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  • 1.
    Andersson, Agneta
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences. Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Domestic Sciences.
    Tengblad, Siv
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Karlström, Brita
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences. Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Domestic Sciences.
    Kamal-Edin, Afaf
    Landberg, Rikard
    Åman, Per
    Vessby, Bengt
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Oförändrad insulinkänslighet och lipidperoxidation efter ökat intag av fullkornsprodukter hos friska män och kvinnor.2006In: Livsmedelsforskardagarna, 2006Conference paper (Other (popular scientific, debate etc.))
    Abstract [en]

    Flertalet epidemilogiska studier har visat positiva hälsoeffekter av ett högt intag av fullkornsprodukter. Framförallt är en minska risk för hjärtinfarkt/sjukdom visad, och data

    talar även för en minskad risk för typ 2 diabetes. Mekanismerna bakom fullkornets positiva effekter är dock fortfarande oklara. Såväl en förbättrad insulinkänslighet som en minskad förekomst av lipidperoxidation och inflammation har föreslagits, vilket vi därför önskade undersöka i denna studie.

    I en randomiserad cross-over design deltog 30 lätt överviktiga (BMI 282) kvinnor (n=22) och män (n=8). Under två på varandra följande 6 veckors perioder fick deltagarna antingen cerealieprodukter med fullkorn eller utan fullkorn. En standardiserad mängd (3 skivor mjukt bröd, 2 skivor hårt bröd, 1 portion musli/gryn och 1 portion pasta/ris) inkluderades dagligen i deras vanliga kost. Perifer insulinkänslighet mättes med euglykemisk hyperinsulinemisk clampteknik. Lipidperoxidationsmarkören 8-iso-PGF2 mättes i urin och inflammationsmarkörerna CRP och IL-6 mättes i plasma. Kostinterventionen monitorerades med hjälp av vägda kostregisteringar och dagboksnoteringar.

    Kostregistreringarna bekräftade ett högre intag av fiber och flertalet mineralämnen under fullkornsperioden jämfört med icke-fullkornsperioden. Vi fann dock ingen förbättring av insulinkänsligheten och inte heller någon förändring av lipidperoxidation eller inflammationsmarkörer.

    Att ersätta icke-fullkorns produkter med fullkorn under en 6 veckors period hos vuxna lätt överviktiga friska män och kvinnor gav således ingen mätbar effekt på vare sig insulinkänslighet, lipidperoxidation eller inflammationsmarkörer. Frågan om vilka mekanismerna som ligger bakom de positiva hälsoeffekterna av fullkornsprodukter kvarstår och längre koststudier på deltagare med varierande metaboltstatus behövs.

  • 2.
    Andersson, Agneta
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences. Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Domestic Sciences.
    Tengblad, Siv
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Karlström, Brita
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences. Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Domestic Sciences.
    Kamal-Eldin, Afaf
    Landberg, Rickard
    Åman, Per
    Vessby, Bengt
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Ökat intag av fullkornsprodukter. Effekter på insulinkänslighet, lipidperoxidation och inflammationsmarkörer?2006In: Svenska Läkarsällskapets Riksstämma, 2006Conference paper (Other (popular scientific, debate etc.))
    Abstract [en]

    Bakgrund: Flertalet epidemiologiska studier har visat positiva hälsoeffekter av ett högt intag av fullkornsprodukter. Framförallt är en minskad risk för hjärtinfarkt/sjukdom visad, men data talar även för en minskad risk för typ 2 diabetes. Mekanismerna bakom fullkornets positiva effekter är dock fortfarande oklara. Såväl en förbättrad insulinkänslighet som en minskad förekomst av lipidperoxidation och inflammation har föreslagits, vilket vi önskade undersöka i denna studie.

    Metod: I en randomiserad cross-over design deltog 30 lätt överviktiga (BMI 282) kvinnor (n=22) och män (n=8). Under två på varandra följande 6-veckors perioder fick deltagarna antingen cerealieprodukter med fullkorn eller utan fullkorn. En standardiserad mängd (3 skivor mjukt bröd, 2 skivor hårt bröd, 1 portion musli/gryn och 1 portion pasta/ris) inkluderades dagligen i deras vanliga kost. Perifer insulinkänslighet mättes med euglykemisk hyperinsulinemisk clampteknik. Lipidperoxidationsmarkören 8-iso-PGF2 mättes i urin och inflammationsmarkörerna CRP och IL-6 mättes i plasma. Kostinterventionen monitorerades med hjälp av vägda kostregisteringar och dagboksnoteringar.

    Resultat: Kostregistreringarna bekräftade ett högre intag av fiber och flertalet mineralämnen under fullkornsperioden jämfört med icke-fullkornsperioden. Vi fann dock ingen förbättring av insulinkänsligheten och inte heller någon förändring av lipidperoxidation eller inflammationsmarkörer.

    Sammanfattning: Att ersätta icke-fullkorns produkter med fullkorn under en 6-veckors period hos vuxna lätt överviktiga friska män och kvinnor gav ingen mätbar effekt på insulinkänslighet, lipidperoxidation eller inflammationsmarkörer. Frågan om vilka mekanismerna som ligger bakom de positiva hälsoeffekterna av fullkornsprodukter kvarstår och längre koststudier på deltagare med varierande metaboltstatus behövs.

  • 3.
    Andersson, Agneta
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Tengblad, Siv
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Kamal-Eldin, Afaf
    Landberg, Rikard
    Basu, Samar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Åman, Per
    Vessby, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Whole-grain foods do not affect insulin sensitivity or markers of lipid peroxidation and inflammation in healthy, moderately overweight subjects2007In: Journal of Nutrition, ISSN 0022-3166, E-ISSN 1541-6100, Vol. 137, no 6, p. 1401-1407Article in journal (Refereed)
    Abstract [en]

    High intakes of whole grain foods are inversely related to the incidence of coronary heart diseases and type 2 diabetes, but the mechanisms remain unclear. Our study aimed to evaluate the effects of a diet rich in whole grains compared with a diet containing the same amount of refined grains on insulin sensitivity and markers of lipid peroxidation and inflammation. In a randomized crossover study, 22 women and 8 men (BMI 28 +/- 2) were given either whole-grain or refined-grain products (3 bread slices, 2 crisp bread slices, 1 portion muesli, and 1 portion pasta) to include in their habitual daily diet for two 6-wk periods. Peripheral insulin sensitivity was determined by euglycemic hyperinsulinemic clamp tests. 8-Iso-prostaglandin F(2alpha) (8-iso PGF(2alpha)), an F(2)-isoprostane, was measured in the urine as a marker of lipid peroxidation, and highly sensitive C-reactive protein and IL-6 were analyzed in plasma as markers of inflammation. Peripheral insulin sensitivity [mg glucose . kg body wt(-1) . min(-1) per unit plasma insulin (mU/L) x 100] did not improve when subjects consumed whole-grain products (6.8 +/- 3.0 at baseline and 6.5 +/- 2.7 after 6 wk) or refined products (6.4 +/- 2.9 and 6.9 +/- 3.2, respectively) and there were no differences between the 2 periods. Whole-grain consumption also did not affect 8-iso-PGF(2alpha) in urine, IL-6 and C-reactive protein in plasma, blood pressure, or serum lipid concentrations. In conclusion, substitution of whole grains (mainly based on milled wheat) for refined-grain products in the habitual daily diet of healthy moderately overweight adults for 6-wk did not affect insulin sensitivity or markers of lipid peroxidation and inflammation.

  • 4.
    Andersson, Karin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Fredén, Susanne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Petersson, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Öhrvall, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Zethelius, Björn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    A two-year clinical lifestyle intervention program for weight loss in obesity2008In: Food & nutrition research, ISSN 1654-661X, Vol. 52, p. 1656-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In recent randomised prospective studies, lifestyle intervention induced a weight loss of approximately 5%. OBJECTIVE: To describe and evaluate a 2-year on-going group intervention program in clinical practice in terms of weight loss and changes in metabolic risk factors, i.e. sagital abdominal diameter (SAD), triglycerides, fasting blood glucose and blood pressure. DESIGN: The aim of the intervention program was to motivate lifestyle changes concerning food intake and physical activity. The emphasis was on lifestyle modification, followed up at regular visits during 2 years. Subjects evaluated were 100 women with mean BMI 37.6 kg/m(2) and 26 men with mean BMI 36.5 kg/m(2). RESULTS: One hundred of 151 enrolled women and 26 of 36 men completed the program. Mean weight decreased by 3.8 kg in women (from 103.5 to 99.7, p<0.001) and 4.4 kg in men (from 116.5 to 112.1, p<0.05), respectively. SAD decreased by 5% (p=0.001 in women, p=0.01 in men), and triglycerides by 16% in women (p=0.01) and 24% in men (p=0.001), however systolic and diastolic blood pressure increased slightly but significantly. CONCLUSION: It is possible to perform a clinical lifestyle intervention program for outpatients on an ongoing basis with weight loss, lowered SAD and triglycerides, and a similar or lower dropout rate compared to clinical trials.

  • 5.
    Byberg, Liisa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Olsson, Erika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Melhus, Håkan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical pharmacogenomics and osteoporosis.
    Sjögren, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Kilander, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Reply to WB Grant2017In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 106, no 2, p. 700-701Article in journal (Other academic)
  • 6.
    Byberg, Liisa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Olsson, Erika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Melhus, Håkan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical pharmacogenomics and osteoporosis.
    Sjögren, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Kilander, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Reply to Y Mao and H Yu.2017In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 106, no 2, p. 698-699Article in journal (Other academic)
  • 7.
    Daryani, Achraf
    et al.
    Uppsala University, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Domestic Sciences. Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Kocturk, Tahire
    Andersson, Agneta
    Uppsala University, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Domestic Sciences. Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Karlstrom, Brita
    Uppsala University, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Domestic Sciences. Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Vessby, Bengt
    Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Becker, Wulf
    Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Greater underreporting of dietary intake among immigrant women from Iran and Turkey than in native-Swedish women in Uppsala County2006In: 6th International Conference on Dietary Assessment Methods, 27-29 april Köpenhamn, Danmark: Complementary advances in diet and physical activity assessment methodologies, 2006Conference paper (Other (popular scientific, debate etc.))
  • 8. Delgado-Lista, J.
    et al.
    Perez-Martinez, P.
    Garcia-Rios, A.
    Phillips, C. M.
    Hall, W.
    Gjelstad, I. M. F.
    Lairon, D.
    Saris, W.
    Kiec-Wilk, B.
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Drevon, C. A.
    Defoort, C.
    Blaak, E. E.
    Dembinska-Kiec, A.
    Risérus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Lovegrove, J. A.
    Roche, H. M.
    Lopez-Miranda, J.
    A gene variation (rs12691) in the CCAT/enhancer binding protein alpha modulates glucose metabolism in metabolic syndrome2013In: NMCD. Nutrition Metabolism and Cardiovascular Diseases, ISSN 0939-4753, E-ISSN 1590-3729, Vol. 23, no 5, p. 417-423Article in journal (Refereed)
    Abstract [en]

    Background and aims: CCAAT/enhancer-binding protein alpha (CEBPA) is a transcription factor involved in adipogenesis and energy homeostasis. Caloric restriction reduces CEBPA protein expression in patients with metabolic syndrome (MetS). A previous report linked rs12691 SNP in CEBPA to altered concentration of fasting triglycerides. Our objective was to assess the effects of rs12691 in glucose metabolism in Metabolic Syndrome (MetS) patients. Methods and results: Glucose metabolism was assessed by static (glucose, insulin, adiponectin, leptin and resistin plasma concentrations) and dynamic (disposition index, insulin sensitivity index, HOMA-IR and acute insulin response to glucose) indices, performed at baseline and after 12 weeks of 4 dietary interventions (high saturated fatty acid (SFA), high monounsaturated fatty acid (MUFA), low-fat and low-fat-high-n3 polyunsaturated fatty acid (PUFA)) in 486 subjects with MetS. Carriers of the minor A allele of rs12691 had altered disposition index (p = 0.0003), lower acute insulin response (p = 0.005) and a lower insulin sensitivity index (p = 0.025) indicating a lower insulin sensitivity and a lower insulin secretion, at baseline and at the end of the diets. Furthermore, A allele carriers displayed lower HDL concentration. Conclusion: The presence of the A allele of rs12691 influences glucose metabolism of MetS patients. Clinical Trials Registry number NCT00429195.

  • 9. Garcia-Rios, Antonio
    et al.
    Delgado-Lista, Javier
    Perez-Martinez, Pablo
    Phillips, Catherine M.
    Ferguson, Jane F.
    Gjelstad, Ingrid M. F.
    Williams, Christine M.
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Kiec-Wilkh, Beata
    Blaak, Ellen E.
    Lairon, Denis
    Planells, Richard
    Malczewska-Malec, Malgorzata
    Defoort, Catherine
    Risérus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Saris, Wim H. M.
    Lovegrove, Julie A.
    Drevon, Christian A.
    Roche, Helen M.
    Lopez-Miranda, Jose
    Genetic variations at the lipoprotein lipase gene influence plasma lipid concentrations and interact with plasma n-6 polyunsaturated fatty acids to modulate lipid metabolism2011In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 218, no 2, p. 416-422Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate whether seven common single nucleotide polymorphisms (SNPs) at the lipoprotein lipase (LPL) locus interact with total plasma fatty acids to modulate plasma lipid metabolism in metabolic syndrome (MetS) patients. Methods: Plasma fatty acid composition, plasma lipid concentrations and LPL SNPs were determined in 452 subjects with the MetS in the European LIPGENE human study and were repeated in 1754 subjects from the LIPGENE-SU.VI.MAX Study. Results: Triglycerides (TG) were lower, and HDL higher in the carriers of rs328 and rs1059611 in the SUVIMAX cohort (all P < 0.001), and these findings showed a similar, non-significant trend in LIPGENE cohort. In this last cohort, we found a gene-fatty acids interaction, as the carriers of the minor allele displayed a lower fasting TG and triglyceride rich lipoproteins-TG (TRL-TG) concentrations only when they had n-6 polyunsaturated fatty acids below the median (all P < 0.05). Moreover, subjects carrying the minor allele for rs328 SNP and with a low level of n-6 PUFA displayed higher nonesterified fatty acid (NEFA) plasma concentrations as compared with homozygous for the major allele (P = 0.034). Interestingly, the n-6 PUFA-dependent associations between those SNPs and TG metabolism were also replicated in subjects without MetS from the SU.VI.MAX cohort. Conclusion: Two genetic variations at the LPL gene (rs328 and rs1059611) influence plasma lipid concentrations and interact with plasma n-6 PUFA to modulate lipid metabolism. The knowledge of new genetic factors together with the understanding of these gene-nutrient interactions could help to a better knowledge of the pathogenesis in the MetS. 

  • 10. Garcia-Rios, Antonio
    et al.
    Perez-Martinez, Pablo
    Delgado-Lista, Javier
    Phillips, Catherine M.
    Gjelstad, Ingrid M. F.
    Wright, John W.
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Kie'c-Wilk, Beata
    van Hees, A. M. J.
    Helal, Olfa
    Polus, Anna
    Defoort, Catherine
    Riserus, Ulf
    Blaak, Ellen E.
    Lovegrove, Julie A.
    Drevon, Christian A.
    Roche, Helen M.
    Lopez-Miranda, Jose
    A Period 2 Genetic Variant Interacts with Plasma SFA to Modify Plasma Lipid Concentrations in Adults with Metabolic Syndrome2012In: Journal of Nutrition, ISSN 0022-3166, E-ISSN 1541-6100, Vol. 142, no 7, p. 1213-1218Article in journal (Refereed)
    Abstract [en]

    Genetic variants of Period 2 (PER2), a circadian clock gene, have been linked to metabolic syndrome (MetS). However, it is still unknown whether these genetic variants interact with the various types of plasma fatty acids. This study investigated whether common single nucleotide polymorphisms (SNPs) in the PER2 locus (rs934945 and rs2304672) interact with various classes of plasma fatty acids to modulate plasma lipid metabolism in 381 participants with MetS in the European LIPGENE study. Interestingly, the rs2304672 SNP interacted with plasma total SFA concentrations to affect fasting plasma TG, TG-rich lipoprotein (TRL-TG), total cholesterol, apoC-II, apoB, and apoB-48 concentrations (P-interaction <0.001-0.046). Carriers of the minor allele (GC+GG) with the highest SFA concentration (>median) had a higher plasma TG concentration (P = 0.001) and higher TRL-TG (P < 0.001) than the CC genotype. In addition, participants carrying the minor G allele for rs2304672 SNP and with a higher SFA concentration (>median) had higher plasma concentrations of apo C-II (P < 0.001), apo C-III (P = 0.009), and apoB-48 (P = 0.028) compared with the homozygotes for the major allele (CC). In summary, the rs2304672 polymorphism in the PER2 gene locus may influence lipid metabolism by interacting with the plasma total SEA concentration in participants with MetS. The understanding of these gene-nutrient interactions could help to provide a better knowledge of the pathogenesis in MetS. 

  • 11.
    Järvi, Anette
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Vessby, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Becker, Wulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism. Natl Food Agcy, Risk Benefit Assessment Dept, POB 622, Uppsala, Sweden..
    Increased intake of fruits and vegetables in overweight subjects: effects on body weight, body composition, metabolic risk factors and dietary intake2016In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 115, no 10, p. 1760-1768Article in journal (Refereed)
    Abstract [en]

    A diet rich in fruits and vegetables has been associated with several health benefits. However, the effects on body weight (BW) and metabolic markers are not fully known. The present study investigated the effects of increased intake of fruits and vegetables in overweight and obese men and women on dietary habits, anthropometry and metabolic control. In a 16-week controlled intervention, thirty-four men and thirty-four women aged 35-65 years (BMI>27 kg/m(2)) were randomised to an intervention (IN) or a reference (RG) group. All participants received general dietary advice, and subjects in the IN group received fruits and vegetables for free, of which >= 500 g had to be eaten daily. BW, waist circumference (WC), sagittal abdominal diameter (SAD), plasma insulin, blood glucose, glycated Hb (HbA1c), serum lipids, blood pressure, plasminogen activator inhibitor-1 activity, urinary isoprostane (iso-8-PGF 2 alpha) and serum carotenoids were measured. Diet was assessed using 3-d weighed food records. In all, thirty subjects in the IN group and thirty-two in the RG group completed the intervention. Intake of fruits and vegetables doubled in the IN group, whereas intake of fruits increased in the RG group. Serum a-and beta-carotene concentrations and intakes of folate and vitamin C increased significantly in the IN group. Energy intake, BW, WC and SAD decreased significantly in both groups. Supine systolic blood pressure decreased significantly in the IN group, with no between-group differences. No significant changes were observed for other metabolic markers. Provision of fruits and vegetables led to substantially increased intakes, with subsequent favourable changes in anthropometry and insulin levels, which tended to be more pronounced in the IN group. The observed improvements may, in combination with improved nutritional markers, have health benefits in the long term.

  • 12.
    Karlsson, Mikael
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Olsson, Erika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Becker, Wulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Sjögren, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Ability to predict resting energy expenditure with six equations compared to indirect calorimetry in octogenarian men2017In: Experimental Gerontology, ISSN 0531-5565, E-ISSN 1873-6815, Vol. 92, p. 52-55Article in journal (Refereed)
    Abstract [en]

    The accuracy of predictive equations for calculating resting energy expenditure (REE) in elderly people has been questioned. Aging is associated with progressive declines in REE, which partly is explained by loss of fat free mass (FFM). Against this background we aimed to identify the most accurate predictive equation for REE in octogenarian men, taking body composition into account and using indirect calorimetry as reference value. REE was measured in 22 men (mean age 82.6 +/- 0.3 years) and compared with six predictive equations: two based on FFM and four based on body weight, height and/or age. FFM was derived from Dual-energy X-ray absorptiometry analyses. Spearman's rank correlations showed a moderate to high positive monotonic correlation (r = 0.62 to 0.79) between measured and calculated REE (all p < 0.005).The mean calculated REE was significantly different from measured REE for all equations except Mifflin-St Jeor. A calculated REE within 10% of measured REE was considered acceptable and the equations of Mifflin-St Jeor, WHO and Harris-Benedict captured 64%, 50% and 45% of the participant, respectively. The Mifflin-St Jeor equation had the lowest root mean square error (138 kcal), followed by the equation by Harris-Benedict (189 kcal) and WHO (220 kcal). The equations from Luhrmann, Henry and Cunningham predicted REE rather poorly in our study subjects, with e.g. <40% of the individuals within 10% of measured REE. Our results indicate that the Mifflin-St Jeor equation (using FFM) is the most accurate equation estimating REE in these octogenarian men. Harris-Benedict or WHO equations are potential alternatives if information on FFM is unavailable, although their accuracy on an individual level is limited.

  • 13. Koochek, Afsaneh
    et al.
    Mirmiran, Parvin
    Azizi, Tohid
    Padyab, Mojgan
    Johansson, Sven-Erik
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Azizi, Fereidoun
    Sundquist, Jan
    Is migration to Sweden associated with increased prevalence of risk factors for cardiovascular disease?2008In: European Journal of Cardiovascular Prevention & Rehabilitation, ISSN 1741-8267, E-ISSN 1741-8275, Vol. 15, no 1, p. 78-82Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: [corrected] The proportion of elderly immigrants in Sweden is increasing. This is an important issue considering that the prevalence of cardiovascular disease (CVD) is a global health problem and that CVD is one of the main causes of morbidity among the elderly. The aim of this study is to analyze whether there is an association between migration status, that is being an elderly Iranian immigrant in Sweden, as compared with being an elderly Iranian in Iran, and the prevalence of risk factors for CVD. DESIGN: Population-based cross-sectional study with face-to-face interviews. PARTICIPANTS AND SETTING: A total of 176 Iranians in Stockholm and 300 Iranians in Tehran, aged 60-84 years. METHODS: The prevalence of general obesity, abdominal obesity, hypertension, smoking, and diabetes was determined. Unconditional logistic regression analysis was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) for outcomes. RESULTS: The age-adjusted risk of hypertension and smoking was higher in Iranian women and men in Sweden. OR for hypertension was 1.9 (95% CI: 1.1-3.2) for women and 3.1 (95% CI: 1.5-6.3) for men and OR for smoking was 6.9 (95% CI: 2.2-21.6) for women and 4.7 (95% CI: 2.0-11.0) for men. The higher risk for hypertension and smoking remained significant after accounting for age, socioeconomic status, and marital status. Abdominal obesity was found in nearly 80% of the women in both groups. CONCLUSION: The findings show a strong association between migration status and the prevalence of hypertension and smoking. Major recommendation for public health is increased awareness of CVD risk factors among elderly immigrants.

  • 14.
    Koochek, Afsaneh
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Mirmiran, Parvin
    Sundquist, Kristina
    Hosseini, Firoozeh
    Azizi, Tohid
    Moeini, Ali S.
    Johansson, Sven-Erik
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Azizi, Fereidoun
    Sundquist, Jan
    Dietary differences between elderly Iranians living in Sweden and Iran a cross-sectional comparative study2011In: BMC Public Health, E-ISSN 1471-2458, Vol. 11, p. 411-Article in journal (Refereed)
    Abstract [en]

    Background: During the last decades, global migration has increased and many immigrant groups have a higher prevalence than the native born population of several cardiovascular disease risk factors, including poor dietary habits. However, it is uncertain if dietary habits in immigrant populations reflect dietary habits in their country of origin or if the current diet is a consequence of the migration and possible change of dietary habits. The aim of this study was to examine possible dietary differences between elderly Iranians living in Stockholm, Sweden with elderly Iranians living in Tehran, Iran, taking into account sex, age, marital status, and education. Methods: Dietary intakes were assessed by semi - quantitative food frequency questionnaire in a cross-sectional study of 121 Iranians living in Stockholm and 52 Iranians living in Tehran, aged 60-80. Differences in dietary habits between the two groups was analysed by bootstrapped regression analyses with 1000 replications. Results: Iranians living in Sweden had significantly higher intake of protein, total fat, fiber than Iranians living in Iran, but lower consumption of carbohydrates. The observed differences in intake of macronutrients were reflected in consumed amount of all food items, which were higher among Iranians living in Iran with the exception of bread and grain consumption which was lower. Conclusions: There are general differences in dietary habits between Iranians living in Iran and Iranians living in Sweden. Parts of observed differences in dietary habits may reflect a favourable adoption process to the Swedish dietary habits after migration. Meanwhile other differences are point of concern in light of the high prevalence of overweight, among Iranians living in Sweden and can have unfavourable impact in particular in the context of cardiovascular health.

  • 15.
    Lundkvist, Pernilla
    et al.
    Uppsala University, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Domestic Sciences.
    Olsson, Erika
    Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Olofsson, Henrik
    Andersson, Agneta
    Uppsala University, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Domestic Sciences. Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Karlström, Brita
    Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences. Uppsala University, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Domestic Sciences.
    Användning av sjudagars menybok hos 82-åriga män i ULSAM-kohorten2004In: Svenska Läkarsällskapets Rikstämma 24-26 nov. 2006, 2004Conference paper (Other (popular scientific, debate etc.))
  • 16.
    Lövestam, Elin
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Orrevall, Ylva
    Karlolinska Institutet, Stockholm.
    Koocheck, Afsaneh
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Andersson, Agneta
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    An NCP-based audit instrument for dietitians´documentation in medical records2012Conference paper (Other academic)
  • 17.
    Lövestam, Elin
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Orrevall, Ylva
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Koochek, Afsaneh
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Andersson, Agneta
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Evaluating Documentation of Dietetic Care in Swedish Medical Records2013In: MEDINFO 2013: Proceedings of the 14Th World Congress On Medical and Health Informatics, Pts 1 And 2 / [ed] Lehmann, CU; Ammenwerth, E and Nohr, C, 2013, p. 1078-1078Conference paper (Refereed)
    Abstract [en]

    An adequate documentation in medical records is essential for patient safety and high quality care. The aim of this study was to evaluate documentation by dietitians in Swedish medical records. A retrospective audit of 147 dietetic notes in electronic medical records was performed. The audit focused at documentation of essential parts of the dietetic care, as well as other quality aspects such as lingual clarity and structure of the documentation. The nutrition intervention showed to be the most documented part of dietetic care. However, the audit showed that several important parts of nutrition care were poorly documented, for instance nearly half of the audited records had no clear nutrition problem documented, and in most of the records, the goal of nutrition intervention was missing. The study shows that Swedish dietitians need to improve documentation in medical records, as a suggestion by implementing a more structured documentation model.

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  • 18.
    Lövestam, Elin
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Orrevall, Ylva
    Karolinska Insitutet, Stockholm.
    Koochek, Afsaneh
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Andersson, Agneta
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Evaluation of a Nutrition Care Process-based audit instrument, the Diet-NCP-Audit, for documentation of dietetic care in medical records2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 2, p. 390-397Article in journal (Refereed)
    Abstract [en]

    Adequate documentation in medical records is important for high-quality health care. Documentation quality is widely studied within nursing, but studies are lacking within dietetic care. The aim of this study was to translate, elaborate and evaluate an audit instrument, based on the four-step Nutrition Care Process model, for documentation of dietetic care in medical records. The audit instrument includes 14 items focused on essential parts of dietetic care and the documentation's clarity and structure. Each item is to be rated 0-1 or 0-2 points, with a maximum total instrument score of 26. A detailed manual was added to facilitate the interpretation and increase the reliability of the instrument. The instrument is based on a similar tool initiated 9 years ago in the United States, which in this study was translated to Swedish and further elaborated. The translated and further elaborated instrument was named Diet-NCP-Audit. Firstly, the content validity of the Diet-NCP-Audit instrument was tested by five experienced dietitians. They rated the relevance and clarity of the included items. After a first rating, minor improvements were made. After the second rating, the Content Validity Indexes were 1.0, and the Clarity Index was 0.98. Secondly, to test the reliability, four dietitians reviewed 20 systematically collected dietetic notes independently using the audit instrument. Before the review, a calibration process was performed. A comparison of the reviews was performed, which resulted in a moderate inter-rater agreement with Krippendorff's α = 0.65-0.67. Grouping the audit results in three levels: lower, medium or higher range, a Krippendorff's α of 0.74 was considered high reliability. Also, an intra-rater reliability test-retest with a 9 weeks interval, performed by one dietitian, showed strong agreement. To conclude, the evaluated audit instrument had high content validity and moderate to high reliability and can be used in auditing documentation of dietetic care.

  • 19.
    Lövestam, Elin
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Orrevall, Ylva
    Karolinska Institutet, Institutionen för lärande, informatik, management och etik.
    Koochek, Afsaneh
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Andersson, Agneta
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Evaluation of Nutrition Care Process documentation in electronic patient records: Need of improvement2015In: Nutrition & Dietetics, ISSN 1446-6368, E-ISSN 1747-0080, Vol. 72, no 1, p. 74-80Article in journal (Refereed)
    Abstract [en]

    Aim

    High-quality documentation in patient records is essential for patient safety and plays a prominent role in the delivery and evaluation of dietetic/nutrition care. We aimed to evaluate dietitians' documentation in patient records according to the four steps in the Nutrition Care Process: assessment, diagnosis, intervention and monitoring/evaluation.

    Methods

    A retrospective audit of 147 systematically collected outpatient dietetic notes from primary care centres and hospitals in central Sweden was performed using a validated audit instrument. The instrument was used to assess the documentation of 14 items: 10 items focusing on the Nutrition Care Process steps and four items on language clarity and structure, with a maximum total score of 26 for each dietetic note. The notes were divided into three different quality levels, A (high score), B (medium score) or C (low score). Comparisons were made between notes from primary care and hospitals.

    Results

    The audit showed that the majority of the notes were placed at level B, scoring 13.5–19.5. Only 3% of the notes scored higher than 19.5. The most frequently documented items were intervention (90%), evaluation (70%) and nutrition problem (56%), whereas the least documented items were nutrition prescription (15%), goal of intervention (9%) and connection of problem-etiology-symptom (5%). Flaws in lingual clarity were common (72%). Primary care notes received higher scores than those from hospitals.

    Conclusions

    The audit shows that Swedish dietetic documentation needs to be improved, for example, by further training and education in the Nutrition Care Process and its standardised terminology.

  • 20. Malmgren A, Anna
    et al.
    Hede, G W
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Lundquist, P
    Wirén, Mikael
    Faxén Irving, Gerd
    Indications for percultaneous endoscopic gastrostomy and survival in old adults2011In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 55, p. 6037-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Many diseases striking old adults result in eating difficulties. Indications for selecting individuals for percutaneous endoscopic gastrostomy (PEG) are unclear and everybody may not benefit from the procedure.

    OBJECTIVE:

    The aim of this study was to evaluate indications for and survival after PEG insertion in patients older than 65 years.

    DESIGN AND METHODS:

    A retrospective analysis including age, gender, diagnosis, indication, and date of death was made in 201 consecutive individuals, 94 male, mean age 79±7 years, who received a nutritional gastrostomy.

    RESULTS:

    Dysphagia was present in 86% of the patients and stroke was the most common diagnosis (49%). Overall median survival was 123 days and 30-day mortality was 22%. Patients with dementia and Mb Parkinson had the longest survival (i.e. 244 and 233 days), while those with other neurological diseases, and head and neck malignancy had the shortest (i.e. 75 and 106 days). There was no difference in mortality in patients older or younger than 80 years, except in patients with dementia.

    CONCLUSIONS:

    Old age should not be a contraindication for PEG. A high 30-day mortality indicates that there is a need of better criteria for selection and timing of PEG insertion in the elderly.

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  • 21. Mann, J I
    et al.
    De Leeuw, I
    Hermansen, K
    Karamanos, B
    Karlstrom, B
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Katsilambros, N
    Riccardi, G
    Rivellese, A A
    Rizkalla, S
    Slama, G
    Toeller, M
    Uusitupa, M
    Vessby, B
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Evidence-based nutritional approaches to the treatment and prevention of diabetes mellitus.2004In: Nutr Metab Cardiovasc Dis, ISSN 0939-4753, Vol. 14, no 6, p. 373-94Article in journal (Refereed)
  • 22. Melin, I
    et al.
    Reynisdottir, S
    Berglund, L
    Zamfir, M
    Karlström, B
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences. Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Domestic Sciences.
    Conservative treatment of obesity in an academic obesity unit. Long-term outcome and drop-out.2006In: Eat Weight Disord, ISSN 1590-1262, Vol. 11, no 1, p. 22-30Article in journal (Refereed)
  • 23.
    Melin, Ingela
    et al.
    Överviktsenheten, Karolinska institutet.
    Karlström, Brita
    Uppsala University, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Domestic Sciences. Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Berglund, L
    Zamfir, M
    Rössner, Stephan
    Överviktsenheten, Karolinska institutet.
    Education and supervision of health care professionals to initiate, implement and improve management of obesity.2005In: Patient Educ and Couns, Vol. 58 (2), no Aug, p. 127-136Article in journal (Refereed)
  • 24.
    Nordhamn, Karin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Södergren, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Olsson, Erika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Vessby, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Berglund, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Reliability of anthropometric measurements in overweight and lean subjects:: consequences for corelations between anthropometric and other variable2000In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 24, no 5, p. 652-657Article in journal (Other academic)
    Abstract [en]

    OBJECTIVE

    To estimate the reliability of anthropometric measurements in overweight and lean subjects, and to examine the influence of this reliability on correlations to other variables, since low reliability leads to underestimation of correlations.

    DESIGN

    Replicate measurements by two observers in 26 overweight and 25 lean subjects measured at two occasions.

    MEASUREMENTS

    Sagittal abdominal diameter (SAD), waist circumference (waist), waist-to-hip ratio (W/H) and skinfold measurements.

    RESULTS

    Intra-class correlation coefficients (ICCs) for SAD and waist were higher than for W/H (0.98 vs 0.90, P<0.001, and 0.97 vs 0.90, P=0.001, respectively). For waist, the ICC was lower for overweight than for lean subjects (0.85 vs 0.95, P=0.030), but the ICC values were comparable for SAD and W/H (0.92 vs 0.95 and 0.78 vs 0.83, respectively). Intra-observer variations (IOV) for SAD and waist were lower than for W/H (coefficients of variation; 1.6%, 1.4% and 2.3%, respectively), as were intra-subject variations (ISV) (2.7%, 3.0% and 3.4%, respectively). ICC values ranged from 0.84 to 0.93 and were lower for overweight than for lean subjects for biceps, subscapular and umbilical skinfolds (P=0.031, P<0.001 and P=0.048, respectively). Coefficients of variations for skinfold measurements ranged between 7.3% and 16.0% for IOV and between 14.9% and 20.8% for ISV.

    CONCLUSIONS

    The low ICC values imply that correlations can be underestimated in overweight groups. We propose that, because of their higher reliability, SAD and waist have a higher predictive capacity for cardiovascular risk than W/H. SAD is the only measurement with high reliability in both weight groups and its use is recommended.

  • 25.
    Olsson, Erika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Byberg, Liisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Melhus, Håkan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical pharmacogenomics and osteoporosis.
    Sjögren, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Kilander, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Vitamin D is not associated with incident dementia or cognitive impairment: an 18-y follow-up study in community-living old men2017In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 105, no 4, p. 936-943Article in journal (Refereed)
    Abstract [en]

    Background: Vitamin D has been implicated as being important for maintaining cognitive function in old age. Results from longitudinal studies examining the association of vitamin D with incident dementia and cognitive impairment have been inconsistent. Objective: We investigated the relation between vitamin D, assessed in 3 different ways, and the risk of dementia. Design: We measured plasma 25-hydroxyvitamin D [25(OH) D] with the use of high-performance liquid chromatography-mass spectrometry, assessed dietary vitamin D intake with the use of 7-d dietary records, and created a vitamin D-synthesis genetic risk score (GRS) at baseline (1991-1995) in a cohort of 1182 Swedish men (mean age: 71 y). In a maximum of 18 y (median: 12 y) of follow-up, 116 men developed Alzheimer disease, 64 men developed vascular dementia, and 250 men developed all-cause dementia. An additional 80 men declined in cognitive function as assessed with the use of the Mini-Mental State Examination. Adjusted HRs and ORs were calculated with the use of Cox and logistic regressions. Results: The mean +/- SD plasma 25(OH) D concentration was 68.7 +/- 19.1 nmol/L. Plasma 25(OH) D, dietary vitamin D intake, and vitamin D-synthesis GRS were not associated with any cognitive outcomes (crude and adjusted HRs and ORs were similar to 1.0 for all continuous exposures). The adjusted HR for all-cause dementia was 0.88 (95% CI: 0.59, 1.31) in men with plasma 25(OH) D concentrations <= 50 compared with >75 nmol/L. The adjusted HR for all-cause dementia was 0.92 (95% CI: 0.63, 1.32) for the lowest compared with highest tertiles of vitamin D intake. The adjusted HR for the continuous GRS for all-cause dementia was 1.04 (95% CI: 0.91, 1.19). Conclusion: In this cohort study, we show that there is no association between baseline vitamin D status and long-term risk of dementia or cognitive impairment over an 18-y period of time.

  • 26.
    Olsson, Erika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Body composition, dietary intake and estimated energy expenditure in female patients on geriatric rehabilitation wards2003In: Scandinavian Journal of Nutrition/Næringsforskning, ISSN 1102-6480, E-ISSN 1651-2359, Vol. 47, no 4, p. 179-187Article in journal (Refereed)
    Abstract [en]

    Background

    An adequate nutritional status is a prerequisite for successful rehabilitation.Objective: To examine body composition, to investigate nutritional intake, to calculate energy expenditure inelderly females at a geriatric rehabilitation clinic, to classify whether they were considered as undernourishedor at risk of becoming undernourished, and to investigate the subjects’ opinions on diet-related issues.

    Design

    20 patients aged 829/6 (mean9/SD) years participated. Percentage body fat was calculated fromskinfold thickness measurements, bioelectrical impedance analysis (BIA) and a combination of the two in amulticompartment model. Dietary intake was assessed through a 7 day food record. Energy expenditure wascalculated with three established formulae and physical activity level (PAL) factors of 1.2 and 1.4. Questionswere asked on diet-related issues.

    Results

    Average BMI was 23.79/4.5 kg m2 and four subjects had BMIB/20. Relative body fat mass asassessed by skinfold was 29.89/6.9%, by BIA 38.99/7.7% and by a multicompartment model 35.59/7.1%.Mean energy intake was 13409/170 kcal (5.69/0.7 MJ), around 79% of the recommended daily intake. In 18of 19 subjects the observed dietary energy intake was lower than estimated energy expenditure when using twoof the formulae and a PAL factor of 1.4. All subjects considered that they received a sufficient amount offood.

    Conclusions

    Only one of the subjects had a satisfactory energy intake relative to calculated energyexpenditure, although all believed that they received sufficient food. Four subjects were considered asundernourished (BMIB/20) and all others as at risk of undernutrition.

  • 27.
    Olsson, Erika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Kilander, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Sjögren, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Kostmönster och risk för utveckling av demenssjukdom: en 12 års uppföljning av 70 åriga män2011In: Svenska läkaresällskapets riksstämma, 2011Conference paper (Other academic)
    Abstract [sv]

    Samband mellan kost och demenssjukdom är inte tydligt fastställda. Studiens syfte var att prospektivt undersöka hur tre olika kostmönster relaterar till utvecklingen av demenssjukdom, inkl. Alzheimers sjukdom (AD), eller alla typer av kognitiv störning hos äldre friska män.

  • 28.
    Olsson, Erika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Kilander, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Byberg, Liisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Sjögren, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Dietary Patterns and Cognitive Dysfunction in a 12-Year Follow-up Study of 70 Year Old Men2015In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 43, no 1, p. 109-119Article in journal (Refereed)
    Abstract [en]

    Background:

    Adherence to dietary patterns has been associated with cognitive decline and dementia, but studies are inconsistent.

    Objective:

    Dietary patterns, i.e., WHO recommendations (Healthy Diet Indicator), a Mediterranean-like diet (modified Mediterranean Diet Score, mMDS), and a low carbohydrate high protein diet (LCHP), were related to incident cognitive dysfunction, as indicated by Alzheimer's disease (AD), all-type dementia, and all-type cognitive impairment, in a cohort of 1,138 elderly Swedish men.

    Methods:

    Dietary patterns were derived from 7-day records. Risk relations were calculated by Cox and logistic regression analyses, adjusted for potential confounders. Sensitivity analysis was performed in a subpopulation (n = 564) with energy intake according to the Goldberg cut-off.

    Results:

    During a mean follow-up of 12 years, 84, 143, and 198 men developed AD, all-type dementia, and all-type cognitive impairment, respectively. There was no association between Healthy Diet Indicator and any of the outcomes. Hazard ratios associated with 1 standard deviation (SD) increment in the LCHP score were 1.16 (95% confidence interval [CI]: 0.95, 1.43) for AD and 1.16 (95% CI: 0.99, 1.37) for all-type dementia. mMDS was not associated with dementia diagnosis. Odds ratio (OR)/1 SD increase for mMDS and all-type cognitive impairment was 0.82 (95% CI: 0.65, 1.05). In the subpopulation OR for mMDS and all-type cognitive impairment was 0.32 (95% CI: 0.11, 0.89).

    Conclusion:

    We found no strong associations with development of cognitive dysfunction for any of the dietary patterns investigated. However, there was a potentially beneficial association for a Mediterranean-like diet on the development of cognitive dysfunction in the subpopulation.

  • 29.
    Olsson, Erika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Kilander, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Byberg, Liisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Sjögren, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Dietary Patterns And Cognitive Dysfunction In A Prospective Study Of 70-Year-Old Swedish Men2013In: Annals of Nutrition and Metabolism, ISSN 0250-6807, E-ISSN 1421-9697, Vol. 63, no Suppl. 1, p. 862-862Article in journal (Other academic)
  • 30. Perez-Martinez, Pablo
    et al.
    Delgado-Lista, Javier
    Garcia-Rios, Antonio
    Tierney, Audrey C.
    Gulseth, Hanne L.
    Williams, Christine M.
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Kiec-Wilk, Beata
    Blaak, Ellen E.
    Helal, Olfa
    Saris, Wim H. M.
    Defoort, Catherine
    Drevon, Christian A.
    Lovegrove, Julie A.
    Dembinska-Kiec, Aldona
    Riserus, Ulf
    Roche, Helen M.
    Lopez-Miranda, Jose
    Insulin receptor substrate-2 gene variants in subjects with metabolic syndrome: Association with plasma monounsaturated and n-3 polyunsaturated fatty acid levels and insulin resistance2012In: Molecular Nutrition & Food Research, ISSN 1613-4125, E-ISSN 1613-4133, Vol. 56, no 2, p. 309-315Article in journal (Refereed)
    Abstract [en]

    Scope: Several insulin receptor substrate-2 (IRS-2) polymorphisms have been studied in relation to insulin resistance and type 2 diabetes. To examine whether the genetic variability at the IRS-2 gene locus was associated with the degree of insulin resistance and plasma fatty acid levels in metabolic syndrome (MetS) subjects.

    Methods and results: Insulin sensitivity, insulin secretion, glucose effectiveness, plasma fatty acid composition and three IRS-2 tag-single nucleotide polymorphisms (SNPs) were determined in 452 MetS subjects. Among subjects with the lowest level of monounsaturated (MUFA) (below the median), the rs2289046 A/A genotype was associated with lower glucose effectiveness (p < 0.038), higher fasting insulin concentrations (p < 0.028) and higher HOMA IR (p < 0.038) as compared to subjects carrying the minor G-allele (A/G and G/G). In contrast, among subjects with the highest level of MUFA (above the median), the A/A genotype was associated with lower fasting insulin concentrations and HOMA-IR, whereas individuals carrying the G allele and with the highest level of omega-3 polyunsaturated fatty acids (above the median) showed lower fasting insulin (p < 0.01) and HOMA-IR (p < 0.02) as compared with A/A subjects.

    Conclusion: The rs2289046 polymorphism at the IRS2 gene locus may influence insulin sensitivity by interacting with certain plasma fatty acids in MetS subjects.

  • 31. Perez-Martinez, Pablo
    et al.
    Garcia-Rios, Antonio
    Delgado-Lista, Javier
    Gjelstad, Ingrid M. F.
    Gibney, James
    Kiec-Wilk, Beata
    Camargo, Antonio
    Helal, Olfa
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Blaak, Ellen E.
    Hall, Wendy
    Risérus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Dembinska-Kiec, Aldona
    Defoort, Catherine
    Saris, Wim H. M.
    Lovegrove, Julie A.
    Drevon, Christian A.
    Roche, Helen M.
    Lopez-Miranda, Jose
    Gene-nutrient interactions on the phosphoenolpyruvate carboxykinase influence insulin sensitivity in metabolic syndrome subjects2013In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 32, no 4, p. 630-635Article in journal (Refereed)
    Abstract [en]

    Background & aims: Genetic background may interact with habitual dietary fat composition, and affect development of the metabolic syndrome (MetS). The phosphoenolpyruvate carboxykinase gene (PCK1) plays a significant role regulating glucose metabolism, and fatty acids are key metabolic regulators, which interact with transcription factors and influence glucose metabolism. We explored genetic variability at the PCK1 gene locus in relation to degree of insulin resistance and plasma fatty acid levels in MetS subjects. Moreover, we analyzed the PCK1 gene expression in the adipose tissue of a subgroup of MetS subjects according to the PCK1 genetic variants. Methods: Insulin sensitivity, insulin secretion, glucose effectiveness, plasma concentrations of C-peptide, fatty acid composition and three PCK1 tag-single nucleotide polymorphisms (SNPs) were determined in 443 MetS participants in the UPGENE cohort. Results: The rs2179706 SNP interacted with plasma concentration of n - 3 polyunsaturated fatty acids (n - 3 PUFA), which were significantly associated with plasma concentrations of fasting insulin, peptide C, and HOMA-IR. Among subjects with n - 3 PUFA levels above the population median, carriers of the C/C genotype exhibited lower plasma concentrations of fasting insulin (P = 0.036) and HOMA-IR (P = 0.019) as compared with C/C carriers with n - 3 PUFA below the median. Moreover, homozygous C/C subjects with n - 3 PUFA levels above the median showed lower plasma concentrations of peptide C as compared to individuals with the T-allele (P = 0.006). Subjects carrying the T-allele showed a lower gene PCK1 expression as compared with carriers of the C/C genotype (P = 0.015). Conclusions: The PCK1 rs2179706 polymorphism interacts with plasma concentration of n - 3 PUFA levels modulating insulin resistance in MetS subjects. 

  • 32. Phillips, Catherine M.
    et al.
    Tierney, Audrey C.
    Perez-Martinez, Pablo
    Defoort, Catherine
    Blaak, Ellen E.
    Gjelstad, Ingrid M. F.
    Lopez-Miranda, Jose
    Kiec-Klimczak, Malgorzata
    Malczewska-Malec, Malgorzata
    Drevon, Christian A.
    Hall, Wendy
    Lovegrove, Julie A.
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Risérus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Roche, Helen M.
    Obesity and Body Fat Classification in the Metabolic Syndrome: Impact on Cardiometabolic Risk Metabotype2013In: Obesity, ISSN 1930-7381, E-ISSN 1930-739X, Vol. 21, no 1, p. E154-E161Article in journal (Refereed)
    Abstract [en]

    Objective: Obesity is a key factor in the development of the metabolic syndrome (MetS), which is associated with increased cardiometabolic risk. We investigated whether obesity classification by BMI and body fat percentage (BF%) influences cardiometabolic profile and dietary responsiveness in 486 MetS subjects (LIPGENE dietary intervention study). Design and Methods: Anthropometric measures, markers of inflammation and glucose metabolism, lipid profiles, adhesion molecules, and hemostatic factors were determined at baseline and after 12 weeks of four dietary interventions (high saturated fat (SFA), high monounsaturated fat (MUFA), and two low fat high complex carbohydrate (LFHCC) diets, one supplemented with long chain n-3 polyunsaturated fatty acids (LC n-3 PUFAs)). Results: About 39 and 87% of subjects classified as normal and overweight by BMI were obese according to their BF%. Individuals classified as obese by BMI (>= 30 kg/m(2)) and BF% (>= 25% (men) and >= 35% (women)) (OO, n = 284) had larger waist and hip measurements, higher BMI and were heavier (P < 0.001) than those classified as nonobese by BMI but obese by BF% (NOO, n = 92). OO individuals displayed a more proinflammatory (higher C reactive protein (CRP) and leptin), prothrombotic (higher plasminogen activator inhibitor-1 (PAI-1)), proatherogenic (higher leptin/adiponectin ratio) and more insulin resistant (higher HOMA-IR) metabolic profile relative to the NOO group (P < 0.001). Interestingly, tumor necrosis factor-alpha (TNF-alpha) concentrations were lower post-intervention in NOO individuals compared with OO subjects (P < 0.001). Conclusions: In conclusion, assessing BF% and BMI as part of a metabotype may help to identify individuals at greater cardiometabolic risk than BMI alone.

  • 33.
    Sarabi, Mahziar
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Fugmann, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Karlström, Brita
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Berne, Christian
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Lithell, Hans
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    An ordinary mixed meal transiently impairs endothelium-dependent vasodilation in healthy subjects2001In: Acta Physiologica Scandinavica, ISSN 0001-6772, E-ISSN 1365-201X, Vol. 172, no 2, p. 107-113Article in journal (Refereed)
    Abstract [en]

    This study was designed to evaluate the effects of an ordinary mixed meal on endothelium-dependent vasodilation. Ten young healthy volunteers were given a mixed meal (minced meat sauce with rice, 900 kcal, 34% of the energy content was fat). In the fasting state, at 60 and 120 min after the start of the meal, endothelium-dependent vasodilation and endothelium-independent vasodilation were evaluated by local infusion of metacholine (4 microg min (-1)) and sodium nitroprusside (10 microg min (-1)) in the brachial artery. Blood flow in the forearm was measured using venous occlusion plethysmography. Endothelium-dependent vasodilation decreased from 15.4 +/- 3.3 (mean +/- SD) at fasting to 13.7 +/- 3.5 mL min (-1) (100 mL tissue)-1 (P < 0.01) 60 min after feeding, but had returned to the fasting level at 120 min. At 60 min, but not in the fasting state, the serum level of free fatty acids was inversely related to endothelium-dependent vasodilation (r=-0.74, P < 0.05), although no significant net changes in FFA levels were seen. Endothelium-independent vasodilation was not affected by the mixed meal. No similar attenuations in endothelium-dependent vasodilation were seen during control meals. In conclusion, an ordinary mixed meal transiently attenuated endothelium-dependent vasodilation. Free fatty acids may be involved in this effect on endothelial function.

  • 34.
    Steer, Peter
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Sarabi, Dennis M.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Karlström, Brita
    Basu, Samar
    Berne, Christian
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Vessby, Bengt
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    The effect of a mixed meal on endothelium-dependent vasodilation is dependent on fat content in healthy humans2003In: Clinical Science, ISSN 0143-5221, E-ISSN 1470-8736, Vol. 105, no 1, p. 81-87Article in journal (Refereed)
    Abstract [en]

    Impaired endothelium-dependent vasodilation (EDV) is an early marker of atherosclerosis. The aim of the present study was to investigate how meals with different fat contents influence endothelial vasodilatory function. A total of 26 young, healthy men and women aged 20-30 years ingested an ordinary Western meal [34 energy% (E%) fat, n =10], or isocaloric meals with low-fat (20 E%, n =8), or minimal-fat (3 E%, n =8) content. EDV was assessed as forearm blood flow (FBF) during local administration of 4 microg/min methacholine chloride (Mch-FBF) and endothelium-independent vasodilation as FBF during administration of 10 microg/min sodium nitroprusside (SNP-FBF) at baseline and 1 and 2 h after each meal. FBF was determined by venous occlusion plethysmography. An endothelial function index (EFI) was calculated as the Mch-FBF/SNP-FBF ratio. Both Mch-FBF and the EFI were decreased at 1 h after the 34 E% fat meal ( P <0.01 and P <0.05 respectively), but approached fasting levels after 2 h. Mch-FBF and EFI did not change significantly in the group consuming the 20 E% fat meal, but increased in the 3 E% fat group ( P <0.01 and P <0.05 compared with baseline for Mch-FBF and EFI respectively). SNP-FBF was not significantly affected by any of the meals. In conclusion, low-fat meals did not attenuate EDV, in contrast with an ordinary Western meal, which transiently impaired EDV. Our findings indicate that a dietary fat content of 20 E% or less might be beneficial to endothelial vasodilatory function.

  • 35. Tierney, A C
    et al.
    McMonagle, J
    Shaw, D I
    Gulseth, H L
    Helal, O
    Saris, W H M
    Paniagua, J A
    Gołąbek-Leszczyñska, I
    Defoort, C
    Williams, C M
    Karsltröm, Brita
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Vessby, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Dembinska-Kiec, A
    López-Miranda, J
    Blaak, E E
    Drevon, C A
    Gibney, M J
    Lovegrove, J A
    Roche, H M
    Effects of dietary fat modification on insulin sensitivity and on other risk factors of the metabolic syndrome-LIPGENE: a European randomized dietary intervention study2011In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 35, no 6, p. 800-809Article in journal (Refereed)
    Abstract [en]

    Background:Excessive energy intake and obesity lead to the metabolic syndrome (MetS). Dietary saturated fatty acids (SFAs) may be particularly detrimental on insulin sensitivity (SI) and on other components of the MetS.Objective:This study determined the relative efficacy of reducing dietary SFA, by isoenergetic alteration of the quality and quantity of dietary fat, on risk factors associated with MetS.Design:A free-living, single-blinded dietary intervention study.Subjects and Methods:MetS subjects (n=417) from eight European countries completed the randomized dietary intervention study with four isoenergetic diets distinct in fat quantity and quality: high-SFA; high-monounsaturated fatty acids and two low-fat, high-complex carbohydrate (LFHCC) diets, supplemented with long chain n-3 polyunsaturated fatty acids (LC n-3 PUFAs) (1.2 g per day) or placebo for 12 weeks. SI estimated from an intravenous glucose tolerance test (IVGTT) was the primary outcome measure. Lipid and inflammatory markers associated with MetS were also determined.Results:In weight-stable subjects, reducing dietary SFA intake had no effect on SI, total and low-density lipoprotein cholesterol concentration, inflammation or blood pressure in the entire cohort. The LFHCC n-3 PUFA diet reduced plasma triacylglycerol (TAG) and non-esterified fatty acid concentrations (P<0.01), particularly in men.Conclusion:There was no effect of reducing SFA on SI in weight-stable obese MetS subjects. LC n-3 PUFA supplementation, in association with a low-fat diet, improved TAG-related MetS risk profiles.

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