• Association of energy and protein intakes with length of stay, readmission and mortality in hospitalised patients with chronic obstructive pulmonary disease.

      Ingadottir, Arora R; Beck, Anne M; Baldwin, Christine; Weekes, C Elizabeth; Geirsdottir, Olof G; Ramel, Alfons; Gislason, Thorarinn; Gunnarsdottir, Ingibjorg; 1 ] Landspitali Univ Hosp, Unit Nutr Res, IS-101 Reykjavik, Iceland Show more [ 2 ] Univ Iceland, Fac Food Sci & Nutr, IS-101 Reykjavik, Iceland Show more [ 3 ] Landspitali Univ Hosp, Dept Clin Nutr, IS-101 Reykjavik, Iceland [ 4 ] Metropolitan Univ Coll, Fac Hlth & Technol, Dept Nutr & Hlth, DK-2200 Copenhagen N, Denmark [ 5 ] Herlev & Gentofte Hosp, Res Unit Nutr, DK-2820 Gentofte, Denmark Show more [ 6 ] Kings Coll London, Div Diabet & Nutr Sci, London SE1 9NH, England Show more [ 7 ] Landspitali Univ Hosp, Iceland Gerontol Res Inst, IS-101 Reykjavik, Iceland Show more [ 8 ] Univ Iceland, IS-101 Reykjavik, Iceland Show more [ 9 ] Univ Iceland, Fac Med, IS-101 Reykjavik, Iceland Show more [ 10 ] Landspitali Univ Hosp, Dept Resp Med & Sleep, IS-108 Reykjavik, Iceland (Cambridge University Press, 2018-03)
      Low energy and protein intakes have been associated with an increased risk of malnutrition in outpatients with chronic obstructive pulmonary disease (COPD). We aimed to assess the energy and protein intakes of hospitalised COPD patients according to nutritional risk status and requirements, and the relative contribution from meals, snacks, drinks and oral nutritional supplements (ONS), and to examine whether either energy or protein intake predicts outcomes. Subjects were COPD patients (n 99) admitted to Landspitali University Hospital in 1 year (March 2015-March 2016). Patients were screened for nutritional risk using a validated screening tool, and energy and protein intake for 3 d, 1-5 d after admission to the hospital, was estimated using a validated plate diagram sheet. The percentage of patients reaching energy and protein intake ≥75 % of requirements was on average 59 and 37 %, respectively. Malnourished patients consumed less at mealtimes and more from ONS than lower-risk patients, resulting in no difference in total energy and protein intakes between groups. No clear associations between energy or protein intake and outcomes were found, although the association between energy intake, as percentage of requirement, and mortality at 12 months of follow-up was of borderline significance (OR 0·12; 95 % CI 0·01, 1·15; P=0·066). Energy and protein intakes during hospitalisation in the study population failed to meet requirements. Further studies are needed on how to increase energy and protein intakes during hospitalisation and after discharge and to assess whether higher intake in relation to requirement of hospitalised COPD patients results in better outcomes.
    • The cardiovascular risk reduction benefits of a low-carbohydrate diet outweigh the potential increase in LDL-cholesterol.

      Wood, Thomas R; Hansen, Robert; Sigurðsson, Axel F; Jóhannsson, Guðmundur F; 11Division of Physiology,Institute of Basic Medical Sciences,University of Oslo,Domus Medica,Sognsvannsveien 9,0372 Oslo,Norway. 22Redding Anesthesia Associates Medical Group,1100 Butte Street,Redding,CA 96001,USA. 33Department of Cardiology,Landspítali University Hospital,Norðurmýri,Reykjavík,IS-101,Iceland. 44Department of Emergency Medicine,Landspítali University Hospital,Norðurmýri,Reykjavík,IS-101,Iceland. (Cambridge Univ Press, 2016-03-28)
    • Dietary supplement use in the older population of Iceland and association with mortality.

      Ólafsdóttir, Birta; Gunnarsdóttir, Ingibjörg; Nikulásdóttir, Hjálmfríður; Eiríksdóttir, Guðný; Harris, Tamara B; Launer, Lenore J; Guðnason, Vilmundur; Halldórsson, Thórhallur I; Einarsdóttir, Kristjana; [ 1 ] Univ Iceland, Sch Hlth Sci, Unit Nutr Res, Eiriksgata 29, IS-101 Reykjavik, Iceland Show the Organization-Enhanced name(s) [ 2 ] Landspitali Univ Hosp, Eiriksgata 29, IS-101 Reykjavik, Iceland [ 3 ] Iceland Heart Assoc, Holtasmari 1, IS-201 Kopavogur, Iceland Show the Organization-Enhanced name(s) [ 4 ] NIA, 31 Ctr Dr,MSC 2292, Bethesda, MD 20892 USA Show the Organization-Enhanced name(s) [ 5 ] Univ Iceland, Saemundargata 2, IS-101 Reykjavik, Iceland Show the Organization-Enhanced name(s) [ 6 ] Univ Iceland, Ctr Publ Hlth Sci, Sch Hlth Sci, Sturlugata 8, IS-101 Reykjavik, Iceland (Cambridge University Press, 2017-05)
      Dietary supplements are often used by the elderly to improve their nutritional status. However, intake above the recommended dietary levels may be detrimental, and uncertainty exists on the potential health benefits of supplementation in this population. The aim of this study was to describe supplement use among Icelandic older adults and to assess its association with total mortality and CVD-related mortality. This study used data from the Age Gene/Environment Susceptibility-Reykjavik study, which recruited 5764 participants aged 66-98 years in 2002-2006. Intake of vitamins and minerals from dietary supplements was estimated from interviews. Hazard ratios (HR) for mortality were estimated in multivariate analyses with follow-up ending in 2009. The results showed that most (77 %) of the participants used supplements. Overall, the consumption of vitamins and minerals from supplements was moderate although 22 and 14 % of users exceeded the upper recommended intake levels for vitamin B6 and Zn, respectively. Supplement users followed in general a healthier lifestyle than non-users. There were 1221 deaths including 525 CVD-related deaths during the follow-up period. When comparing multivitamin users with non-users in multivariable models, no associations with total mortality (HR 0·91; 95 % CI: 0·77, 1·08) or CVD-related mortality (HR 0·91; 95 % CI 0·70, 1·18) were observed. In conclusion, users of supplements generally lead healthier lifestyles than non-users and supplements did not confer any added advantage or harm relative to mortality risk. However, the intake of vitamin B6 and Zn from dietary supplements exceeded the recommended daily intake for almost a quarter of the supplement users.
    • Do descriptive norms related to parents and friends predict fruit and vegetable intake similarly among 11-year-old girls and boys?

      Lehto, Elviira; Ray, Carola; Haukkala, Ari; Yngve, Agneta; Thorsdottir, Inga; Roos, Eva; [ 1 ] Folkhalsan Res Ctr, Helsinki 00250, Finland [ 2 ] Univ Helsinki, Dept Publ Hlth, Helsinki 00014, Finland [ 3 ] Univ Helsinki, Dept Social Res, FIN-00014 Helsinki, Finland [ 4 ] Univ Orebro, Sch Hosp Culinary Arts & Meal Sci, S-70182 Orebro, Sweden [ 5 ] Landspitali Univ Hosp, Unit Nutr Res, IS-101 Reykjavik, Iceland   Organization-Enhanced Name(s)      Landspitali National University Hospital [ 6 ] Univ Iceland, Sch Hlth Sci, Fac Food Sci & Nutr, IS-101 Reykjavik, Iceland (Cambridge Univ Press, 2016-01-14)
      We examined whether there are sex differences in children's fruit and vegetable (FV) intake and in descriptive norms (i.e. perceived FV intake) related to parents and friends. We also studied whether friends' impact is as important as that of parents on children's FV intake. Data from the PRO GREENS project in Finland were obtained from 424 children at the age 11 years at baseline. At baseline, 2009 children filled in a questionnaire about descriptive norms conceptualised as perceived FV intake of their parents and friends. They also filled in a validated FFQ that assessed their FV intake both at baseline and in the follow-up in 2010. The associations were examined with multi-level regression analyses with multi-group comparisons. Girls reported higher perceived FV intake of friends and higher own fruit intake at baseline, compared with boys, and higher vegetable intake both at baseline and in the follow-up. Perceived FV intake of parents and friends was positively associated with both girls' and boys' FV intake in both study years. The impact of perceived fruit intake of the mother was stronger among boys. The change in children's FV intake was affected only by perceived FV intake of father and friends. No large sex differences in descriptive norms were found, but the impact of friends on children's FV intake can generally be considered as important as that of parents. Future interventions could benefit from taking into account friends' impact as role models on children's FV intake.
    • Maternal dietary glycaemic load during pregnancy and gestational weight gain, birth weight and postpartum weight retention: a study within the Danish National Birth Cohort.

      Knudsen, Vibeke K; Heitmann, Berit L; Halldorsson, Thorhallur I; Sørensen, Thorkild I A; Olsen, Sjurdur F; Ctr Fetal Programming, Dept Epidemiol Res, Statens Serum Inst, Dk Copenhagen S, Denmark, Tech Univ Denmark, Div Nutr, Natl Food Inst, DK-2860 Soborg, Denmark, Copenhagen Univ Hosp, Inst Prevent Med, Copenhagen, Denmark, Univ Iceland, Unit Nutr Res, Fac Food Sci & Nutr, Sch Hlth Sci, Reykjavik, Iceland, Harvard Univ, Sch Publ Hlth, Ctr Fetal Programming, Boston, MA 02115 USA (Cambridge Univ Press, 2013-04-28)
      Dietary glycaemic index and glycaemic load (GL) have been related to obesity and other health outcomes. The objective of the present study was to examine the associations between maternal dietary GL and gestational weight gain, birth weight, the risk of giving birth to a child large-for-gestational age (LGA) or small-for-gestational age and postpartum weight retention (PPWR). Data were derived from the Danish National Birth Cohort (1996-2002), including data on gestational and lifestyle factors in pregnancy and 18 months postpartum. Dietary data were collected using a validated FFQ. Information on birth outcome was obtained through registers. A total of 47,003 women were included. The associations between the GL and birth outcome, gestational weight gain, assessed between weeks 12 and 30 of gestation, and PPWR were analysed by linear and logistic regression. Birth weight increased by 36 g from the lowest to highest GL quintile (95% CI 19, 53 g), and an increased risk of LGA of 14% was detected in the highest GL quintile compared with the lowest GL quintile. Among normal-weight and overweight women, higher gestational weight gain rates were detected in the highest GL quintile (26 g/week (95% CI 19, 34) and 30 g/week (95% CI 13, 46), respectively). The association between the GL and PPWR was most pronounced among pre-pregnant obese women, with an increase in weight retention of 1·3 (95% CI 0·2, 2·8) kg from the lowest to highest GL quintile. The GL may play a role for excessive gestational weight gain and PPWR, which may be more pronounced among overweight and obese women.
    • No association between the intake of marine n-3 PUFA during the second trimester of pregnancy and factors associated with cardiometabolic risk in the 20-year-old offspring.

      Rytter, Dorte; Bech, Bodil H; Halldorsson, Thorhallur; Christensen, Jeppe H; Schmidt, Erik B; Danielsen, Inge; Henriksen, Tine B; Olsen, Sjurdur F; Aarhus Univ, Dept Publ Hlth, Epidemiol Sect, DK-8000 Aarhus C, Denmark, Statens Serum Inst, Ctr Fetal Programming, Dept Epidemiol Res, DK-2300 Copenhagen, Denmark, Univ Iceland, Fac Food Sci & Nutr, Reykjavik, Iceland, Landspitali Univ Hosp, Unit Nutr Res, Reykjavik, Iceland, Aarhus Univ Hosp, Aalborg Hosp, Dept Nephrol, Aalborg, Denmark, Aarhus Univ Hosp, Aalborg Hosp, Ctr Cardiovasc Dis, Aalborg, Denmark, Aarhus Univ Hosp, Aalborg Hosp, Dept Cardiol, Aalborg, Denmark, Aarhus Univ Hosp, Skejby Hosp, Dept Pediat, DK-8000 Aarhus, Denmark (Cambridge Univ Press, 2013-12-14)
      The intake of marine n-3 PUFA has been shown to decrease the risk of CVD in a number of studies. Since the development of CVD is often a lifelong process, marine n-3 PUFA intake early in life may also affect the development of later CVD. The aim of the present study was to investigate the association between maternal intake of marine n-3 PUFA during the second trimester of pregnancy and factors associated with cardiometabolic risk in the 20-year-old offspring. The study was based on the follow-up of the offspring of a Danish pregnancy cohort who participated in a study conducted from 1988 to 1989. A total of 965 pregnant women were originally included in the cohort and detailed information about the intake of marine n-3 PUFA during the second trimester was collected. In 2008-9, the offspring were invited to participate in a clinical examination including anthropometric, blood pressure (BP) and short-term heart rate variability measurements. Also, a fasting venous blood sample was drawn from them. Multiple linear regression modelling, using the lowest quintile of marine n-3 PUFA intake as the reference, was used to estimate the association with all outcomes. A total of 443 offspring participated in the clinical examination. No association between the intake of marine n-3 PUFA during the second trimester of pregnancy and offspring adiposity, glucose metabolism, BP or lipid profile was found. In conclusion, no association between the intake of marine n-3 PUFA during the second trimester of pregnancy and the factors associated with cardiometabolic risk in the 20-year-old offspring could be detected.
    • The PRO GREENS intervention in Finnish schoolchildren - the degree of implementation affects both mediators and the intake of fruits and vegetables.

      Lehto, Reetta; Määttä, Suvi; Lehto, Elviira; Ray, Carola; Te Velde, Saskia; Lien, Nanna; Thorsdottir, Inga; Yngve, Agneta; Roos, Eva; Folkhalsan Res Ctr, Helsinki 00250, Finland, Univ Helsinki, Dept Publ Hlth, Hjelt Inst, Helsinki, Finland, Vrije Univ Amsterdam Med Ctr, EMGO Inst Hlth & Care Res, Dept Epidemiol & Biostat, Amsterdam, Netherlands, Univ Oslo, Fac Med, Dept Nutr, Oslo, Norway, Univ Iceland, Sch Hlth Sci, Fac Food Sci & Nutr, Unit Nutr Res, Reykjavik, Iceland, Univ Orebro, Sch Hospitality Culinary Arts & Meal Sci, SE-70182 Orebro, Sweden (Cambridge Univ Press, 2014-10-14)
      Little is known about the mediating effects of the determinants of fruit and vegetable (FV) intake in school-based interventions that promote FV intake, and few studies have examined the impact of the degree of implementation on the effects of an intervention. The present study examined whether the degree of implementation of an intervention had an effect on children's fruit or vegetable intake and determined possible mediators of this effect. The study is part of the European PRO GREENS intervention study which aimed to develop effective strategies to promote consumption of fruit and vegetables in schoolchildren across Europe. Data from 727 Finnish children aged 11 years were used. The baseline study was conducted in spring 2009 and the follow-up study 12 months later. The intervention was conducted during the school year 2009-2010. The effects were examined using multilevel mediation analyses. A high degree of implementation of the intervention had an effect on children's fruit intake. Knowledge of recommendations for FV intake and liking mediated the association between a high degree of implementation of the intervention and an increase in the frequency of fruit intake. Knowledge of recommendations for FV intake and bringing fruits to school as a snack mediated the association between a low degree of implementation of the intervention and an increase in the frequency of fruit intake. Overall, the model accounted for 34 % of the variance in the change in fruit intake frequency. Knowledge of recommendations acted as a mediator between the degree of implementation of the intervention and the change in vegetable intake frequency. In conclusion, the degree of implementation had an effect on fruit intake, and thus in future intervention studies the actual degree of implementation of interventions should be assessed when considering the effects of interventions.