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- Anandavadivelan, Poorna, et al.
(author)
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Role of dietitian support in improving weight loss and nutrition impact symptoms after oesophageal cancer surgery
- 2021
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In: European Journal of Clinical Nutrition. - : Springer Nature. - 0954-3007 .- 1476-5640. ; 75, s. 1134-1141
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Journal article (peer-reviewed)abstract
- Background: Oesophageal cancer is frequently accompanied with malnutrition. We aimed to evaluate if early support from dietitians and patient's level of satisfaction with the support from dietitians are associated with better outcomes for weight loss and nutrition impact symptoms (NIS).Methods: A nationwide and prospective cohort study on patients operated for oesophageal cancer in Sweden from 2013 onwards, included one year after surgery. Study exposures were (1) preoperative dietitian support (yes vs no) and, (2) patient reported satisfaction with dietitian support (high vs low) and outcomes were postoperative (1) percentage weight loss and (2) NIS score (range 0-24); one year after surgery. An ANCOVA model adjusted for predefined confounders was used and presented as mean differences (MD) with 95% confidence intervals (CI).Results: Among 245 patients, as many as 57% had received preoperative dietitian support. Preoperative dietitian support was not associated with statistically significant differences in mean postoperative weight loss (MD 0.2 [95% CI -2.6 to 2.9]) and mean NIS score (MD 0.1 [95% CI: -0.8 to 1.0]). Likewise, satisfaction with the dietitian support was not associated with significant differences in mean postoperative weight loss (MD 1.4 [95% CI: -1.5 to 4.3]) and NIS score (MD -0.1 [95% CI: -1 to 0.8]).Conclusions: Long-term postoperative weight loss and NIS were not influenced based on whether dietitian support was initiated preoperatively or not and patient's satisfaction level with dietitian support. Similarity in results may reflect effective screening of malnutrition and dietitian support in centres treating oesophageal cancer in Sweden.
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- Costabile, Giuseppina, et al.
(author)
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Effects on cardiovascular risk factors of a low- vs high-glycemic index Mediterranean diet in high cardiometabolic risk individuals: the MEDGI-Carb study
- 2024
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In: European Journal of Clinical Nutrition. - 0954-3007 .- 1476-5640. ; 78:5, s. 384-390
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Journal article (peer-reviewed)abstract
- Background : The role of dietary Glycemic Index (GI), independently of fiber intake, in modulating cardiovascular disease (CVD) risk among non-diabetic individuals has not been fully elucidated. Objective : To evaluate the effects of a low- versus a high-GI diet, based on a Mediterranean dietary pattern, on cardiometabolic risk factors in individuals at high CVD risk, participating in the MEDGI-Carb intervention study. Subjects and methods : 160 individuals, aged 30–69 years, BMI 25–37 kg/m2, with a waist circumference >102 cm (males) or >88 cm (females) and one feature of the metabolic syndrome, participated in a multi-national (Italy, Sweden, USA) randomized controlled parallel group trial. Participants were assigned to a low GI (< 55) or high-GI MedDiet (> 70) for 12 weeks. The diets were isoenergetic and similar for available carbohydrate (270 g/d) and fiber (35 g/d) content. Fasting metabolic parameters were evaluated in the whole cohort, while an 8-h triglyceride profile (after standard breakfast and lunch) was evaluated only in the Italian cohort. Results : Blood pressure and most fasting metabolic parameters improved at the end of the dietary intervention (time effect, p < 0.05 for all); however, no differences were observed between the low- and the high-GI MedDiet groups (time x group effect; p > 0.05 for all). Conversely, the low-GI diet, compared with high-GI diet, significantly reduced the 8-h triglyceride profile (p < 0.017, time*group effect) that was measured only in the Italian cohort. However, it induced a reduction of plasma triglycerides after lunch (tAUC) that was of only borderline statistically significance (p = 0.065). Conclusions : Consuming a low-GI in comparison with a high-GI MedDiet does not differentially affect the major cardiometabolic risk factors at fasting in individuals at increased cardiometabolic risk. Conversely, it could reduce postprandial plasma triglycerides. Clinical trial registry number: NCT03410719, (https://clinicaltrials.gov).
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- Dey, D K, et al.
(author)
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Body mass index, weight change and mortality in the elderly. A 15 y longitudinal population study of 70 y olds
- 2024
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In: European Journal of Clinical Nutrition. - : Nature Publishing Group. - 0954-3007 .- 1476-5640. ; 55:6, s. 482-492
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To examine the relationship between body mass index (BMI) at age 70, weight change between age 70 and 75, and 15 y mortality. DESIGN: Cohort study of 70-y-olds. SETTING: Geriatric Medicine Department, Göteborg University, Sweden. SUBJECTS: A total of 2628 (1225 males and 1403 females) 70-y-olds examined in 1971--1981 in Gothenburg, Sweden. RESULTS: The relative risks (RRs) for 15 y mortality were highest in the lowest BMI quintiles of males 1.20 (95% CI 0.96--1.51) and females 1.49 (95% CI 1.14--1.96). In non-smoking males, no significant differences were observed across the quintiles for 5, 10 and 15 y mortality. In non-smoking females, the highest RR (1.58, 95% CI 1.15--2.16) for 15 y mortality was in the lowest quintile. After exclusion of first 5 y death, no excess risks were found in males for following 5 and 10 y mortality across the quintiles. In females, a U-shaped relation was observed after such exclusions. BMI ranges with lowest 15 y mortality were 27--29 and 25--27 kg/m(2) in non-smoking males and females, respectively. A weight loss of > or = 10% between age 70 and 75 meant a significantly higher risk for subsequent 5 and 10 y mortality in both sexes relative to individuals with 'stable' weights. CONCLUSION: Low BMI and weight loss are risk factors for mortality in the elderly and smoking habits did not significantly modify that relationship. The BMI ranges with lowest risks for 15 y mortality are relatively higher in elderly. Exclusion of early deaths from the analysis modified the weight-mortality relationship in elderly males but not in females.
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- Dey, D K, et al.
(author)
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Height and body weight in the elderly. I. A 25-year longitudinal study of a population aged 70 to 95 years
- 2024
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In: European Journal of Clinical Nutrition. - : Nature Publishing Group. - 0954-3007 .- 1476-5640. ; 53:12, s. 905-914
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To describe longitudinal changes in height and body weight between the ages of 70 and 95 y. DESIGN : Longitudinal cohort study with representative sample of 70-y-olds. SETTING: Department of Geriatric Medicine, Göteborg University, Sweden. SUBJECTS: 449 males and 524 females, aged 70 y, living in Göteborg were examined in 1971-72 and this study population participated on 11 occasions during a 25-year follow-up. RESULTS: Mean height decreased 4 and 4.9 cm in males and females respectively and the trend was significant between the ages of 70 and 95 y in both sexes. Between 70 and 75 y of age, a significant difference was found between quintiles of body height where in the highest quintile height was lowered by 0.4 and 0. 3 cm/y, in males and females respectively, and in the lowest quintile by 0.1 cm/y in both sexes. Mean body weight decreased 3.2 and 5.1 kg in males and females respectively, from age 70 to 95 y. The trend was significant over 22 and 20 y for males and females, respectively.Between the ages of 70 and 80 y, individuals in highest quintile of body weight decreased at a rate of 0.8 and 0.6 kg/y, three times higher than those in lowest quintile. Due to the decrease in both height and weight over time, body mass index (BMI) was less affected. CONCLUSION: Height, body weight and BMI decreased significantly in both sexes after age 70 y, and there was a gender difference in the trend. The results can be used as reference data for Swedish elderly and might be of importance to the understanding of anthropometry with the ageing process.
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- Eustachio Colombo, Patricia, et al.
(author)
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Developing a novel optimisation approach for keeping heterogeneous diets healthy and within planetary boundaries for climate change
- 2024
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In: European Journal of Clinical Nutrition. - 0954-3007 .- 1476-5640. ; 78:3, s. 193-201
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Journal article (peer-reviewed)abstract
- Background and objectives: Current dietary habits have substantial negative impacts on the health of people and the planet. This study aimed to develop a novel approach for achieving health-promoting and climate-friendly dietary recommendations for a broad range of consumers. Subjects and methods: Hierarchical clustering analysis was combined with linear programming to design nutritionally adequate, health-promoting, climate-friendly and culturally acceptable diets using Swedish national dietary data (n = 1797). Diets were optimised for the average consumption of the total population as well as for the dietary clusters. Results: Three dietary clusters were identified. All optimised diets had lower shares of animal-source foods and contained higher amounts of plant-based foods. These dietary shifts reduced climate impacts by up to 53% while leaving much of the diet unchanged. The optimised diets of the three clusters differed from the optimised diet of the total population. All optimised diets differed considerably from the food-group pattern of the EAT-Lancet diet. Conclusions: The novel cluster-based optimisation approach was able to generate alternatives that may be more acceptable and realistic for a sustainable diet across different groups in the population.
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- Gallagher, Valery, et al.
(author)
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Parenteral nutrition : a call to action for harmonization of policies to increase patient safety.
- 2020
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In: European Journal of Clinical Nutrition. - : Springer Science and Business Media LLC. - 0954-3007 .- 1476-5640. ; 75:1, s. 3-11
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Journal article (peer-reviewed)abstract
- Unsafe medication practices and medication errors are leading causes of injury and avoidable harm worldwide and are highest in vulnerable groups. In 2017, the World Health Organization launched the third Medication Without Harm Global Patient Safety Challenge to try to reduce risks related to medical treatment. Parenteral nutrition (PN) is in the unique position that, although licensed products are available from manufacturers, formulas may be prepared ad hoc for first-line use that might not be subject to the same regulatory oversight. Safety issues around PN can arise through lack of harmonization in practices, misinterpretation and product unfamiliarity and can occur at any stage from prescription to preparation to administration. Government legislation and regulation vary considerably, with PN not explicitly handled in many countries. We therefore call on policy leaders in all countries to establish policies that ensure patient safety, and that these include PN along with medicines. The available evidence supports obtaining industry prepared PN as first-line therapy for reasons of safety, primarily, and of cost. If a suitable industry prepared ready-to-use PN is not available, standardized all-in-one PN admixtures should be the next line of care, with individualized PN being reserved for patients whose complex nutritional needs cannot be met using standardized admixtures.
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- Giménez-Legarre, Natalia, et al.
(author)
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Breakfast consumption and its relationship with diet quality and adherence to Mediterranean diet in European adolescents : the HELENA study
- 2022
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In: European Journal of Clinical Nutrition. - : Springer Nature. - 0954-3007 .- 1476-5640. ; 76:12, s. 1690-1696
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Journal article (peer-reviewed)abstract
- Objective: The aim of the current study is to analyze the associations between breakfast consumption and adherence to diet quality index (DQI) and Mediterranean Diet Score (MDS) in European adolescents.Methods: A multinational cross-sectional study was carried out in 1804 adolescents aged 12.5–17.5 years. The Food Choices and Preferences questionnaire was used to ascertain breakfast consumption (consumers, occasional consumers and skippers), and two non-consecutive 24 h dietary recalls were used to estimate the total daily intake and to calculate the subsequent DQI and MDS. Mixed linear regression models were used to examine the relationship between breakfast consumption and DQI-A and MDS. Age, maternal education, BMI, country and total energy intake were included as covariates.Results: In both sexes, significant differences were observed among the breakfast consumption categories. In both boys and girls, breakfast consumers had significantly higher DQI indices than those adolescents who skipped breakfast regularly (p < 0.001). Regarding total MDS, in both boys and girls, breakfast consumers had a higher total MDS than breakfast skippers (p < 0.001), however, no associations were shown between occasional breakfast consumers and DQI indices and MDS.Conclusion: Breakfast consumption has been linked with better dietary quality scores compared with those children who usually skip breakfast. Promotion of regular breakfast consumption in adolescents could be an effective strategy to improve the overall diet quality.
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