A cross-sectional study on nutrient intake and -status in inflammatory bowel disease patients.

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.Inflammatory bowel disease (IBD) can be associated with nutritional problems. The aim of this study was to investigate diet and nutritional status of IBD patients.A total of 78 participants (35 men and 43 women aged 18-74 years) were included in this cross-sectional study. The majority (80 %) of the participant received infliximab treatment. Participants filled out disease related questionnaires and 31 participants also a 3-day food record. Body composition was measured and blood samples analysed in order to estimate nutritional status.The majority (87 %) claimed that diet affects digestive tract symptoms and 72 % had changed diet accordingly. The most common foods restricted were dairy products (60 %), processed meat (55 %), soft drinks (46 %), alcohol (45 %) and fast food (44 %). Body mass index was mostly in the overweight range but 46 % of the participants had been diagnosed with some nutritional deficiency since IBD diagnosis (most common was iron deficiency: 39 %). Patients who restricted meat products had lower ferritin values (48 ± 39 vs. 95 ± 74 μg/L, P = 0.011). Intake of vitamin D and calcium were not adequate (65 % below recommeded intake for both) and 60 % had poor vitamin D status.IBD patients often change their dietary intake in order to affect digestive tract symptoms. Many patients have a history of nutrient deficiency. Restriction of dairy and meat consumption is common and is negatively associated with intake or status of micronutrients like calcium and iron. Dietary advice by a dietitian and use of potentially helpful dietary supplements is indicated.Science funds of the Landspitali- The National University Hospital of Icelan

Dietary habits and their association with blood pressure among elderly Icelandic people

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/Open Allur texti - Full textOBJECTIVE: Prevalence of hypertension, which is the most common risk factor for cardiovascular disease in elderly people, increases with age. The aim of the study was to investigate the association between diet and blood pressure in elderly Icelanders, with focus on cod liver oil, and to compare their diet to dietary guidelines. MATERIAL AND METHODS: Diet was assessed using three-day weighed food records and blood pressure was measured after a 12-hour-fast in 236, 65-91 years old, Icelanders living in the capital area of Iceland. 99 men (42%) and 137 women (58%) participated in the study. RESULTS: According to Nordic nutrition recommendations, intake of nutrients was above lower intake levels among the majority of participants. However, 19% were under this level for vitamin-D, 13% for iodine, 17% of men for vitamin-B6, and 26% and 12% of men and women, respectively, for iron. Systolic blood pressure was inversely associated with cod liver oil intake, even when adjusted for age, body mass index, gender, and antihypertensive medications (P=0.01). Intake of long-chain omega-3 fatty acids correlated with blood pressure in a similar way. Other dietary factors were not associated with blood pressure. CONCLUSION: The results indicate that intake of cod liver oil is associated with lower blood pressure among elderly people and may therefore have beneficial effects on health. A notable proportion of participants was at risk of vitamin D, vitamin B6, iodine, and iron deficiency.Tilgangur: Tíðni langvinnra sjúkdóma, svo sem háþrýstings, eykst með hækkandi aldri, en fæðuvenjur og aðrir lífsstílsþættir geta haft áhrif á þessa þróun. Þar sem háþrýstingur er einn helsti áhættuþáttur hjarta- og æðasjúkdóma meðal eldra fólks eru tengsl mataræðis og blóðþrýstings mikilvægt rannsóknarefni. Tilgangur rannsóknarinnar var að kanna tengsl fæðuþátta, sérstaklega lýsis, við blóðþrýsting meðal eldri Íslendinga á höfuðborgarsvæðinu og meta fæðuneyslu þeirra með samanburði við íslenskar og norrænar ráðleggingar um mataræði og næringarefni. Efniviður og aðferðir: Þátttakendur voru 236 talsins, 65 til 91 árs gamlir Íslendingar af höfuðborgarsvæðinu. Níutíu og níu karlar (42%) og 137 konur (58%) tóku þátt. Mataræði þeirra var metið með þriggja daga veginni fæðuskráningu og blóðþrýstingur mældur eftir 12 tíma föstu. Niðurstöður: Flestir þátttakendur fengu meira en lágmarksskammt af öllum nauðsynlegum næringarefnum. Hins vegar fengu 19% minna en lágmarksskammt af D-vítamíni, 13% af joði, 17% karla af B6-vítamíni, og 26% karla og 12% kvenna af járni. Marktæk neikvæð fylgni var á milli lýsisneyslu og slagbilsþrýstings. Þessi tengsl voru enn til staðar eftir að leiðrétt hafði verið fyrir aldri, þyngdarstuðli, kyni og inntöku á blóðþrýstingslækkandi lyfjum (p=0,01). Neysla á löngum ómega-3 fitusýrum tengdist slagbilsþrýstingi einnig marktækt. Aðrir fæðuþættir tengdust ekki blóðþrýstingi. Ályktanir: Niðurstöður benda til þess að neysla á lýsi sé tengd lægri blóðþrýstingi meðal eldra fólks og hafi á þann hátt jákvæð áhrif á heilsufar. Stór hluti þátttakenda var í áhættuhópi vegna skorts á D-vítamíni, B6-vítamíni, joði og járni

Assessment tool for malnutrition in elderly people

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenThe aim of this research study was to construct a new and more suitable instrument to assess nutritional status of elderly hospitalized patients. The participants were 60 elderly patients (>65 years old) who were admitted over a six month period at the Division of Geriatric Medicine at the Landspitali University Hospital. They were able to undergo a physical test (height and weight) and they were not suffering from advanced dementia. The sensitivity and specificity of variables was calculated to assess the instruments. Variables that were significantly different between well nourished and malnourished patients or had a strong correlation with a full nutritional assessment were used to construct the equation. The findings show that by using three variables together (body mass index (height and weight), unintended weight loss, and recent surgery) it is possible to construct a sensitive (1,00) and specific (0,78) screening tool. The screening tool is both fast and simple in application and when used with the mandatory RAI assessment it only takes a few minutes to get results.Tilgangur rannsóknarinnar var að útbúa hentugt skimunartæki til að greina vannæringu hjá öldruðum sem dvelja á sjúkrahúsi. Þátttakendur voru 60 sjúklingar (>65 ára) sem voru lagðir inn á öldrunarsvið Landspítala á sex mánaða tímabili. Þeir voru færir um að gangast undir líffræðilegt mat (hæð og þyngd) og þeir voru ekki með alvarlega heilabilun. Næmi og sértæki breytna voru reiknuð til að meta matstækin. Breytur, sem sýndu marktækan mun á vannærðum og vel nærðum sjúklingum eða höfðu sterka fylgni við fullt mat á næringarástandi, voru notaðar í jöfnu til að spá fyrir um vannæringu. Niðurstöðurnar sýndu að með þremur breytum, sem notaðar eru saman (líkamsþyngdarstuðull (hæð og þyngd), ósjálfrátt þyngdartap og nýleg skurðaðgerð), er hægt að útbúa skimunartæki sem bæði er næmt (1,00) og sértækt (0,78). Matstækið er einfalt og auðvelt í notkun og með því að tengja það við reglulegt RAImat tekur notkun þess aðeins örfáar mínútur

Protein intake in children and growth and risk of overweight or obesity : A systematic review and meta-analysis

Objectives: The aim of this study was to examine the evidence for an association between the dietary protein intake in children and the growth and risk of overweight or obesity up to 18 years of age in settings relevant for the Nordic countries. Methods: We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scopus up to February 26, 2021 for randomized controlled trials (RCTs) or prospective cohort studies assessing for protein intake from foods (total and from different sources) in children. The outcomes include weight, height/length, adiposity indices, and/or risk of overweight and/or obesity. The risk of bias was evaluated with instruments for each respective design (Cochrane’s Risk of Bias 2.0 and RoB-NObS). A meta-analysis of five cohort studies was performed. The evidence was classified according to the criteria of the World Cancer Research Fund. Results: The literature search resulted in 9,132 abstracts, of which 55 papers were identified as potentially relevant. In total, 21 studies from 27 publications were included, of which five were RCTs and 16 were cohort studies. The RCTs found generally null effects of high-protein intake in infants on weight gain, nor that lower protein diets negatively affected growth. All included RCTs had some concern regarding the risk of bias and were limited by small sample sizes. Total protein intake and BMI were assessed in 12 cohorts, of which 11 found positive associations. The meta-analysis revealed a pooled effect estimate of 0.06 (95% CI 0.03, 0.1) kg/m2 BMI per one E% increment in total protein (I2 = 15.5). Therefore, the evidence for a positive relationship between total protein intake and BMI was considered probable. Furthermore, there was probable evidence for an association between higher intake of animal protein and increased BMI. There was limited, suggestive evidence for an effect of total protein intake and higher risk of overweight and/or obesity, while no conclusions could be made on the associations between animal vs. plant protein intake and risk of overweight and/or obesity. Discussion: In healthy, well-nourished children of Western populations, there is probably a causal relationship between a high-protein intake in early childhood (≤ 18 months) – particularly protein of animal origin – and higher BMI later in childhood, with consistent findings across cohort studies. A lack of RCTs precluded a stronger grading of the evidence.Peer reviewe

Cross-sectional study of oral health care service, oral health beliefs and oral health care education of caregivers in nursing homes

© 2021 The Authors. Published by Elsevier Inc.Objectives: To assess oral care beliefs and oral hygiene procedures among nursing home personnel to identify strengths and weaknesses in managing oral care. Methods: A cross-sectional study in two nursing homes using an oral health care questionnaire including the Nursing Dental Coping Belief Scale. Results: A total of 109 health personnel participated. Oral care was seldomly achieved twice a day and dental supplies were not guaranteed. Registered nurses found the oral health of residents more acceptable than did allied health personnel with less oral care education, who mostly delivered daily care. Conversely, nursing staff with oral care education had lower dental coping beliefs, suggesting a lack of self-reliance in controlling oral health outcomes. Conclusion: Dental supplies should be part of nursing care equipment. Educational programs could increase positive oral health beliefs and enhance the quality of care in these settings, particularly among those who are accountable for oral care.Peer reviewe

Supplementation with long chain n-3 fatty acids during pregnancy, lactation, or infancy in relation to risk of asthma and atopic disease during childhood : a systematic review and meta-analysis of randomized controlled clinical trials

Objective: To assess whether supplementation with long chain n-3 fatty acids during pregnancy, lactation, or infancy reduces the risk of developing asthma or atopic disease during childhood.Methods: Searches were performed in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scopus up to 2021-09-20, for randomized controlled trials (RCTs) that investigated the effect of supple-mental long chain n-3 fatty acids during pregnancy, lactation, or infancy for the prevention of childhood asthma or allergy. Article selection, data extraction, and risk of bias assessment (Cochrane's Risk of Bias 2.0) were independently conducted by two assessors. The evidence was synthesized qualitatively according to the criteria of the World Cancer Research Fund and meta-analyzed.Results: A total of nine RCTs met inclusion criteria; six were conducted during pregnancy, two during infancy, and one during both pregnancy and infancy. Meta-analysis showed that long chain n-3 fatty acid supplementation during pregnancy significantly reduced the risk of asthma/wheeze in the child (RR 0.62 [95% confidence interval 0.34-0.91], P = 0.005, I2 = 67.4%), but not other outcomes. Supplementation during lactation of infancy showed no effects on any outcome. The strength of evidence that long chain n-3 fatty acid supplementation during pregnancy reduces risk of asthma/wheeze in the offspring was con-sidered limited - suggestive. No conclusion could be made for the effects of long chain n-3 fatty acid supplementation during pregnancy for other atopic diseases, or for supplementation during lactation or infancy for any outcome. Conclusion: The intake of long chain n-3 fatty acid supplements during pregnancy may reduce the risk of asthma and/or wheeze in the offspring, but the strength of evidence is low. There is inconclusive evidence for the effects of long chain n-3 fatty acid supplements during pregnancy for other outcomes, as well as for sup-plementation during lactation or infancy.Peer reviewe

Quality of dietary fat and risk of Alzheimer's disease and dementia in adults aged >= 50 years : a systematic review

Objective: To identify, critically appraise, and synthesize evidence on the effect of quality of dietary fat intake and different classes of fatty acids on the risk of Alzheimer's disease (AD) and dementia in adults aged >= 50 years. Methods: We searched MEDLINE, EMBASE, Cochrane Central of Controlled Trials, and Scopus for clinical trials and prospective cohort studies published until May 2021. Two reviewers independently screened retrieved literature, extracted relevant data, and performed risk of bias assessment. Classes of fatty acids included were saturated fatty acids (SFAs), trans fatty acids (TFAs), monounsaturated fatty acids (MUFAs), poly-unsaturated fatty acids (PUFAs), and their subtypes and sources. Given between-study heterogeneity, we did not perform meta-analyses but narratively described findings from the studies. Results: From 4,491 identified records, five articles (based on four prospective cohort studies) met the inclusion criteria. Three studies had an overall serious risk of bias, while one study had a moderate risk. Overall, we found no robust association between intake of any fatty acids type and the development of AD and dementia. For example, for SFA and TFA, there was contradictory associations reported on AD: one study found that each unit increase in energy-adjusted intake of SFA (risk ratio (RR) 0.83, 95%CI 0.70 0.98) and TFA (RR 0.80, 95%CI 0.65-0.97) was associated with a decreased risk of AD, but not dementia. For PUFA, one study found that higher quintile intake of marine-based n-3 PUFA was associated with a decreased risk of AD. The intake of other fatty acids was not associated with the outcomes. The certainty of the overall evidence was inconclusive. Conclusion: We found no clear association between the intake of various classes of fatty acids and the risk of AD and dementia in adults. More well-designed prospective studies are required to clarify these findings.Peer reviewe

Dietary fiber and growth, iron status and bowel function in children 0-5 years old : a systematic review

Background: While dietary fiber intake is low in many children, the current trend to plant-based diets is associated with higher fiber intake in children raised on these diets. As older reports indicate that diets providing high fiber intake in children 0-5 years may affect growth, iron status and bowel function, we summarized the available evidence in this systematic review. Objective: To identify, critically appraise, and synthesize evidence on the effect of high fiber intake on growth, iron and bowel function in children 0-5 years, with relevance to the Nordic and Baltic countries. Methods: Following a pre-registered protocol, we searched MEDLINE, EMBASE, Cochrane Central of Controlled Trials, and Scopus for clinical trials and prospective cohort studies published until November 2021. Two reviewers independently screened retrieved literature, extracted relevant data, and performed risk of bias assessment. Outcomes were growth, iron metabolism and bowel function in children 0-5 years. We narratively described findings from studies that met inclusion criteria. Results: From 5,644 identified records, five articles met the inclusion criteria. Two RCTs had an overall moderate risk of bias, while the three observational studies had serious risk. Overall, we found no robust association between high intake of dietary fiber and growth. In the RCTs, higher intake of fiber had a positive effect on bowel movements and constipation. No studies on fiber intake and iron status were identified. The certainty of the overall evidence was inconclusive for growth and bowel function, while no assess-ment was made for iron status. Conclusion: We found no clear association between high intake of dietary fiber and growth or bowel func-tion in young children living in affluent countries, albeit with only a limited number of studies. There is a lack of studies investigating health effects of high fiber intake in small children.Peer reviewe

Nuts and seeds consumption and risk of cardiovascular disease, type 2 diabetes and their risk factors : a systematic review and meta-analysis

Objectives: We aimed to systematically review studies and evaluate the strength of the evidence on nuts/seeds consumption and cardiometabolic diseases and their risk factors among adults. Methods: A protocol was pre-registered in PROSPERO (CRD42021270554). We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials and Scopus up to September 20, 2021 for prospec-tive cohort studies and >= 12-week randomized controlled trials (RCTs). Main outcomes were cardiovascular disease (CVD), coronary heart disease (CHD), stroke and type 2 diabetes (T2D), secondary total-/low density lipoprotein (LDL)-cholesterol, blood pressure and glycaemic markers. Data extraction and risk of bias (RoB) assessments (using RoB 2.0 and RoB-NObS) were performed in duplicate. Effect sizes were pooled using random-effects meta-analyses and expressed as relative risk (RR) or weighted mean differences with 95% confidence intervals (CI); heterogeneity quantified as I2. One-stage dose-response analyses assessed the linear and non-linear associations with CVD, CHD, stroke and T2D. The strength of evidence was classified per the World Cancer Research Fund criteria. Results: After screening 23,244 references, we included 42 papers from cohort studies (28 unique cohorts, 1,890,573 participants) and 18 RCTs (2,266 participants). In the cohorts, mainly populations with low con-sumption, high versus low total nuts/seeds consumption was inversely associated with total CVD (RR 0.81; 95% CI 0.75, 0.86; I-2 = 67%), CVD mortality (0.77; 0.72, 0.82; I-2 = 59.3%), CHD (0.82; 0.76, 0.89; I-2 = 64%), CHD mortality (0.75; 0.65, 0.87; I-2 = 66.9%) and non-fatal CHD (0.85; 0.75, 0.96; I-2 = 62.2%). According to the non-linear dose-response analyses, consumption of 30 g/day of total nuts/seeds was associated with RRs of similar magnitude. For stroke and T2D the summary RR for high versus low intake was 0.91 (95% CI 0.85, 0.97; I-2 = 24.8%) and 0.95 (0.75, 1.21; I-2 = 82.2%). Intake of nuts (median similar to 50 g/day) lowered total (-0.15 mmol/L; -0.22, -0.08; I-2 = 31.2%) and LDL-cholesterol (-0.13 mmol/L; -0.21, -0.05; I-2 = 68.6%), but not blood pressure. Findings on fasting glucose, HbA1c and insulin resistance were conflicting. The results were robust to sensitivity and subgroup analyses. We rated the associations between nuts/seeds and both CVD and CHD as probable. There was limited but suggestive evidence for no association with stroke. No conclusion could be made for T2D. Conclusion: There is a probable relationship between consumption of nuts/seeds and lower risk of CVD, mostly driven by CHD, possibly in part through effects on blood lipids. More research on stroke and T2D may affect the conclusions. The evidence of specific nuts should be further investigated.Peer reviewe

Hemoglobin Concentrations Predict Physical Function After A 12-Week Resistance Exercise Training and Subsequent Changes After 11 Months of Follow-Up Among Community Dwelling Older Adults

Background: Hemoglobin transports oxygen in blood yet its concentrations generally decrease with age. The aim of the study was to examine whether hemoglobin is connected with physical function in older age people. Design: Intervention study. Setting: Community. Participants: Older adults (N=236, 73.7±5.7 years, 58.2% female). Intervention: A 12-week resistance exercise program (3 times/week; 3 sets, 6-8 repetitions at 75-80% of the 1-repetition maximum) was conducted to increase strength and muscle mass of major muscle groups. Measurements: Anthropometrics, muscle strength, timed up and go (TUG in sec), six-minute walking distance (6MWD in m) and blood chemical variables were measured at baseline, endpoint and after 10.7 months followup. The linear regression model was used to examine the association between baseline hemoglobin and physical function outcome. Results: Only about 4% of the participants were anemic. According to calculations baseline hemoglobin was associated with TUG (0.14 to 0.36 sec improvement by 10 g/L increase of hemoglobin) at all-time points, even though this was of borderline significance for baseline (p=0.57) and endpoint (p=0.062). Hemoglobin also predicted endpoint 6 MWD (4.88m), but not at baseline (follow up 6 MWD was not available). Statistical correction for compliance did not influences results. Conclusion: Hemoglobin is positively associated to physical function in community dwelling old aged people. Additionally, we found that baseline hemoglobin is associated to adaptions to 12-week resistance exercise training and changes in physical function during the follow-up.Rannís (No 071323008), Rannsóknarsjóður Háskóla Íslands, Styrkur frá Landspítala Hákólasjúkrahúsi Helga Jonsdottir and Sigurlidi Kristjansson Geriatric Research Fund.Peer Reviewe