»Många studier genom åren har visat att inte ens en så enkel och lätt bestämd variabel som kroppsvikt registreras och analyseras tydligt över tid.«

Man försöker trycka in kvalitet i klinisk nutrition i ett vårdsystem som inte är förberett på saken. Detta i en situation med a) brist på infrastruktur i vården, b) brist på utbildning/träning i klinisk nutrition hos personalen och c) avsaknad av en medicinsk specialitet för klinisk nutrition. Det skriver professor Gunnar Akner i en debatterande översiktsartikel.

High salt intake has traditionally been linked to an increased risk of hypertension, particularly among certain groups. In this work, the relationship between salt intake and blood pressure is explored through a systematic literature review of randomized controlled trials, focusing on healthy individuals. The aim is to evaluate whether and to what extent salt consumption affects blood pressure levels in this population. The study is based on a literature search in PubMed where relevant articles are identified using the search terms ((high-salt) OR (high-sodium)) AND ((hypertension) OR (blood pressure) AND (healthy)).

An analysis of 17 studies shows that the effect of salt intake on blood pressure is negligible or nonexistent in healthy individuals. These results emphasize the need to differentiate between different groups regarding dietary recommendations and point out that individual differences, including salt sensitivity, may be crucial.

The discussion highlights the complexity of the relationship between salt intake and blood pressure, and it is difficult to draw conclusions about the long-term effects of high salt consumption. It underlines the importance of further research to clarify the relationship between salt consumption and cardiovascular health across different populations.

As the use of food supplements increases, voices are being raised questioning the safety of these products. As acontribution to understanding the trace and major elemental composition of food supplements and their potential health risks, this study presents concentrations of 71 elements in 138 supplements, categorised intosynthetic products and three groups of products with natural ingredients. Concentrations were converted intoaverage daily doses (ADDs) and compared to tolerable daily intakes (TDIs). For elements where we found significant ADDs relative to the TDI a comparison was also made to the normal dietary intake. Our main findings arethat: 1) Most elements display highly variable concentrations in food supplements; more so than in normalfoodstuff; 2) For ten of the analysed elements some products rendered ADDs > 50 % of the TDI. Half of theelements were essential (Fe, Mn, Se, Mo, Zn), and as such motivated in food supplements. The other half (As, Pb,Cd, Al, Ni) represent non-essential and highly toxic elements, where the occurrence in food supplements ought tobe viewed as contamination. Although none of these toxic metals were declared on any product’s table ofcontent, several products gave high ADDs - in several cases even exceeding the TDIs; 3) The risk of reaching highADDs for the toxic elements is strongly associated with products that contain marine ingredients (e.g. algae,mussels etc), and to some degree products of terrestrial plant-based origin. The health of consumers wouldbenefit if food regulatory frameworks were updated to better address the risks of food supplements occasionallybeing contaminated with different toxic metals, for example by setting maximum permissible concentrations fora longer list of elements. 

Earlier studies have implied a change in dietary habits of the Swedish population towards a low carbohydrate, high fat diet. Questions have been raised about the development in recent years and potential health effects. We have investigated the dietary intake of Swedish female students enrolled in a university nutrition course between 2002 and 2017. The students carried out self-reporting of all food and drink intake over one weekday and one weekend day. Intake of macronutrients (E%) and micronutrients were calculated for the whole period while statistical analysis was performed for changes between 2009 and 2017 (729 women). Results showed significant changes in carbohydrate intake (from 47.0 to 41.4 E%) and fat intake (from 31.7 to 37.5 E%). Carbohydrate intake was significantly lower than the Nordic Nutrition Recommendations (45-60 E%). However, daily fiber intake remains high (3.0 g/MJ) in a national context, and intake of vitamin D and folate appears to increase during the period. The results suggest that the observed national transition from carbohydrate to fat intake persists, and that it might be especially evident among individuals interested in food and nutrition. Considering the fiber and micronutrient intake, the change is not necessarily unfavorable for this particular group.

This study is based on a dietary survey conducted by Håkan Andersson and Anna Blücher with the help of students in conjunction with the course Food, Nutrition and health, 7.5 credits at the Linnaeus University Kalmar. The study covers the years 2001-2013 and explores whether, and if so how, the students' dietary intake changed during the period, and discusses potential environmental factors underlying potential changes in dietary habits. The study also investigates whether the students follow the Swedish Food Administration guidelines and if their dietary habits are consistent with other surveys from the same interval. The results indicate that there has been a redistribution of macronutrients, e.g. carbohydrates has partly been replaced with fat, but the intake still remains within the nutritional recommendations. This observation is in agreement with other dietary surveys for the same period. However, BMI appears unchanged in this study, in contrast to what has been observed elsewhere. The reasons for the reduced intake of carbohydrates and increased fat intake may be linked to the increased interest in popular diets such as LCHF.

While the Swedish nutrition recommendations have been kept relatively constant in recent years, public attitudes to different diets have been swinging faster. The National food survey (Riksmaten), being performed in Sweden only once per decade, cannot identify any corresponding rapid changes in diets. Hence, our understanding of potential fluctuations is limited. During the last 15 years, nutrition students at the Linnaeus University (formerly University of Kalmar) have reported their food intake in the context of the course Diet, Nutrition and Health 7,5 hp. The result is an extensive data set comprising more than 1100 individuals and over 2500 days of food intake reports, and although not originally intended or designed as a study, it became apparent that these data could be of interest as an indicator for national dietary trends. Food intake was reported (by weighing or estimating the amounts) for two weekdays and one weekend day per student, along with age, length, sex and weight. Food intake was translated to nutrient intake using Dietist Net software (Kost & Näringsdata).  Admittedly, the data set has some validity problems: the students differ from the Riksmaten study groups in mean age and geographical distribution, and all data was collected during March-April. As students in a nutrition course, they can also be expected to be more interested and more knowledgeable in the nutrition subject than the average person. Nevertheless, the results clearly demonstrate a substantial change in nutrient intake from 2006 and onwards, where the energy from carbohydrates decreased from above 50% to below 40%, and where the energy intake from fat increased from about 25% to 36%. Further details, such as the effects on the intake of selected micronutrients, will be presented.

Controversy pervades the definition of adequate and optimal vitamin D status. The Institutes of Medicine have recommended serum 25(OH) D levels above 50 nmol/L based upon evidence related to bone health, but some experts, including the Endocrine Society and International Osteoporosis Foundation, suggest a minimum serum 25(OH) D level of 75 nmol/L to reduce the risk of falls and fractures in older adults. In a cross-sectional study, we compared vitamin D status in people >= 75 years selected from four groups with a frailty phenotype, combined with a control group free from serious illness, and who considered themselves completely healthy. Only 13% of the 169 controls were vitamin D deficient (S-25(OH) D) < 50 nmol/L), in contrast with 49% of orthopedic patients with hip fractures (n = 133), 31% of stroke patients (n = 122), 39% of patients visiting the hospital's emergency department >= 4 times a year (n = 81), and 75% of homebound adult residents in long-term care nursing homes (n = 51). The mean vitamin D concentration of the healthy control group (74 nmol/L) was similar to a suggested optimal level based on physiological data and mortality studies, and much higher than that of many officially recommended cut-off levels for vitamin D deficiency (< 50 nmol/L). The present study provides a basis for planning and implementing public guidelines for the screening of vitamin D deficiency and vitamin D treatment for frail elderly patients.

The Ministry of Public Health of Cameroon advises mothers to follow the World Health Organization’s recommendation of exclusive breastfeeding during the first six months of life and to continue breastfeeding along with appropriate complementary foods up to two years or beyond. Despite these recommendations, malnutrition due to inadequate feeding practices is still prevalent in Cameroon. Therefore, this study aims to explore infant feeding perceptions and identify factors influencing infant feeding practices in Cameroon. Forty-nine women aged 19 to 38 who had infants aged 6 days to 15 months were purposively selected from hospitals during the vaccination days and interviewed until saturation. The research tools included six qualitative group interviews, with each group comprising 6 to 10 women. The study was conducted in the rural area of Bandja and the urban areas of Yaoundé and Bamenda. Data were analysed using content analysis. In the study, breastfeeding was agreed upon as the best way to feed infants and was commonly practised for 1 to 2 years. Nevertheless, few infants were breastfed exclusively. Complementary foods were often nutritionally inadequate; many children were not given fruit, vegetables or foods of animal origin on a daily basis. Cultural beliefs, tradition, community norms and low educational and economic levels negatively influenced the implementation of appropriate infant feeding recommendations. The short duration of exclusive breastfeeding and the poor food diversity are the main problems. In response, it is necessary to strengthen the position of women, increase the period of maternal leave, introduce sustainable and practical education for both parents about breastfeeding, and provide good, local complementary foods. 

OBJECTIVE: To assess energy and nutrient intakes and physical activity of adolescents in urban Cameroon according to sex and socio-economic status (SES).

DESIGN: Cross-sectional study with adolescents randomly selected from schools in low-, middle- and high-SES areas. Weight and height were measured and information about food intake and physical activity was obtained through repeated individual 24 h recalls. Under- and over-reporting of energy intake and inadequacy of nutrient intake were assessed.

SETTING: Yaoundé, Cameroon.

SUBJECTS: Boys and girls aged 12-16 years (n 227).

RESULTS: Boys had a lower BMI and reported higher energy expenditures and physical activity levels (PAL) than girls. Under-reporting of energy intake was large among boys and girls regardless of PAL; boys under-reported more than girls. Among those with low PAL, over-reporting of energy intake was common. Over 50% of boys and girls had protein below the recommendations. The intake of fat varied; 26% of the adolescents were below and 25% were above the recommendations. Inadequate intakes of vitamin B₁, vitamin B₃ and Fe were more common among girls, while boys more often had inadequate intake of vitamin A. Adolescents with low SES were more likely to be below the recommendations for fat and vitamins B₂, B₃, B₆ and B₁₂ than those with high SES.

CONCLUSIONS: A high proportion of boys and girls reported inadequate intakes. However under- and over-reporting were also very common. Boys under-reported energy intake more than girls and inadequate nutrient intake was more frequently reported by adolescents with low SES than by those with high SES.

The aim of this study was to assess adolescents' nutritional status according to socioeconomic status (SES) and sex using anthropometry in urban Cameroon, Africa. Adolescent boys (n = 248) and girls (n = 333) 12 to 16 years old were recruited from randomly selected schools in a cross sectional study in Yaoundé city and grouped according to SES. Weight, height, skinfold thickness, and circumferences were measured, and body mass index, waist/hip ratio, arm muscle, and arm fat areas were calculated. Stunting, underweight, and overweight were determined using international cutoff points. Adolescents with medium and high SES were less likely to be stunted than adolescents with low SES (odds ratio [OR], 0.40; P < .01). Prevalences of stunting (12%, 6%, and 5%) and underweight (3%, 4%, and 1%) were higher among the adolescents with low and medium SES than those with high SES. Overweight prevalence was high among the adolescents with low (8%), medium (11%), and high (9%) SES. The OR for overweight was higher among girls than boys (OR, 4.13; P < .001). Girls were less likely to be stunted and underweight than boys (OR, 0.29 [P < .001] and OR, 0.20 [P < .01], respectively). Prevalences of stunting (15% and 6%) and underweight (5% and 2%) were higher among boys than girls. Pubescent adolescents were less likely to be stunted than nonpubescent (OR, 0.53; P < .05). Adolescents with low and medium SES were more underweight and stunted than adolescents with high SES. Girls were more overweight, less stunted, and underweight than boys.

Background: Sub-Saharan Africa has a long history of struggling with child undernutrition. The prevalence of undernutrition is still high and knowledge about this public health problem and the underlying causes is essential for children’s health.

Aim: To evaluate the anthropometric status of children under five in the Bandja village of Cameroon.

Methods: A cross-sectional study was undertaken that included 388 children. Undernutrition was evaluated in terms of wasting, stunting and underweight. Information on sex, age, birth order, birth interval, duration of breastfeeding, and mother’s age at birth, occupation and educational level were collected.

Results: The prevalence of wasting, stunting and underweight was 3.2%, 16.4% and 5.2%, respectively. Boys were more stunted than girls (OR 2.24; 95% CI 1.16–4.34). Children less than 30 months were more often wasted than older children (OR 17.70; 95% CI 1.82–172.40). The first and second born in order were more stunted than the third or later born in order (OR 2.06; 95% CI 1.02–4.18). Children of farming mothers were more often stunted (OR 2.87; 95% CI 1.35–6.13) and underweight (OR 3.47; 95% CI 1.09–11.09) than others. Children still being breastfed were more underweight (OR 6.52; 95% CI 1.31–32.43) than those whose mothers had finished breastfeeding.

Conclusion: Undernutrition is highly prevalent in Bandja, and is more common among boys, younger children, first born in order, children still being breastfed and children of farming mothers. This study underlines the importance of intervention to prevent and reduce undernutrition among children.

Background: Food intake in Cameroon is based on three meals daily. The diet in rural areas is based on traditional staple foods, while that of the urban population incorporates more modern foods. The health and nutrition of adolescents is important as their eating behaviour and nutrition will affect their future health.

Objective: To describe and compare food habits and nutritional status of adolescents in Cameroon.

Design: A cross-Stional study using an unquantified food frequency questionnaire and anthropometric data, in urban and rural areas. Fifty-two adolescents, 12–15 years old, were selected from schools.

Results: Frequencies of consumption of meat, vegetables, cereals, milk products and junk food were significantly higher in urban than in rural adolescents (11.8 vs 4.5, 9.5 vs 3.9, 16.5 vs 11.9, 5.7 vs 0.8, 24.2 vs 8.7, respectively). The frequency of in-between meals was higher in urban than in rural adolescents (4.9 vs 0.9, respectively). Arm muscle area (AMA, mm2) and waist/hip ratio were significantly higher in rural than in urban adolescents (3554 vs 2802 and 0.82 vs 0.79, respectively). Body mass index (BMI, kg m−2) was higher in rural than urban adolescents, although not significant (20.6 vs 19.4, respectively). There was a positive significant correlation between BMI and AMA in urban and rural areas (r=0.67 and r=0. 72, respectively).

Conclusions: Despite a lower frequency of food consumption, rural adolescents had higher AMA and waist/hip ratio than urban adolescents. Less junk food and more traditional food consumption, more manual activities and walking in rural adolescents could explain these results.

OBJECTIVE: To investigate factors influencing rural and urban adolescents' food perceptions during a time of nutritional transition in Cameroon, Africa.

DESIGN: Qualitative in-depth interviews.

SETTINGS: Yaoundé urban and Bandja rural areas.

PARTICIPANTS: Fifteen adolescents 12 to 15 years old purposely selected from schools in urban and rural areas.

ANALYSIS: Interviews were audiotaped, transcribed, and analyzed using Grounded Theory method.

FINDINGS: Factors influencing adolescents' food perceptions from the rural area were "to live" "health" and "poverty." Among adolescents from the urban poor area, "health," "beauty," and "not enough money" were factors. Among adolescents from the urban rich area, "pleasure" and "beauty" were factors. Rural girls liked "to be fat," whereas girls from the urban poor wanted "to be a little bit fat," and girls from the urban rich wanted "to be normal."

CONCLUSIONS AND IMPLICATIONS: Food behavior is changing from a diet composed of traditional food in rural areas to a more westernized diet in urban areas. The relationship between socioeconomic factors and nutrition needs to be examined with a sufficiently large number of adolescents to investigate these factors in a quantitative survey. Healthful local food should be available at home and from vendors. Nutrition education about food and diet-related diseases is needed in school.

Female endurance athletes are considered a high-risk group for developing Relative Energy Deficiency in Sport (REDs). Due to the lack of educational and behavioral intervention studies, targeting and evaluating the effects of the practical daily management of REDs, we developed the Food and nUtrition for Endurance athletes—a Learning (FUEL) program, consisting of 16 weekly online lectures and individual athlete-centered nutrition counseling every other week. We recruited female endurance athletes from Norway (n = 60), Sweden (n = 84), Ireland (n = 17), and Germany (n = 47). Fifty athletes with symptoms of REDs and with low risk of eating disorders, with no use of hormonal contraceptives and no chronic diseases, were allocated to either the FUEL intervention (n = 32) (FUEL) or a 16-week control period (n = 18) (CON). All but one completed FUEL, while 15 completed CON. We found strong evidence for improvements in sports nutrition knowledge, assessed via interviews, and moderate to strong evidence in the ratings concerning self-perceived sports nutrition knowledge in FUEL versus CON. Analyses of the seven-day prospective weighed food record and questions related to sports nutrition habits, suggested weak evidence for improvements in FUEL versus CON. The FUEL intervention improved sports nutrition knowledge and suggested weak evidence for improved sports nutrition behavior in female endurance athletes with symptoms of REDs.

Introduction: Dietary protein comes from foods with greatly different compositions that may not relate equally with mortality risk. Few cohort studies from non-Western countries have examined the association between various dietary protein sources and cause-specific mortality. Therefore, the associations between dietary protein sources and all-cause, cardiovascular disease, and cancer mortality were evaluated in the Golestan Cohort Study in Iran. Methods: Among 42,403 men and women who completed a dietary questionnaire at baseline, 3,291 deaths were documented during 11 years of follow up (2004-2015). Cox proportional hazards models estimated age-adjusted and multivariate-adjusted hazard ratios (HRs) and 95% CIs for all cause and disease-specific mortality in relation to dietary protein sources. Data were analyzed from 2015 to 2016. Results: Comparing the highest versus the lowest quartile, egg consumption was associated with lower all-cause mortality risk (HR=0.88, 95% CI=0.79, 0.97, ptrend=0.03). In multivariate analysis, the highest versus the lowest quartile of fish consumption was associated with reduced risk of total cancer (HR=0.79, 95% CI=0.64, 0.98, ptrend=0.03) and gastrointestinal cancer (HR=0.75, 95% CI=0.56, 1.00, ptrend=0.02) mortality. The highest versus the lowest quintile of legume consumption was associated with reduced total cancer (HR=0.72, 95% CI=0.58, 0.89, ptrend=0.004), gastrointestinal cancer (HR=0.76, 95% CI=0.58, 1.01, ptrend=0.05), and other cancer (HR=0.66, 95% CI=0.47, 0.93, ptrend=0.04) mortality. Significant associations between total red meat and poultry intake and allcause, cardiovascular disease, or cancer mortality rate were not observed among all participants. Conclusions: These findings support an association of higher fish and legume consumption with lower cancer mortality, and higher egg consumption with lower all-cause mortality. (C) 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

The project was carried out in collaboration with Lantmännen with the aim to analyse the lipase activity in oat endosperm, non-heat-treated whole grain oat flour and heat-treated whole grain oat flour and to investigate whether lipase activity could be inactivated in oat endosperm by reducing water activity by various methods such as oven drying and freeze drying to extend oat shelf life. Lipase activity was measured by a wet extraction of the flour and an artificial substrate that gives a coloured product if lipase enzymes are active in the extract. The formation of the product was measured during five minutes at room temperature or 37 °C using a spectrophotometer, and the enzyme activity in units/g of flour was calculated. It was not possible to measure the enzyme activity in the flour directly. The obtained results for the different oat fractions indicated differences in lipase activity between the oat fractions. Lipase activity for oat endosperm was 0.183 U/g, lipase activity for non-heat-treated whole grain oat flour was 0.088 U/mg and the heat-treated whole grain oat flour had no lipase activity. The differences were statistically significant since the p-value was <0.0001. The results from the analysis that compared whether oven-drying and freeze-drying as methods had an effect on lipase activity indicated that oven drying had the greatest effect when assay was performed at room temperature. However, when the assay was performed at 37 °C the lipase activity in oven-dried and freeze-dried oat endosperm were similar to non- treated samples. This indicates that temperature has a great impact on the lipase activity. Thus, oven drying and freeze drying could not completely inactivate the lipase activity, but probably reduce it.

The concept of glycaemic index (GI) has led to efforts to develop low-GI foods. Bread contributes around one-quarter of carbohydrate intake in the Swedish diet. In this study, we sought to develop low-GI bread prototypes and examined the effects of bread making on content of total dietary fibre (TDF) and resistant starch (RS). Five bread prototypes were made in a commercial bakery, using sourdough fermentation and intact cereal and legume kernels. Predicted (p-GI) andin vivoGI values were determined, and TDF and RS were quantified. The p-GI value of the five prototypes was between 56 and 68. The confirmedin vivoGI value was 65 and 67 for two of the breads. The TDF content (>= 17%) was not affected by bread making, but RS content was increased by three-fold. All breads were categorised as medium-GI, but with low glycaemic load (GL).

Public health authorities recommend all fertile women to increase their folate intake to 400 μg/d by eating folate-rich foods or by taking a folic acid supplement to protect against neural tube defects. In a previous study it was shown that folate-rich foods improved folate blood status as effectively as folic acid supplementation. The aim of the present study was to investigate, using NMR metabolomics, the effects of an intervention with a synthetic folic acid supplement v. native food folate on the profile of plasma metabolites. Healthy women with normal folate status received, in parallel, 500 μg/d synthetic folic acid from a supplement (n 18), 250 μg/d folate from intervention foods (n 19), or no additional folate (0 μg/d) through a portion of apple juice (n 20). The metabolic profile of plasma was measured using 1H-NMR in fasted blood drawn at baseline and after 12 weeks of intervention. Metabolic differences between the groups at baseline and after intervention were assessed using a univariate statistical approach (P ≤ 0·001, Bonferroni-adjusted significance level). At baseline, the groups showed no significant differences in measured metabolite concentrations. After intervention, eight metabolites, of which six (glycine, choline, betaine, formate, histidine and threonine) are related to one-carbon metabolism, were identified as discriminative metabolites. The present study suggests that different folate forms (synthetic v. natural) may affect related one-carbon metabolites differently.

The health benefits of bean consumption are widely recognized and are largely attributed to the dietary fiber content. This study investigated and compared the effects of whole brown beans and an isolated bean dietary fiber fraction on the plasma lipid profile, atherosclerotic plaque amount, gut microbiota, and microbiota-dependent metabolites (cecal short-chain fatty acids (SCFAs) and plasma methylamines) in Apoe−/− mice fed high fat diets for 10.5 weeks. The results showed that both whole bean and the isolated fiber fraction had a tendency to lower atherosclerotic plaque amount, but not plasma lipid concentration. The whole bean diet led to a significantly higher diversity of gut microbiota compared with the high fat diet. Both bean diets resulted in a lower Firmicutes/Bacteroidetes ratio, higher relative abundance of unclassified S24-7, Prevotella, Bifidobacterium, and unclassified Clostridiales, and lower abundance of Lactobacillus. Both bean diets resulted in higher formation of all cecal SCFAs (higher proportion of propionic acid and lower proportion of acetic acid) and higher plasma trimethylamine N-oxide concentrations compared with the high fat diet. Whole beans and the isolated fiber fraction exerted similar positive effects on atherosclerotic plaque amount, gut microbiota, and cecal SCFAs in Apoe−/− mice compared with the control diets.

Diet is mentioned by many seamen as a subject of joy and aims to give nutritional value and sufficient energy to manage a long working day at sea. The purpose with this investigation is to examine if there is a need among seamen to receive more information about diet regulations onboard and if they wish that it was shaped differently to meet their demands. The study is based on a literature part where diet regulations are examined and an interview part with semi structured qualitative interviews with five seamen. The conclusion of the study indicates that seamen have limited knowledge about the enunciation of the regulation, where it is to be found and consider it to be imprecise. Interviews showed that seamen believe that variety is the most important factor in diet intake and it was this expression that they primarily wanted stated in the regulations. There are legitimate reasons to assume that Livsmedelsverket´s (compare NFA) recommendations also are applicable regarding diet at sea. A good diet is not only good for the individual’s health but also gains including safety and quality of work performed.

Objectives: This study aimed to assess the prevalence of undernutrition among elderly and to investigate the association of risk of undernutrition with health-related quality of life and life satisfaction controlling for age, gender, marital status, economic status, housing arrangement, education level, functional ability, and diseases.

Design: A cross-sectional study design was used for this study. The baseline data (2001-€“2003) of "€œThe Swedish National Study of Aging and Care-Blekinge (SNAC-B)"€ was used.

Setting: This population-based study focused on both home-living and special-housing residents.

Participants: The participants (n=1402) were randomly selected and included both males and females 60-€“96 years of age residing in a municipality of south-east Sweden.

Measurements: The risk of undernutrition was estimated by the occurrence of at least one anthropometric measure (body mass index, mid-arm circumference, and calf circumference) below cut-off, in addition to the presence of at least one subjective measure (declined food intake, weight loss, and eating difficulty). The dependent variables, health-related quality of life and life satisfaction, were measured by the validated short form health survey (SF-12) and Liang’s life satisfactions index A (LSIA), respectively.

Results: According to the criterion, 8.5% of the participants were at risk of undernutrition, and subjects at nutritional risk were significantly older, female, unmarried/widowed/divorced, residing in special housing, and functionally impaired. The risk of undernutrition was significantly associated with poor health-related quality of life, both in the physical (OR 2.31, 95% CI 1.18-€“4.52) and mental (OR 2.34, 95% CI 1.22-€“4.47) dimensions. However, no significant association was observed between nutritional status and life satisfaction (OR 1.30, 95% CI 0.70-€“2.40).

Conclusion: The risk of undernutrition significantly increases the risk of poor physical and mental health-related quality of life but has negligible impact on life satisfaction. This study also highlights the importance of functional ability both for the prevention of undernutrition and promotion of quality of life. However, more studies are needed to validate the tool used here for undernutrition risk assessment before it can be used in clinical or population settings.

Investigate how a loss of appetite in the elderly population can be prevented och cocounteracted, based on factors that cause reduced appetite in elderly. Litterature study and a minor review of Hudiksvalls municipalities activities regarding diet for the elderly. Interview with the nutritionist in charge. Physiological changes in combination with patological causes, cause a decrease in appetite. Adaptions according to the elderly persons prerequsitites are required to stimulate appetite and reduce the risk of weight loss. 

Background: According to the 2018 Demographic and Health Survey, undernutrition remains a public health problem among Cameroonian children under-five. This varies across the country, greatest in areas with ongoing humanitarian crisis, such as the Southwest region. However, data on the burden of undernutrition in the Southwest region is sparse. This study aimed to assess the prevalence and predictors of undernutrition among children under-five in the Buea health district of the Southwest region of Cameroon.Methods: This was a community based cross-sectional study of 321 children under-five/caretaker pairs, surveyed from households selected using multistage randomized sampling. Data were collected by trained data collectors, with the aid of a structured, pre-tested questionnaire that captured information on sociodemographic characteristics, food security, dietary diversity and anthropometric measurements. The weight, height/length and mid upper arm circumference (MUAC) were measured using standardized instruments. Stunting, Wasting and Underweight of children were calculated from Z-scores of Height-for-age (HAZ), Weight-for-height (WHZ) and Weight-for-age (WAZ) based on 2006 WHO standards. Data was analysed using SPSS version 27.0. Predictors of malnutrition were obtained using multivariate logistic regression, adjusting for potential confounders.Results: Overall, 31.8% (102/321) of the children were undernourished (26.5% stunted, 1.6% underweight, 3.7% wasted). Drinking water from inappropriate sources (OR: 2.32, 95% CI: 1.30-4.15) and a Dietary Diversity Score < 4 (OR: 2.59, 95%CI: 1.46-4.61) were independently associated with increased risk of stunting. Children of the male sex were more likely to be wasted than females (OR: 5.34, 95%CI: 1.09-26.14).Conclusion: Childhood undernutrition, particularly stunting is common in the Buea Health District. Risk factors of undernutrition identified are potentially modifiable, highlighting the need for nutrition specific and sensitive interventions to improve dietary diversity, and the need to improve access to safe drinking water, and educate caretakers on the importance of clean potable water, good sanitation and hygiene for the proper growth and development of their children.

The statistical assessment of undernutrition is usually restricted to a pairwise analysis of anthropometric indicators. The main objective of this study was to model the associations between underweight, stunting and wasting and to check whether multidimensionality of undernutrition can be justified from a purely statistical point of view. 3742 children aged 0 to 59 months were enrolled in a cross-sectional household survey (2004 Cameroon Demographic and Health Surveys (DHS)). The saturated loglinear model and the multiple correspondence analysis (MCA) showed no interaction and a highly significant association between underweight and stunting (P=0), underweight and wasting (P=0); but not between stunting and wasting (P=0.430). Cronbach's alpha coefficient between weight-for-age, height-for-age and weight-for-height was 0.62 (95% CI 0.59, 0.64). Thus, the study of these associations is not straightforward as it would appear in a first instance. The lack of three-factor interaction and the value of the Cronbach's alpha coefficient indicate that undernutrition is indeed (statistically) multidimensional. The three indicators are not statistically redundant; thus for the case of Cameroon the choice of a particular anthropometric indicator should depend on the goal of the policy maker, as it comes out of this study that no single indicator is to be used for all situations.

Background: BCAA or branched amino acids are a commonly used dietary supplement. Supplements of BCAA are assumed to increase physical performance based on research results obtained from animal experiments and some research on humans. The results are, however, partly contradictory. Physical performance can be divided into different types, depending on measurement methods and tests that differentiate them. Examples of different forms of physical performance are aerobic performance, anaerobic performance and muscle performance.

Aim: The purpose of the study was to investigate possible correlation between supplements of BCAA and increased physical performance in the areas of aerobic performance, anaerobic performance and muscle performance. In addition, it is also investigated whether the effect of BCAA is affected by the duration of supplementation.

Method: Six studies were included in this literature study, which investigated the impact of supplementation of BCAA on physical performance, in terms of either aerobic performance, anaerobic performance or muscle performance.

Results: Two studies demonstrated positive effect on muscle performance after long-term supplementation, one with significant correlation with the supplement. One study failed to demonstrate positive effect on muscle performance after short-term supplementation. One study showed a positive effect on muscle performance after long-term supplementation, with significant association with the supplement. Two studies failed to show positive effect on aerobic performance, regardless of the length of the supplementation period. One of the two latter studies demonstrated positive effects on anaerobic performance, without significant correlation with the supplement.

Conclusion: Several studies demonstrated a positive effect on performance after supplementation of BCAA, but differences and lack of significant association between BCAA supplementation and the studied effect in several of the studies make it difficult to ensure that supplementation of BCAA has an effect. More research in the field is needed.

The proportion of elderly people in the population is increasing, presenting a number of new challenges in society. The purpose of this qualitative study was to in- vestigate how elderly persons with motoric eating difficulties perceive and perform their food and meal practices in everyday life. By using Goffman’s concept of performance as a theoretical framework together with Bourdieu’s thinking on habitus, a deeper understanding of food and meal practices is obtained. Semi- structured interviews were conducted with  elderly people (aged between  and  years) and meal observations were carried out with  of these people. Participants were found to manage food and meal practices by continuously adjust- ing and adapting to the new conditions arising as a result of eating difficulties. This was displayed by conscious planning of what to eat and when, avoiding certain foods and beverages, using simple eating aids, but also withdrawing socially during the meals. All these adjustments were important in order to be able to demonstrate proper food and meal behaviour, to maintain the façade and to act according to the perceived norms. As well as being a pleasurable event, food and meals were also perceived in terms of being important for maintaining health and as ‘fuel’ where the main purpose is to sustain life. This was strongly connected to the social context and the ability to enjoy food and meals with family members and friends, which appeared to be particularly crucial due to the impending risk of failing the meal performance. 

ObjectivesThis cross-sectional study aimed to describe dietary habits in Swedish adolescent handball players and differences with respect to sex and school grade.MethodsParticipants in the Swedish Handball Cohort answered a web-survey assessing adherence to sports nutrition recommendations for meal frequency and meal timing, and the Nordic Nutrition Recommendations (NNR) for fruits/vegetables and fish/seafood, food exclusions and use of dietary supplements. Differences with respect to sex and school grade were estimated with generalised linear models, generating prevalence ratios (PR) with 95% CIs.ResultsA total of 1040 participants (16.6 +/- 0.9 years, 51% males) were included. Overall, 70% and 90%, respectively, met recommendations for meal frequency and meal timing, whereas adherence to recommended carbohydrate intake during training/game was met by 17%. Adherence to the NNR for fruits/vegetables and fish/seafood was met by 16% and 37%, respectively. Twenty-eight per cent reported using dietary supplements. Females reported lower frequency of meals, especially morning snacks (-0.6 days/week (95% CI -0.3 to -0.9)) and evening snacks (-0.8 days/week (95% CI -0.5 to -1.1)), higher prevalence of exclusions due to intolerances (PR 1.66 (95% CI 1.31 to 2.01)) and other reasons (PR 1.36 (95% CI 1.08 to 1.64)), higher adherence to the NNR for fruits/vegetables (PR 2.30 (95% CI 1.98 to 2.62)) and use of micronutrient supplements (PR 1.72 (95% CI 1.43 to 2.00)) compared with males. Only small differences were observed between school grades.ConclusionsSwedish adolescent handball players' dietary habits are fairly in accordance with sports nutrition recommendations but not the NNR. Females appear to display more restrictive habits than males.

The aim of this project was to optimize the assortment of Picadeli’s salad bar regarding research on health and climate, mainly according to the EAT Lancet reference diet and the Nordic Nutrition Recommendations (NNR) 2012. With special emphasis on chemical properties of compounds in wheat pasta, whether Picadeli should switch from refined wheat pasta to whole grain pasta for health reasons were evaluated. A theoretical representative salad bowl (RSB) were made, in proportions to sales of products in Europe, and compared to food group and nutrient quantitative ranges set by the EAT Lancet Commission and NNR. Analysis of the RSB showed that most food groups matched within EAT Lancet and NNR ranges. The poultry and pork content were too high in order to agree with EAT Lancet. The salt and fat content were too high, and the carbohydrate content was too low, in order to agree with NNR. The discrepancies between RSB and EAT Lancet respectively NNR were used to make final recommendations on how Picadeli could change the assortment in order to provide customers with a more sustainable choice of food regarding health and climate. Since total fiber content was sufficient in the RSB and the pasta in the Picadeli salad bar most likely contains retrograded starch, promoting decreased blood sugar response and other health benefits, the refined wheat pasta does not necessarily need to be replaced with whole grain in order to agree as a part of a healthy diet. Main recommendations included replacing substantial amounts of pork and poultry with plant based alternatives, decreasing salt content (regarding sodium chloride) and switching cheese to low fat or plant based cheese.

PURPOSE: A few recent studies have found elevated ferritin levels in patients with anorexia nervosa (AN), indicating ferritin as a potential biomarker of disease severity. The purpose of this study was to study how body mass index (BMI) and changes in BMI affect plasma ferritin concentrations in Swedish patients with eating disorders.

MATERIALS AND METHODS: In a retrospective computer search from 2009 to 2014, 662 patients with an eating disorder were identified from more than 200,000 individuals with electronic medical records. Three hundred and eighty-nine patients (374 females and 15 males) were found to have at least one p-ferritin value with a corresponding BMI value. Patients with AN were compared to a combined group consisting of patients with bulimia nervosa (BN) and patients with an eating disorder not otherwise specified (EDNOS).

RESULTS: Patients with AN had lower BMI compared to the combined group of patients with other eating disorders (BMI = 16.5 ± 1.5, n = 77 vs. 21.0 ± 4.7, n = 312, p < 0.001). Patients with AN also had higher plasma ferritin levels (median 42 μg/L (range 3.3-310) vs. 31 μg/L (range 2.8-280); p < 0.001). As BMI increased in patients with AN, ferritin levels decreased (from a median of 40 μg/L (7-400) to 26 (4-170), n = 47; p < 0.001).

DISCUSSION: Measuring ferritin in patients with AN could be valuable in monitoring improvements of nutritional status, but the full clinical value of following ferritin in individual patients has yet to be determined. The study also shows how research can benefit from electronically captured clinical data using electronic health records.

The aim was to collect and appraise scientific evidence that could be used to derive an upper intake level for folic acid/folate. Five systematic reviews of the literature were conducted to identify evidence to i) characterize the dose-response curve between plasma/serum (P/S) folate and dietary folate intake expressed as dietary folate equivalents (DFE) in adults, and to assess the relationship between ‘high’ folate (intake/biomarkers) in humans with low B12 status and the ii) development of neuropathy and iii) cognitive impairment or dementia, and risk of iv) colorectal adenomas and colorectal cancer (CRC) and v) and prostate cancer. Narrative reviews were also performed. The linear meta-regression model P/S folate (nmol/L) = 6.0 + 0.034*DFE/d (95% confidence interval, CI; 0.027-0.040), R2 = 0.68, based on 22 studies and 60 data points could be used to predict mean P/S folate (and 95% CI) based on DFE intake. In view of the paucity of data, no comprehensive uncertainty analysis and evidence integration were performed for effects of ‘high’ folate intake on neuropathy, cognitive function/dementia. Comprehensive uncertainty analyses and evidence integration for a detrimental effect at high folate intake/status were performed for folic acid interventions and development of colorectal adenomas, for P/S folate from observational studies in relation to CRC incidence, and for total folate intake from observational studies in relation to prostate cancer incidence. The folic acid interventions were few (n = 4) and revealed both beneficial and detrimental effects on adenoma recurrence. For CRC the meta-analyses on P/S folate indicated no association, but the risk estimates in the highest folate exposure groups were compared to levels indicating folate inadequacy or deficiency, thus, the research question could not be adequately addressed. For prostate cancer incidence too few studies with mixed results prevented any clear conclusion on total folate intake and risk of prostate cancer.

Scope: Ingestion of rye bread leads to lower postprandial plasma insulin concentrations than wheat bread ingestion, but most often not too different glucose profiles. The mechanism behind this discrepancy is still largely unknown. This study investigates whether glucose kinetics may explain the observed discrepancy. Methods and results: Nine healthy men participated in a crossover study, eating 50 g of available carbohydrates as either refined wheat (WB) or traditional wholemeal rye bread (WMR) during d-[6,6- 2 H 2 ]glucose infusion. Labeled glucose enrichment is measured by an HPLC-TOF-MS method. The calculated rate of glucose appearance (RaE) is significantly lower after ingestion of WMR during the initial 15 min postprandial period. Additionally, the 0‒90 min RaE area under the curve (AUC) is significantly lower after ingestion of WMR, as is plasma gastric inhibitory polypeptide (GIP) at 60 and 90 min. Postprandial glycemic responses do not differ between the breads. Postprandial insulin is lower after ingestion of WMR at 45 and 60 min, as is the 0‒90 min AUC. Conclusion: Ingestion of WMR elicits a lower rate of glucose appearance into the bloodstream compared with WB. This may explain the lower insulin response observed after rye bread ingestion, commonly known as the rye factor. © 2019 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim