Nutritional status, dietary energy intake and the risk of exacerbations in patients with chronic obstructive pulmonary disease (COPD)

SummaryLoss of body weight, as a result of imbalance between increased energy demand and/or reduced dietary intake, is a common problem in patients with COPD. The aim of this investigation was to examine the relationship between nutritional intake, change in body weight and the risk of exacerbation in patients with COPD.The study comprised 41 patients who were hospitalised because of an exacerbation of COPD. The follow-up period was 12 months. Weight, height and lung function were measured at baseline. At the 12-month follow-up, weight change and current weight were assessed by an interview and nutritional intake was recorded in a food diary for 7 days. An acute exacerbation was defined as having been admitted to hospital and/or making an emergency visit to hospital, due to COPD during the follow-up period.At baseline, 24% of the patients were underweight (body mass index (BMI)<20kg/m2), 46% were of normal weight (BMI 20–25kg/m2) and 29% were overweight (BMI>25kg/m2). Energy intake was lower than the calculated energy demand for all groups. During the follow-up period, 24 of the 41 patients had an exacerbation. A low BMI at inclusion and weight loss during the follow-up period were independent risk factors for having an exacerbation (P=0.003 and 0.006, respectively).We conclude that, in patients who are hospitalised because of COPD, underweight and weight loss during the follow-up period are related to a higher risk of having new exacerbations

Riksmaten Adolescents 2016-17 : A national dietary survey in Sweden - design, methods, and participation

Background: Nationally representative information on food consumption data is essential to evaluate dietary habits, inform policy-making and nutritional guidelines, as well as forming a basis for risk assessment and identification of risk groups. Objective: To describe the methods used in the Swedish national dietary survey of adolescents, Riksmaten Adolescents 2016-2017. Design: Students in grades 5, 8, and 11 (mean ages 12, 15, and 18 years) were recruited in this school-based cross-sectional survey. A new, validated, web-based method was used to assess dietary intake. Information on physical activity, health, and socioeconomic background was collected through web questionnaires. Physical activity was also evaluated by accelerometers. Weight and height were measured in all participants, while blood and urine samples were collected in a subsample of 40% of the participants. Results: A total of 3,477 (68%) respondents participated and 3,099 (60%) had complete dietary information. In the subsample, 1,305 (55%) respondents participated and 1,105 (46%) had complete dietary information. The participants were overall representative for the population with regard to socioeconomic background and school organization (public or independent). All types of municipalities were represented in the survey and overall, the geographic distribution corresponded to the underlying population. Some differences by school grade were observed. Sample weights were calculated for the total sample and the subsample. Conclusion: The Riksmaten Adolescents 2016-2017 provides valuable national data on diet, physical activity, and markers of exposure in age groups where data have been lacking. The data will provide a valuable basis for risk assessment, public health policy, and in-depth analyses

Riksmaten Adolescents 2016-17 : A national dietary survey in Sweden - design, methods, and participation

Background: Nationally representative information on food consumption data is essential to evaluate dietary habits, inform policy-making and nutritional guidelines, as well as forming a basis for risk assessment and identification of risk groups. Objective: To describe the methods used in the Swedish national dietary survey of adolescents, Riksmaten Adolescents 2016-2017. Design: Students in grades 5, 8, and 11 (mean ages 12, 15, and 18 years) were recruited in this school-based cross-sectional survey. A new, validated, web-based method was used to assess dietary intake. Information on physical activity, health, and socioeconomic background was collected through web questionnaires. Physical activity was also evaluated by accelerometers. Weight and height were measured in all participants, while blood and urine samples were collected in a subsample of 40% of the participants. Results: A total of 3,477 (68%) respondents participated and 3,099 (60%) had complete dietary information. In the subsample, 1,305 (55%) respondents participated and 1,105 (46%) had complete dietary information. The participants were overall representative for the population with regard to socioeconomic background and school organization (public or independent). All types of municipalities were represented in the survey and overall, the geographic distribution corresponded to the underlying population. Some differences by school grade were observed. Sample weights were calculated for the total sample and the subsample. Conclusion: The Riksmaten Adolescents 2016-2017 provides valuable national data on diet, physical activity, and markers of exposure in age groups where data have been lacking. The data will provide a valuable basis for risk assessment, public health policy, and in-depth analyses

Everyday Family Food Practices

This chapter considers the debates around childhood obesity and focuses on UK public health campaigns, such as Change4Life, aimed at children and their parents. It aims to broaden the childhood obesity debate commonly discussed in the UK public health literature by using Childhood Studies to critique everyday assumptions that seem to be made about children in public health policy. The chapter consider views and perspectives of children, thereby challenging assumptions that children are ‘passive vessels’ to be filled, suggesting instead that children play an active part in everyday family feeding practices. The family as a context for the negotiation of everyday food practices is explored and the dichotomous relationship of parent and child considered. Reflections are also offered on the fluidity and complexity of family structures and the importance that food plays within the context of everyday family life and how food provisioning impacts on intergenerational relationships within the family. The chapter finishes by exploring perceptions of ‘proper’ or ‘real’ food and its perceived importance for children. While the health literature assumes that children are simply recipients of parental feeding, this chapter highlights research that shows that children also construct their own understandings about the healthiness of food and that they are active participants in negotiating family food practices. Through exploring studies situated within contemporary childhood and families research, the chapter affords a much more nuanced picture of everyday family food practices and children’s roles in those practices than is often presented in childhood obesity discourses