Weight changes and mobility in the early phase after hip fracture in community-dwelling older persons

Purpose Hip fractures in older persons are associated with reduced mobility and loss of independence. Few studies address the nutritional status and mobility in the early phase after hip fracture. The objective of the present study was, therefore, to investigate weight changes and their effect on mobility during the first two months following hip fracture in community-dwelling older persons without dementia. Methods Patients (> 60 years) admitted for a first hip fracture were recruited from two tertiary referral hospitals in Bergen, Norway. The patients' weights and dietary intakes were determined in the hospital and at home after two months. Mobility was assessed based on the New Mobility Score (NMS) (scale 0–9, with values > 5 regarded as sufficient mobility). Results We included 64 patients (median age 80 years, 48 women, 16 men) with information on weight collected in the hospital. Follow-up measurements were available for 32 patients, corresponding to an attrition rate of 50%. The patients had a median weight loss of 1.8 kg (IQR = − 3.7, 0 kg). Most of them had reduced mobility at two months after the surgery [median NMS = 5 (IQR = 3–6)]. Both age and the weight change after surgery were predictors of the NMS at follow-up. Conclusion Bodyweight loss was observed in three out of four patients in the early phase after hip fracture and was associated with decreased mobility measured by the NMS. The results should be interpreted with caution as half of the patients dropped out of the study and did not participate in the follow-up visit.publishedVersio

Limited Benefit of Fish Consumption on Risk of Hip Fracture among Men in the Community-Based Hordaland Health Study

Hip fractures have a high prevalence worldwide. Few studies have investigated whether fish consumption is associated with risk of hip fractures. The objective of the present study was to investigate the effect of fish intake on the subsequent risk of a hip fracture because of the low number of studies on this topic. A community-based prospective cohort study of 2865 men and women from Hordaland county in Norway, born between 1925–1927 and enrolled in the study in 1997–1999. Information on hip fracture cases was extracted from hospital records until 31 December 2009. Baseline information on the intake of fish was obtained from a semi-quantitative food frequency questionnaire. Cox proportional hazard regression models with death as a competing risk were used to evaluate the association of fish intake with risk of hip fracture. During a mean (SD) follow-up time of 9.6 (2.7) years, 226 hip fractures (72 in men, 154 in women) were observed. The mean (SD) fish intake was 48 (25) g/1000 kcal. The association between fish intake and risk of hip fracture was not linear and displayed a threshold, with low intake of fish being associated with an increased risk of hip fracture in men (HR (Hazard Ratio) = 1.84, 95% CI 1.10, 3.08). In this community-based prospective study of men and women, a low intake of fish was associated with the risk of a hip fracture in men.publishedVersio

Bioavailability of iodine from a meal consisting of sushi and a wakame seaweed salad—A randomized crossover trial

The consumption of seaweed is on the rise in the Western world. Seaweeds may contain substantial amounts of iodine, and some species could serve as a potential dietary iodine source. However, limited data on the iodine content and in vivo bioavailability of iodine from seaweeds exist. The objective was to assess whether iodine from a meal consisting of sushi with nori, (Porphyra spp) and a wakame seaweed salad (Undaria pinnatifida) had similar bioavailability as a potassium iodide reference supplement of similar iodine content. A randomized 2 × 2 crossover trial (AB/BA model) was conducted in 20 healthy young women. One intervention arm consisted of a meal with sushi and wakame salad (231 μg iodine), and the other of potassium iodide (KI) supplement (225 μg iodine). Urinary iodine concentration (UIC) was measured at 11 different time points for 48 h after the interventions. The UIC increased after consumption of both the sushi and wakame meal and the KI supplement, but the median UIC was higher after ingestion of the KI supplement. The estimated bioavailability of iodine during the first 24 h was 75% from sushi with wakame and 97% from the KI supplement. The bioequivalence analyses confirmed that the KI supplement had higher estimated bioavailability than the sushi and wakame meal, however, with small margins. Our findings on iodine bioavailability imply that sushi and wakame could be potential iodine sources in the diet, which may be favorable for population groups at risk for iodine deficiency. However, further research is needed to account for the variability of iodine content in seaweeds by different locations and degree of processing, to assure that the iodine levels are stable and predictable for the consumers.Bioavailability of iodine from a meal consisting of sushi and a wakame seaweed salad—A randomized crossover trialpublishedVersio

Comparison of a digital iodine-specific dietary screener with 24-hour recall and urinary iodine concentration

Mild-to-moderate iodine deficiency remains a problem worldwide, including in Norway. Of particular, concern is fertile, pregnant and lactating women. The Norwegian Dairy Council developed a digital iodine-specific dietary screener (I-screener) for the assessment of iodine intake levels but has yet to be validated. The aim was thus to investigate the relative validity of the I-screener by comparing estimates of iodine intake from the I-screener against a single 24-hour recall (24HR) and urinary iodine concentration (UIC) in fertile women. Healthy females were recruited in Bergen in August–December 2021. Six spot-urine samples from six consecutive days were collected into a pooled sample to assess UIC. Each participant completed a single administration of the I-screener and the 24HR. The estimated daily iodine intake from the I-screener was compared with the estimations from the 24HR and UIC. Seventy-two women aged 19–39 completed the study. The median UIC was 76 μg/l. Compared with the 24HR, the I-screener placed 83 % of the participants in the same/adjacent tertial, with a slight agreement between the methods (Cohen's kappa = 0⋅187). The present study shows an acceptable correlation between the I-screener and the 24HR (r = 0⋅318), but not between the I-screener and UIC (r = 0⋅122). Despite its varying iodine estimate abilities, the I-screener may be used as an initial screening tool to rank fertile women on an individual level into deficient inadequate, and sufficient iodine intake. However, due to the relatively high risk of misclassification, further assessment of iodine status should follow.publishedVersio

Exploratory analyses on the effect of time since last meal on concentrations of amino acids, lipids, one-carbon metabolites, and vitamins in the Hordaland Health Study

Purpose Dietary intake may have pronounced effects on circulating biomarker concentrations. Therefore, the aim was to provide a descriptive overview of serum metabolite concentrations in relation to time since last meal, focusing on amino acids, lipids, one-carbon metabolites, and biomarkers of vitamin status. Methods We used baseline data from the observational community-based Hordaland Health Study, including 2960 participants aged 46–49 years and 2874 participants aged 70–74 years. A single blood draw was taken from each participant, and time since last meal varied. Estimated marginal geometric mean metabolite concentrations were plotted as a function of time since last meal, up to 7 h, adjusted for age, sex, and BMI. Results We observed a common pattern for nearly all amino acids and one-carbon metabolites with highest concentrations during the first 3 h after dietary intake. Homocysteine and cysteine were lowest the 1st hour after a meal, while no patterns were observed for glutamate and glutamic acid. The concentrations of phylloquinone and triglycerides were highest 1 h after dietary intake. Thiamine and thiamine monophosphate concentrations were highest, while flavin mononucleotide concentrations were lowest within the first 2 h after a meal. No clear patterns emerged for the other fat-soluble vitamins, blood lipids, or B-vitamin biomarkers. Conclusion Our findings suggest that distinguishing between “fasting” and “non-fasting” blood samples may be inadequate, and a more granular approach is warranted. This may have implications for how to account for dietary intake when blood sampling in both clinical and research settings.publishedVersio

A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Copyright © 2022. Published by Elsevier Inc.Bread is a major source of grain-derived carbohydrates worldwide. High intakes of refined grains, low in dietary fiber and high in glycemic index, are linked with increased risk for type 2 diabetes mellitus (T2DM) and other chronic diseases. Hence, improvements in the composition of bread could influence population health. This systematic review evaluated the effect of regular consumption of reformulated breads on glycemic control among healthy adults, adults at cardiometabolic risk or with manifest T2DM. A literature search was performed using MEDLINE, Embase, Web of Science and the Cochrane Central Register of Controlled Trials. Eligible studies employed a bread intervention (≥2 wk) in adults (healthy, at cardiometabolic risk or manifest T2DM) and reported glycemic outcomes (fasting blood glucose, fasting insulin, HOMA-IR, HbA1c, and postprandial glucose responses). Data were pooled using generic inverse variance with random-effects model and presented as mean difference (MD) or standardized MD between treatments with 95% CIs. Twenty-two studies met the inclusion criteria (n = 1037 participants). Compared with "regular" or comparator bread, consumption of reformulated intervention breads yielded lower fasting blood glucose concentrations (MD: -0.21 mmol/L; 95% CI: -0.38, -0.03; I2 = 88%, moderate certainty of evidence), yet no differences in fasting insulin (MD: -1.59 pmol/L; 95% CI: -5.78, 2.59; I2 = 38%, moderate certainty of evidence), HOMA-IR (MD: -0.09; 95% CI: -0.35, 0.23; I2 = 60%, moderate certainty of evidence), HbA1c (MD: -0.14; 95% CI: -0.39, 0.10; I2 = 56%, very low certainty of evidence), or postprandial glucose response (SMD: -0.46; 95% CI: -1.28, 0.36; I2 = 74%, low certainty of evidence). Subgroup analyses revealed a beneficial effect for fasting blood glucose only among people with T2DM (low certainty of evidence). Our findings suggest a beneficial effect of reformulated breads high in dietary fiber, whole grains, and/or functional ingredients on fasting blood glucose concentrations in adults, primarily among those with T2DM. This trial was registered at PROSPERO as CRD42020205458.publishersversionpublishe

Sixteen-week multicentre randomised controlled trial to study the effect of the consumption of an oat beta-glucan- enriched bread versus a whole-grain wheat bread on glycaemic control among persons with pre-diabetes: a study protocol of the CarbHealth study

Introduction In 2012, the estimated global prevalence of pre-diabetes was 280 million, and the prevalence is expected to rise to 400 million by 2030. Oat-based foods are a good source of beta-glucans, which have been shown to lower postprandial blood glucose. Studies to evaluate the effectiveness of the long-term intake of beta-glucan- enriched bread as part of a habitual diet among individuals with pre-diabetes are needed. Therefore, we designed a multicentre intervention study in adults with pre-diabetes to investigate the effects of consumption of an oat-derived beta-glucan- enriched bread as part of a normal diet on glycated haemoglobin (HbA1c) in comparison to consumption of whole-grain wheat bread. Methods and analysis The CarbHealth trial is a multicentre double-blind randomised controlled 16-week dietary intervention trial in participants 40–70 years of age with a body mass index of ≥27 kg/m2 and HbA1c of 35–50 mmol/ mol. The study is conducted at four universities located in Norway, Sweden and Germany and uses intervention breads specifically designed for the trial by Nofima AS. The aim is to recruit 250 participants. The primary outcome is the difference in HbA1c between the intervention and the control groups. The main analysis will include intervention group, study centre and baseline HbA1c as independent variables in an analysis of covariance model. Ethics and dissemination The study protocol was approved by respective ethical authorities in participating countries. The results of the study will be communicated through publication in international scientific journals and presentations at (inter)national conferences. Trial registration number NCT04994327.Sixteen-week multicentre randomised controlled trial to study the effect of the consumption of an oat beta-glucan- enriched bread versus a whole-grain wheat bread on glycaemic control among persons with pre-diabetes: a study protocol of the CarbHealth studypublishedVersio

Sixteen-week multicentre randomised controlled trial to study the effect of the consumption of an oat beta-glucan-enriched bread versus a whole-grain wheat bread on glycaemic control among persons with pre-diabetes: a study protocol of the CarbHealth study

INTRODUCTION: In 2012, the estimated global prevalence of pre-diabetes was 280 million, and the prevalence is expected to rise to 400 million by 2030. Oat-based foods are a good source of beta-glucans, which have been shown to lower postprandial blood glucose. Studies to evaluate the effectiveness of the long-term intake of beta-glucan-enriched bread as part of a habitual diet among individuals with pre-diabetes are needed. Therefore, we designed a multicentre intervention study in adults with pre-diabetes to investigate the effects of consumption of an oat-derived beta-glucan-enriched bread as part of a normal diet on glycated haemoglobin (HbA1c) in comparison to consumption of whole-grain wheat bread. METHODS AND ANALYSIS: The CarbHealth trial is a multicentre double-blind randomised controlled 16-week dietary intervention trial in participants 40-70 years of age with a body mass index of ≥27 kg/m2 and HbA1c of 35-50 mmol/mol. The study is conducted at four universities located in Norway, Sweden and Germany and uses intervention breads specifically designed for the trial by Nofima AS. The aim is to recruit 250 participants. The primary outcome is the difference in HbA1c between the intervention and the control groups. The main analysis will include intervention group, study centre and baseline HbA1c as independent variables in an analysis of covariance model. ETHICS AND DISSEMINATION: The study protocol was approved by respective ethical authorities in participating countries. The results of the study will be communicated through publication in international scientific journals and presentations at (inter)national conferences. TRIAL REGISTRATION NUMBER: NCT04994327

Limited Benefit of Fish Consumption on Risk of Hip Fracture among Men in the Community-Based Hordaland Health Study

Hip fractures have a high prevalence worldwide. Few studies have investigated whether fish consumption is associated with risk of hip fractures. The objective of the present study was to investigate the effect of fish intake on the subsequent risk of a hip fracture because of the low number of studies on this topic. A community-based prospective cohort study of 2865 men and women from Hordaland county in Norway, born between 1925–1927 and enrolled in the study in 1997–1999. Information on hip fracture cases was extracted from hospital records until 31 December 2009. Baseline information on the intake of fish was obtained from a semi-quantitative food frequency questionnaire. Cox proportional hazard regression models with death as a competing risk were used to evaluate the association of fish intake with risk of hip fracture. During a mean (SD) follow-up time of 9.6 (2.7) years, 226 hip fractures (72 in men, 154 in women) were observed. The mean (SD) fish intake was 48 (25) g/1000 kcal. The association between fish intake and risk of hip fracture was not linear and displayed a threshold, with low intake of fish being associated with an increased risk of hip fracture in men (HR (Hazard Ratio) = 1.84, 95% CI 1.10, 3.08). In this community-based prospective study of men and women, a low intake of fish was associated with the risk of a hip fracture in men

Dietary predictors of bone mineral density, hip fractures, mobility and muscle strength - in community-dwelling older persons

Background: The aging process involves decline of both muscle and bone mass. The loss of muscle mass is associated with decreased muscle strength and mobility, while loss of bone mass leads to osteoporosis and increased risk of fractures. This process maybe accelerated due to poor dietary quality, low energy intake and undernutrition. Fish is a good source of nutrients that are associated with preserving both muscle and bone mass. In particular, fish is contributing substantially to vitamin D intake. Overall aim: The overall aim of this PhD-project was to investigate dietary predictors of bone mineral density, risk of hip fractures, muscle strength and mobility in community-dwelling older persons. Specific aims: The aim was to summarize the available literature in a systematic literature search on randomized clinical trials investigating the effects of vitamin D supplementation (with or without calcium supplementation) on muscle strength and mobility in community-dwelling older persons, presented as a narrative systematic review and a formal meta-analysis on measures of muscle strength and mobility. The aim was to examine the association of fish intake with bone mineral density and risk of hip fractures in the Hordaland Health Study (HUSK), by conducting a) a cross sectional analysis of the association between fish intake and bone mineral density in middle - aged and older participants, and b) a prospective analysis of the association of baseline fish intake with the risk of hip fractures in the older cohort during a follow -up of ten years. The aim was to conduct a clinical observational study on weight change and mobility in community-dwelling hip fracture patients during the first two to three months after the fracture. Results: The systematic review included 15 studies. In the majority of studies, no improvements in muscle strength or mobility were observed after administration of vitamin D with or without calcium supplementation. The quantitative meta-analysis did not reveal any clinically relevant effects of vitamin D supplementation neither on handgrip strength (seven studies) nor on the timed-up-and-go test (five studies). a) Cross-sectional analyses from the HUSK study showed an association between high fish intake and higher bone mineral density in older women, but not in middleaged women or in men. b) A low intake of fish was associated with increased risk of hip fracture in older men during a follow-up of ten years. This association was not evident in older women. Among community-dwelling hip fracture patients with normal cognitive function, age and weight loss were associated with insufficient mobility two months after the fracture. Conclusions: Vitamin D supplementation had no clinically relevant effect on measures of muscle strength and mobility. Fish intake did not have consistent effects on bone mineral density and risk of hip fractures. The findings of positive effects of fish intake in subgroups but not in the entire population have to be interpreted with care. Age and weight loss were the main determinants of mobility in patients after a hip fracture. In conclusion, maintenance of weight, muscle mass and bone mineral density are key issues for health of older persons. The results of the present investigations suggest that the there is a need for more studies regarding diet and health outcomes in community-dwelling older persons