Hvordan påvirker livsstilintervensjon med fokus på kosthold og fysisk aktivitet risikofaktorer for type 2-diabetes hos en gruppe risikoindivider?

Utbredelsen av diabetes øker i alle land man har data for og sykdommen er i ferd med å anta epidemiske dimensjoner. I Norge regner man med at ca 200 000 personer kan ha type 2-diabetes. Halvparten av disse vet ikke at de har sykdommen. Internasjonale studier har vist at man ved å endre livsstil (kosthold og fysisk aktivitet) kan redusere risikoen for å få sykdommen. Formålet med denne livsstilsintervensjonen var å se på effekten av 12 måneders livsstilsintervensjon på risikofaktorer for diabetes type 2 hos en gruppe personer med økt risiko Førtifire kvinner og menn med økt risiko for å utvikle type 2-diabetes eller nylig hadde utviklet type 2-diabetes i alderen 20 til 65 år gjennomførte 12 måneders livsstilsintervensjon med fokus på kosthold og økt fysisk aktivitet. Livsstilsintervensjonen besto av et livsstilskurs ned fokus på endring av kost og fysisk aktivitetsvaner med 16 kurskvelder og trening i grupper to ganger i uken. Kostrådene ble basert på de europeiske anbefalingene for behandling og forebygging av diabetes mellitus. Antropometriske mål og blodprøver ble tatt for analyse av fastende blodglukose, HbA1c og blodlipider ved intervensjonsstart og ved 12 måneder. Kosthold ble registrert ved hjelp av en prekodet kostdagbok. Resultatene viste signifikant reduksjon i kroppsvekt, kroppsmasseindeks og livvidde. Fastende blodglukose, LDL-kolesterol og triglyserider ble signifikant redusert og det var en signifikant økning i HDL-kolesterol. Det var ingen endring i totalkolesterol eller HbA1c. Kostdata viste ingen signifikante endringer i inntak av energi og energigivende næringsstoffer, men det var en signifikant økning i inntak av kostfiber og vitamin C og folat. Det var ingen signifikante endringer i inntak av matvarer med unntak av frukt, bær, grønnsaker, og saft og brus med sukker. Næringstettheten økte signifikant med hensyn til kostfiber, vitamin C, folat og riboflavin. Enkelte av funnene i denne studien indikerer at livsstilsintervensjon med fokus på kosthold og fysisk aktivitet kan redusere risikofaktorer for type 2-diabetes hos personer med økt risiko for eller nyoppdaget type 2-diabetes. Erfaringer fra Diabetesverkstedet viser at livsstilveiledning i grupper kan motivere til endringer som kan forebygge og/eller utsette tidspunktet for sykdom

Consumption of ultra-processed foods : an assessment of the literature on determinants of ultra-processed food consumption and an investigation of the potential effect of time scarcity

Masteroppgave folkehelsevitenskap - Universitetet i Agder 2016Background Highly processed foods have been classified as ultra-processed, and consumption of such foodstuffs have expanded rapidly over the last decades. Ultra-processed foods are characterized as being accessible, attractive, palatable and often time-saving. An excess intake of ultra-processed foods has been associated with increased risk of e.g. overweight/obesity and diabetes type II. The aim of this master’s project was to investigate factors influencing consumption of ultra-processed foods. This resulted in one review paper on young adults, and one cross-sectional study where the association between time scarcity and ultra-processed food consumption was investigated. Methods In order to identify relevant material for the review paper, a systematic literature search was conducted in four databases, using a two-folded search string with terms indicative of ultra-processed foods and determinants. The cross-sectional study included 497 participants. A validated score was used as an indicator of time scarcity, and three scores were developed as indicators of ultra-processed food consumption; ultra-processed dinner products, snacks & soft drinks, fast foods. Binary logistic regression analyses were used to investigate the association between time scarcity and consumption of ultra-processed foods. Analyses were adjusted for sociodemographic factors. Results In total, 65 studies were included in the review paper, and the majority of these investigated determinants on the individual level. Gender, younger age and more television watching were associated with consumption of ultra-processed foods. The cross-sectional study showed that participants with higher degree of time scarcity had higher odds of being high consumers of fast foods. Regression analyses also showed sociodemographic differences in consumption of ultra-processed foods. Conclusions Future research should further investigate factors influencing consumption of ultra-processed foods, particularly on the environmental level where there is currently a lack of research. Intervention studies and studies with a longitudinal design are needed. Keywords Ultra-processed food, processed food, determinants, time scarcity, young adult

The association between time scarcity, sociodemographic correlates and consumption of ultra-processed foods among parents in Norway: a cross-sectional study

Background: Use of ultra-processed foods has expanded rapidly over the last decades and high consumption has been positively associated with risk of e.g. overweight, obesity and type 2 diabetes. Ultra-processed foods offer convenience as they require minimal time for preparation. It is therefore reasonable to assume that such foods are consumed more often among people who experience time scarcity. The main aim of this study was to investigate the association between time scarcity and consumption of ultra-processed foods among parents of 2-year olds in Norway. A secondary aim was to investigate the association between sociodemographic correlates, weight status and consumption of ultra-processed foods. Methods: This cross-sectional study included 497 participants. Chi-square and cross tabulations were used to calculate proportions of high vs. low consumption of ultra-processed foods in relation to time scarcity, sociodemographic correlates and weight status. Binary logistic regression analyses were performed to test the relationship between independent variables and consumption of ultra-processed foods. Results: Participants reporting medium and high time scarcity were more likely to have a high consumption of ultra-processed dinner products (OR = 3. 68, 95% CI = 2. 32–5.84 and OR = 3.10, 1.80–5.35, respectively) and fast foods (OR = 2.60, 1.62–4.18 and OR = 1.90, 1.08–3.32, respectively) compared to those with low time scarcity. Further, participants with medium time scarcity were more likely to have a high consumption of snacks and soft drinks compared to participants with low time scarcity (OR = 1.63, 1.06–2.49). Finally, gender, ethnicity, educational level, number of children in the household and weight status were identified as important factors associated with the consumption of certain types of ultra-processed foods. Conclusions: Results from the present study showed that time scarcity, various sociodemographic factors and weight status was associated with consumption of processed foods. Future studies with a longitudinal design are needed to further explore these patterns over a longer period of time. Keywords: Ultra-processed foods, Processed foods, Time scarcity, Convenience, Adults, ParentspublishedVersionnivå

Consumption of ultra-processed foods : an assessment of the literature on determinants of ultra-processed food consumption and an investigation of the potential effect of time scarcity

Masteroppgave folkehelsevitenskap - Universitetet i Agder 2016Background Highly processed foods have been classified as ultra-processed, and consumption of such foodstuffs have expanded rapidly over the last decades. Ultra-processed foods are characterized as being accessible, attractive, palatable and often time-saving. An excess intake of ultra-processed foods has been associated with increased risk of e.g. overweight/obesity and diabetes type II. The aim of this master’s project was to investigate factors influencing consumption of ultra-processed foods. This resulted in one review paper on young adults, and one cross-sectional study where the association between time scarcity and ultra-processed food consumption was investigated. Methods In order to identify relevant material for the review paper, a systematic literature search was conducted in four databases, using a two-folded search string with terms indicative of ultra-processed foods and determinants. The cross-sectional study included 497 participants. A validated score was used as an indicator of time scarcity, and three scores were developed as indicators of ultra-processed food consumption; ultra-processed dinner products, snacks & soft drinks, fast foods. Binary logistic regression analyses were used to investigate the association between time scarcity and consumption of ultra-processed foods. Analyses were adjusted for sociodemographic factors. Results In total, 65 studies were included in the review paper, and the majority of these investigated determinants on the individual level. Gender, younger age and more television watching were associated with consumption of ultra-processed foods. The cross-sectional study showed that participants with higher degree of time scarcity had higher odds of being high consumers of fast foods. Regression analyses also showed sociodemographic differences in consumption of ultra-processed foods. Conclusions Future research should further investigate factors influencing consumption of ultra-processed foods, particularly on the environmental level where there is currently a lack of research. Intervention studies and studies with a longitudinal design are needed. Keywords Ultra-processed food, processed food, determinants, time scarcity, young adult

Changes in obesity-related diseases and biochemical variables after laparoscopic sleeve gastrectomy: a two-year follow-up study

Background: To evaluate changes in obesity-related diseases and micronutrients after laparoscopic sleeve gastrectomy (LSG). Methods: We started the procedure in May 2007, and by December 2011, 117 patients could be evaluated for a two year follow-up. Comparisons of preoperative status with 12 and 24 months postoperative status were made for body mass index (BMI), obesity-related diseases and micronutrients. Results: Major complications included bleeding requiring transfusion at 5.1%, leak at 1.7% and abscess without a visible leak at 0.9%. Mean BMI was reduced from 46.6 (standard deviation (SD) 6.0) kg/m2 to 30.6 (SD 5.6) kg/m2 at two years, and resolution occurred for 80.7% of patients with type 2 diabetes, 63.9% with hypertension, 75.8% with hyperlipidemia, 93.0% with sleep apnea, 31.4% with musculoskeletal pain, 85.4% with snoring and 73.3% with urinary incontinence. Amenorrhea resolved in all premenopausal females. The proportion of patients with symptomatic gastroesophageal reflux disease increased from 12.8% to 27.4%. The prevalence of patients with low ferritin-levels increased, while 25-hydroxyvitamin D (25(OH)D) deficiency decreased postoperatively. Conclusions: LSG is an effective procedure for morbid obesity and obesity-related diseases, but the technique should be further explored particularly to avoid gastroesophageal reflux