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  • 1.
    Akner, Gunnar
    et al.
    Örebro University, School of Health and Medical Sciences.
    Cederholm, T.
    Treatment of protein-energy malnutrition in chronic nonmalignant disorders2001In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 74, no 1, p. 6-24Article in journal (Refereed)
    Abstract [en]

    Protein-energy malnutrition (PEM) is common in connection with chronic disease and is associated with increased morbidity and mortality. Because the risk of PEM is related to the degree of illness, the causal connections between malnutrition and a poorer prognosis are complex. It cannot automatically be inferred that nutritional support will improve the clinical course of patients with wasting disorders. We reviewed studies of the treatment of PEM in cases of chronic obstructive pulmonary disease, chronic heart failure, stroke, dementia, rehabilitation after hip fracture, chronic renal failure, rheumatoid arthritis, and multiple disorders in the elderly. Several methodologic problems are associated with nutrition treatment studies in chronically ill patients. These problems include no generally accepted definition of PEM, uncertain patient compliance with supplementation, and a wide range of outcome variables. Avail-able treatment studies indicate that dietary supplements, either alone or in combination with hormonal treatment, may have positive effects when given to patients with manifest PEM or to patients at risk of developing PEM. In chronic obstructive pulmonary disease, nutritional treatment may improve respiratory function. Nutritional therapy of elderly women after hip fractures may speed up the rehabilitation process. When administered to elderly patients with multiple disorders, diet therapy may improve functional capacity. The data regarding nutritional treatment of the conditions mentioned above is still inconclusive. There is still a great need for randomized controlled long-term studies of the effects of defined nutritional intervention programs in chronically ill and frail elderly with a focus on determining clinically relevant outcomes.

  • 2.
    Ekelund, Ulf
    et al.
    Örebro University, School of Health and Medical Sciences.
    Anderssen, Sigmund
    Andersen, Lars Bo
    Riddoch, Chris J.
    Sardinha, Luis B.
    Luan, Jian An
    Froberg, Karsten
    Brage, Sören
    Prevalence and correlates of the metabolic syndrome in a population-based sample of European Youth2009In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 89, no 1, p. 90-96Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Until recently, there has been no unified definition of the metabolic syndrome (MetS) in the youth. Therefore, the prevalence of MetS and its association with potential correlates are largely unknown. OBJECTIVE: The objective was to quantify the prevalence, identify the correlates, and examine the independent associations between potential correlates with MetS. DESIGN: A population-based cohort study was conducted in 10- and 15-y-old youth from Estonia, Denmark, and Portugal (n = 3193). MetS was defined according to the International Diabetes Federation. Correlates included maternal socioeconomic status, body mass index (BMI), hypertension, and prevalent diabetes and maternally reported child's birth weight and duration of breastfeeding. Data on sexual maturity, objectively measured physical activity, cardiorespiratory fitness, self-reported sports participation, television viewing, and regular play were collected for the children. RESULTS: The prevalence of MetS was 0.2% and 1.4% in 10- and 15-y-olds, respectively. Cardiorespiratory fitness (standardized odds ratio: 0.33; 95% CI: 0.15, 0.75), physical activity (standardized odds ratio: 0.40; 95% CI: 0.18, 0.88), and maternal BMI (standardized odds ratio: 1.61; 95% CI: 1.11, 2.34) were all independently associated with MetS after adjustment for sex, age group, study location, birth weight, and sexual maturity. An increase in daily moderate-intensity physical activity by 10-20% was associated with a 33% lower risk of being categorized with MetS. CONCLUSIONS: High maternal BMI and low levels of cardiorespiratory fitness and physical activity independently contribute to the MetS and may be targets for future interventions. Relatively small increases in physical activity may significantly reduce the risk of MetS in healthy children.

  • 3.
    Ekelund, Ulf
    et al.
    MRC Epidemiology Unit, Cambridge, United Kingdom; Department of Physical Education and Health, Örebro University, Örebro, Sweden; MRC Epidemiology Unit, Strangeways Research Laboratory, Worts Causeway, Cambridge, United Kingdom .
    Yngve, Agneta
    PREVNUT at Novum, Karolinska Institutet, Stockholm, Sweden .
    Brage, Sören
    Department of Physical Education and Health, Örebro University, Örebro, Sweden; Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark .
    Westerterp, Klaas
    Department of Human Biology, Maastricht University, Maastricht, Netherlands .
    Sjöström, Michael
    PREVNUT at Novum, Karolinska Institutet, Stockholm, Sweden .
    Body movement and physical activity energy expenditure in children and adolescents: how to adjust for differences in body size and age2004In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 79, no 5, p. 851-856Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Physical activity data in children and adolescents who differ in body size and age are influenced by whether physical activity is expressed in terms of body movement or energy expenditure.

    OBJECTIVE: We examined whether physical activity expressed as body movement (ie, accelerometer counts) differs from physical activity energy expenditure (PAEE) as a function of body size and age.

    DESIGN: This was a cross-sectional study in children [n = 26; (+/-SD) age: 9.6 +/- 0.3 y] and adolescents (n = 25; age: 17.6 +/- 1.5 y) in which body movement and total energy expenditure (TEE) were simultaneously measured with the use of accelerometry and the doubly labeled water method, respectively. PAEE was expressed as 1) unadjusted PAEE [TEE minus resting energy expenditure (REE); in MJ/d], 2) PAEE adjusted for body weight (BW) (PAEE. kg(-1). d(-1)), 3) PAEE adjusted for fat-free mass (FFM) (PAEE. kg FFM(-1). d(-1)), and 4) the physical activity level (PAL = TEE/REE).

    RESULTS: Body movement was significantly higher (P = 0.03) in children than in adolescents. Similarly, when PAEE was normalized for differences in BW or FFM, it was significantly higher in children than in adolescents (P = 0.03). In contrast, unadjusted PAEE and PAL were significantly higher in adolescents (P < 0.01).

    CONCLUSIONS: PAEE should be normalized for BW or FFM for comparison of physical activity between children and adolescents who differ in body size and age. Adjusting PAEE for FFM removes the confounding effect of sex, and therefore FFM may be the most appropriate body-composition variable for normalization of PAEE. Unadjusted PAEE and PAL depend on body size.

  • 4.
    Ekelund, Ulf
    et al.
    Unit for Preventive Nutrition, Department of Medical Nutrition/Biosciences, Karolinska Institutet, Stockholm, Sweden; Department of Physical Education and Health, Örebro University, Örebro, Sweden; .
    Åman, Jan
    Örebro University, School of Health and Medical Sciences. Unit for Preventive Nutrition, Department of Medical Nutrition/Biosciences, Karolinska Institutet, Stockholm, Sweden; .
    Yngve, Agneta
    Unit for Preventive Nutrition, Department of Medical Nutrition/Biosciences, Karolinska Institutet, Stockholm, Sweden .
    Renman, Cecilia
    Department of Pediatrics, Örebro Medical Center, Örebro, Sweden .
    Westerterp, Klaas
    Department of Human Biology, Maastricht University, Maastricht, Netherlands.
    Sjöström, Michael
    Unit for Preventive Nutrition, Department of Medical Nutrition/Biosciences, Karolinska Institutet, Stockholm, Sweden .
    Physical activity but not energy expenditure is reduced in obese adolescents: a case-control study2002In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 76, no 5, p. 935-941Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The influence of physical activity on body weight in children and adolescents is controversial.

    OBJECTIVE: The objective was to test the hypothesis that the intensity and duration of physical activity differ between obese and normal-weight adolescents, with no difference in estimated energy expenditure.

    DESIGN: We compared physical activity in 18 (8 males, 10 females) obese [body mass index (in kg/m(2)) > 30] adolescents (14-19 y) with that in a matched, normal-weight (BMI < 27) control group. Total energy expenditure (TEE) was measured with the doubly labeled water method, and physical activity was measured simultaneously by accelerometry. The physical activity level was determined as the ratio of TEE to the resting metabolic rate (RMR) and activity energy expenditure as 0.9 TEE minus RMR. Accelerometry data included total physical activity (counts x min(-1) x d(-1)), accumulated and continuous duration of activity, and continuous 10-min periods of physical activity of moderate intensity.

    RESULTS: There was no significant difference in adjusted (analysis of covariance) TEE, RMR, or AEE between groups. The physical activity level was significantly lower (P < 0.05) in the obese group. No sex x group interaction was observed. Differences in total physical activity (P < 0.001), accumulated time (P < 0.05), continuous time (P < 0.01), and continuous 10-min periods of physical activity of moderate intensity (P < 0.01) were observed between groups.

    CONCLUSIONS: Obese adolescents are less physically active than are normal-weight adolescents, but physical activity-related energy expenditure is not significantly different between groups. The data suggest that physical activity is not necessarily equivalent to the energy costs of activity.

  • 5.
    Epstein, Mara M.
    et al.
    Channing Lab, Dept Medicine, Brigham & Womens Hosp, Harvard University, Boston MA, USA; School of Public Health, Dept. of Epidemiology, Harvard University, Boston MA, USA.
    Kasperzyk, Julie L.
    Channing Lab, Dept Medicine, Brigham & Womens Hosp, Harvard University, Boston MA, USA; School of Public Health, Dept. of Epidemiology, Harvard University, Boston MA, USA.
    Andrén, Ove
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Giovannucci, Edward L.
    Channing Lab, Dept Medicine, Brigham & Womens Hosp, Harvard University, Boston MA, USA; School of Public Health, Dept. of Epidemiology and Dept. of Nutrition, Harvard University, Boston MA, USA.
    Wolk, Alicja
    Inst. Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
    Håkansson, Niclas
    Inst. Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
    Andersson, Swen-Olof
    Örebro County Council, Örebro, Sweden.
    Johansson, Jan-Erik
    Örebro County Council, Örebro, Sweden.
    Fall, Katja
    School of Public Health, Dept. Epidemiology, Harvard University, Boston MA, USA; Dept. Genetics & Pathology, Uppsala University Hospital, Uppsala, Sweden; Center for Public Health Services, University of Iceland, Reykjavik, Iceland.
    Mucci, Lorelei A.
    Channing Lab, Dept. of Medicine, School of Medicine, Brigham & Womens Hospital, Harvard University, Boston MA, USA; School of Public Health, Dept. Epidemiology, Harvard University, Boston MA, USA; Center for Public Health Services, Univ Iceland, Reykjavik, Iceland.
    Dietary zinc and prostate cancer survival in a Swedish cohort2011In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 93, no 3, p. 586-593Article in journal (Refereed)
    Abstract [en]

    Background: Zinc is involved in many essential cellular functions, including DNA repair and immune system maintenance. Although experimental evidence supports a role for zinc in prostate carcinogenesis, epidemiologic data are inconsistent; no data on cancer-specific survival have been reported.

    Objective: Our objective was to determine whether dietary zinc assessed near the time of prostate cancer diagnosis is associated with improved disease-specific survival.

    Design: This population-based cohort consists of 525 men aged < 80 y from Orebro County, Sweden, with a diagnosis of prostate cancer made between 1989 and 1994. Study participants completed self-administered food-frequency questionnaires, and zinc intake was derived from nutrient databases. Cox proportional hazards regression was used to estimate multivariate hazard ratios (HRs) and 95% CIs for time to death from prostate cancer as well as death from all causes through February 2009 by quartile (Q) of dietary zinc intake. Models were also stratified by disease stage at diagnosis (localized or advanced).

    Results: With a median follow-up of 6.4 y, 218 (42%) men died of prostate cancer and 257 (49%) died of other causes. High dietary zinc intake was associated with a reduced risk of prostate cancer-specific mortality (HR(Q4 vs Q1): 0.64; 95% CI: 0.44, 0.94; P for trend = 0.05) in the study population. The association was stronger in men with localized tumors (HR: 0.24; 95% CI: 0.09, 0.66; P for trend = 0.005). Zinc intake was not associated with mortality from other causes.

    Conclusion: These results suggest that high dietary intake of zinc is associated with lower prostate cancer-specific mortality after diagnosis, particularly in men with localized disease. Am J Clin Nutr 2011;93:586-93.

  • 6.
    Eriksson, Britt
    et al.
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Henriksson, Hanna
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Löf, Marie
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Hannestad, Ulf
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Forsum, Elisabet
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Body-composition development during early childhood and energy expenditure in response to physical activity in 1.5-y-old children2012In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 96, no 3, p. 567-573Article in journal (Refereed)
    Abstract [en]

    Background: The prevalence of childhood overweight and obesity has increased recently, but the mechanisms involved are incompletely known. Previous research has shown a correlation between the percentage of total body fat (TBF) and physical activity level (PAL). However, the PAL values used may involve a risk of spurious correlations because they are often based on predicted rather than measured estimates of resting energy metabolism. l

    Objectives: We studied the development of body composition during early childhood and the relation between the percentage of TBF and PAL on the basis of the measured resting energy metabolism.

    Design: Body composition was previously measured in 108 children when they were 1 and 12 wk old. When 44 of these children (21 girls and 23 boys) were 1.5 y old, their total energy expenditure and TBF were assessed by using the doubly labeled water method. Resting energy metabolism, which was assessed by using indirect calorimetry, was used to calculate PAL.

    Results: Significant correlations were shown for TBF (r = 0.32, P = 0.035) and fat-free mass (r = 0.34, P = 0.025) between values (kg) assessed at 12 wk and 1.5 y of age. For TBF (kg) a significant interaction (P = 0.035) indicated a possible sex difference. PAL at 1.5 y was negatively correlated with the percentage of TBF (r = -0.40, P = 0.0076) and the increase in the percentage of TBF between 12 wk and 1.5 y (r = 0.38, P = 0.0105).

    Conclusions: The results indicate that body fatness and physical activity interact during early childhood and thereby influence obesity risk. Our results are based on a small sample, but nevertheless, they motivate additional studies in boys compared with girls regarding the development of body composition during early life.

  • 7.
    Forsgård, Richard A.
    Örebro University, School of Medical Sciences. Pharmacology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
    Lactose digestion in humans: intestinal lactase appears to be constitutive whereas the colonic microbiome is adaptable2019In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 110, no 2, p. 273-279Article in journal (Refereed)
    Abstract [en]

    Globally, ∼70% of adults are deficient in intestinal lactase, the enzyme required for the digestion of lactose. In these individuals, the consumption of lactose-containing milk and dairy products can lead to the development of various gastrointestinal (GI) symptoms. The primary solution to lactose intolerance is withdrawing lactose from the diet either by eliminating dairy products altogether or substituting lactose-free alternatives. However, studies have shown that certain individuals erroneously attribute their GI symptoms to lactose and thus prefer to consume lactose-free products. This has raised the question whether consuming lactose-free products reduces an individual's ability to absorb dietary lactose and if lactose-absorbers should thus avoid these products. This review summarizes the current knowledge regarding the acclimatization of lactose processing in humans. Human studies that have attempted to induce intestinal lactase expression with different lactose feeding protocols have consistently shown lack of enzyme induction. Similarly, withdrawing lactose from the diet does not reduce intestinal lactase expression. Evidence from cross-sectional studies shows that milk or dairy consumption is a poor indicator of lactase status, corroborating the results of intervention studies. However, in lactase-deficient individuals, lactose feeding supports the growth of lactose-digesting bacteria in the colon, which enhances colonic lactose processing and possibly results in the reduction of intolerance symptoms. This process is referred to as colonic adaptation. In conclusion, endogenous lactase expression does not depend on the presence of dietary lactose, but in susceptible individuals, dietary lactose might improve intolerance symptoms via colonic adaptation. For these individuals, lactose withdrawal results in the loss of colonic adaptation, which might lower the threshold for intolerance symptoms if lactose is reintroduced into the diet.

  • 8.
    Karimi, Mohsen
    et al.
    Department of Medicine and Hematology (HERM), Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Vedin, Inger
    Department of Medicine and Hematology (HERM), Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Freund-Levi, Yvonne
    Department of Neurobiology, Care, Sciences and Society, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Basun, Hans
    Department of Public Health and Caring Sciences, Division of Geriatrics, Uppsala University Hospital, Uppsala, Sweden.
    Faxén Irving, Gerd
    Department of Neurobiology, Care, Sciences and Society, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Eriksdotter, Maria
    Department of Neurobiology, Care, Sciences and Society, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Wahlund, Lars-Olof
    Department of Neurobiology, Care, Sciences and Society, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Schultzberg, Marianne
    Department of Neurobiology, Care, Sciences and Society, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Hjorth, Erik
    Department of Neurobiology, Care, Sciences and Society, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Cederholm, Tommy
    Department of Clinical Nutrition and Metabolism, Uppsala University Hospital, Uppsala, Sweden.
    Palmblad, Jan
    Department of Medicine and Hematology (HERM), Karolinska Institutet, Karolinska University Hospital Huddinge, 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 (ω-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'-cytosine-phosphate-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.

  • 9. Kasperzyk, Julie L.
    et al.
    Fall, Katja
    Mucci, Lorelei A.
    Håkansson, Niclas
    Wolk, Alicja
    Johansson, Jan-Erik
    Örebro University, School of Health and Medical Sciences.
    Andersson, Swen-Olof
    Andrén, Ove
    One-carbon metabolism-related nutrients and prostate cancer survival2009In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 90, no 3, p. 561-569Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Folate and other one-carbon metabolism nutrients may influence prostate cancer pathogenesis. Prior studies of these nutrients in relation to prostate cancer incidence have been inconclusive, and none have explored prostate cancer survival. OBJECTIVE: The objective was to assess whether dietary intakes of folate, riboflavin, vitamin B-6, vitamin B-12, and methionine measured around the time of prostate cancer diagnosis are associated with prostate cancer survival. DESIGN: This population-based prospective study comprised 525 men from Orebro, Sweden, who received a diagnosis of incident prostate cancer between 1989 and 1994 and completed a self-administered food-frequency questionnaire. Record linkages to the Swedish Death Registry enabled all cases to be followed for up to 20 y after diagnosis, and the cause of death was assigned via medical record review. Cox proportional hazards regression was used to calculate multivariable hazard ratios (HRs) and 95% CIs. During a median of 6.4 y of follow-up, 218 men (42%) died of prostate cancer and 257 (49%) of other causes. RESULTS: A comparison of the highest with the lowest quartile showed that vitamin B-6 intake was inversely associated with prostate cancer-specific death (HR: 0.71; 95% CI: 0.46, 1.10; P for trend = 0.08), especially in men with a diagnosis of localized-stage disease (HR; 0.05; 95% CI: 0.01, 0.26; P for trend = 0.0003). However, vitamin B-6 intake was not associated with improved prostate cancer survival among advanced-stage cases (HR: 1.04; 95% CI: 0.64, 1.72; P for trend = 0.87). Folate, riboflavin, vitamin B-12, and methionine intakes were not associated with prostate cancer survival. CONCLUSION: A high vitamin B-6 intake may improve prostate cancer survival among men with a diagnosis of localized-stage disease.

  • 10. Kilpelaeinen, Tuomas O.
    et al.
    den Hoed, Marcel
    Ong, Ken K.
    Grontved, Anders
    Brage, Sören
    Jameson, Karen
    Cooper, Cyrus
    Khaw, Kay-Tee
    Ekelund, Ulf
    Örebro University, School of Health and Medical Sciences.
    Wareham, Nicholas J.
    Loos, Ruth J. F.
    Obesity-susceptibility loci have a limited influence on birth weight: a meta-analysis of up to 28,219 individuals2011In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 93, no 4, p. 851-860Article in journal (Refereed)
    Abstract [en]

    Background: High birth weight is associated with adult body mass index (BMI). We hypothesized that birth weight and BMI may partly share a common genetic background. Objective: The objective was to examine the associations of 12 established BMI variants in or near the NEGR1, SEC16B, TMEM18, ETV5, GNPDA2, BDNF, MTCH2, BCDIN3D, SH2B1, FTO, MC4R, and KCTD15 genes and their additive score with birth weight. Design: A meta-analysis was conducted with the use of 1) the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk, Hertfordshire, Fenland, and European Youth Heart Study cohorts (n(max) = 14,060); 2) data extracted from the Early Growth Genetics Consortium meta-analysis of 6 genome-wide association studies for birth weight (n(max) = 10,623); and 3) all published data (n(max) = 14,837). Results: Only the MTCH2 and FTO loci showed a nominally significant association with birth weight. The BMI-increasing allele of the MTCH2 variant (rs10838738) was associated with a lower birth weight (beta +/- SE: 213 +/- 5 g/allele; P = 0.012; n = 23,680), and the BMI-increasing allele of the FTO variant (rs1121980) was associated with a higher birth weight (beta +/- SE: 11 +/- 4 g/allele; P = 0.013; n = 28,219). These results were not significant after correction for multiple testing. Conclusions: Obesity-susceptibility loci have a small or no effect on weight at birth. Some evidence of an association was found for the MTCH2 and FTO loci, ie, lower and higher birth weight, respectively. These findings may provide new insights into the underlying mechanisms by which these loci confer an increased risk of obesity. Am J Clin Nutr 2011;93:851-60.

  • 11.
    Konttinen, Hanna
    et al.
    Department of Social Research, University of Helsinki, Helsinki, Finland .
    Peltonen, Markku
    Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland .
    Sjöström, Lars
    Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden .
    Carlsson, Lena
    Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden .
    Karlsson, Jan
    Örebro University Hospital. Center for Health Care Sciences, Örebro University Hospital, Örebro, Sweden; Department of Medical Sciences, Örebro University, Örebro, Sweden.
    Psychological aspects of eating behavior as predictors of 10-y weight changes after surgical and conventional treatment of severe obesity: results from the Swedish Obese Subjects intervention study2015In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 101, no 1, p. 16-24Article in journal (Refereed)
    Abstract [en]

    Background: There is a need for a better understanding of the factors that influence long-term weight outcomes after bariatric surgery.

    Objective: We examined whether pretreatment and posttreatment levels of cognitive restraint, disinhibition, and hunger and 1-y changes in these eating behaviors predict short- and long-term weight changes after surgical and conventional treatments of severe obesity.

    Design: Participants were from an ongoing, matched (nonrandomized) prospective intervention trial of the Swedish Obese Subjects (SOS) study. The current analyses included 2010 obese subjects who underwent bariatric surgery and 1916 contemporaneously matched obese controls who received conventional treatment. Physical measurements (e.g., weight and height) and questionnaires (e.g., Three-Factor Eating Questionnaire) were completed before the intervention and 0.5, 1, 2, 3, 4, 6, 8, and 10 y after the start of the treatment. Structural equation modeling was used as the main analytic strategy.

    Results: The surgery group lost more weight and reported greater decreases in disinhibition and hunger at 1- and 10-y follow-ups (all P < 0.001 in both sexes) than the control group did. Pretreatment eating behaviors were unrelated to subsequent weight changes in surgically treated patients. However, patients who had lower levels of 6-mo and 1-y disinhibition and hunger (beta = 0.13-0.29, P < 0.01 in men; beta = 0.11-0.28, P < 0.001 in women) and experienced larger 1-y decreases in these behaviors (beta = 0.31-0.48, P < 0.001 in men; beta = 0.24-0.51, P < 0.001 in women) lost more weight 2, 6, and 10 y after surgery. In control patients, larger 1-y increases in cognitive restraint predicted a greater 2-y weight loss in both sexes.

    Conclusion: A higher tendency to eat in response to various internal and external cues shortly after surgery predicted less-successful short- and long-term weight outcomes, making postoperative susceptibility for uncontrolled eating an important indicator of targeted interventions.

  • 12. Larsson, Susanna C.
    et al.
    Andersson, Swen-Olof
    Örebro University, School of Health and Medical Sciences.
    Johansson, Jan-Erik
    Örebro University, School of Health and Medical Sciences.
    Wolk, Alicja
    Cultured milk, yogurt, and dairy intake in relation to bladder cancer risk in a prospective study of Swedish women and men2008In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 88, no 4, p. 1083-1087Article in journal (Refereed)
    Abstract [en]

    Background:Findings from epidemiologic studies of the effect of dairy foods (mainly milk) on the risk of bladder cancer have been inconsistent.

    Objective:We aimed to examine the association between the intake of cultured milk and other dairy foods and the incidence of bladder cancer in a prospective, population-based cohort.

    Design:We prospectively followed 82 002 Swedish women and men who were cancer-free and who completed a 96-item food-frequency questionnaire in 1997. Incident cases of bladder cancer were identified in the Swedish cancer registries.

    Results:During a mean follow-up of 9.4 y, 485 participants (76 women and 409 men) were diagnosed with bladder cancer. Total dairy intake was not significantly associated with risk of bladder cancer [7.0 servings/d compared with < 3.5 servings/d: multivariate rate ratio (RR) = 0.87; 95% CI: 0.66, 1.15; P for trend = 0.33]. However, a statistically significant inverse association was observed for the intake of cultured milk (sour milk and yogurt). The multivariate RRs for the highest category of cultured milk intake (2 servings/d) compared with the lowest category (0 serving/d) were 0.62 (95% CI: 0.46, 0.85; P for trend = 0.006) in women and men combined, 0.55 (95% CI: 0.25, 1.22; P for trend = 0.06) in women, and 0.64 (95% CI: 0.46, 0.89; P for trend = 0.03) in men. The intake of milk or cheese was not associated with bladder cancer risk.

  • 13. Larsson, Susanna C.
    et al.
    Bergkvist, Leif
    Rutegård, Jörgen
    Örebro University, Department of Clinical Medicine.
    Giovannucci, Edward
    Wolk, Alicja
    Calcium and dairy food intakes are inversely associated with colorectal cancer risk in the Cohort of Swedish Men2006In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 83, no 3, p. 667-673Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Recent epidemiologic studies have generally reported a modest inverse association between calcium intake and the risk of colorectal cancer. However, findings pertaining to specific subsites in the colorectum have been conflicting. OBJECTIVE: Our objective was to prospectively examine the relations between intakes of calcium and dairy foods and the risk of colorectal cancer, overall and by anatomic subsite, in men from the Cohort of Swedish Men. DESIGN: In 1997, 45 306 men aged 45-79 y and without a history of cancer completed a food-frequency questionnaire. The men were followed through 31 December 2004. RESULTS: During a mean follow-up of 6.7 y, we ascertained 449 incident cases of colorectal cancer. After adjustment for age and other known or potential risk factors, the multivariate rate ratio (RR) of colorectal cancer for men in the highest quartile of total calcium intake compared with those in the lowest quartile was 0.68 (95% CI: 0.51, 0.91; P for trend = 0.01). A high consumption of dairy foods was also associated with a lower risk of colorectal cancer. The multivariate RR of colorectal cancer for > or = 7 servings/d of total dairy foods compared with <2 servings/d was 0.46 (0.30, 0.71; P for trend = 0.01). For cancer subsites, the corresponding RRs were 0.37 (0.16, 0.88) for proximal colon, 0.43 (0.20, 0.93) for distal colon, and 0.48 (0.23, 0.99) for rectum. CONCLUSION: Our findings provide support for inverse associations between intakes of calcium and dairy foods and the risk of colorectal cancer.

  • 14.
    Rautiainen, Susanne
    et al.
    Divisions of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Lindblad, Birgitta Ejdervik
    Divisions of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Ophthalmology, Sundsvall Hospital, Sundsvall, Sweden.
    Morgenstern, Ralf
    Biochemical Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Wolk, Alicja
    Divisions of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Vitamin C supplements and the risk of age-related cataract: a population-based prospective cohort study in women2010In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 91, no 2, p. 487-93Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Experimental animal studies have shown adverse effects of high-dose vitamin C supplements on age-related cataract.

    OBJECTIVE: We examined whether vitamin C supplements (approximately 1000 mg) and multivitamins containing vitamin C (approximately 60 mg) are associated with the incidence of age-related cataract extraction in a population-based, prospective cohort of women.

    DESIGN: Our study included 24,593 women aged 49-83 y from the Swedish Mammography Cohort (follow-up from September 1997 to October 2005). We collected information on dietary supplement use and lifestyle factors with the use of a self-administrated questionnaire. Cataract extraction cases were identified by linkage to the cataract extraction registers in the geographical study area.

    RESULTS: During the 8.2 y of follow-up (184,698 person-years), we identified 2497 cataract extraction cases. The multivariable hazard ratio (HR) for vitamin C supplement users compared with that for nonusers was 1.25 (95% CI: 1.05, 1.50). The HR for the duration of >10 y of use before baseline was 1.46 (95% CI: 0.93, 2.31). The HR for the use of multivitamins containing vitamin C was 1.09 (95% CI: 0.94, 1.25). Among women aged > or = 65 y, vitamin C supplement use increased the risk of cataract by 38% (95% CI: 12%, 69%). Vitamin C use among hormone replacement therapy users compared with that among nonusers of supplements or of hormone replacement therapy was associated with a 56% increased risk of cataract (95% CI: 20%, 102%). Vitamin C use among corticosteroid users compared with that among nonusers of supplements and corticosteroids was associated with an HR of 1.97 (95% CI: 1.35, 2.88).

    CONCLUSION: Our results indicate that the use of vitamin C supplements may be associated with higher risk of age-related cataract among women.

  • 15. Ruiz, Jonatan R.
    et al.
    Rizzo, Nico S.
    Hurtig-Wennlöf, Anita
    Örebro University, Department of Clinical Medicine.
    Ortega, Francisco B.
    Wärnberg, Julia
    Sjöström, Michael
    Relations of total physical activity and intensity to fitness and fatness in children: the European Youth Heart Study2006In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 84, no 2, p. 299-303Article in journal (Refereed)
    Abstract [en]

    Background: It is unclear how the amount and intensity of physical activity (PA) are associated with cardiovascular fitness (CVF) and body fatness in children.

    Objective: We aimed to examine the associations of total PA and intensity levels to CVF and fatness in children.

    Design: A cross-sectional study of 780 children aged 9–10 y from Sweden and Estonia was conducted. PA was measured by accelerometry and was expressed as min/d of total PA, moderate PA, and vigorous PA. CVF was measured with a maximal ergometer bike test and was expressed as W/kg. Body fat was derived from the sum of 5 skinfold-thickness measurements. Multiple regression analysis was used to determine the degree to which variance in CVF and body fat was explained by PA, after control for age, sex, and study location.

    Results: Lower body fat was significantly associated with higher levels of vigorous PA, but not with moderate or total PA. Those children who engaged in >40 min vigorous PA/d had lower body fat than did those who engaged in 10–18 min vigorous PA/d. Total PA, moderate PA, and vigorous PA were positively associated with CVF. Those children who engaged in >40 min vigorous PA/d had higher CVF than did those who accumulated <18 min vigorous PA/d.

    Conclusions: The results suggest that PA of vigorous intensity may have a greater effect on preventing obesity in children than does PA of lower intensity, whereas both total and at least moderate to vigorous PA may improve children's CVF.

  • 16.
    Schindler, Karin
    et al.
    Medical University of Vienna, Vienna, Austria.
    Themessl-Huber, Michael
    Medical University of Vienna, Vienna, Austria.
    Hiesmayr, Michael
    Medical University of Vienna, Vienna, Austria.
    Kosak, Sigrid
    Medical University of Vienna, Vienna, Austria.
    Lainscak, Mitja
    General Hospital Celje, Celje, Slovenia.
    Laviano, Alessandro
    University La Sapienza, Rome, Italy.
    Ljungqvist, Olle
    Örebro University, School of Medical Sciences.
    Mouhieddine, Mohamed
    Medical University of Vienna, Vienna, Austria.
    Schneider, Stéphane
    Archet University Hospital, Nice, France.
    de van der Schueren, Marian
    Medical Center, Vrije Universiteit, Amsterdam, Netherlands.
    Schütz, Tatjana
    University of Leipzig, Leipzig, Germany.
    Schuh, Christian
    Medical University of Vienna, Vienna, Austria.
    Singer, Pierre
    Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
    Bauer, Peter
    Medical University of Vienna, Vienna, Austria.
    Pichard, Claude
    Geneva University Hospital, Geneva, Switzerland.
    To eat or not to eat? Indicators for reduced food intake in 91,245 patients hospitalized on nutritionDays 2006-2014 in 56 countries worldwide: a descriptive analysis2016In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 104, no 5, p. 1393-1402Article in journal (Refereed)
    Abstract [en]

    Background: Inadequate nutrition during hospitalization is strongly associated with poor patient outcome, but ensuring adequate food intake is not a priority in clinical routine worldwide. This lack of priority results in inadequate and unbalanced food intake in patients and huge amounts of wasted food.

    Objectives: We evaluate the main factors that are associated with reduced meal intake in hospitalized patients and the differences between geographical regions.

    Design: We conducted a descriptive analysis of data from 9 consecutive, annual, and cross-sectional nutritionDay samples (2006-2014) in a total of 91,245 adult patients in 6668 wards in 2584 hospitals in 56 countries. A general estimation equation methodology was used to develop a model for meal intake, and P-value thresholding was used for model selection.

    Results: The proportion of patients who ate a full meal varied widely (24.7-61.5%) across world regions. The factors that were most strongly associated with reduced food intake on nutritionDay were reduced intake during the previous week (OR: 0.20; 95% CI: 0.17, 0.22), confinement to bed (OR: 0.49; 95% CI: 0.44, 0.55), female sex (OR: 0.53; 95% CI: 0.5, 0.56), younger age (OR: 0.74; 95% CI: 0.64, 0.85) and older age (OR: 0.80; 95% CI: 0.74; 0.88), and low body mass index (OR: 0.84; 95% CI: 0.79, 0.90). The pattern of associated factors was homogenous across world regions.

    Conclusions: A set of factors that are associated with full meal intake was identified and is applicable to patients hospitalized in any region of the world. Thus, the likelihood for reduced food intake is easily estimated through access to patient characteristics, independent of world regions, and enables the easy personalization of food provision. This trial was registered at clinicaltrials.gov as NCT02820246.

  • 17.
    Shannon, Oliver M.
    et al.
    Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.
    Stephan, Blossom C. M.
    Institute of Health and Society and Newcastle University Institute of Ageing, Newcastle University, Newcastle upon Tyne, United Kingdom.
    Granic, Antoneta
    Institute of Health and Society and Newcastle University Institute of Ageing, Newcastle University, Newcastle upon Tyne, United Kingdom.
    Lentjes, Marleen
    Örebro University, School of Medical Sciences. Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
    Hayat, Shabina
    Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
    Mulligan, Angela
    Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
    Brayne, Carol
    Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
    Khaw, Kay-Tee
    Clinical Gerontology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom.
    Bundy, Rafe
    Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
    Aldred, Sarah
    School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom.
    Hornberger, Michael
    Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, United Kingdom.
    Paddick, Stella-Maria
    Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital and Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom.
    Muniz-Tererra, Graciela
    Centre for Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom.
    Minihane, Anne-Marie
    Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
    Mathers, John C.
    Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.
    Siervo, Mario
    Human Nutrition Research Centre, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom; School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, United Kingdom.
    Mediterranean diet adherence and cognitive function in older UK adults: the European Prospective Investigation into Cancer and Nutrition-Norfolk (EPIC-Norfolk) Study2019In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 110, no 4, p. 938-948Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In Mediterranean countries, adherence to a traditional Mediterranean dietary pattern (MedDiet) is associated with better cognitive function and reduced dementia risk. It is unclear if similar benefits exist in non-Mediterranean regions.

    OBJECTIVES: The aims of this study were to examine associations between MedDiet adherence and cognitive function in an older UK population and to investigate whether associations differed between individuals with high compared with low cardiovascular disease (CVD) risk.

    METHODS: We conducted an analysis in 8009 older individuals with dietary data at Health Check 1 (1993-1997) and cognitive function data at Health Check 3 (2006-2011) of the European Prospective Investigation into Cancer and Nutrition-Norfolk (EPIC-Norfolk). Associations were explored between MedDiet adherence and global and domain-specific cognitive test scores and risk of poor cognitive performance in the entire cohort, and when stratified according to CVD risk status.

    RESULTS: Higher MedDiet adherence defined by the Pyramid MedDiet score was associated with better global cognition (β ± SE = -0.012 ± 0.002; P < 0.001), verbal episodic memory (β ± SE = -0.009 ± 0.002; P < 0.001), and simple processing speed (β ± SE = -0.002 ± 0.001; P = 0.013). Lower risk of poor verbal episodic memory (OR: 0.784; 95% CI: 0.641, 0.959; P = 0.018), complex processing speed (OR: 0.739; 95% CI: 0.601, 0.907; P = 0.004), and prospective memory (OR: 0.841; 95% CI: 0.724, 0.977; P = 0.023) was also observed for the highest compared with the lowest Pyramid MedDiet tertiles. The effect of a 1-point increase in Pyramid score on global cognitive function was equivalent to 1.7 fewer years of cognitive aging. MedDiet adherence defined by the Mediterranean Diet Adherence Screener (MEDAS) score (mapped through the use of both binary and continuous scoring) showed similar, albeit less consistent, associations. In stratified analyses, associations were evident in individuals at higher CVD risk only (P < 0.05).

    CONCLUSIONS: Higher adherence to the MedDiet is associated with better cognitive function and lower risk of poor cognition in older UK adults. This evidence underpins the development of interventions to enhance MedDiet adherence, particularly in individuals at higher CVD risk, aiming to reduce the risk of age-related cognitive decline in non-Mediterranean populations.

  • 18.
    Silventoinen, Karri
    et al.
    Departments of Social Research, Research Programs Unit, University of Helsinki, Helsinki, Finland; Osaka University Graduate School of Medicine, Osaka University, Osaka, Japan.
    Tuvblad, Catherine
    Örebro University, School of Law, Psychology and Social Work. Department of Psychology, University of Southern California, Los Angeles CA, United States.
    Kaprio, Jaakko
    Departments of Public Health, Research Programs Unit, University of Helsinki, Helsinki, Finland; Institute for Molecular Medicine, Helsinki, Finland.
    Differences in genetic and environmental variation in adult BMI by sex, age, time period, and region: an individual-based pooled analysis of 40 twin cohorts2017In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 106, no 2, p. 457-466Article in journal (Refereed)
    Abstract [en]

    Background: Genes and the environment contribute to variation in adult body mass index [BMI (in kg/m(2))], but factors modifying these variance components are poorly understood.

    Objective: We analyzed genetic and environmental variation in BMI between men and women from young adulthood to old age from the 1940s to the 2000s and between cultural-geographic regions representing high (North America and Australia), moderate (Europe), and low (East Asia) prevalence of obesity.

    Design: We used genetic structural equation modeling to analyze BMI in twins >= 20 y of age from 40 cohorts representing 20 countries (140,379 complete twin pairs).

    Results: The heritability of BMI decreased from 0.77 (95% CI: 0.77, 0.78) and 0.75 (95% CI: 0.74, 0.75) in men and women 2029 y of age to 0.57 (95% CI: 0.54, 0.60) and 0.59 (95% CI: 0.53, 0.65) in men 70-79 y of age and women 80 y of age, respectively. The relative influence of unique environmental factors correspondingly increased. Differences in the sets of genes affecting BMI in men and women increased from 20-29 to 60-69 y of age. Mean BMI and variances in BMI increased from the 1940s to the 2000s and were greatest in North America and Australia, followed by Europe and East Asia. However, heritability estimates were largely similar over measurement years and between regions. There was no evidence of environmental factors shared by co-twins affecting BMI.

    Conclusions: The heritability of BMI decreased and differences in the sets of genes affecting BMI in men and women increased from young adulthood to old age. The heritability of BMI was largely similar between cultural-geographic regions and measurement years, despite large differences in mean BMI and variances in BMI. Our results show a strong influence of genetic factors on BMI, especially in early adulthood, regardless of the obesity level in the population.

  • 19.
    Silventoinen, Karri
    et al.
    Department of Social Research, University of Helsinki, Helsinki, Finland; Osaka University Graduate School of Medicine, Osaka University, Osaka, Japan.
    Tuvblad, Catherine
    Örebro University, School of Law, Psychology and Social Work. Department of Psychology, University of Southern California, Los Angeles CA, USA.
    Kaprio, Jaakko
    Public Health, University of Helsinki, Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland; Institute for Molecular Medicine (FIMM), Helsinki, Finland.
    Genetic and environmental effects on body mass index from infancy to the onset of adulthood: an individual-based pooled analysis of 45 twin cohorts participating in the COllaborative project of Development of Anthropometrical measures in Twins (CODATwins) study2016In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 104, no 2, p. 371-379Article in journal (Refereed)
    Abstract [en]

    Background: Both genetic and environmental factors are known to affect body mass index (BMI), but detailed understanding of how their effects differ during childhood and adolescence is lacking.

    Objectives: We analyzed the genetic and environmental contributions to BMI variation from infancy to early adulthood and the ways they differ by sex and geographic regions representing high (North America and Australia), moderate (Europe), and low levels (East Asia) of obesogenic environments.

    Design: Data were available for 87,782 complete twin pairs from 0.5 to 19.5 y of age from 45 cohorts. Analyses were based on 383,092 BMI measurements. Variation in BMI was decomposed into genetic and environmental components through genetic structural equation modeling.

    Results: The variance of BMI increased from 5 y of age along with increasing mean BMI. The proportion of BMI variation explained by additive genetic factors was lowest at 4 y of age in boys (a(2) = 0.42) and girls (a(2) = 0.41) and then generally increased to 0.75 in both sexes at 19 y of age. This was because of a stronger influence of environmental factors shared by co-twins in midchildhood. After 15 y of age, the effect of shared environment was not observed. The sex-specific expression of genetic factors was seen in infancy, but was most prominent at 13 y of age and older. The variance of BMI was highest in North America and Australia and lowest in East Asia, but the relative proportion of genetic variation to total variation remained roughly similar across different regions.

    Conclusions: Environmental factors shared by co-twins affect BMI in childhood, but little evidence for their contribution was found in late adolescence. Our results suggest that genetic factors play a major role in the variation of BMI in adolescence among populations of different ethnicities exposed to different environmental factors related to obesity.

  • 20.
    Sjögren, Per
    et al.
    Dept Publ Hlth & Caring Sci, Sect Clin Nutr & Metab, Uppsala Univ, Uppsala, Sweden.
    Becker, Wulf
    Dept Publ Hlth & Caring Sci, Sect Clin Nutr & Metab, Uppsala Univ, Uppsala, Sweden.
    Warensjö, Eva
    Dept Publ Hlth & Caring Sci, Sect Clin Nutr & Metab, Uppsala Univ, Uppsala, Sweden.
    Olsson, Erika
    Dept Publ Hlth & Caring Sci, Sect Clin Nutr & Metab, Uppsala Univ, Uppsala, Sweden.
    Byberg, Liisa
    Uppsala Univ, Uppsala, Sweden.
    Gustafsson, Inga-Britt
    Örebro University, School of Hospitality, Culinary Arts & Meal Science.
    Karlström, Brita
    Dept Publ Hlth & Caring Sci, Sect Clin Nutr & Metab, Uppsala Univ, Uppsala, Sweden.
    Cederholm, Tommy
    Dept Publ Hlth & Caring Sci, Sect Clin Nutr & Metab, Uppsala Univ, Uppsala, Sweden.
    Mediterranean and carbohydrate-restricted diets and mortality among elderly men: a cohort study in Sweden2010In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 92, no 4, p. 967-974Article in journal (Refereed)
    Abstract [en]

    Background: Comparative studies on dietary patterns and long-term mortality are sparse.

    Objective: The objective was to examine the relations between 10-y mortality and adherence to the World Health Organization dietary guidelines [Healthy Diet Indicator (HDI)], a Mediterranean-like diet, and a carbohydrate-restricted (CR) diet in elderly Swedish men.

    Design: Dietary habits were determined by 7-d dietary records in a population-based longitudinal study of 924 Swedish men (age: 71 ± 1 y). The HDI score (–1 to 8 points), the Mediterranean Diet Score (MDS; 0–8 points), and the CR score (2–20 points) were calculated for each participant. Nonadequate reporters of energy intake were identified (n = 413). Mortality was registered during a median follow-up of 10.2 y. Cox proportional hazards regression, with multivariable adjustments, was used to determine the effects of adherence to each dietary pattern.

    Results: Two hundred fifteen and 88 subjects died of all-cause and cardiovascular disease, respectively. In all individuals, risk relations to mortality for each SD increment in the scores were observed for only MDS, with an adjusted hazard ratio (HR) of 0.83 (95% CI: 0.70, 0.99). Among adequate dietary reporters (n = 511), adjusted HRs for each SD increment in scores were enhanced for MDS (ie, 0.71; 95% CI: 0.55, 0.92) for all-cause mortality and 0.63 (95% CI: 0.42, 0.96) for cardiovascular mortality. Corresponding HRs for CR diet score were 1.19 (95% CI: 0.97, 1.45) for all-cause mortality and 1.44 (95% CI: 1.03, 2.02) for cardiovascular mortality.

    Conclusion: Adherence to a Mediterranean-like dietary pattern reduced mortality, whereas adherence to a CR dietary pattern appeared to increase mortality in elderly Swedish men, especially when only adequate dietary reporters were considered.

  • 21.
    Vedin, Inger
    et al.
    Department of Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Cederholm, Tommy
    Department of Public Health and Caring Sciences, Division of Clinical Nutrition and Metabolism Research, Uppsala University Hospital, Uppsala, Sweden.
    Freund-Levi, Yvonne
    Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Basun, Hans
    Department of Public Health and Caring Sciences, Division of Geriatrics, Uppsala University Hospital, Uppsala, Sweden.
    Garlind, Anita
    Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Faxén Irving, Gerd
    Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Jönhagen, Maria Eriksdotter
    Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Vessby, Bengt
    Department of Public Health and Caring Sciences, Division of Clinical Nutrition and Metabolism Research, Uppsala University Hospital, Uppsala, Sweden.
    Wahlund, Lars-Olof
    Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Palmblad, Jan
    Department of Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Effects of docosahexaenoic acid-rich n-3 fatty acid supplementation on cytokine release from blood mononuclear leukocytes: the OmegAD study2008In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 87, no 6, p. 1616-1622Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Dietary fish or fish oil rich in n-3 fatty acids (n-3 FAs), eg, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), ameliorate inflammatory reactions by various mechanisms. Whereas most studies have explored the effects of predominantly EPA-based n-3 FAs preparations, few have addressed the effects of n-3 FAs preparations with DHA as the main FA.

    OBJECTIVE: The objective was to determine the effects of 6 mo of dietary supplementation with an n-3 FAs preparation rich in DHA on release of cytokines and growth factors from peripheral blood mononuclear cells (PBMCs).

    DESIGN: In a randomized, double-blind, placebo-controlled trial, 174 Alzheimer disease (AD) patients received daily either 1.7 g DHA and 0.6 g EPA (n-3 FAs group) or placebo for 6 mo. In the present study blood samples were obtained from the 23 first randomized patients, and PBMCs were isolated before and after 6 mo of treatment.

    RESULTS: Plasma concentrations of DHA and EPA were significantly increased at 6 mo in the n-3 FAs group. This group also showed significant decreases of interleukin (IL)-6, IL-1beta, and granulocyte colony-stimulating factor secretion after stimulation of PBMCs with lipopolysaccharide. Changes in the DHA and EPA concentrations were negatively associated with changes in IL-1beta and IL-6 release for all subjects. Reductions of IL-1beta and IL-6 were also significantly correlated with each other. In contrast, this n-3 FA treatment for 6 mo did not decrease tumor necrosis factor-alpha, IotaL-8, IL-10, and granulocyte-macrophage colony-stimulating factor secretion.

    CONCLUSION: AD patients treated with DHA-rich n-3 FAs supplementation increased their plasma concentrations of DHA (and EPA), which were associated with reduced release of IL-1beta, IL-6, and granulocyte colony-stimulating factor from PBMCs. This trial was registered at clinicaltrials.gov as NCT00211159.

  • 22.
    Wall, Rebecca
    et al.
    Alimentary Pharmabiotic Centre, Biosciences Institute, Cork, Ireland; Teagasc Moorepark Food Research Centre, Fermoy, Ireland .
    Marques, Tatiana M.
    Alimentary Pharmabiotic Centre, Biosciences Institute, Cork, Ireland: Department of Microbiology, University College Cork, Cork, Ireland .
    O'Sullivan, Orla
    Teagasc Moorepark Food Research Centre, Fermoy, Ireland.
    Ross, R. Paul
    Alimentary Pharmabiotic Centre, Biosciences Institute, Cork, Ireland; Teagasc Moorepark Food Research Centre, Fermoy, Ireland .
    Shanahan, Fergus
    Alimentary Pharmabiotic Centre, Biosciences Institute, Cork, Ireland .
    Quigley, Eamonn M.
    Alimentary Pharmabiotic Centre, Biosciences Institute, Cork, Ireland .
    Dinan, Timothy G.
    Alimentary Pharmabiotic Centre, Biosciences Institute, Cork, Ireland .
    Kiely, Barry
    Alimentary Pharmabiotic Centre, Biosciences Institute, Cork, Ireland .
    Fitzgerald, Gerald F.
    Alimentary Pharmabiotic Centre, Biosciences Institute, Cork, Ireland; Department of Microbiology, University College Cork, Cork, Ireland .
    Cotter, Paul D.
    Alimentary Pharmabiotic Centre, Biosciences Institute, Cork, Ireland; Teagasc Moorepark Food Research Centre, Fermoy, Ireland .
    Fouhy, Fiona
    Department of Microbiology, University College Cork, Cork, Ireland; Teagasc Moorepark Food Research Centre, Fermoy, Ireland .
    Stanton, Catherine
    Alimentary Pharmabiotic Centre, Biosciences Institute, Cork, Ireland; Teagasc Moorepark Food Research Centre, Fermoy, Ireland .
    Contrasting effects of Bifidobacterium breve NCIMB 702258 and Bifidobacterium breve DPC 6330 on the composition of murine brain fatty acids and gut microbiota2012In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 95, no 5, p. 1278-1287Article in journal (Refereed)
    Abstract [en]

    Background: We previously showed that microbial metabolism in the gut influences the composition of bioactive fatty acids in host adipose tissue.

    Objective: This study compared the effect of dietary supplementation for 8 wk with human-derived Bifidobacterium breve strains on fat distribution and composition and the composition of the gut microbiota in mice.

    Methods: C57BL/6 mice (n = 8 per group) received B. breve DPC 6330 or B. breve NCIMB 702258 (10(9) microorganisms) daily for 8 wk or no supplement (controls). Tissue fatty acid composition was assessed by gas-liquid chromatography while 16S rRNA pyrosequencing was used to investigate microbiota composition.

    Results: Visceral fat mass and brain stearic acid, arachidonic acid, and DHA were higher in mice supplemented with B. breve NCIMB 702258 than in mice in the other 2 groups (P < 0.05). In addition, both B. breve DPC 6330 and B. breve NCIMB 702258 supplementation resulted in higher propionate concentrations in the cecum than did no supplementation (P < 0.05). Compositional sequencing of the gut microbiota showed a tendency for greater proportions of Clostridiaceae (25%, 12%, and 18%; P = 0.08) and lower proportions of Eubacteriaceae (3%, 12%, and 13%; P = 0.06) in mice supplemented with B. breve DPC 6330 than in mice supplemented with B. breve NCIMB 702258 and unsupplemented controls, respectively.

    Conclusion: The response of fatty acid metabolism to administration of bifidobacteria is strain-dependent, and strain-strain differences are important factors that influence modulation of the gut microbial community by ingested microorganisms.

  • 23.
    Wall, Rebecca
    et al.
    Alimentary Pharmabiotic Centre, Cork, Ireland; Teagasc, Moorepark Food Research Centre, Fermoy, County Cork, Ireland; Department of Microbiology, University College Cork, National University of Ireland, Cork, Ireland.
    Ross, R. Paul
    Alimentary Pharmabiotic Centre, Cork, Ireland; Teagasc, Moorepark Food Research Centre, Fermoy, County Cork, Ireland.
    Shanahan, Fergus
    Alimentary Pharmabiotic Centre, Cork, Ireland.
    O'Mahony, Liam
    Alimentary Pharmabiotic Centre, Cork, Ireland.
    O'Mahony, Caitlin
    Alimentary Pharmabiotic Centre, Cork, Ireland.
    Coakley, Mairead
    Teagasc, Moorepark Food Research Centre, Fermoy, County Cork, Ireland .
    Hart, Orla
    Teagasc, Moorepark Food Research Centre, Fermoy, County Cork, Ireland .
    Lawlor, Peadar
    Teagasc, Moorepark Food Research Centre, Fermoy, County Cork, Ireland .
    Quigley, Eamonn M.
    Alimentary Pharmabiotic Centre, Cork, Ireland.
    Kiely, Barry
    Alimentary Pharmabiotic Centre, Cork, Ireland.
    Fitzgerald, Gerald F.
    Alimentary Pharmabiotic Centre, Cork, Ireland; Department of Microbiology, University College Cork, National University of Ireland, Cork, Ireland.
    Stanton, Catherine
    Alimentary Pharmabiotic Centre, Cork, Ireland; Teagasc, Moorepark Food Research Centre, Fermoy, County Cork, Ireland.
    Metabolic activity of the enteric microbiota influences the fatty acid composition of murine and porcine liver and adipose tissues2009In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 89, no 5, p. 1393-1401Article in journal (Refereed)
    Abstract [en]

    Background: Recent reports suggest that the metabolic activity of the gut microbiota may contribute to the pathogenesis of obesity and hepatic steatosis.

    Objective: The objective was to determine whether the fat composition of host tissues might be influenced by oral administration of commensal bifidobacteria previously shown by us to produce bioactive isomers of conjugated linoleic acid (CLA).

    Design: Murine trials were conducted in which linoleic acid-supplemented diets were fed with or without Bifidobacterium breve NCIMB 702258 (daily dose of 10(9) microorganisms) to healthy BALB/c mice and to severe combined immunodeficient mice for 8-10 wk. To ensure that the observations were not peculiar to mice, a similar trial was conducted in weanling pigs over 21 d. Tissue fatty acid composition was assessed by gas-liquid chromatography.

    Results: In comparison with controls, there was an increase in cis-9, trans-11 CLA in the livers of the mice and pigs after feeding with linoleic acid in combination with B. breve NCIMB 702258 (P < 0.05). In addition, an altered profile of polyunsaturated fatty acid composition was observed, including higher concentrations of the omega-3 (n-3) fatty acids eicosapentaenoic acid and docosahexaenoic acid in adipose tissue (P < 0.05). These changes were associated with reductions in the proinflammatory cytokines tumor necrosis factor-alpha and interferon-gamma (P < 0.05).

    Conclusions: These results are consistent with the concept that the metabolome is a composite of host and microbe metabolic activity and that the influence of the microbiota on host fatty acid composition can be manipulated by oral administration of CLA-producing microorganisms.

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