty in performing meta-analyses of observational cohort studies is that the availability of confounders may vary between cohorts, so that some cohorts provide fully adjusted analyses while others only provide partially adjusted analyses. Commonly, analyses of the association between an exposure and disease either are restricted to cohorts with full confounder information, or use all cohorts but do not fully adjust for confounding. We propose using a bivariate random-effects meta-analysis model to use information from all available cohorts while still adjusting for all the potential confounders. Our method uses both the fully adjusted and the partially adjusted estimated effects in the cohorts with full confounder information, together with an estimate of their within-cohort correlation. The method is applied to estimate the association between fibrinogen level and coronary heart disease incidence using data from 154,012 participants in 31 cohorts
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