Development and Validation of a Photographic Method to Use for Dietary Assessment in School Settings.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.To develop and validate a photographic method aimed at making assessment of dietary intake in school canteens non-obstrusive, practical and feasible.The study was conducted in two elementary schools representing two different school canteen systems; main dish being served by canteen staff (Iceland), and complete self-serving (Sweden). Food items in serving and leftovers were weighed and photographed. Trained researchers estimated weights of food items by viewing the photographs and comparing them with pictures of half and full reference portions with known weights. Plates of servings and leftovers from 48 children during five school days (n = 448 plates) and a total of 5967 food items were estimated. The researchers' estimates were then compared with the true weight of the foods and the energy content calculated.Weighed and estimated amounts correlated across meals both in grams and as total energy (0.853-0.977, p<0.001). The agreement between estimated energy content in school meals was close to the true measurement from weighed records; on average 4-19 kcal below true values. Organisation of meal service impacted the efficacy of the method as seen in the difference between countries; with Iceland (served by canteen staff) having higher rate of acceptable estimates than Sweden (self-serving), being 95% vs 73% for total amount (g) in serving. Iceland more often had serving size between or above the half and full reference plates compared with Sweden.The photographic method provides acceptable estimates of food and energy intake in school canteens. However, greater accuracy can be expected when foods are served by canteen staff compared with self-serving

Intrusive thoughts and quality of life among men with prostate cancer before and three months after surgery.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.Sudden, unwelcome and repetitive thoughts about a traumatic event--intrusive thoughts--could relate to how men assess their quality of life after prostate-cancer diagnosis. We aimed to study the prevalence of intrusive thoughts about prostate cancer and their association with quality-of-life outcomes before and after radical prostatectomy.During the first year of the LAPPRO-trial, 971 men scheduled for radical prostatectomy were prospectively included from 14 urological centers in Sweden. Of those, 833 men responded to two consecutive study-specific questionnaires before and three months after surgery (participation rate 86%). The association of intrusive thoughts with three quality-of-life outcomes, i.e. self-assessed quality of life, depressive mood and waking up with anxiety was estimated by prevalence ratios that were calculated, together with a 95% confidence interval, at the same time-point as well as over time. Fisher's exact-test was used to analyze differences between respondents and non-respondents. Wilcoxon signed-ranks and Cochran-Armitage trend tests were used for analysis of change over time. To validate new questions on intrusive thoughts, written answers to open-ended questions were read and analyzed by qualitative content analysis.Before surgery, 603 men (73%) reported negative intrusive thoughts about their cancer at some time in the past month and 593 men (59%) reported such thoughts three months after surgery. Comparing those reporting intrusive thoughts at least weekly or once a week before surgery with those who did not, the prevalence ratio (95% confidence interval), three months after surgery, for waking up in the middle of the night with anxiety was 3.9 (2.7 to 5.5), for depressed mood 1.8 (1.6 to 2.1) and for impaired self-assessed quality of life 1.3 (1.2 to 1.5).The prevalence of negative intrusive thoughts about prostate cancer at the time of surgery associates with studied quality-of-life outcomes three months later.Current Controlled Trials, ISRCTN06393679.Swedish Cancer Society CAN2008/922 CAN2009/1099 CAN2010/593 Region Vastra Gotaland Sahlgrenska University Hospital VGR 27551 79291 152231 ALF 11573 138751 146201 HTA - VGR 6011 Swedish Research Council Mrs Mary von Sydow Foundation Anna and Edvin Berger foundat

The Anticaries Effect of a Food Extract (Shiitake) in a Short-Term Clinical Study

The main objective was to investigate whether low-molecular-weight fraction of edible mushroom shiitake extract (Lentinus edodes) possesses caries-preventive properties. The study was designed as a double-blind, three-leg, cross-over, randomized, controlled clinical trial carried out on two series of volunteers at the University of Gothenburg, and the Academic Centre for Dentistry Amsterdam. Volunteers rinsed twice daily with a solution containing low-molecular-weight fraction of edible mushroom, placebo (negative control without active ingredients), or Meridol (positive control, AmF-SnF2) for two weeks, with a two-week washout period between each rinsing period. Changes in the acidogenicity of dental plaque before and after a sucrose challenge, shifts in microbial composition, and plaque scores were determined. Frequent rinses with shiitake reduced the metabolic activity of dental plaque. No reduction of plaque scores and no inhibition of the production of organic acids in plaque was found. Minor differences in microbial composition between test sessions were found. To conclude, the results indicate that shiitake extract has anticariogenic potential, but not to the same extent as the positive control

Dietary intake of fish, omega-3, omega-6 polyunsaturated fatty acids and vitamin D and the prevalence of psychotic-like symptoms in a cohort of 33 000 women from the general population

<p>Abstract</p> <p>Background</p> <p>Low intake of fish, polyunsaturated fatty acids (PUFA) and vitamin D deficiency has been suggested to play a role in the development of schizophrenia. Our aim was to evaluate the association between the intake of different fish species, PUFA and vitamin D and the prevalence of psychotic-like symptoms in a population-based study among Swedish women.</p> <p>Methods</p> <p>Dietary intake was estimated using a food frequency questionnaire among 33 623 women aged 30-49 years at enrolment (1991/92). Information on psychotic-like symptoms was derived from a follow-up questionnaire in the years 2002/03. Participants were classified into three predefined levels: low, middle and high frequency of symptoms. The association between diet and psychotic-like symptoms was summarized in terms of relative risks (RR) and corresponding 95% confidence intervals and was evaluated by energy-adjusted multinomial logistic regression.</p> <p>Results</p> <p>18 411 women were classified as having a low level of psychotic-like symptoms, 14 395 as middle and 817 as having a high level. The risk of high level symptoms was 53% (95% CI, 30-69%) lower among women who ate fish 3-4 times per week compared to women who never ate fish. The risk was also lower for women with a high intake of omega-3 and omega-6 PUFA compared to women with a lower intake of these fatty acids. The effect was most pronounced for omega-6 PUFAs. The RR comparing the highest to the lowest quartile of omega-6 PUFAs intake was 0.78 (95% CI, 0.64-0.97). The associations were J-shaped with the strongest reduced risk for an intermediate intake of fish or PUFA. For fatty fish (herring/mackerel, salmon-type fish), the strongest inverse association was found for an intermediate intake (RR: 0.81, 95% CI, 0.66-0.98), whereas a high intake of fatty fish was associated with an increased risk of psychotic-like symptoms (RR: 1.90, 95% CI, 1.34-2.70). Women in the highest compared with the lowest quartile of vitamin D consumption experienced a 37% (95% CI, 22-50%) lower risk of psychotic-like symptoms.</p> <p>Conclusion</p> <p>Our findings raise a possibility that adult women with a high intake of fish, omega-3 or omega-6 PUFA and vitamin D have a lower rate of psychotic-like symptoms.</p

Dietary and genetic factors in the etiology of prostate cancer

The etiology of prostate cancer is poorly understood. However, genetic factors may be more important than for many other malignancies. In addition, several studies suggest that dietary factors axe of etiologic importance. In particular, dietary intake of phytoestrogens or marine fatty adds from fish may protect against prostate cancer development. Because phytoestrogens bind tightly to the estrogen receptor-beta that is involved in prostate cancer progression, we investigated whether there is a synergistic effect between phytoestrogen intake and estrogen receptor-beta (ERbeta) gene polymorphisms in prostate cancer development. Furthermore, we investigated the interaction between intake of fatty fish and polymorphisms in the cyclooxygenase (COX)-2 gene, a key enzyme in fatty add metabolism and inflammation. Finally, we examined whether the association of alcohol consumption with prostate cancer risk varies between localized and advanced cases, or between sporadic and familial cases. We conducted a large population-based case-control study in Sweden (CAPS); in this study, we assessed dietary intake of phytoestrogens, fish consumption and alcohol drinking among 1499 cases and 1130 controls. Scrum enterolactone levels were analyzed for 209 cases and 214 controls, chosen randomly. We identified four single nucleotide polymorphisms (SNPs) in the ERbeta gene and five in the COX-2 gene, and genotyped these SNPs in 1314 (ERbeta) or 1378 (COX2) cases and 782 controls, respectively. Unconditional logistic regression was performed to estimate multivariate odds ratios and 95% confidence intervals. Stratified analyses, as well as both multiplicative and additive models, were used to evaluate interactions between dietary intake and SNPs on prostate cancer risk. We found that high intake of food items rich in phytoestrogens was strongly associated with a decreased relative risk of prostate cancer, and intermediate serum levels of enterolactone were associated with a decreased relative risk. Furthermore, we found that the overall decreased risk of prostate cancer for men with a high intake of phytoestrogens was strongly modified by a promoter SNP in the ERbeta gene (-13950 T/C). Carriers of the variant allele had an almost 60% lower risk of prostate cancer, compared to men with low phytoestrogen intake, whereas no such association was found among men with the common genotype. Frequent consumption of fatty fish or marine fatty adds was strongly associated with a decreased relative risk of prostate cancer. The inverse association between salmon-type fish and prostate cancer was modified by a nucleotide sequence variant in the COX-2 gene (+6365 T/C). Prostate cancer cases were more likely than controls to be current or former, rather than never, drinkers. However, there was no association between recent alcohol consumption and risk of overall prostate cancer, nor advanced, sporadic, or familial prostate cancer. There was a marginal positive association between intake of any alcohol type and risk of localized disease. In summary, our study provides strong evidence that high intake of phytoestrogens substantially reduces prostate cancer risk among men with specific polymorphic variation in the promoter region of the ERbeta gene. In addition, frequent consumption of fatty fish and marine fatty acids strongly reduces the risk of prostate cancer, and this association appears to be modified by genetic variation in the COX-2 gene. Furthermore, we found no association between recent alcohol consumption and risk of overall prostate cancer, although we observed a marginal positive association with localized disease

The effect of a phytoestrogen intervention and impact of genetic factors on tumor proliferation markers among Swedish patients with prostate cancer : study protocol for the randomized controlled PRODICA trial

Background: A high intake of phytoestrogens, found in soy, rye, and seeds, is associated with a reduced risk of a prostate cancer diagnosis. Previously, we found that the overall decreased risk of prostate cancer diagnosis in males with a high intake of phytoestrogens was strongly modified by a nucleotide sequence variant in the estrogen receptor-beta (ERβ) gene. However, we do not know if phytoestrogens can inhibit the growth of prostate cancer in males with established diseases. If there is an inhibition or a delay, there is reason to believe that different variants of the ERβ gene will modify the effect. Therefore, we designed an intervention study to investigate the effect of the addition of foods high in phytoestrogens and their interaction with the ERβ genotype on prostate tumor proliferation in patients with prostate cancer. Method: The PRODICA trial is a randomized ongoing intervention study in patients with low- and intermediate-risk prostate cancer with a Gleason score &lt; 8, prostate-specific antigen (PSA) &lt; 20, and scheduled for radical prostatectomy. The study is conducted at Sahlgrenska University Hospital in Gothenburg, Sweden. The intervention consists of a daily intake of soybeans and flaxseeds (~ 200 mg of phytoestrogens) until the surgery, approximately 6 weeks. The aim is to recruit 200 participants. The primary outcome is the difference in the proliferation marker Ki-67 between the intervention and the control groups. The genotype of ERβ will be investigated as an effect-modifying factor. Secondary outcomes include, e.g., concentrations of PSA and steroid hormones in the blood. Discussion: The results of the PRODICA trial will contribute important information on the relevance of increasing the intake of phytoestrogens in patients with prostate cancer who want to make dietary changes to improve the prognosis of their cancer. If genetic factors turn out to influence the effect of the intervention diet, dietary advice can be given to patients who most likely benefit from it. Dietary interventions are cost-effective, non-invasive, and result in few mild side effects. Lastly, the project will provide basic pathophysiological insights which could be relevant to the development of treatment strategies for patients with prostate cancer. Trial registration. ClinicalTrials.gov NCT02759380. Registered on 3 May 2016