Effectiveness of the gold standard programmes (GSP) for smoking cessation in pregnant and non-pregnant women

Background: Smoking is considered the most important preventable risk factor in relation to the development of complications during pregnancy and delivery. The aim of this study was to evaluate the effectiveness of an intensive 6-week gold standard programme (GSP) on pregnant women in real life. Methods: This was a prospective cohort study based on data from a national Danish registry on smoking cessation interventions. The study population included 10,682 women of a fertile age. The pregnancy status of the study population was identified using the National Patient Registry. Results: The response rate to follow up was 76%. The continuous abstinence rate for both pregnant and non-pregnant smokers was 24–32%. The following prognostic factors for continuous abstinence were identified: programme format (individual/group), older age, heavy smoking, compliance with the programme, health professional recommendation, and being a disadvantaged smoker. Conclusions: The GSP seems to be as effective among pregnant smokers as among non-pregnant smoking women. Due to the relatively high effect and clinical significance, the GSP would be an attractive element in smoking cessation intervention among pregnant women

Association between dairy consumption and cardiovascular disease events, bone fracture and all-cause mortality

Dairy products are important constituents of a healthy and balanced diet, but their association with health outcomes remains to be established. We investigated the association of total dairy, total fermented dairy, and different dairy subtypes (including total/high-fat/low-fat milk, yogurt, cheese, butter, and cream) and the risk of cardiovascular disease (CVD), coronary heart disease (CHD), bone fracture and all-cause mortality among 1746 Danish healthy men and women (30–60 years, 52%female). Hazard ratios (HRs) and 95% CIs were estimated using the multivariable Cox proportional hazard models. During a mean follow-up of 30 years, incident cases of CVD (n = 904), CHD (n = 332), fracture (n = 447) and all-cause mortality (n = 680) were reported. High intake of total fermented dairy was associated with lower fracture risk (HR 0.67, 95% CI: 0.51–0.90, P = 0.02) than observed in the lowest tertile of the fermented dairy group. Furthermore, high intake of low-fat milk was associated with lower risks of CVD (HR 0.84, 95% CI: 0.68–1.03, P = 0.03), CHD (HR 0.82, 95% CI: 0.59–1.16, P = 0.04), and all-cause mortality (HR 0.77, 95% CI: 0.61–0.97, P = 0.004) compared with the lowest tertile of low-fat milk group. No associations were found with other dairy subtypes. The findings from this prospective cohort study suggest an inverse association between total fermented dairy and fracture risk, and also inverse associations were found between low-fat milk consumption and risk of CVD, CHD and all-cause mortality

Longitudinal associations between intake of fruit and vegetables and height attainment from preschool to school entry

To examine associations between fruit and vegetable intake in young childhood and height attainment during preschool and at school entry. Data for this study was based on “The Healthy Start” primary intervention study, which included 635 obesity-prone children, (58% boys), from the greater Copenhagen area, with a mean (SD) age of 4.0 (1.1) years (age range 2–6 years) at baseline. In the current study, 553 children (57% boys) were included with information on dietary intake at baseline and height measured at baseline (preschool age), and 511 children (56.8% boys) with the height measured at school entry (~6 years old). Height was measured by trained health professionals during the intervention and by school nurses at school entry. Information on intakes of fruit and vegetables, separately and combined, was gathered with four-day dietary records reported by parents. Participants were grouped into tertiles for their intakes at baseline. Compared to boys with low consumption, those with a moderate and high intakes of fruit and vegetables (F&V) had a greater attained height at preschool of 1.3 cm (95% confidence interval (CI): 0.3; 2.3) and at school entry of 2.4 cm (95% CI: 0.8; 3.9) and 1.8 cm (95% CI: 0.2; 3.4), respectively, also after adjustment for differences in age, body mass index (BMI), and total energy intake. Additional adjustment for mid-parental height and parents’ education did not alter the significant associations between moderate consumption of F&V and attained height at preschool and school entry. There was no association among girls. Our results showed that a moderate consumption of F&V was directly associated with higher attainment in height at preschool and school entry in boys. From a public health perspective, it should be prioritized to continue developing intervention programs to improve fruit and vegetable intake.The Healthy Start Study was supported by grants from Tryg Fonden (grant: 7984-07, 7106-09, and 7-10-0330), The Danish Medical Research Council (grant: 271-07-0281), and Helsefonden (grant: 2008B101). The Parker Institute, Bispebjerg and Frederiksberg Hospital, is supported by a core grant from the Oak Foundation (OCAY-13-309)

The relation between red meat and whole-grain intake and the colonic mucosal barrier:A cross-sectional study

Publisher's version (útgefin grein)The Colonic Mucosal Barrier (CMB) is the site of interaction between the human body and the colonic microbiota. The mucus is the outer part of the CMB and is considered as the front-line defense of the colon. It separates the host epithelial lining from the colonic content, and it has previously been linked to health and diseases. In this study, we assessed the relationship between red meat and whole-grain intake and (1) the thickness of the colonic mucus (2) the expression of the predominant mucin gene in the human colon (MUC2). Patients referred to colonoscopy at the University Hospital of Southern Denmark-Sonderjylland were enrolled between June 2017 and December 2018, and lifestyle data was collected in a cross-sectional study design. Colonic biopsies, blood, urine, and fecal samples were collected. The colonic mucus and bacteria were visualized by immunostaining and fluorescence in situ hybridization techniques. We found a thinner mucus was associated with high red meat intake. Similarly, the results suggested a thinner mucus was associated with high whole-grain intake, albeit to a lesser extent than red meat. This is the first study assessing the association between red meat and whole-grain intake and the colonic mucus in humans. This study is approved by the Danish Ethics Committee (S-20160124) and the Danish Data Protecting Agency (2008-58-035). A study protocol was registered at clinical trials.gov under NCT04235348.This study is a part of SysCID project, which has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 733100, The Region of Southern Denmark”, “The University Hospital of Southern Denmark-Sonderjylland”, “The University of Southern Denmark”, and “Knud og Edith Eriksens mindefond”.Peer Reviewe

Intentional Weight Loss and Longevity in Overweight Patients with Type 2 Diabetes:A Population-Based Cohort Study

OBJECTIVE:This study examined the influence of weight loss on long-term morbidity and mortality in overweight (BMI≥25 kg/m2) patients with type 2 diabetes, and tested the hypothesis that therapeutic intentional weight loss supervised by a medical doctor prolongs life and reduces the risk for cardiovascular disease in these patients. METHODS:This is a 19 year cohort study of patients in the intervention arm of the randomized clinical trial Diabetes Care in General Practice. Weight and prospective intentions for weight loss were monitored every third month for six years in 761 consecutive patients (≥40 years) newly diagnosed with diabetes in general practices throughout Denmark in 1989-92. Multivariable Cox regression was used to estimate the association between weight change during the monitoring period (year 0 to 6) and the outcomes during the succeeding 13 years (year 6 to 19) in 444 patients who were overweight at diagnosis and alive at the end of the monitoring period (year 6). The analysis was adjusted for age, sex, education, BMI at diagnosis, change in smoking, change in physical activity, change in medication, and the Charlson comorbidity 6-year score. Outcomes were from national registers. RESULTS:Overall, weight loss regardless of intention was an independent risk factor for increased all-cause mortality (P<0.01). The adjusted hazard ratio for all-cause mortality, cardiovascular mortality, and cardiovascular morbidity attributable to an intentional weight loss of 1 kg/year was 1.20 (95%CI 0.97-1.50, P = 0.10), 1.26 (0.93-1.72, P = 0.14), and 1.06 (0.79-1.42, P = 0.71), respectively. Limiting the analysis to include only those patients who survived the first 2 years after the monitoring period did not substantially change these estimates. A non-linear spline estimate indicated a V-like association between weight change and all-cause mortality, suggesting the best prognosis for those who maintained their weight. CONCLUSIONS:In this population-based cohort of overweight patients with type 2 diabetes, successful therapeutic intentional weight loss, supervised by a doctor over six years, was not associated with reduced all-cause mortality or cardiovascular morbidity/mortality during the succeeding 13 years