uu.seUppsala University Publications
Change search
Refine search result
12345 101 - 150 of 219
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 101. Hjorth, Erik
    et al.
    Zhu, Mingqin
    Toro, Veronica Cortes
    Vedin, Inger
    Palmblad, Jan
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Freund-Levi, Yvonne
    Faxen-Irving, Gerd
    Wahlund, Lars-Olof
    Basun, Hans
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Eriksdotter, Maria
    Schultzberg, Marianne
    Omega-3 Fatty Acids Enhance Phagocytosis of Alzheimer's Disease-Related Amyloid-beta(42) by Human Microglia and Decrease Inflammatory Markers2013In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 35, no 4, p. 697-713Article in journal (Refereed)
    Abstract [en]

    The use of supplements withomega-3 (omega 3) fatty acids (FAs) such as docosahexaenoic acid(DHA) and eicosapentaenoic acid (EPA) is widespread due to proposed beneficial effects on the nervous and cardiovascular systems. Many effects of omega 3 FAs are believed to be caused by down-regulation and resolution of inflammation. Alzheimer's disease (AD) is associated with inflammation mediated by microglia and astrocytes, and omega 3 FAs have been proposed as potential treatments for AD. The focus of the present study is on the effects of DHA and EPA on microglial phagocytosis of the AD pathogen amyloid-beta(A beta), on secreted and cellular markers of immune activity, and on production of brain-derived neurotrophic factor (BDNF). Human CHME3 microglial cells were exposed to DHA or EPA, with or without the presence of A beta(42). Phagocytosis of A beta(42) was analyzed by flow cytometry in conjunction with immunocytochemistry using antibodies to cellular proteins. Secreted proteins were analyzed by ELISA. Both DHA and EPA were found to stimulate microglial phagocytosis of A beta(42). Phagocytosis of A beta(42) was performed by microglia with a predominance of M2 markers. EPA increased the levels of BDNF in the culture medium. The levels of TNF-alpha were decreased by DHA. Both DHA and EPA decreased the pro-inflammatory M1 markers CD40 and CD86, and DHA had a stimulatory effect on the anti-inflammatory M2 marker CD206. DHA and EPA can be beneficial in AD by enhancing removal of A beta(42), increasing neurotrophin production, decreasing pro-inflammatory cytokine production, and by inducing a shift in phenotype away from pro-inflammatory M1 activation.

  • 102. Holmbäck, Ulf
    et al.
    Berglund, Marie
    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.
    Sundbom, Magnus
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Upper Abdominal Surgery.
    Body composition, energy metabolism and endocrine variables in weight stable gastric-bypass patients2013In: The FASEB Journal, ISSN 0892-6638, E-ISSN 1530-6860, Vol. 27, no S1, p. lb309-Article in journal (Other academic)
  • 103. Holst, Mette
    et al.
    Yifter-Lindgren, Elinor
    Surowiak, Mirek
    Nielsen, Kari
    Mowe, Morten
    Carlsson, Maine
    Jacobsen, Bent
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Fenger-Groen, Morten
    Rasmussen, Henrik
    Nutritional screening and risk factors in elderly hospitalized patients: association to clinical outcome?2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 4, p. 953-961Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to test the intervalidity of three different nutrition screening tools towards a broad population of elderly hospitalized patients. The association with risk factors and mortality was investigated. This is a prospective cohort study in three medical, surgical and geriatric settings, in Denmark and Sweden. Patients >65years were consecutively included. Patients were screened by mini-nutritional assessment (MNA), malnutrition universal screening tool (MUST) and nutritional risk screening (NRS-2002). Anthropometrics, cognitive test (SPMSQ), as well as a questionnaire investigation regarding eating problems and life situation, were performed. Mortality within 12months was investigated. In total, 233 patients mean (SD) age 81(7.64) years were included. A large variation in prevalence of nutritional risk was determined between the screening tools, MNA was 68% vs. MUST, 47% and NRS 54%, p<0.0001. An overall agreement of 67% was seen ( 0.52-0.55). Risk factors were associated with nutritional risk, including depressive mood. Only handgrip strength, fungus in mouth, serum albumin, CRP and cognitive function were associated with mortality. Fungus had the strongest association (OR 3.7; CI 1.19-11.30). The overall mortality rate was 27% during 12months. However, none of the three screening tools predicted 12-month mortality. The findings show great variation in the prevalence of nutritional risk of under nutrition both between the tools and the settings. The level of agreement between the tools was moderate, and none of the three tools were capable of predicting 12-month mortality. A functional and psychological evaluation including oral health seems recommendable in elderly patients at nutritional risk.

  • 104. Huang, X.
    et al.
    Sjögren, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Ärnlöv, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Stenvinkel, P.
    Lindholm, B.
    Risérus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Carrero, J. J.
    Serum fatty acid patterns, insulin sensitivity and the metabolic syndrome in individuals with chronic kidney disease2014In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 275, no 1, p. 71-83Article in journal (Refereed)
    Abstract [en]

    Objectives

    The causes of the multiple metabolic disorders of individuals with chronic kidney disease (CKD) are not fully known. We investigated the relationships between dietary fat quality, the metabolic syndrome (MetS), insulin sensitivity and inflammation in individuals with CKD.

    Subjects

    Two population-based surveys were conducted in elderly Swedish individuals (aged 70 years) with serum cystatin C-estimated glomerular filtration rate <60 mL min−1/1.73 m2: the Uppsala Longitudinal Study of Adult Men (ULSAM) and the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) surveys. The present population comprised 274 men and 187 subjects (63% women) from the ULSAM and PIVUS cohorts, respectively.

    Design

    Factor analyses of serum fatty acids were used to evaluate dietary fat quality. Insulin sensitivity was measured by homeostasis model assessment of insulin resistance (IR) and, in ULSAM, also by euglycaemic clamp.

    Results

    Factor analyses generated two fatty acid patterns of (i) low linoleic acid (LA)/high saturated fatty acid (SFA) or (ii) high n-3 polyunsaturated fatty acid (n-3 PUFA) levels. In both surveys, the low LA/high SFA pattern increased the odds of having MetS [adjusted odds ratio 0.60 [95% confidence interval (CI) 0.44–0.81] and 0.45 (95% CI 0.30–0.67) per SD decrease in factor score in the ULSAM and PIVUS surveys, respectively] and was directly associated with both IR and C-reactive protein. The n-3 PUFA pattern was not consistently associated with these risk factors.

    Conclusions

    A serum fatty acid pattern reflecting low LA and high SFA was strongly associated with MetS, IR and inflammation in two independent surveys of elderly individuals with CKD. At present, there are no specific dietary guidelines for individuals with CKD; however, these findings indirectly support current recommendations to replace SFAs with PUFAs from vegetable oils.

  • 105. Huang, X.
    et al.
    Stenvinkel, P.
    Qureshi, A. R.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Barany, P.
    Heimburger, O.
    Lindholm, B.
    Riserus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Carrero, J. J.
    Clinical determinants and mortality predictability of stearoyl-CoA desaturase-1 activity indices in dialysis patients2013In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 273, no 3, p. 263-272Article in journal (Refereed)
    Abstract [en]

    Huang X, Stenvinkel P, Qureshi AR, Cederholm T, Barany P, Heimburger O, Lindholm B, Riserus U, Carrero JJ (Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm; and Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden). Clinical determinants andmortality predictability of stearoyl-CoA desaturase-1 activity indices in dialysis patients. J InternMed 2013; 273: 263-272. Background Stearoyl-CoA desaturase-1 (SCD-1) converts dietary saturated fatty acids to monounsaturated fatty acids. Elevated SCD-1 activity thus signifies impaired fatty acid metabolism and excess saturated fat intake. In the general population, increased SCD-1 activity is associated with cardiovascular disease and mortality. The determinants and implications of SCD-1 activity in dialysis patients are unknown. Subjects A total of 222 dialysis patients (39% women) with prospective follow-up, median age of 57years and an average of 12months of dialysis. Design Fatty acid compositions in plasma phospholipids and free fatty acids (FFAs) were assessed by gasliquid chromatography. SCD-1 activity indices were calculated as the product-to-precursor fatty acid ratio (palmitoleic acid/palmitic acid) in each fraction to reflect SCD-1 activities in the liver and adipose tissue. Results Median hepatic and adipose tissue SCD-1 activity indices were 0.016 and 0.150, respectively. In multivariate analyses, SCD-1 was positively associated with age, female sex and serum interleukin-6 level. During 18.4 (interquartile range 5.537.3) months of follow-up, there were 61 deaths and 115 kidney transplants. The cut-off level for high SCD-1 indices was determined by receiver operating characteristic curve analyses. In fully adjusted competing risk models, patients with high SCD-1 indices in both phospholipids and FFAs had more than twofold increased mortality risk before kidney transplantation [hazard ratio (HR) 2.29, 95% confidence interval (CI) 1.284.11 and HR 2.36, 95% CI 1.384.03, respectively], compared with patients with low SCD-1 indices. Conclusions Both hepatic and adipose tissue SCD-1 activity indices independently predict mortality in dialysis patients. Further studies are warranted to determine whether reducing SCD-1 activity by dietary intervention (limiting saturated fat) could improve survival in dialysis patients.

  • 106. Huang, Xiaoyan
    et al.
    Juan Jimenez-Moleon, Jose
    Lindholm, Bengt
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Ärnlöv, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Risérus, Ulf
    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.
    Carrero, Juan Jesus
    Mediterranean Diet, Kidney Function, and Mortality in Men with CKD2013In: American Society of Nephrology. Clinical Journal, ISSN 1555-9041, E-ISSN 1555-905X, Vol. 8, no 9, p. 1548-1555Article in journal (Refereed)
    Abstract [en]

    Background and objectivesAdherence to a Mediterranean diet may link to a better preserved kidney function in the community as well as a favorable cardiometabolic profile and reduced mortality risk in individuals with manifest CKD.Design, setting, participants, & measurementsDietary habits were determined by 7-day dietary records in a population-based cohort of 1110 Swedish men (age 70 years) from 1991 to 1995, 506 of whom were considered to have CKD because of a GFR<60 ml/min per 1.73 m(2). A Mediterranean Diet Score was calculated, and participants were categorized as having low, medium, or high adherence. Adequate dietary reporters were identified with Goldberg cutoffs (n=597). Deaths were registered during a median follow-up of 9.9 years.ResultsCompared with low adherents, medium and high adherents were 23% and 42% less likely to have CKD, respectively (adjusted odds ratio [95% confidence interval]=0.77 [0.57 to 1.05] and 0.58 [0.38 to 0.87], respectively, P for trend=0.04). Among those individuals with CKD, phosphate intake and net endogenous acid production were progressively lower across increasing adherence groups. No differences were observed regarding other cardiometabolic risk factors across adherence groups. As many as 168 (33%) CKD individuals died during follow-up. Compared with low adherents, proportional hazards regression associated medium and high adherents to a 25% and 23% lower mortality risk, respectively (adjusted hazard ratio [95% confidence interval]=0.75 [0.52 to 1.06] and 0.77 [0.44 to 1.36], respectively, P for trend=0.10). Sensitivity analyses showed significant and stronger associations when only adequate dietary reporters were considered.ConclusionsAdherence to a Mediterranean dietary pattern is associated with lower likelihood of CKD in elderly men. A greater adherence to this diet independently predicted survival in those patients with manifest CKD. Clinical trials are warranted to test the hypothesis that following such a diet could improve outcomes (independent of other healthy lifestyles) in CKD patients.

  • 107. Huang, Xiaoyan
    et al.
    Sjögren, Per
    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.
    Ärnlöv, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Lindholm, Bengt
    Risérus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Carrero, Juan Jesús
    Serum and adipose tissue fatty acid composition as biomarkers of habitual dietary fat intake in elderly men with chronic kidney disease2014In: Nephrology, Dialysis and Transplantation, ISSN 0931-0509, E-ISSN 1460-2385, Vol. 29, no 1, p. 128-136Article in journal (Refereed)
    Abstract [en]

    Background

    Fatty acid (FA) composition in serum cholesterol esters (CE) and adipose tissue (AT) reflect the long-term FA intake in the general population. Because both dietary intake and FA biomarkers associate with renal function, our aim was to identify which CE and AT FAs are useful biomarkers of habitual FA intake in individuals with chronic kidney disease (CKD).

    Methods

    Cross-sectional analysis was performed in 506 men (aged 70 years) with a glomerular filtration rate (GFR) of <60 mL/min per 1.73 m(2) from the Uppsala Longitudinal Study of Adult Men cohort. Dietary habits were evaluated with a 7-day dietary record. FA compositions in CE and AT were analyzed by gas-liquid chromatography in two random subsamples of 248 and 318 individuals, respectively.

    Results

    Both CE and AT linoleic acid and docosahexaenoic acid (DHA) were strongly associated with their corresponding intake, after adjustments for non-dietary factors. The proportions of eicosapentaenoic acid (EPA) and palmitic acid in CE and AT moderately correlated with dietary intake, whereas correlations of other FAs were weaker or absent. Proportions of EPA and DHA in CE and AT were positively associated with the total energy-adjusted fish intake. Results were confirmed in adequate reporters as identified by the Goldberg cutoff method. These relationships held constant, regardless of a GFR above or below 45 mL/min per 1.73 m(2) or the prevalence of microalbuminuria.

    Conclusions

    Proportions of EPA, DHA, palmitic and linoleic acid in serum CE and AT are good indicators of their dietary intake in men with CKD. They can be considered valid biomarkers for epidemiological studies and assessment of compliance.

  • 108. Huang, Xiaoyan
    et al.
    Stenvinkel, Peter
    Qureshi, Abdul Rashid
    Riserus, Ulf
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Barany, Peter
    Heimburger, Olof
    Lindholm, Bengt
    Carrero, Juan Jesus
    Essential polyunsaturated fatty acids, inflammation and mortality in dialysis patients2012In: Nephrology, Dialysis and Transplantation, ISSN 0931-0509, E-ISSN 1460-2385, Vol. 27, no S2, p. 287-287Article in journal (Other academic)
  • 109. Huang, Xiaoyan
    et al.
    Stenvinkel, Peter
    Qureshi, Abdul Rashid
    Riserus, Ulf
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Barany, Peter
    Heimburger, Olof
    Lindholm, Bengt
    Carrero, Juan Jesus
    Estimated hepatic and adipose tissue stearoyl-coa desaturase-1 activities are associated with inflammation and all-cause mortality in dialysis patients2012In: Nephrology, Dialysis and Transplantation, ISSN 0931-0509, E-ISSN 1460-2385, Vol. 27, no S2, p. 272-272Article in journal (Other academic)
  • 110. Huang, Xiaoyan
    et al.
    Stenvinkel, Peter
    Qureshi, Abdul Rashid
    Risérus, Ulf
    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.
    Barany, Peter
    Heimburger, Olof
    Lindholm, Bengt
    Carrero, Juan Jesus
    Essential polyunsaturated fatty acids, inflammation and mortality in dialysis patients2012In: Nephrology, Dialysis and Transplantation, ISSN 0931-0509, E-ISSN 1460-2385, Vol. 27, no 9, p. 3615-3620Article in journal (Refereed)
    Abstract [en]

    Background. Polyunsaturated fatty acids (PUFA) are essential nutrients with anti-inflammatory and cardioprotective properties. We investigated the association of essential dietary PUFA intake, reflected by plasma fatty acid composition, with inflammation and mortality in dialysis patients.

    Methods. We recruited 222 Swedish dialysis subjects (39% women) with median age of 57 years and average 12 months of dialysis vintage. Plasma phospholipid PUFA were assessed by gas-liquid chromatography. Overall mortality was assessed after 18.4 (10th-90th percentiles: 2.3-60) months of follow-up.

    Results. Linoleic acid (LA), Mead acid (MA), alpha-linolenic acid (ALA) and long-chain n-3 PUFA (LC n-3; the sum of eicosapentaenoic, docosapentaenoic and docosahexaenoic acids) represented 19.7, 0.26, 0.26 and 7.64% of all fatty acids in plasma, respectively. This may reflect an adequate n-3 PUFA intake. LA was negatively (beta = -0.21, P = 0.004) but MA positively (beta = 0.25, P < 0.001) associated with interleukin (IL)-6 in multivariate analyses. Neither ALA nor LC n-3 were independently associated with IL-6. During follow-up, 61 deaths and 115 kidney transplants occurred. Fully adjusted competing risk models showed that every percent increase in the proportion of plasma LA was associated with 12% reduction in mortality risk before transplantation (hazard ratio 0.88, 95% confidence interval 0.79-0.99). MA was directly associated with mortality. Neither ALA nor LC n-3 predicted outcome.

    Conclusions. The proportion of plasma phospholipid LA is inversely associated with IL-6 and all-cause mortality in Swedish dialysis patients. We raise the hypothesis that dialysis patients could benefit from increased intake of vegetable oils, the primary source of LA in the Western-type diet.

  • 111.
    Iggman, David
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Center for Clinical Research Dalarna. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Ärnlöv, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Dalarna Univ, Falun, Sweden..
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Adipose tissue fatty acids and cardiovascular and all-cause mortality in elderly men2015In: Annals of Nutrition and Metabolism, ISSN 0250-6807, E-ISSN 1421-9697, Vol. 67, p. 422-422Article in journal (Other academic)
  • 112.
    Iggman, David
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Ärnlöv, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Cederholm, Tommy
    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.
    Adipose tissue fatty acids and cardiovascular and all-cause mortality in elderly men: a prospective cohort studyManuscript (preprint) (Other academic)
    Abstract [en]

    Background: For several fatty acids, adipose tissue reflects long-term dietary intake and may provide more objective information than self-reported intake. No prospective studies have examined whether adipose tissue fatty acids predict cardiovascular and all-cause mortality.

    Objective: To investigate associations between adipose tissue fatty acids and cardiovascular and overall mortality in a cohort of elderly men. We hypothesized that polyunsaturated fatty acids (PUFA) could be inversely associated with cardiovascular and all-cause mortality.

    Methods: In the Swedish community-based cohort study ULSAM, adipose tissue biopsies were taken from the buttocks of 853 men at age 71. Cox regression analyses were performed primarily for four PUFA that were considered to reflect dietary intake (linoleic acid, 18:2n-6, alpha-linolenic acid, 18:3n-3, eicosapentaenoic acid, 20:5n-3, and docosahexaenoic acid, 22:6n-3), and for all other available fatty acids (secondary analyses) analyzed by gas-liquid chromatography.

    Results: During 20-year follow-up, 605 individuals died of which 251 were cardiovascular deaths. After adjusting for risk factors, none of the four primary fatty acids were associated with cardiovascular mortality (hazard ratios (HR)=0.92-1.05 for each SD increase, P≥0.27). Linoleic acid was inversely associated with mortality (HR=0.90, 95% confidence interval (CI) 0.82-0.99, P=0.03). In secondary analyses, palmitoleic acid, 16:1n-7, (HR=1.11, 95% CI 1.02-1.21, P=0.01), and arachidonic acid, 20:4n-6, (HR=1.09, 95% CI 1.00-1.19, P=0.05) were associated with increased mortality, whereas heptadecanoic acid, 17:0, was inversely associated with mortality (HR=0.89, 95% CI 0.79-1.00, P=0.05).

    Conclusions: Adipose tissue PUFA was inversely associated with total mortality, but not cardiovascular mortality in elderly men. The mechanisms behind adipose tissue PUFA and longevity warrant further investigation.

  • 113.
    Iggman, David
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Ärnlöv, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab. School of Health and Social Studies, Dalarna University.
    Cederholm, Tommy
    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.
    Association of Adipose Tissue Fatty Acids With Cardiovascular and All-Cause Mortality in Elderly Men2016In: JAMA cardiology, ISSN 2380-6591, Vol. 1, no 7, p. 745-753Article in journal (Refereed)
    Abstract [en]

    Importance: The major polyunsaturated fatty acids in adipose tissue objectively reflect long-term dietary intake, and may provide more reliable information than would self-reported intake. Whether adipose tissue fatty acids predict cardiovascular and all-cause mortality needs investigation.

    Objective: To investigate associations between adipose tissue fatty acids and cardiovascular and overall mortality in a cohort of elderly men.

    Design, Setting, and Participants: We hypothesized that polyunsaturated fatty acids reflecting dietary intake, are inversely associated with cardiovascular and all-cause mortality. In the Swedish cohort study Uppsala Longitudinal Cohort of Adult Men, buttock fatty acid composition was analyzed by gas-liquid chromatography in 1992 to 1993 and 2008. The study participants were followed during 11 311 person-years, between 1991 and 2011 (median follow-up, 14.8 years). In this community-based study that took place from 1970 to 1973, all men born in 1920 to 1924 in Uppsala, Sweden, were invited and 2322 (82%) were included (at age 50 years). At the reinvestigation at age 71 years, 1221 (73%) of the 1681 invited men participated. Adipose tissue biopsy specimens were taken in a subsample of 853 men. There was no loss to follow-up.

    Exposures: Adipose tissue proportions of 4 polyunsaturated fatty acids that were considered to mainly reflect dietary intake (linoleic acid, 18:2n-6; α-linolenic acid, 18:3n-3; eicosapentaenoic acid, 20:5n-3; and docosahexaenoic acid, 22:6n-3) comprised primary analyses, and all other available fatty acids were secondary analyses.

    Main Outcomes and Measures: Hazard ratios (HRs) for cardiovascular and all-cause mortality using Cox proportional hazards regression analyses, performed in 2015.

    Results: Among the 853 Swedish men, there were 605 deaths, of which 251 were cardiovascular deaths. After adjusting for risk factors, none of the 4 primary fatty acids were associated with cardiovascular mortality (HR, 0.92-1.05 for each standard deviation increase; P ≥ .27). Linoleic acid was inversely associated with all-cause mortality (HR, 0.90; 95% CI, 0.82-0.98; P = .02) and directly associated with intake (P < .001). In secondary analyses, palmitoleic acid, 16:1n-7 (HR, 1.11; 95% CI, 1.02-1.21; P = .02) was associated with higher all-cause mortality, whereas heptadecanoic acid, 17:0, tended to be associated with lower all-cause mortality (HR, 0.89; 95% CI, 0.79-1.00; P = .05). Arachidonic:linoleic acid ratio was associated with both cardiovascular (HR, 1.15; 95% CI, 1.05-1.31; P = .04) and all-cause (HR, 1.13; 95% CI, 1.04-1.23; P = .005) mortality.

    Conclusions and Relevance: Adipose tissue linoleic acid was inversely associated with all-cause mortality in elderly men, although not significantly with cardiovascular mortality.

  • 114. Irving, Gerd Faxén
    et al.
    Freund-Levi, Yvonne
    Eriksdotter-Jönhagen, Maria
    Basun, Hans
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Brismar, Kerstin
    Hjorth, Erik
    Palmblad, Jan
    Vessby, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Vedin, Inger
    Wahlund, Lars-Olof
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Omega-3 fatty acid supplementation effects on weight and appetite in patients with Alzheimer's disease: the omega-3 Alzheimer's disease study2009In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 57, no 1, p. 11-17Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To study the effects of omega (Omega)-3 fatty acid (FA) supplements on weight and appetite in patients with mild to moderate Alzheimer's disease (AD) in relation to inflammatory biomarkers and apolipoprotein E epsilon4 (APOEepsilon4). DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: Specialist memory clinics in the Stockholm catchment area. PARTICIPANTS: Two hundred four patients (aged 73+/-9, 52% women) with mild to moderate AD. INTERVENTION: Patients with AD received 1.7 g of docosahexaenoic acid (DHA) and 0.6 g of eicosapentaenoic acid (EPA) (Omega-3/Omega-3 group; n=89, aged 73+/-9, 57% women) or placebo 0.6 g of linoleic acid per day (placebo/Omega-3 group; n=85, aged 73+/-9, 46% women) for 6 months. After 6 months, all patients received DHA and EPA for another 6 months. MEASUREMENTS: Anthropometry, biochemical nutritional and inflammatory markers, and appetite assessed by caregiver. RESULTS: Mean weight and body mass index (kg/m(2)) at baseline were 70.0+/-11.8 kg and 24.3+/-3.0 kg/m(2), respectively. At 6- and 12-month follow-up, weight had increased 0.7+/-2.5 kg (P=.02) and 1.4+/-2.9 kg (P<.001) in the Omega-3/Omega-3 group. In the placebo group, weight was unchanged at 6 months but had increased (P=.01) at 12 months follow-up after Omega-3 supplementation was initiated. Appetite improved in the Omega-3/Omega-3 group over the treatment period (P=.01). In logistic regression analyses, not carrying the APOEepsilon4 allele and high plasma DHA concentrations were independently related to weight gain in the combined group of patients at 6 months follow-up. CONCLUSION: A DHA-enriched Omega-3 FA supplement may positively affect weight and appetite in patients with mild to moderate AD. Not carrying the APOEepsilon4 allele and high DHA were independently associated with weight gain.

  • 115. Isoyama, Naohito
    et al.
    Qureshi, Abdul Rashid
    Avesani, Carla Maria
    Lindholm, Bengt
    Barany, Peter
    Heimburger, Olof
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Stenvinkel, Peter
    Carrero, Juan Jesus
    Comparative Associations of Muscle Mass and Muscle Strength with Mortality in Dialysis Patients2014In: American Society of Nephrology. Clinical Journal, ISSN 1555-9041, E-ISSN 1555-905X, Vol. 9, no 10, p. 1720-1728Article in journal (Refereed)
    Abstract [en]

    Background and objectives Reduced muscle mass and strength are prevalent conditions in dialysis patients. However, muscle strength and muscle mass are not congruent; muscle strength can diminish even though muscle mass is maintained or increased. This study addresses phenotype and mortality associations of these muscle dysfunction entities alone or in combination (i.e., concurrent loss of muscle mass and strength/mobility, here defined as sarcopenia). Design, setting, participants, & measurements This study included 330 incident dialysis patients (203 men, mean age 53 +/- 13 years, and mean GFR 7 +/- 2 ml/min per 1.73 m(2)) recruited between 1994 and 2010 and followed prospectively for up to 5 years. Low muscle mass (by dual-energy x-ray absorptiometry appendicular mass index) and low muscle strength (by handgrip) were defined against young reference populations according to the European Working Group on Sarcopenia in Older People. Results Whereas 20% of patients had sarcopenia, low muscle mass and low muscle strength alone were observed in a further 24% and 15% of patients, respectively. Old age, comorbidities, protein-energy wasting, physical inactivity, low albumin, and inflammation associated with low muscle strength, but not with low muscle mass (multivariate ANOVA interactions). During follow-up, 95 patients (29%) died and both conditions associated with mortality as separate entities. When combined, individuals with low muscle mass alone were not at increased risk of mortality (adjusted hazard ratio [HR], 1.23; 95% confidence interval [95% CI] 0.56 to 2.67). Individuals with low muscle strength were at increased risk, irrespective of their muscle stores being appropriate (HR, 1.98; 95% CI, 1.01 to 3.87) or low (HR, 1.93; 95% CI, 1.01 to 3.71). Conclusions Low muscle strength was more strongly associated with aging, protein-energy wasting, physical inactivity, inflammation, and mortality than low muscle mass. Assessment of muscle functionality may provide additional diagnostic and prognostic information to muscle-mass evaluation.

  • 116.
    Jensen, Gordon L.
    et al.
    Univ Vermont, Larner Coll Med, Burlington, VT USA.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Global Leadership Initiative on Malnutrition: Progress Report From ASPEN Clinical Nutrition Week 20172018In: JPEN - Journal of Parenteral and Enteral Nutrition, ISSN 0148-6071, E-ISSN 1941-2444, Vol. 42, no 2, p. 266-267Article in journal (Other academic)
  • 117.
    Jensen, Gordon L.
    et al.
    Univ Vermont, Larner Coll Med, Deans Off, Burlington, VT 05405 USA;Univ Vermont, Larner Coll Med, Dept Med, Burlington, VT 05405 USA.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism. Karolinska Univ Hosp, Theme Aging, Stockholm, Sweden.
    The malnutrition overlap syndromes of cachexia and sarcopenia: a malnutrition conundrum2018In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 108, no 6, p. 1157-1158Article in journal (Other academic)
  • 118.
    Jensen, Gordon L.
    et al.
    Univ Vermont, Deans Off, Burlington, VT USA; Univ Vermont, Dept Med, Larner Coll Med, Burlington, VT USA.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism. Karolinska Univ Hosp, Theme Aging, Stockholm, Sweden.
    Correia, M. Isabel T. D.
    Univ Fed Minas Gerais, Dept Surg, Belo Horizante, Brazil.
    Gonzalez, M. Christina
    Univ Catolica Pelotas, Postgrad Program Hlth & Behav, Pelotas, RS, Brazil.
    Fukushima, Ryoji
    Univ Tokyo, Sch Med, Dept Med, Dept Surg, Tokyo, Japan.
    Higashiguchi, Takashi
    Fujita Hlth Univ, Sch Med, Dept Surg & Palliat Med, Toyoake, Aichi, Japan.
    de Baptista, Gertrudis Adrianza
    Univ Cent Venezuela, Med Fac Cent Univ Venezuela, Univ Hosp Caracas, Acad Caracas, Chief Nutr Support Unit Hosp Univ, Caracas, Venezuela.
    Barazzoni, Rocco
    Univ Trieste, Osped Cattinara, Dept Med Technol & Translat Sci, Trieste, Italy.
    Blaauw, Renee
    Stellenbosch Univ, Fac Med & Hlth Sci, Div Human Nutr, Cape Town, South Africa.
    Coats, Andrew J. S.
    Monash Univ Australia, Warwick, England; Univ Warwick, Warwick, England.
    Crivelli, Adriana
    San Martin Hosp, Nutr Support Unit, La Plata, Argentina.
    Evans, David C.
    Ohio State Univ, Dept Surg, Columbus, OH USA.
    Gramlich, Leah
    Univ Alberta, Edmonton, AB, Canada.
    Fuchs-Tarlovsky, Vanessa
    Hosp Gen Mexico City, Clin Nutr Dept, Mexico City, DF, Mexico.
    Keller, Heather
    Univ Waterloo, Schlegel UW Res Inst Aging, Waterloo, ON, Canada; Univ Waterloo, Dept Kinesiol, Waterloo, ON, Canada.
    Llido, Luisito
    St Lukes Med Ctr Quezon City, Clin Nutr Serv, Quezon City, Philippines.
    Malone, Ainsley
    Amer Soc Parenteral & Enteral Nutr, Silver Spring, MD USA; Mt Carmel West Hosp, Columbus, OH USA.
    Mogensen, Kris M.
    Brigham & Womens Hosp, Dept Med, Boston, MA USA.
    Morley, John E.
    St Louis Univ Hosp, Div Geriatr, St Louis, MO USA.
    Muscaritoli, Maurizio
    Sapienza Univ Rome, Dept Clin Med, Rome, Italy.
    Nyulasi, Ibolya
    La Trobe Univ, Dept Nutr, Alfred Hlth, Melbourne, Vic, Australia; La Trobe Univ, Dept Rehabil Nutr & Sport, Dietet Practice, Melbourne, Vic, Australia; Monash Univ, Cent Clin Sch, Dept Med, Clayton, Vic, Australia.
    Pirlich, Matthias
    Imperial Oak Outpatient Clin, Endocrinol Gastroenterol & Clin Nutr, Berlin, Germany.
    Pisprasert, Veeradej
    Khon Kaen Univ Coll Med, Dept Med, Khon Kaen, Thailand.
    de van der Schueren, Marian
    Vrije Univ Amsterdam, Amsterdam UMC, Dept Nutr & Dietet, Amsterdam, Netherlands; HAN Univ Appl Sci, Fac Hlth & Social Studies, Dept Nutr & Dietet, Nijmegen, Netherlands.
    Siltharm, Soranit
    Minist Sci & Technol, Bangkok, Thailand.
    Singer, Pierre
    Tel Aviv Univ, Petah Tikva & Sackler Sch Med, Dept Gen Intens Care, Rabin Med Ctr, Tel Aviv, Israel.
    Tappenden, Kelly A.
    Univ Illinois, Dept Kinesiol & Nutr, Chicago, IL USA.
    Velasco, Nicolas
    Pontificia Univ Catolica Chile, Sch Med, Dept Nutr Diabet & Metabolismo, Santiago, Chile.
    Waitzberg, Dan L.
    Univ Sao Paulo, Sch Med, Dept Gastroenterol, Sao Paulo, Brazil.
    Yamwong, Preyanuj
    Siriaj Hosp, Dept Med, Bangkok, Thailand.
    Yu, Jianchun
    Peking Union Med Coll Hosp, Dept Gen Surg, GI Surg & Nutr Metab Div, Beijing, Peoples R China.
    Compher, Charlene
    Univ Penn, Sch Nursing, Biobehav Hlth Sci Dept, Philadelphia, PA USA; Univ Penn, Sch Nursing, Nutr Programs, Philadelphia, PA USA.
    Van Gossum, Andre
    Free Univ Brussels, Hop Erasme, Clin Intestinal Dis & Nutr Support, Dept Gastroenterol, Brussels, Belgium.
    GLIM Criteria for the Diagnosis of Malnutrition: A Consensus Report From the Global Clinical Nutrition Community2019In: JPEN - Journal of Parenteral and Enteral Nutrition, ISSN 0148-6071, E-ISSN 1941-2444, Vol. 43, no 1, p. 32-40Article in journal (Refereed)
    Abstract [en]

    Background: This initiative aims to build a global consensus around core diagnostic criteria for malnutrition in adults in clinical settings.

    Methods: The Global Leadership Initiative on Malnutrition (GLIM) was convened by several of the major global clinical nutrition societies. Empirical consensus was reached through a series of face‐to‐face meetings, telephone conferences, and e‐mail communications.

    Results: A 2‐step approach for the malnutrition diagnosis was selected, that is, first screening to identify at risk status by the use of any validated screening tool, and second, assessment for diagnosis and grading the severity of malnutrition. The malnutrition criteria for consideration were retrieved from existing approaches for screening and assessment. Potential criteria were subjected to a ballot among GLIM participants that selected 3 phenotypic criteria (non‐volitional weight loss, low body mass index, and reduced muscle mass) and 2 etiologic criteria (reduced food intake or assimilation, and inflammation or disease burden). To diagnose malnutrition at least 1 phenotypic criterion and 1 etiologic criterion should be present. Phenotypic metrics for grading severity are proposed. It is recommended that the etiologic criteria be used to guide intervention and anticipated outcomes. The recommended approach supports classification of malnutrition into four etiology‐related diagnosis categories.

    Conclusions: A consensus scheme for diagnosing malnutrition in adults in clinical settings on a global scale is proposed. Next steps are to secure endorsements from leading nutrition professional societies, to identify overlaps with syndromes like cachexia and sarcopenia, and to promote dissemination, validation studies, and feedback. The construct should be re‐considered every 3–5 years.

  • 119.
    Jernerén, Fredrik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics. Karolinska Univ Hosp, Theme Ageing, Stockholm, Sweden.
    Refsum, Helga
    Univ Oslo, Dept Nutr, Oslo, Norway;Univ Oxford, Dept Pharmacol, Oxford, England.
    Smith, A. David
    Univ Oxford, Dept Pharmacol, Oxford, England.
    Turner, Cheryl
    Univ Oxford, Dept Pharmacol, Oxford, England.
    Palmblad, Jan
    Karolinska Univ Hosp Huddinge, Dept Med, Stockholm, Sweden;Karolinska Univ Hosp Huddinge, Dept Hematol, Stockholm, Sweden;Karolinska Inst, Stockholm, Sweden.
    Eriksdotter, Maria
    Karolinska Univ Hosp, Theme Ageing, Stockholm, Sweden;Karolinska Inst, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.
    Hjorth, Erik
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.
    Faxen-Irving, Gerd
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.
    Wahlund, Lars-Olof
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.
    Schultzberg, Marianne
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.
    Basun, Hans
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Freund-Levi, Yvonne
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden;Karolinska Inst, Ctr Alzheimer Res, Div Clin Geriatr, Huddinge, Sweden;Orebro Univ, Dept Psychiat Reg Orebro Cty, Fac Med & Hlth, Orebro, Sweden;Orebro Univ, Sch Med Sci, Fac Med & Hlth, Orebro, Sweden;Kings Coll London, Dept Old Age Psychiat Psychol & Neurosci, London, England.
    Homocysteine Status Modifies the Treatment Effect of Omega-3 Fatty Acids on Cognition in a Randomized Clinical Trial in Mild to Moderate Alzheimer's Disease: The OmegAD Study2019In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 69, no 1, p. 189-197Article in journal (Refereed)
    Abstract [en]

    Background: Trials of supplementation with omega-3 fatty acids (omega 3-FAs) in patients with mild cognitive impairment or Alzheimer's disease (AD) have produced inconsistent effects on cognitive decline. There is evidence of an interaction between B vitamin status and omega 3-FAs in relation to brain atrophy and cognitive decline.

    Objective: We investigated whether baseline levels of plasma total homocysteine (tHcy), a marker of B vitamin status, modify the effects of omega 3-FAs supplementation on cognitive performance in moderate AD.

    Methods: This post hoc analysis of the OmegAD trial included 171 community-based patients with AD (MMSE >= 15): 88 patients received daily doses of 1.7 g docosahexaenoic acid and 0.6 g eicosapentaenoic acid for 6 months. Treatment outcome on cognition was analyzed according to baseline levels of tHcy using a general linear model and ANCOVA.

    Results: We found significant interactions between omega 3-FA supplementation and tHcy on cognition and clinical stage assessed by MMSE (p = 0.040), global CDR (p = 0.059), and CDRsob (p = 0.023), but not on ADAS-cog (p = 0.649). In patients with tHcy levels <11.7 mu mol/L, omega 3-FA supplementation improved cognitive performance as measured by MMSE (+7.1%, 95% CI: 0.59 to 13.7%, p = 0.033) and clinical status as measured by CDRsob (-22.3%, 95% CI: -5.8 to -38.7%, p = 0.009) compared with placebo.

    Conclusion: The effect of omega 3-FA supplementation on MMSE and CDR appears to be influenced by baseline tHcy, suggesting that adequate B vitamin status is required to obtain beneficial effects of omega 3-FA on cognition.

  • 120. Jia, Ting
    et al.
    Huang, Xiaoyan
    Qureshi, Abdul R.
    Xu, Hong
    Ärnlöv, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology.
    Lindholm, Bengt
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Stenvinkel, Peter
    Risérus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Carrero, Juan J.
    Validation of insulin sensitivity surrogate indices and prediction of clinical outcomes in individuals with and without impaired renal function2014In: Kidney International, ISSN 0085-2538, E-ISSN 1523-1755, Vol. 86, no 2, p. 383-391Article in journal (Refereed)
    Abstract [en]

    As chronic kidney disease (CKD) progresses with abnormalities in glucose and insulin metabolism, commonly used insulin sensitivity indices (151s) may not be applicable in individuals with CKD. Here we sought to validate surrogate ISls against the glucose disposal rate by the gold-standard hyperinsulinemic euglycemic glucose clamp (HEGC) technique in 1074 elderly men of similar age (70 years) of whom 495 had and 579 did not have CKD (estimated glomerular filtration rate (eGFR) under 60 ml/min per 1.73 m2 (median eGFR of 46 ml/min per 1.73 m2)). All ISls provided satisfactory (weighted K over 0.6) estimates of the glucose disposal rate in patients with CKD. ISls derived from oral glucose tolerance tests (OGTTs) agreed better with HEGC than those from fasting samples (higher predictive accuracy). Regardless of CKD strata, all ISls allowed satisfactory clinical discrimination between the presence and absence of insulin resistance (glucose disposal rate under 4 mg/kg/min). We also assessed the ability of both HEGC and ISls to predict all-cause and cardiovascular mortality during a 10-year follow-up. Neither HEGC nor ISIs independently predicted mortality. Adjustment for renal function did not materially change these associations. Thus, ISls can be applied in individuals with moderately impaired renal function for diagnostic purposes. For research matters, OGTT-derived ISls may be preferred. Our data do not support the hypothesis of kidney function mediating insulin sensitivity (I5)-associated outcomes nor a role for IS as a predictor of mortality

  • 121. Jia, Ting
    et al.
    Risérus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Xu, Hong
    Lindholm, Bengt
    Ärnlöv, Johan
    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.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Larsson, Tobias E.
    Ikizler, Talat Alp
    Carrero, Juan J.
    Kidney Function, beta-Cell Function and Glucose Tolerance in Older Men2015In: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 100, no 2, p. 587-593Article in journal (Refereed)
    Abstract [en]

    Context: Kidney dysfunction induces insulin resistance, but it is unknown if beta cell function is affected. Objective: To investigate insulin release (beta cell function) and glucose tolerance following a standardized oral glucose tolerance test (OGTT) across kidney function strata. Setting and Design: Community-based cohort study from the Uppsala Longitudinal Study of Adult Men (ULSAM). Participants and Main Outcome Measure: Included were 1015 nondiabetic Swedish men aged 70-71 years. All participants underwent OGTT and euglycaemic hyperinsulinaemic clamp (HEGC) tests, allowing determination of insulin sensitivity, beta cell function, and glucose tolerance. Kidney function was estimated by cystatin C-algorithms. Mixed models were used to identify determinants of insulin secretion after the hyperglycemic load. Results: Asmanyas 466 (46%) of participants presented moderate-advanced kidney disease. Insulin sensitivity (by HEGC) decreased across decreasing kidney function quartiles. After the OGTT challenge, however, beta cell function indices (area under the curve for insulin release, the estimated first phase insulin release, and the insulinogenic index) were incrementally higher. Neither the oral disposition index nor the 2-h postload glucose tolerance differed across the kidney function strata. Mixed models showed that dynamic insulin release during the OGTT was inversely associated with kidney function, despite the correction for each individual's insulin sensitivity or its risk factors. Conclusions: In older men, beta cell function after a hyperglycemic load appropriately compensated the loss in insulin sensitivity that accompanies kidney dysfunction. As a result, the net balance between insulin sensitivity and beta cell function was preserved.

  • 122. Kabir, Zarina Nahar
    et al.
    Ferdous, Tamanna
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Khanam, Masuma Akter
    Streatfied, Kim
    Wahlin, Åke
    Mini Nutritional Assessment of rural elderly people in Bangladesh: the impact of demographic, socio-economic and health factors2006In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 9, no 8, p. 968-974Article in journal (Refereed)
    Abstract [en]

    Objective: In stating the Millennium Development Goals, the United Nations aims to halve malnutrition around the world by 2015. Nutritional status of the elderly population in low-income countries is seldom focused upon. The present study aimed to evaluate the magnitude of malnutrition among an elderly population in rural Bangladesh.

    Design and setting: Data collection for a multidimensional cross-sectional study of community-based elderly people aged 60 years and over was conducted in a rural area in Bangladesh.

    Subjects: Of 850 randomly selected elderly individuals, 625 participated in home interviews. Complete nutritional information was available for 457 individuals (mean age 69 +/- 8 years, 55% female). Nutritional status was assessed using an adapted form of the Mini Nutritional Assessment (MNA) including body mass index (BMI). Age, sex, education, household expenditure on food and self-reported health problems were investigated as potential predictors of nutritional status.

    Results: BMI < 18.5 kg m(-2), indicating chronic energy deficiency, was found in 50% of the population. MNA revealed a prevalence of 26% for protein-energy malnutrition and 62% for risk of malnutrition. Health problems rather than age had a negative impact on nutritional status. Level of education and food expenditure were directly associated with nutritional status.

    Conclusion: In order to reduce world hunger by half in the coming decade, it is important to recognise that a substantial proportion of the elderly population, particularly in low-income countries, is undernourished.

  • 123. Kaiser, Matthias J.
    et al.
    Bauer, Juergen M.
    Raemsch, Christiane
    Uter, Wolfgang
    Guigoz, Yves
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Thomas, David R.
    Anthony, Patricia S.
    Charlton, Karen E.
    Maggio, Marcello
    Tsai, Alan C.
    Vellas, Bruno
    Sieber, Cornel C.
    Frequency of Malnutrition in Older Adults: A Multinational Perspective Using the Mini Nutritional Assessment2010In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 58, no 9, p. 1734-1738Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES To provide pooled data on the prevalence of malnutrition in elderly people as evaluated using the Mini Nutritional Assessment (MNA). DESIGN Retrospective pooled analysis of previously published datasets. SETTING Hospital, rehabilitation, nursing home, community. PARTICIPANTS Four thousand five hundred seven people (75.2% female) with a mean age of 82.3. MEASUREMENTS The prevalence of malnutrition in the combined database and in the four settings was examined. RESULTS Twenty-four data sets with information on full MNA classification from researchers from 12 countries were submitted. In the combined database, the prevalence of malnutrition was 22.8%, with considerable differences between the settings (rehabilitation, 50.5%; hospital, 38.7%; nursing home, 13.8%; community, 5.8%). In the combined database, the "at risk" group had a prevalence of 46.2%. Consequently, approximately two-thirds of study participants were at nutritional risk or malnourished. CONCLUSION The MNA has gained worldwide acceptance and shows a high prevalence of malnutrition in different settings, except for the community. Because of its specific geriatric focus, the MNA should be recommended as the basis for nutritional evaluation in older people.

  • 124.
    Karimi, Mohsen
    et al.
    Karolinska Inst, Karolinska Univ Hosp Huddinge, Dept Med & Hematol HERM, Stockholm, Sweden..
    Vedin, Inger
    Karolinska Inst, Karolinska Univ Hosp Huddinge, Dept Med & Hematol HERM, Stockholm, Sweden..
    Levi, Yvonne Freund
    Karolinska Inst, Karolinska Univ Hosp Huddinge, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Basun, Hans
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Irving, Gerd Faxen
    Karolinska Inst, Karolinska Univ Hosp Huddinge, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Eriksdotter, Maria
    Karolinska Inst, Karolinska Univ Hosp Huddinge, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Wahlund, Lars-Olof
    Karolinska Inst, Karolinska Univ Hosp Huddinge, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Schultzberg, Marianne
    Karolinska Inst, Karolinska Univ Hosp Huddinge, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Hjorth, Erik
    Karolinska Inst, Karolinska Univ Hosp Huddinge, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Cederholm, T
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Palmblad, Jan
    Karolinska Inst, Karolinska Univ Hosp Huddinge, Dept Med & Hematol HERM, Stockholm, Sweden..
    DHA-rich n-3 fatty acid supplementation decreases DNA methylation in blood leukocytes: the OmegAD study2017In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 106, no 4, p. 1157-1165Article in journal (Refereed)
    Abstract [en]

    Background: Dietary fish oils, rich in long-chain n-3 (omega-3) fatty acids (FAs) [e.g., docosahexaenoic acid (DHA, 22:6n-3) and eicosapentaenoic acid (EPA, 20:5n-3)], modulate inflammatory reactions through various mechanisms, including gene expression, which is measured as messenger RNA concentration. However, the effects of long-term treatment of humans with DHA and EPA on various epigenetic factors-such as DNA methylation, which controls messenger RNA generation-are poorly described. Objective: We wanted to determine the effects of 6 mo of dietary supplementation with an n-3 FA preparation rich in DHA on global DNA methylation of peripheral blood leukocytes (PBLs) and the relation to plasma EPA and DHA concentrations in Alzheimer disease (AD) patients. Design: In the present study, DNA methylation in four 5'-cytosinephosphate- guanine-3' (CpG) sites of long interspersed nuclear element-1 repetitive sequences was assessed in a group of 63 patients (30 given the n-3 FA preparation and 33 given placebo) as an estimation of the global DNA methylation in blood cells. Patients originated from the randomized, double-blind, placebo-controlled OmegAD study, in which 174 AD patients received either 1.7 g DHA and 0.6 g EPA (the n-3 FA group) or placebo daily for 6 mo. Results: At 6 mo, the n-3 FA group displayed marked increases in DHA and EPA plasma concentrations (2.6-and 3.5-fold), as well as decreased methylation in 2 out of 4 CpG sites (P<0.05 for all), respectively. This hypomethylation in CpG2 and CpG4 sites showed a reverse correlation to changes in plasma EPA concentration (r = -0.25, P = 0.045; and r = -0.26, P = 0.041, respectively), but not to changes in plasma DHA concentration, and were not related to apolipoprotein E-4 allele frequency. Conclusion: Supplementation with n-3 FA for 6 mo was associated with global DNA hypomethylation in PBLs. Our data may be of importance in measuring various effects of marine oils, including gene expression, in patients with AD and in other patients taking n-3 FA supplements. This trial was registered at clinicaltrials.gov as NCT00211159.

  • 125.
    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.

  • 126.
    Kirn, Dylan R.
    et al.
    Tufts Univ, Nutr Exercise Physiol & Sarcopenia Lab, Jean Mayer USDA Human Nutr Res Ctr Aging, Boston, MA 02111 USA..
    Koochek, Afsaneh
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Reid, Kieran F.
    Tufts Univ, Nutr Exercise Physiol & Sarcopenia Lab, Jean Mayer USDA Human Nutr Res Ctr Aging, Boston, MA 02111 USA..
    von Berens, Asa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Travison, Thomas G.
    Hebrew SeniorLife, Inst Aging Res, Boston, MA USA.;Harvard Univ, Sch Med, Boston, MA USA.;Beth Israel Deaconess Med Ctr, Div Gerontol, Boston, MA 02215 USA..
    Folta, Sara
    Tufts Univ, Friedman Sch Nutr Sci & Policy, Boston, MA 02111 USA..
    Sacheck, Jennifer
    Tufts Univ, Friedman Sch Nutr Sci & Policy, Boston, MA 02111 USA..
    Nelson, Miriam
    Tufts Univ, Friedman Sch Nutr Sci & Policy, Boston, MA 02111 USA.;Tufts Univ, Jonathan M Tisch Coll Citizenship & Publ Serv, Medford, MA 02155 USA..
    Liu, Christine
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics. Tufts Univ, Nutr Exercise Physiol & Sarcopenia Lab, Jean Mayer USDA Human Nutr Res Ctr Aging, Boston, MA 02111 USA..
    Phillips, Edward
    Tufts Univ, Nutr Exercise Physiol & Sarcopenia Lab, Jean Mayer USDA Human Nutr Res Ctr Aging, Boston, MA 02111 USA.;Harvard Univ, Sch Med, Boston, MA USA.;Spaulding Rehabil Hosp, Boston, MA USA..
    Åberg, Anna Cristina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Nydahl, Margaretha
    Boston Univ, Sch Med, Sect Geriatr, Boston, MA 02118 USA..
    Gustafsson, Thomas
    Karolinska Inst, Dept Lab Med, Stockholm, Sweden..
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Fielding, Roger A.
    Tufts Univ, Nutr Exercise Physiol & Sarcopenia Lab, Jean Mayer USDA Human Nutr Res Ctr Aging, Boston, MA 02111 USA..
    The Vitality, Independence, and Vigor in the Elderly 2 Study (VIVE2): Design and methods2015In: Contemporary Clinical Trials, ISSN 1551-7144, E-ISSN 1559-2030, Vol. 43, p. 164-171Article in journal (Refereed)
    Abstract [en]

    Background: Nutritional supplementation may potentiate the increase in skeletal muscle protein synthesis following exercise in healthy older individuals. Whether exercise and nutrition act synergistically to produce sustained changes in physical functioning and body composition has not been well studied, particularly in mobility-limited older adults. Methods: The VIVE2 study was a multi-center, randomized controlled trial, conducted in the United States and Sweden. This study was designed to compare the effects of a 6-month intervention with a once daily, experimental, 4 fl. oz. liquid nutritional supplement providing 150 kcal, whey protein (20 g), and vitamin D (800 IU) (Nestle Health Science, Vevey, Switzerland), to a low calorie placebo drink (30 kcal, non-nutritive; identical format) when combined with group-based exercise in 150 community-dwelling, mobility-limited older adults. All participants participated in a structured exercise program (3 sessions/week for 6 months), which included aerobic, strength, flexibility, and balance exercises. Results: The primary outcome was 6-month change in 400 m walk performance (m/s) between supplement and placebo groups. Secondary outcomes included 6 month change in: body composition, muscle cross-sectional area, leg strength, grip strength, stair climb time, quality of life, physical performance, mood/depressive symptoms and nutritional status. These outcomes were selected based on their applicability to the health and wellbeing of older adults. Conclusions: The results of this study will further define the role of nutritional supplementation on physical functioning and restoration of skeletal muscle mass in older adults. Additionally, these results will help refine the current physical activity and nutritional recommendations for mobility-limited older adults.

  • 127. Laguzzi, F
    et al.
    Alsharari, Zayed
    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.
    Vikström, M
    Sjögren, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Gigante, B
    Hellénius, M-L
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Bottai, M
    de Faire, U
    Leander, K
    Cross-sectional relationships between dietary fat intake and serum cholesterol fatty acids in a Swedish cohort of 60-year-old men and women2016In: Journal of human nutrition and dietetics (Print), ISSN 0952-3871, E-ISSN 1365-277X, Vol. 29, no 3, p. 325-337Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The present study aimed to describe the relationship between self-reported dietary intake and serum cholesterol fatty acids (FAs) in a Swedish population of 60-year-old men and women.

    METHODS: Cross-sectional data collected in 1997-1998 from 4232 individuals residing in Stockholm County were used. Five diet scores were created to reflect the intake of saturated fats in general, as well as fats from dairy, fish, processed meat and vegetable oils and margarines. Gas chromatography was used to assess 13 FAs in serum cholesterol esters. The association between each diet score and specific FAs was assessed by percentile differences (PD) with 95% confidence intervals (CI) at the 10th, 25th, 50th, 75th and 90th percentile of each FA across levels of diet scores using quantile regression.

    RESULTS: Fish intake was associated with high proportions of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). For each point increase in fish score, the 50th PD in EPA and DHA was 32.78% (95% CI = 29.22% to 36.35%) and 10.63% (95% CI = 9.52% to 11.74%), respectively. Vegetable fat intake was associated with a high proportion of linoleic acid and total polyunsaturated fatty acids (PUFA) and a low proportion of total saturated fatty acids (SFA). The intake of saturated fats in general and dairy fat was slightly associated with specific SFA, although the intake of fat from meat was not.

    CONCLUSIONS: In the present study population, using a rather simple dietary assessment method, the intake of fish and vegetable fats was clearly associated with serum PUFA, whereas foods rich in saturated fats in general showed a weak relationship with serum SFA. Our results may contribute to increased knowledge about underlying biology in diet-cardiovascular disease associations.

  • 128.
    Laguzzi, F.
    et al.
    Karolinska Inst, Inst Environm Med, Unit Cardiovasc Epidemiol, Nobels Vag 13,Box 210, S-17177 Stockholm, Sweden.
    Risérus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Marklund, Matti
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Vikström, M.
    Karolinska Inst, Inst Environm Med, Unit Cardiovasc Epidemiol, Nobels Vag 13,Box 210, S-17177 Stockholm, Sweden.
    Sjögren, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Gigante, B.
    Karolinska Inst, Inst Environm Med, Unit Cardiovasc Epidemiol, Nobels Vag 13,Box 210, S-17177 Stockholm, Sweden;Danderyd Hosp Univ, Karolinska Inst, Dept Clin Sci, Div Cardiovasc Med, S-18288 Stockholm, Sweden.
    Alsharari, Zayed
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Hellenius, M. -L
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Frumento, P.
    Karolinska Inst, Unit Biostat, Inst Environm Med, Nobels Vag 13,Box 210, S-17177 Stockholm, Sweden.
    de Faire, U.
    Karolinska Inst, Inst Environm Med, Unit Cardiovasc Epidemiol, Nobels Vag 13,Box 210, S-17177 Stockholm, Sweden;Karolinska Inst, Dept Med, Cardiol Unit, S-17176 Stockholm, Sweden.
    Leander, K.
    Karolinska Inst, Inst Environm Med, Unit Cardiovasc Epidemiol, Nobels Vag 13,Box 210, S-17177 Stockholm, Sweden.
    Circulating fatty acids in relation to alcohol consumption: Cross-sectional results from a cohort of 60-year-old men and women2018In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 37, no 6, Part A, p. 2001-2010Article in journal (Refereed)
    Abstract [en]

    Background & aims: Alcohol consumption is considered to affect circulating fatty acids (FAs) but knowledge about specific associations is limited. We aimed to assess the relation between alcohol consumption and serum FAs in 60-year-old Swedish men and women.

    Methods: In a random sample of 1917 men and 2058 women residing in Stockholm county, cross-sectional associations between different categories of alcohol consumption and FAs were assessed using linear regression; beta(1) coefficients with 95% confidence interval (Cl) were calculated. Self-reported alcohol consumption was categorized as none, low (<= 9.9 g/day) (reference), moderate (10-29.9 g/day) and high (>= 30 g/day). Moderate alcohol consumption was further subdivided into consumption of beer, wine, liquor and their combinations. Thirteen serum cholesterol ester FM were measured by gas chromatography and individual FM were expressed as percentage of total FAs.

    Results: Increasing alcohol consumption was associated to linear increase of saturated myristic acid, monounsaturated FAs and n-6 polyunsaturated (PUFA) arachidonic acid, whereas linear decrease was noted for saturated pentadecanoic acid and for n-6 PUFA linoleic acid. With non-linear associations, increasing alcohol consumption also associated to decreased saturated stearic acid, n-6 PUFA dihomogamma-linolenic acid, and n-3 PUFA docosahexaenoic acid and increased saturated palmitic acid, n-6 PUFA gamma-linolenic acid and n-3 PUFA eicosapentaenoic acid. Among types of beverages, wine consumption was associated with n-6 PUFA arachidonic acid (beta(1) 0.59; 95% CI: 030;0.88) and the n-3 PUFAs eicosapentaenoic acid (beta(1) 0.54; 95% CI: 0.30;0.78), and docosahexaenoic acid (beta(1) 0.06; 95% CI: 0.00;0.12).

    Conclusions: These findings may give important basis for further investigations to better understand biological mechanisms behind the dose-dependent associations between alcohol consumption and health outcomes observed in many previous studies.

  • 129. Levi, Freund Y.
    et al.
    Vedin, I
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Basun, H.
    Irving, Faxen G.
    Jonhagen, Eriksdotter M.
    Vessby, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Wahlund, L. O.
    Salem, N., Jr.
    Palmblad, J.
    Effects of a DHA rich omega-3 fatty acid supplementation for Alzheimer disease patients on fatty acid composition in cerebrospinal fluid, disease biomarkers and cognition: The OmegAD study2012In: Journal of Molecular Neuroscience, ISSN 0895-8696, E-ISSN 1559-1166, Vol. 48, no S1, p. S36-S36Article in journal (Other academic)
  • 130.
    Liberman, Keliane
    et al.
    VUB, Frailty Ageing Res Grp FRIA, Laarbeeklaan 103, B-1090 Brussels, Belgium.
    Njemini, Rose
    VUB, Frailty Ageing Res Grp FRIA, Laarbeeklaan 103, B-1090 Brussels, Belgium.
    Luiking, Yvette
    Nutricia Res, Nutricia Adv Med Nutr, Utrecht, Netherlands.
    Forti, Louis N.
    VUB, Frailty Ageing Res Grp FRIA, Laarbeeklaan 103, B-1090 Brussels, Belgium.
    Verlaan, Sjors
    Vrije Univ Amsterdam, Med Ctr, Sect Gerontol & Geriatr, Dept Internal Med, Amsterdam, Netherlands.
    Bauer, Juergen M.
    Heidelberg Univ, Ctr Geriatr Med, Heidelberg, Germany.
    Memelink, Robert
    VUB, Frailty Ageing Res Grp FRIA, Laarbeeklaan 103, B-1090 Brussels, Belgium;Amsterdam Univ Appl Sci, Fac Sports & Nutr, Amsterdam, Netherlands.
    Brandt, Kirsten
    Newcastle Univ, Inst Cellular Med, Human Nutr Res Ctr, Newcastle Upon Tyne, Tyne & Wear, England.
    Donini, Lorenzo M.
    Sapienza Univ Rome, Sect Med Pathophysiol Endocrinol & Human Nutr, Dept Expt Med, Rome, Italy.
    Maggio, Marcello
    Univ Parma, Sect Geriatr, Dept Med & Surg, Parma, Italy.
    Mets, Tony
    VUB, Frailty Ageing Res Grp FRIA, Laarbeeklaan 103, B-1090 Brussels, Belgium.
    Wijers, Sander L. J.
    Nutricia Res, Nutricia Adv Med Nutr, Utrecht, Netherlands.
    Sieber, Cornel
    Friedrich Alexander Univ Erlangen Nurnberg, Erlangen, Germany.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Bautmans, Ivan
    VUB, Frailty Ageing Res Grp FRIA, Laarbeeklaan 103, B-1090 Brussels, Belgium.
    Thirteen weeks of supplementation of vitamin D and leucine-enriched whey protein nutritional supplement attenuates chronic low-grade inflammation in sarcopenic older adults: the PROVIDE study2019In: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 31, no 6, p. 845-854Article in journal (Refereed)
    Abstract [en]

    Background A chronic low-grade infammatory profle (CLIP) is associated with sarcopenia in older adults. Protein and Vitamin (Vit)D have immune-modulatory potential, but evidence for efects of nutritional supplementation on CLIP is limited. Aim To investigate whether 13 weeks of nutritional supplementation of VitD and leucine-enriched whey protein afected CLIP in subjects enrolled in the PROVIDE-study, as a secondary analysis. Methods Sarcopenic adults (low skeletal muscle mass) aged ≥ 65 years with mobility limitations (Short Physical Performance Battery 4–9) and a body mass index of 20–30 kg/m2 were randomly allocated to two daily servings of active (n=137, including 20 g of whey protein, 3 g of leucine and 800 IU VitD) or isocaloric control product (n=151) for a double-blind period of 13 weeks. At baseline and after 13 weeks, circulating interleukin (IL)-8, IL-1 receptor antagonist (RA), soluble tumor-necrosis-factor receptor (sTNFR)1, IL-6, high-sensitivity C-reactive protein, pre-albumin and 25-hydroxyvitamin(OH) D were measured. Data-analysis included repeated measures analysis of covariance (corrected for dietary VitD intake) and linear regression. Results IL-6 and IL-1Ra serum levels showed overall increases after 13 weeks (p=0.006 and p<0.001, respectively). For IL-6 a signifcant time × treatment interaction (p=0.046) was observed, with no signifcant change over time in the active group (p=0.155) compared to control (signifcant increase p=0.012). IL-8 showed an overall signifcant decrease (p=0.03). The change in pre-albumin was a signifcant predictor for changes in IL-6 after 13 weeks. Conclusions We conclude that 13 weeks of nutritional supplementation with VitD and leucine-enriched whey protein may attenuate the progression of CLIP in older sarcopenic persons with mobility limitations.

  • 131. Lu, Yingchang
    et al.
    Day, Felix R
    Gustafsson, Stefan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab.
    Buchkovich, Martin L
    Na, Jianbo
    Bataille, Veronique
    Cousminer, Diana L
    Dastani, Zari
    Drong, Alexander W
    Esko, Tõnu
    Evans, David M
    Falchi, Mario
    Feitosa, Mary F
    Ferreira, Teresa
    Hedman, Åsa K
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Science for Life Laboratory, SciLifeLab.
    Haring, Robin
    Hysi, Pirro G
    Iles, Mark M
    Justice, Anne E
    Kanoni, Stavroula
    Lagou, Vasiliki
    Li, Rui
    Li, Xin
    Locke, Adam
    Lu, Chen
    Mägi, Reedik
    Perry, John R B
    Pers, Tune H
    Qi, Qibin
    Sanna, Marianna
    Schmidt, Ellen M
    Scott, William R
    Shungin, Dmitry
    Teumer, Alexander
    Vinkhuyzen, Anna A E
    Walker, Ryan W
    Westra, Harm-Jan
    Zhang, Mingfeng
    Zhang, Weihua
    Zhao, Jing Hua
    Zhu, Zhihong
    Afzal, Uzma
    Ahluwalia, Tarunveer Singh
    Bakker, Stephan J L
    Bellis, Claire
    Bonnefond, Amélie
    Borodulin, Katja
    Buchman, Aron S
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Choh, Audrey C
    Choi, Hyung Jin
    Curran, Joanne E
    de Groot, Lisette C P G M
    De Jager, Philip L
    Dhonukshe-Rutten, Rosalie A M
    Enneman, Anke W
    Eury, Elodie
    Evans, Daniel S
    Forsen, Tom
    Friedrich, Nele
    Fumeron, Frédéric
    Garcia, Melissa E
    Gärtner, Simone
    Han, Bok-Ghee
    Havulinna, Aki S
    Hayward, Caroline
    Hernandez, Dena
    Hillege, Hans
    Ittermann, Till
    Kent, Jack W
    Kolcic, Ivana
    Laatikainen, Tiina
    Lahti, Jari
    Mateo Leach, Irene
    Lee, Christine G
    Lee, Jong-Young
    Liu, Tian
    Liu, Youfang
    Lobbens, Stéphane
    Loh, Marie
    Lyytikäinen, Leo-Pekka
    Medina-Gomez, Carolina
    Michaëlsson, Karl
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Nalls, Mike A
    Nielson, Carrie M
    Oozageer, Laticia
    Pascoe, Laura
    Paternoster, Lavinia
    Polašek, Ozren
    Ripatti, Samuli
    Sarzynski, Mark A
    Shin, Chan Soo
    Narančić, Nina Smolej
    Spira, Dominik
    Srikanth, Priya
    Steinhagen-Thiessen, Elisabeth
    Sung, Yun Ju
    Swart, Karin M A
    Taittonen, Leena
    Tanaka, Toshiko
    Tikkanen, Emmi
    van der Velde, Nathalie
    van Schoor, Natasja M
    Verweij, Niek
    Wright, Alan F
    Yu, Lei
    Zmuda, Joseph M
    Eklund, Niina
    Forrester, Terrence
    Grarup, Niels
    Jackson, Anne U
    Kristiansson, Kati
    Kuulasmaa, Teemu
    Kuusisto, Johanna
    Lichtner, Peter
    Luan, Jian'an
    Mahajan, Anubha
    Männistö, Satu
    Palmer, Cameron D
    Ried, Janina S
    Scott, Robert A
    Stancáková, Alena
    Wagner, Peter J
    Demirkan, Ayse
    Döring, Angela
    Gudnason, Vilmundur
    Kiel, Douglas P
    Kühnel, Brigitte
    Mangino, Massimo
    Mcknight, Barbara
    Menni, Cristina
    O'Connell, Jeffrey R
    Oostra, Ben A
    Shuldiner, Alan R
    Song, Kijoung
    Vandenput, Liesbeth
    van Duijn, Cornelia M
    Vollenweider, Peter
    White, Charles C
    Boehnke, Michael
    Boettcher, Yvonne
    Cooper, Richard S
    Forouhi, Nita G
    Gieger, Christian
    Grallert, Harald
    Hingorani, Aroon
    Jørgensen, Torben
    Jousilahti, Pekka
    Kivimaki, Mika
    Kumari, Meena
    Laakso, Markku
    Langenberg, Claudia
    Linneberg, Allan
    Luke, Amy
    Mckenzie, Colin A
    Palotie, Aarno
    Pedersen, Oluf
    Peters, Annette
    Strauch, Konstantin
    Tayo, Bamidele O
    Wareham, Nicholas J
    Bennett, David A
    Bertram, Lars
    Blangero, John
    Blüher, Matthias
    Bouchard, Claude
    Campbell, Harry
    Cho, Nam H
    Cummings, Steven R
    Czerwinski, Stefan A
    Demuth, Ilja
    Eckardt, Rahel
    Eriksson, Johan G
    Ferrucci, Luigi
    Franco, Oscar H
    Froguel, Philippe
    Gansevoort, Ron T
    Hansen, Torben
    Harris, Tamara B
    Hastie, Nicholas
    Heliövaara, Markku
    Hofman, Albert
    Jordan, Joanne M
    Jula, Antti
    Kähönen, Mika
    Kajantie, Eero
    Knekt, Paul B
    Koskinen, Seppo
    Kovacs, Peter
    Lehtimäki, Terho
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Liu, Yongmei
    Orwoll, Eric S
    Osmond, Clive
    Perola, Markus
    Pérusse, Louis
    Raitakari, Olli T
    Rankinen, Tuomo
    Rao, D C
    Rice, Treva K
    Rivadeneira, Fernando
    Rudan, Igor
    Salomaa, Veikko
    Sørensen, Thorkild I A
    Stumvoll, Michael
    Tönjes, Anke
    Towne, Bradford
    Tranah, Gregory J
    Tremblay, Angelo
    Uitterlinden, André G
    van der Harst, Pim
    Vartiainen, Erkki
    Viikari, Jorma S
    Vitart, Veronique
    Vohl, Marie-Claude
    Völzke, Henry
    Walker, Mark
    Wallaschofski, Henri
    Wild, Sarah
    Wilson, James F
    Yengo, Loïc
    Bishop, D Timothy
    Borecki, Ingrid B
    Chambers, John C
    Cupples, L Adrienne
    Dehghan, Abbas
    Deloukas, Panos
    Fatemifar, Ghazaleh
    Fox, Caroline
    Furey, Terrence S
    Franke, Lude
    Han, Jiali
    Hunter, David J
    Karjalainen, Juha
    Karpe, Fredrik
    Kaplan, Robert C
    Kooner, Jaspal S
    McCarthy, Mark I
    Murabito, Joanne M
    Morris, Andrew P
    Bishop, Julia A N
    North, Kari E
    Ohlsson, Claes
    Ong, Ken K
    Prokopenko, Inga
    Richards, J Brent
    Schadt, Eric E
    Spector, Tim D
    Widén, Elisabeth
    Willer, Cristen J
    Yang, Jian
    Ingelsson, Erik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology.
    Mohlke, Karen L
    Hirschhorn, Joel N
    Pospisilik, John Andrew
    Zillikens, M Carola
    Lindgren, Cecilia
    Kilpeläinen, Tuomas Oskari
    Loos, Ruth J F
    New loci for body fat percentage reveal link between adiposity and cardiometabolic disease risk2016In: Nature Communications, ISSN 2041-1723, E-ISSN 2041-1723, Vol. 7, article id 10495Article in journal (Refereed)
    Abstract [en]

    To increase our understanding of the genetic basis of adiposity and its links to cardiometabolic disease risk, we conducted a genome-wide association meta-analysis of body fat percentage (BF%) in up to 100,716 individuals. Twelve loci reached genome-wide significance (P<5 × 10(-8)), of which eight were previously associated with increased overall adiposity (BMI, BF%) and four (in or near COBLL1/GRB14, IGF2BP1, PLA2G6, CRTC1) were novel associations with BF%. Seven loci showed a larger effect on BF% than on BMI, suggestive of a primary association with adiposity, while five loci showed larger effects on BMI than on BF%, suggesting association with both fat and lean mass. In particular, the loci more strongly associated with BF% showed distinct cross-phenotype association signatures with a range of cardiometabolic traits revealing new insights in the link between adiposity and disease risk.

  • 132. Luis, Desiree
    et al.
    Huang, Xiaoyan
    Risérus, Ulf
    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.
    Lindholm, Bengt
    Arnlov, Johan
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Carrero, Juan Jesos
    Estimated Dietary Acid Load Is Not Associated with Blood Pressure or Hypertension Incidence in Men Who Are Approximately 70 Years Old2015In: Journal of Nutrition, ISSN 0022-3166, E-ISSN 1541-6100, Vol. 145, no 2, p. 315-321Article in journal (Refereed)
    Abstract [en]

    Background: Dietary acid load affects acid-base homeostasis, which may be associated with blood pressure (BP). Previous research on dietary acid load and BP in the community has provided conflicting results, which may be confounded by underlying kidney function with inability to eliminate acid excess. Objective: The objective of this study was to determine whether dietary acid load is associated with blood pressure or the incidence of hypertension in older men taking into account each individual's kidney function. Methods: We included 673 men aged 70-71 y and not receiving antihypertensive medication from the Uppsala Longitudinal Study of Adult Men. Of those, 378 men were re-examined after 7 y. Dietary acid load was estimated at baseline by potential renal acid load (PRAL) and net endogenous acid production (NEAP), based on nutrient intake assessed by 7-d food records at baseline. Ambulatory blood pressure monitoring (ABPM) was performed at both visits. Cystatin C-estimated kidney function allowed identification of underlying chronic kidney disease. Results: Median estimated PRAL and NEAP were 3.3 and 40.7 mEq/d, respectively. In cross-section, PRAL was in general not associated with ABPM measurements (all P > 0.05, except for the 24-h diastolic BP). During follow-up, PRAL did not predict ABPM changes (all P > 0.05). When individuals with baseline hypertension (ABPM >= 130/80 mm Hg) or nondippers (with nighttime-to-daytime systolic BP ratio > 0.9) were excluded, PRAL was not a predictor of incident cases (P > 0.30). Kidney function did not modify these null relations. Similar findings were obtained with the use of NEAP as the exposure. Conclusion: Our analyses linking estimated dietary acid load with BP outcome measurements both cross-sectionally and after 7 y in community-based older Swedish men of similar age did not reveal an association between dietary acid load and BP.

  • 133.
    Luis, Desiree
    et al.
    Karolinska Inst, Div Renal Med & Baxter Novum, Stockholm, Sweden..
    Huang, Xiaoyan
    Karolinska Inst, Div Renal Med & Baxter Novum, Stockholm, Sweden..
    Risérus, Ulf
    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.
    Lindholm, Bengt
    Karolinska Inst, Div Renal Med & Baxter Novum, Stockholm, Sweden..
    Ärnlöv, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Carrero, Juan Jesus
    Karolinska Inst, Div Renal Med & Baxter Novum, Stockholm, Sweden..
    Dietary Acid Load, Kidney Function, Changes in Blood Pressure and Hypertension Incidence in Community Dwelling Elderly Men2015In: Nephrology, Dialysis and Transplantation, ISSN 0931-0509, E-ISSN 1460-2385, Vol. 30Article in journal (Other academic)
  • 134. Luis, Desiree
    et al.
    Huang, Xiaoyan
    Sjögren, Per
    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.
    Ärnlöv, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology.
    Lindholm, Bengt
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Carrero, Juan Jesus
    Renal function associates with energy intake in elderly community-dwelling men2014In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 111, no 12, p. 2184-2189Article in journal (Refereed)
    Abstract [en]

    Energy intake and renal function decrease with age. In patients with chronic kidney disease (CKD), spontaneous food intake decreases in parallel with the loss of renal function. The objective of the present study was to evaluate a possible relationship between renal dysfunction and energy intake in elderly community-dwelling men. A cross-sectional study including 1087 men aged 70 years from the Uppsala Longitudinal Study of Adult Men (ULSAM) community-based cohort was carried out. Dietary intake was assessed using 7 d food records, and glomerular filtration rate was estimated from serum cystatin C concentrations. Energy intake was normalised by ideal body weight, and macronutrient intake was energy-adjusted. The median normalised daily energy intake was 105 (interquartile range 88-124) kJ, and directly correlated with estimated glomerular filtration rate (eGFR) as determined by univariate analysis. Across the decreasing quartiles of eGFR, a significant trend of decreasing normalised energy intake was observed (P = 0.01). A multivariable regression model including lifestyle factors and co-morbidities was used for predicting total energy intake. In this model, regular physical activity (standardised beta = 0.160; P = 0.008), smoking (standardised beta = -0.081; P = 0.008), hypertension (standardised beta = -0.097; P = 0.002), hyperlipidaemia (standardised beta = -0.064; P = 0.037) and eGFR (per SD increase, standardised beta = 0.064; P = 0.04) were found to be independent predictors of energy intake. Individuals with manifest CKD (eGFR < 60 ml/min per 1.73m(2)) were more likely to have lower energy intake than those without. In conclusion, there was a direct and independent correlation between renal function and energy intake in a population-based cohort of elderly men. We speculate on a possible link between renal dysfunction and malnutrition in the elderly.

  • 135. Maggio, Marcello
    et al.
    Cattabiani, Chiara
    Lauretani, Fulvio
    Mantovani, Marco
    Butto, Valeria
    De Vita, Francesca
    Volpi, Riccardo
    Artoni, Andrea
    Giallauria, Francesco
    Zuliani, Giovanni
    Aloe, Rosalia
    Lippi, Giuseppe
    Ceresini, Graziano
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Ceda, Gian Paolo
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    SHBG and endothelial function in older subjects2013In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 168, no 3, p. 2825-2830Article in journal (Refereed)
    Abstract [en]

    Background: Endothelial dysfunction is predictor of cardiovascular diseases that have different prevalence in men and women before menopause. Sex hormones and sex hormone binding globulin (SHBG), novel risk factors for diabetes and cardiovascular diseases even in older individuals, might explain this difference. However, the relationship between these hormones and endothelial function has never been addressed in the elderly. Methods and results: 430 men and, 424 women 70 years older of Prospective Study of the Vasculature in Uppsala Seniors study, with complete data on SHBG, testosterone(T), estradiol(E2), endothelium-independent vasodilation (EIDV), endothelium-dependent vasodilation(EDV), flow-mediated vasodilation (FMD) and the pulse wave analysis (reflection index, RI) were evaluated. Multivariate regression analysis adjusted for confounders was used to assess the relationship between T, E2, SHBG and endothelial function. In men we found a positive relationship between SHBG and EDV (beta +/- SE 3.60 +/- 0.83, p < 0.0001), EIDV (2.42 +/- 0.58, p < 0.0001) but not with FMD. The relationship between SHBG and EDV and EIDV was maintained after adjustment for sex (1.64 +/- 0.47, p < 0.001 and 1.79 +/- 0.35, p < 0.0006, respectively). After adjustment for confounders, the relationship between SHBG and EDV and EIDV was still statistically significant (2.63 +/- 0.90 and 1.86 +/- 0.63, p = 0.004 for both). In women SHBG and EIDV were positively associated (1.58 +/- 0.46; p = 0.0007), and this relationship was independent of sex (1.79 +/- 0.35; p < 0.001). No significant interaction SHBG * SEX was found for EIDV (p = 0.72). In a combined analysis in two sexes, SHBG and EIDV were positively associated (1.13 +/- 0.45; p = 0.01). SHBG was not associated with EDV, FMD and RI. No significant relationship was found between T or E2 and EDV, EIDV, FMD or RI in both sexes. Conclusions: In older men SHBG, but not T and E2, is positively and independently associated with EDV in resistance arteries. In both sexes, SHBG was positively and independently associated with EIDV.

  • 136. Maggio, Marcello
    et al.
    De Vita, Francesca
    Lauretani, Fulvio
    Ceda, Gian Paolo
    Volpi, Elena
    Giallauria, Francesco
    De Cicco, Giuseppe
    Cattabiani, Chiara
    Melhus, Håkan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical pharmacogenomics and osteoporosis.
    Michaëlsson, Karl
    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.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Vitamin D and Endothelial Vasodilation in Older Individuals: Data From the PIVUS Study2014In: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 99, no 9, p. 3382-3389Article in journal (Refereed)
    Abstract [en]

    CONTEXT:

    Vitamin D plays a role in a wide range of extraskeletal processes, including vascular function. Endothelial dysfunction is a predictor of cardiovascular disease, especially in older subjects. However, the relationship between vitamin D levels and indexes of endothelial vasodilation has never been fully addressed in older individuals.

    OBJECTIVE:

    The objective of this study was to examine the association between vitamin D and endothelial function in a large community-based sample of older subjects.

    METHODS:

    This cross-sectional study involved 852 community-dwelling men and women aged 70 years from the Prospective Study of the Vasculature in Uppsala Seniors (PIVUS), with complete data on vascular function and 25-hydroxyvitamin D. We evaluated endothelium-dependent vasodilation by an invasive forearm technique with acetylcholine, endothelium-independent vasodilation by sodium nitroprussiate, flow-mediated vasodilation, and the pulse wave analysis (reflectance index). Vitamin D levels were measured by chemiluminescence. We used multivariate regression models adjusted for body mass index (model 1) and for multiple confounders (high-sensitivity C-reactive protein, insulin, total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, smoking, sex hormones, season of blood collection, hypertension, diabetes, cardiovascular medications and diseases, statin usage, plasma calcium and calcium intake, PTH, physical exercise, liver and kidney function tests, albumin; model 2).

    RESULTS:

    In women, but not in men, vitamin D levels were positively associated with endothelium-independent vasodilation in both model 1 (β ± SE = 1.41 ± 0.54; P = .001), and model 2 (β ± SE = 2.01 ± 0.68; P = .003).We found no significant relationship between vitamin D levels and endothelium-dependent vasodilation, flow-mediated vasodilation, and reflectance index in both sexes.

    CONCLUSIONS:

    In older women, but not in men, vitamin D is positively and independently associated with EIDV.

  • 137.
    Marklund, Matti
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Leander, Karin
    Vikstrom, Max
    Laguzzi, Federica
    Gigante, Bruna
    Sjögren, Per
    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.
    de Faire, Ulf
    Hellenius, Mai-Lis
    Risérus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Polyunsaturated Fat Intake Estimated by Circulating Biomarkers and Risk of Cardiovascular Disease and All-Cause Mortality in a Population-Based Cohort of 60-Year-Old Men and Women2015In: Circulation, ISSN 0009-7322, E-ISSN 1524-4539, Vol. 132, no 7, p. 586-594Article in journal (Refereed)
    Abstract [en]

    Background High intake of polyunsaturated fatty acids (PUFAs) may reduce the risk of cardiovascular disease (CVD) and mortality. Large, prospective studies including both sexes and circulating PUFAs as dietary biomarkers are needed. We investigated sex-specific associations of the major dietary PUFAs, eicosapentaenoic acid, docohexaenoic acid, linoleic acid, and -linolenic acid, with incident CVD and all-cause mortality in a population-based cohort. Methods and Results PUFAs in serum cholesterol esters were measured at baseline in 60-year-old Swedish women (n=2193) and men (n=2039). With the use of national registers, 484 incident CVD events (294 men and 190 women) and 456 all-cause deaths (265 men and 191 women) were identified during follow-up (median, 14.5 years) in individuals without prior CVD at baseline. Associations of PUFAs with CVD and mortality were evaluated with Cox proportional hazard models. In multivariable-adjusted models, 1-SD increases in eicosapentaenoic acid and docohexaenoic acid were associated with lower risk of incident CVD among women (hazard ratio [HR], 0.79 [95% confidence interval (CI), 0.64-0.97] and 0.74 [95% CI, 0.61-0.89], respectively). -Linolenic acid was associated with moderately increased CVD risk in women (HR, 1.16; 95% CI, 1.02-1.32). Inverse associations with all-cause mortality were observed for eicosapentaenoic acid and docohexaenoic acid among all participants (HR, 0.81 [95% CI, 0.72-0.91] and 0.80 [95% CI, 0.72-0.89], respectively) and for linoleic acid in men (HR, 0.73; 95% CI, 0.64-0.83). Conclusions Serum linoleic acid and very-long-chain n-3 PUFAs, partly reflecting vegetable oil and fish intake, respectively, were inversely associated with all-cause mortality. Inverse associations of eicosapentaenoic acid and docohexaenoic acid with incident CVD were observed only in women.

  • 138.
    Marklund, Matti
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Leander, Karin
    Karolinska Inst, Inst Environm Med, Unit Cardiovasc Epidemiol, Stockholm, Sweden..
    Vikstrom, Max
    Karolinska Inst, Inst Environm Med, Unit Cardiovasc Epidemiol, Stockholm, Sweden..
    Laguzzi, Federica
    Karolinska Inst, Inst Environm Med, Unit Cardiovasc Epidemiol, Stockholm, Sweden..
    Gigante, Bruna
    Karolinska Inst, Inst Environm Med, Unit Cardiovasc Epidemiol, Stockholm, Sweden.;Danderyd Hosp, Karolinska Inst, Dept Clin Sci, Div Cardiovasc Med, Danderyds, Sweden..
    Sjögren, Per
    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.
    de Faire, Ulf
    Karolinska Inst, Inst Environm Med, Unit Cardiovasc Epidemiol, Stockholm, Sweden.;Karolinska Univ Hosp, Karolinska Inst, Dept Med, Cardiol Unit, Solna, Sweden..
    Hellenius, Mai-Lis
    Karolinska Univ Hosp, Karolinska Inst, Dept Med, Cardiol Unit, Solna, Sweden..
    Risérus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Serum Pentadecanoic Acid, A Biomarker Of Dairy Fat Intake, Is Associated With Lower Risk Of Incident Cardiovascular Disease And All-Cause Mortality In Swedish Men And Women2017In: Annals of Nutrition and Metabolism, ISSN 0250-6807, E-ISSN 1421-9697, Vol. 71, p. 322-323Article in journal (Other academic)
  • 139. Michel, Jean-Pierre
    et al.
    Cruz-Jentoft, Alfonso J.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Frailty, Exercise and Nutrition2015In: Clinics in Geriatric Medicine, ISSN 0749-0690, E-ISSN 1879-8853, Vol. 19, no 3, p. 375-387Article in journal (Refereed)
    Abstract [en]

    This article first reports the spontaneous course of frailty conditions, and then focuses on randomized, controlled frailty interventions (such as physical exercise, nutrition, combined exercise plus nutrition, and multifactorial interventions) or metaanalysis in community-dwelling older adults or volunteers published in 2012, 2013, and 2014. The main take-home messages that emerge from recent literature are summarized.

  • 140.
    Miguel, Sophie
    et al.
    Mars Wrigley, 1132 W Blackhawk St, Chicago, IL 60642 USA..
    Champ, Claire
    Univ Leeds, Sch Psychol, Human Appetite Res Unit, Leeds LS2 9JT, W Yorkshire, England..
    Day, Jon
    Cerebrus Associates Ltd, White House,2 Meadrow, Godalming GU7 3HN, Surrey, England..
    Aarts, Esther
    Radboud Univ Nijmegen, Donders Inst Brain Cognit & Behav, Kapittelweg 29, NL-6525 EN Nijmegen, Netherlands..
    Bahr, Ben A.
    Univ N Carolina, Biotechnol Res & Training Ctr, Pembroke, WA USA..
    Bakker, Martijntje
    Netherlands Org Hlth Res & Dev, Laan Nieuw Oost Indie 334, NL-2593 CE The Hague, Netherlands..
    Banati, Diana
    Europe ILSI Europe, Int Life Sci Inst, E Mounier 83,Box 6, B-1200 Brussels, Belgium..
    Calabrese, Vittorio
    Univ Catania, Dept Biomed & Biotechnol Sci, Biol Tower Via Santa Sofia 97, Catania, Italy..
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Cryan, John
    Univ Coll Cork, Anat & Neurosci, 386 Western Gateway Bldg, Cork, Ireland..
    Dye, Louise
    Univ Leeds, Sch Psychol, Human Appetite Res Unit, Leeds LS2 9JT, W Yorkshire, England..
    Farrimond, Jonathan A.
    Lucozade Ribena Suntory Ltd, Uxbridge, Middx, England..
    Korosi, Aniko
    Univ Amsterdam, Ctr Neurosci, Swammerdam Inst Life Sci, Sci Pk 904, NL-1098 XH Amsterdam, Netherlands..
    Laye, Sophie
    INRA Bordeaux Univ, Nutr & Neurobiol Integree, 146 Rue Lio Saignat, F-33076 Bordeaux, France..
    Maudsley, Stuart
    Univ Antwerp, Dept Biomed Res, Gebouw V,Campus Drie Eileen,Univ Pl 1, Antwerp, Belgium.;Univ Antwerp, VIBU Antwerp Ctr Mol Neurol, Gebouw V,Campus Drie Eileen,Univ Pl 1, Antwerp, Belgium..
    Milenkovic, Dragan
    UCA, INRA, Human Nutr Unit, F-63003 Clermont Ferrand, France.;Univ Calif Davis, Sch Med, Dept Internal Med, Div Cardiovasc Med, Davis, CA 95616 USA..
    Mohajeri, M. Hasan
    DSM Nutr Prod Ltd, Wurmisweg 576, CH-4303 Kaiseraugst, Switzerland..
    Sijben, John
    Nutr Adv Med Nutr, Nutr Res, POB 80141, NL-3508 TC Utrecht, Netherlands..
    Solomon, Alina
    Karolinska Inst, Aging Res Ctr, Gavlegatan 16, SE-11330 Stockholm, Sweden..
    Spencer, Jeremy P. E.
    Univ Reading, Hugh Sinclair Unit Human Nutr, Reading RG6 6AP, Berks, England.;Univ Reading, Inst Cardiovasc & Metab Res, Dept Food & Nutr Sci, Reading RG6 6AP, Berks, England..
    Thuret, Sandrine
    Kings Coll London, Inst Psychiat Psychol & Neurosci, Maurice Wohl Clin Neurosci Inst, 125 Coldharbour Lane, London SE5 9NU, England..
    Vanden Berghe, Wim
    Univ Antwerp, Dept Biomed Sci, PPES, Campus Drie Eileen,Univ Pl 1, B-2610 Antwerp, Belgium..
    Vauzour, David
    Univ East Anglia, Norwich Res Pk, Norwich NR4 7TJ, Norfolk, England..
    Vellas, Bruno
    CHU Toulouse, Dept Geriatr Med, Toulouse, France..
    Wesnes, Keith
    Wesnes Cognit Ltd, Little Paddock, Streatley On Thames RG8 9RD, England.;Univ Exeter, Med Sch, Exeter, Devon, England.;Northumbria Univ, Dept Psychol, Newcastle, NSW, Australia.;Swinbume Univ, Ctr Human Psychopharmacol, Melbourne, Vic, Australia.;Newcastle Univ, Med Plant Res Croup, Newcastle, NSW, Australia..
    Willatts, Peter
    Univ Dundee Nethergate, Sch Psychol, Dundee DD1 4HN, Scotland..
    Wittenberg, Raphael
    London Sch Econ & Polit Sci, Personal Social Serv, Res Unit, London, England..
    Geurts, Lucie
    Europe ILSI Europe, Int Life Sci Inst, E Mounier 83,Box 6, B-1200 Brussels, Belgium..
    Poor cognitive ageing: Vulnerabilities, mechanisms and the impact of nutritional interventions2018In: Ageing Research Reviews, ISSN 1568-1637, E-ISSN 1872-9649, Vol. 42, p. 40-55Article, review/survey (Refereed)
    Abstract [en]

    Background: Ageing is a highly complex process marked by a temporal cascade of events, which promote alterations in the normal functioning of an individual organism. The triggers of normal brain ageing are not well understood, even less so the factors which initiate and steer the neuronal degeneration, which underpin disorders such as dementia. A wealth of data on how nutrients and diets may support cognitive function and preserve brain health are available, yet the molecular mechanisms underlying their biological action in both normal ageing, age-related cognitive decline, and in the development of neurodegenerative disorders have not been clearly elucidated.

    Objectives: This review aims to summarise the current state of knowledge of vulnerabilities that predispose towards dysfunctional brain ageing, highlight potential protective mechanisms, and discuss dietary interventions that may be used as therapies. A special focus of this paper is on the impact of nutrition on neuroprotection and the underlying molecular mechanisms, and this focus reflects the discussions held during the 2nd workshop ‘Nutrition for the Ageing Brain: Functional Aspects and Mechanisms’ in Copenhagen in June 2016. The present review is the most recent in a series produced by the Nutrition and Mental Performance Task Force under the auspice of the International Life Sciences Institute Europe (ILSI Europe).

    Conclusion: Coupling studies of cognitive ageing with studies investigating the effect of nutrition and dietary interventions as strategies targeting specific mechanisms, such as neurogenesis, protein clearance, inflammation, and non-coding and microRNAs is of high value. Future research on the impact of nutrition on cognitive ageing will need to adopt a longitudinal approach and multimodal nutritional interventions will likely need to be imposed in early-life to observe significant impact in older age.

  • 141.
    Modig, Karin
    et al.
    Karolinska Inst, Inst Environm Med, Stockholm, Sweden;Karolinska Inst, Inst Environm Med, Unit Epidemiol, Stockholm, Sweden.
    Erdefelt, Annelie
    Karolinska Inst, Inst Environm Med, Stockholm, Sweden;Karolinska Univ Hosp, Stockholm, Sweden.
    Meliner, Carl
    Karolinska Inst, Inst Environm Med, Stockholm, Sweden;Umea Univ, Dept Surg & Perioperat Sci, Umea, Sweden.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics. Karolinska Inst, Inst Environm Med, Stockholm, Sweden;Karolinska Univ Hosp, Stockholm, Sweden.
    Talbäck, Mats
    Karolinska Inst, Inst Environm Med, Stockholm, Sweden;Karolinska Inst, Inst Environm Med, Unit Epidemiol, Stockholm, Sweden.
    Hedström, Margareta
    Karolinska Inst, Inst Environm Med, Stockholm, Sweden;Karolinska Univ Hosp, Stockholm, Sweden;Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden.
    "Obesity Paradox" Holds True for Patients with Hip Fracture: A Registry-Based Cohort Study2019In: Journal of Bone and Joint Surgery. American volume, ISSN 0021-9355, E-ISSN 1535-1386, Vol. 101, no 10, p. 888-895Article in journal (Refereed)
    Abstract [en]

    Background: Hip fractures are associated with high mortality and reduced quality of life. Studies have reported a high body mass index (BMI) as being positively associated with survival when linked to old age and some chronic diseases. This phenomenon is called the "obesity paradox." The association between BMI and survival after hip fracture has not been thoroughly studied in large samples, nor has to what extent the association is altered by comorbidities, sex, and age. The objective of this study was to investigate the association of BMI with survival after hip fracture and with the probability of returning to living at home after hip fracture.

    Methods: This cohort study was based on data from a prospectively maintained national registry of patients with hip fracture. A total of 17,756 patients >= 65 years of age who were treated for hip fracture during the period of 2013 to 2016, and followed until the end of 2017, were included. BMI was clinically assessed at hospital admission, comorbidity was measured with the American Society of Anesthesiologists (ASA) score, and the date of death was retrieved from a national database. Self-reported data on living arrangements were assessed on admission and 4 months after fracture. Multi-variable regression models were used to estimate the associations.

    Results: Despite ASA scores being similar among all BMI groups, obese patients had the highest 1-year survival and patients with a BMI of <22 kg/m(2) had the lowest. Adjustment for potential confounders strengthened the associations. For the chance of returning to living at home, no advantage was seen for obese patients, but patients with a BMI of <22 kg/m(2) had clearly worse odds compared with patients who were of normal weight, overweight, or obese.

    Conclusions: The obesity paradox appears to be true for hip fracture patients aged 65 and older. Attention should be given to patients with malnutrition and underweight status rather than to those with overweight status or obesity when developing the orthogeriatric care.

  • 142. Muscaritoli, Maurizio
    et al.
    Krznarić, Zeljko
    Barazzoni, Rocco
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Golay, Alain
    Van Gossum, André
    Kennedy, Nicholas
    Kreimann, Georg
    Laviano, Alessandro
    Pavić, Tajana
    Schneider, Stéphane M
    Singer, Pierre
    Effectiveness and efficacy of nutritional therapy: A cochrane systematic review2017In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 36, no 4, p. 939-957Article in journal (Refereed)
    Abstract [en]

    BACKGROUND & AIMS: Disease-related malnutrition has deleterious consequences on patients' outcome and healthcare costs. The demonstration of improved outcome by appropriate nutritional management is on occasion difficult. The European Society of Clinical Nutrition and Metabolism (ESPEN) appointed the Nutrition Education Study Group (ESPEN-NESG) to increase recognition of nutritional knowledge and support in health services.

    METHODS: To obtain the best available evidence on the potential effects of malnutrition on morbidity, mortality and hospital stay; cost of malnutrition; effect of nutritional treatment on outcome parameters and pharmaco-economics of nutritional therapy, a Cochrane systematic review of the literature was performed by the Croatian Cochrane Branch to answer the following key questions: Q1) Is malnutrition an independent predictive factor for readmission within 30 days from hospital discharge? Q2) Does nutritional therapy reduce the risk of readmission within 30 days from hospital discharge? Q3) Is nutritional therapy cost-effective/does it reduce costs in hospitalized patients? and Q4) Is nutritional therapy cost effective/does it reduce costs in outpatients?

    RESULTS: For Q1 six of 15 identified observational studies indicated that malnutrition was predictive of re-admissions, whereas the remainder did not. For Q2 nine randomized controlled trials and two meta-analyses gave non-conclusive results whether re-admissions could be reduced by nutritional therapy. Economic benefit and cost-effectiveness of nutritional therapy was consistently reported in 16 identified studies for hospitalized patients (Q3), whereas the heterogeneous and limited corresponding data on out-patients (Q4) indicated cost-benefits in some selected sub-groups.

    CONCLUSIONS: This result of this review supports the use of nutritional therapy to reduce healthcare costs, most evident from large, homogeneous studies. In general, reports are too heterogeneous and overall of limited quality for conclusions on impact of malnutrition and its treatment on readmissions.

  • 143. Muscaritoli, Maurizio
    et al.
    Lucia, Simone
    Molfino, Alessio
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Fanelli, Filippo Rossi
    Muscle atrophy in aging and chronic diseases: is it sarcopenia or cachexia?2013In: INTERNAL AND EMERGENCY MEDICINE, ISSN 1828-0447, Vol. 8, no 7, p. 553-560Article, review/survey (Refereed)
    Abstract [en]

    Cachexia and sarcopenia present several analogies in both the pathogenic mechanisms and the clinical picture. The loss of muscle mass and strength is a hallmark of these two clinical conditions. Although frequently overlapping and often indistinguishable, especially in old individuals, these two conditions should be considered distinct clinical entities. A prompt and accurate patient evaluation, guiding the physician through a proper differential diagnostic procedure and providing the best therapeutic options, is recommended. Given the several commonalities between cachexia and sarcopenia, it is likely that the therapeutic approaches may prove effective in both conditions. This review focuses on the most recent available literature and aims at providing physicians with the correct tools that are available to aid in diagnosing these two different entities that often clinically overlap. Currently available or proposed therapeutic strategies for pre-cachexia, cachexia and sarcopenia are also briefly described.

  • 144. Nascimento, Marcelo Mazza
    et al.
    Qureshi, Abdul Rashid
    Stenvinkel, Peter
    Pecoits-Filho, Roberto
    Heimburger, Olof
    Cederholm, Tommy
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lindholm, Bengt
    Barany, Peter
    Malnutrition and inflammation are associated with impaired pulmonary function in patients with chronic kidney disease.2004In: Nephrol Dial Transplant, ISSN 0931-0509, Vol. 19, no 7, p. 1823-8Article in journal (Refereed)
  • 145. Nordenram, G
    et al.
    Ljunggren, G
    Cederholm, T
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Nutritional status and chewing capacity in nursing home residents.2001In: Aging (Milano), ISSN 0394-9532, Vol. 13, no 5, p. 370-7Article in journal (Refereed)
  • 146. Nyberg, Lillemor
    et al.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Bendrik, Regina
    Klässbo, Maria
    Eriksson, Margareta
    Primärvården har en nyckelroll för tidig diagnos och uppföljning: [Primary health care plays a key role in early diagnosis and follow-up].2014In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 111, no 21, p. 939-942Article in journal (Refereed)
    Abstract [no]

    Tidig klinisk diagnos av den kro-niska sjukdomen artros i knä och i höft är viktig för att tidigt kunna förebygga och behandla smärta, försämrad funktion och övervikt.Fysioterapeuten ställer klinisk diagnos enligt de nationella rikt-linjerna, prioriterar information (artrosskola), leder långvarig trä-ning och lär ut självtest för styrka och kondition samt ordinerar fysisk aktivitet på recept (FaR) livslångt.I dag rekommenderas all vård-personal att använda ett enkelt test, 30-sekunders sitt och stå-test, för bedömning av den aktuella benstyrkan.Riskfaktorer för hjärt–kärlsjuk-dom är viktiga att behandla. Ar-tros minskar patientens fysiska aktivitet, därför ökar risken för förtida död. Ökad kunskap om sarkopeni visar på metabola konsekvenser.

  • 147. Odlund Olin, A
    et al.
    Armyr, I
    Soop, M
    Jerstrom, S
    Classon, I
    Cederholm, T
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Ljungren, G
    Ljungqvist, O
    Energy-dense meals improve energy intake in elderly residents in a nursing home.2003In: Clin Nutr, ISSN 0261-5614, Vol. 22, no 2, p. 125-31Article in journal (Refereed)
  • 148. Odlund Olin, A
    et al.
    Koochek, Afsaneh
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Ljungqvist, O
    Minimal effect on energy intake by additional evening meal for frail elderly service flat residents: a pilot study2008In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 12, no 5, p. 295-301Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Nutritional problems are common in frail elderly individuals receiving municipal care. OBJECTIVE: To evaluate if an additional evening meal could improve total daily food intake, nutritional status, and health-related quality of life (HRQOL) in frail elderly service flat (SF) residents. DESIGN: Out of 122 residents in two SF complexes, 60 subjects agreed to participate, of which 49 subjects (median 84 (79-90) years, (25th-75th percentile)) completed the study. For six months 23 residents in one SF complex were served 530 kcal in addition to their regular meals, i.e. intervention group (I-group). Twenty-six residents in the other SF building were controls (C-group). Nutritional status, energy and nutrient intake, length of night time fast, cognitive function and HRQOL was assessed before and after the intervention. RESULTS: At the start, the Mini Nutritional Assessment classified 27% as malnourished and 63% as at risk for malnutrition, with no difference between the groups. After six months the median body weight was unchanged in the I-group, +0.6 (-1.7-+1.6) kg (p=0.72) and the C-group -0.6 (-2.0-+0.5) kg (p=0.15). Weight change ranged from -13% to +15%. The evening meal improved the protein and carbohydrate intake (p<0.01) but the energy intake increased by only 180 kcal/day (p=0.15). The night time fast decreased in the I-group from 15.0 (13.0-16.0) to 13.0 (12.0-14.0) hours (p<0.05). There was no significant difference in cognitive function or HRQOL between the groups. CONCLUSION: Nine out of ten frail elderly SF residents had nutritional problems. Serving an additional evening meal increased the protein and carbohydrate intake, but the meal had no significant effect on energy intake, body weight or HRQOL. The variation in outcome within each study group was large.

  • 149. Odlund Olin, A
    et al.
    Koochek, Afsaneh
    Ljungqvist, O
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Nutritional status, well-being and functional ability in frail elderly service flat residents2005In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 59, no 2, p. 263-70Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate nutritional status and its relationship to cognition, well-being, functional ability and energy intake in frail elderly service flat residents.

    DESIGN: Cross-sectional and prospective study.

    SETTING: Two municipal service flat complexes.

    SUBJECTS: A total of 80 residents (median age 85.5 (79-90) y) with regular home care assistance participated. A subgroup of 35 residents took part in a re-examination 1 y later.

    METHODS: Mini Nutritional Assessment (MNA), Short Portable Mental Status Questionnaire, Barthel Index and Health Index were used for the evaluation of nutritional, cognitive and ADL function and well-being, respectively.

    RESULTS: In all, 30% of the frail and chronically ill service flat residents were assessed as malnourished and 59% were at risk of malnutrition. The malnourished residents had worse cognitive conditions (P<0.001) and well-being (P<0.05), lower functional ability (P<0.01) and they had a greater need for daily assistance (P<0.05) than the other residents. The median night fast period was 14.0 (12.5-15.0) h. Five subjects classified as malnourished at baseline had lost a median of -9.6 kg (range -11.0 to +7.3 kg) (P<0.05) in body weight at the 1-y follow-up, which contrasted significantly from the weight stability in residents classified as at risk for malnutrition or well-nourished.

    CONCLUSION: Out of 10 residents, nine were assessed to have impending nutritional problems that related to impaired well-being, cognition, and functional ability. Malnourished residents had a significant weight loss over one year. Studies are needed to determine whether weight loss and nutrition-related dysfunction in service flat residents are preventable or treatable.

  • 150.
    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.

12345 101 - 150 of 219
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf