Ad hoc Joint FAO/WHO Expert Consultation on Risk Assessment of Food Allergens Part 1: Review and validation of Codex priority allergen list through risk assessment

The objectives of the meeting is to see whether the published criteria (FAO/WHO, 2000) for assessing additions and exclusions to the list is still current and appropriate. The Expert Committee determined that only foods or ingredients that cause immune-mediated hypersensitivities such as IgE-mediated food allergies and coeliac disease should be included on the list of foods and ingredients included in section 4.2.1.4 of the GSLPF. Thus, it was recommended that foods or ingredients such as lactose, sulphite, and food additives which cause food intolerances rather than immune-mediated responses, should be excluded from this list. The Committee identified prevalence of the immune-mediated hypersensitivity to a specific food, severity (i.e. proportion of severe objective reactions to a food/ingredient such as anaphylaxis), and the potency of food/ingredient (i.e. the amount of the food/ingredient required to cause objective symptoms) as the three key criteria that should be used to establish the priority allergen list. Subgroups of the Expert Committee were established to review the literature on the prevalence, severity and potency of immune-mediated hypersensitivity of each food currently on the GSLPF list (cereals containing gluten and products of these; crustacea and products of these; eggs and egg products; fish and fish products; peanuts, soybeans and products of these; milk and milk products; tree nuts and nut products; ), as well as other foods found on priority allergen lists established in individual countries or regions (e.g. mollusks, mustard, celery, sesame, buckwheat, lupin, and others).Los objetivos de la reunión son ver si los criterios publicados (FAO / OMS, 2000) para evaluar las adiciones y exclusiones a la lista siguen vigentes y son apropiados. El Comité de Expertos determinó que solo los alimentos o ingredientes que causan hipersensibilidades inmunomediadas, como las alergias alimentarias mediadas por IgE y la enfermedad celíaca, deben incluirse en la lista de alimentos e ingredientes incluidos en la sección 4.2.1.4 de la GSLPF. Por lo tanto, se recomendó que se excluyeran de esta lista alimentos o ingredientes como lactosa, sulfito y aditivos alimentarios que causan intolerancias alimentarias en lugar de respuestas inmunomediadas. El Comité identificó la prevalencia de la hipersensibilidad inmunomediada a un alimento específico, la gravedad (es decir, la proporción de reacciones objetivas graves a un alimento / ingrediente como la anafilaxia) y la potencia del alimento / ingrediente (es decir, la cantidad de alimento / ingrediente requerida causar síntomas objetivos) como los tres criterios clave que deben utilizarse para establecer la lista de alérgenos prioritarios. Se establecieron subgrupos del Comité de Expertos para revisar la literatura sobre la prevalencia, severidad y potencia de la hipersensibilidad inmunomediada de cada alimento actualmente en la lista GSLPF (cereales que contienen gluten y productos de estos; crustáceos y productos de estos; huevos y productos de huevo ; pescado y productos de pescado; cacahuetes, soja y productos de estos; leche y productos lácteos; frutos secos y productos de frutos secos;), así como otros alimentos que se encuentran en las listas de alérgenos prioritarios establecidas en países o regiones individuales (por ejemplo, moluscos, mostaza, apio , sésamo, alforfón, altramuz y otros).Instituto de Investigación de Tecnología de AlimentosFil: Baumert, Joseph. Universidad de Nebraska-Lincoln. Departamento de Ciencia y Tecnología de Alimentos; Estados UnidosFil: Brooke-Taylor, Simon. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Chen, Hongbing. Nanchang Universidad. Instituto Conjunto de Investigación Chino-Alemán; China.Fil: Crevel, René W.R. René Crevel Consulting Limited; Reino Unido.Fil: Geert Houben. Organización para la Investigación Científica Aplicada TNO; Países Bajos.Fil: Jackson, Lauren. División de Ciencia y Tecnología del Procesamiento de Alimentos. Ingeniería de Procesos de la Administración de Alimentos y Medicamentos de los EE. UU. (FDA); Estados Unidos de América.Fil: Kyriakidis, Symeon. Laboratorio Estatal de Química General (GCSL). Autoridad Independiente de Ingresos Públicos (IAPR); Grecia.Fil: La Vieille, Sébastien. Universidad Laval. Departamento de Ciencias de los Alimentos; Canadá.Fil: Lee, N Alice. Universidad de Nueva Gales del Sur . Escuela de Química e Ingeniería. Ciencia e ingeniería de los alimentos; Australia.Fil: López, María Cristina. Universidad Nacional de San Martín. Ingeniería de Alimentos; Argentina.Fil: Luccioli, Stefano. Administración de Alimentos y Medicamentos de los Estados Unidos. Centro de Seguridad Alimentaria y Nutrición Aplicada; Estados UnidosFil: O’Mahony, Patrick. Universidad College Dublin; Irlanda.Fil: O’Mahony, Patrick. Autoridad de Seguridad Alimentaria de Irlanda; Irlanda.Fil: Polenta, Gustavo Alberto. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Investigación Tecnología de Alimentos; Argentina.Fil: Polenta, Gustavo Alberto. Instituto de Ciencia y Tecnología de los Sistemas Alimentarios Sustentables (ICyTeSAS) UEDD INTA-CONICET; Argentina.Fil: Pöpping, Bert. Food Consulting Strategically (FOCO); Alemania.Fil: Pöpping, Bert. Comités de Normalización ISO - CEN. Grupo de trabajo CEN Alérgenos Alimentarios (CEN TC 275 WG 12).); Alemania.Fil: Remington, Benjamin C. Remington Consulting Group B.V.; Holanda.Fil: Remington, Benjamin C. Universidad de Nebraska–Lincoln. Programa de Recursos e Investigación de Alergias Alimentarias. Estados UnidosFil: Södergren, Eva. ThermoFisher Scientific; Suecia.Fil: Srikulnath, Sirinrat. Universidad de Kasetsart (UKaset). Instituto de Investigación y Desarrollo de Productos Alimentarios. Centro de Servicio de Aseguramiento de la Calidad de los Alimentos. Unidad de Alérgenos Alimentarios; Tailandia.Fil: Taylor, Stephen L. Universidad de Nebraska-Lincoln. Departamento de Ciencia y Tecnología de Alimentos; Estados UnidosFil: Turner, Paul J. Universidad de Sídney; Australia.Fil: Turner, Paul J. Colegio Imperial de Ciencia, Tecnología y Medicina. Alergia e Inmunología Pediátricas; Inglaterra

Risk Assessment of Food Allergens. Part 1: Review and Validation of Codex Alimetarius Priority Allergen list Through Risk Assessment

The labelling of food allergens in pre-packaged foods plays a key role in protecting food allergic individuals, as no preventative clinical treatment is currently available. The list of major foods and ingredients known to cause hypersensitivity was included into the Codex General Standard for the Labelling of Packaged Foods (GSLPF) in 1999. There have been many scientific developments in the understanding of food allergens and their management since the original drafting of the GSLPF. Thus, in response to the request from Codex for scientific advice, including current evidence of consumer understanding of allergens, FAO and WHO convened a series of three expert meetings to provide scientific advice on this subject. The purpose of the first meeting of the Ad hoc Joint FAO/WHO Expert Consultation on Risk Assessment of Food Allergens was to review and validate the Codex priority allergen list through risk assessment. This report focuses on the deliberations and conclusions of this meeting. Resumen: El etiquetado de los alérgenos alimentarios en los alimentos preenvasados ​​juega un papel clave en la protección personas alérgicas a los alimentos, ya que actualmente no se dispone de un tratamiento clínico preventivo. Se incluyó la lista de los principales alimentos e ingredientes que causan hipersensibilidad en la Norma General del Codex para el Etiquetado de Alimentos Envasados ​​(GSLPF) en 1999. Ha habido muchos avances científicos en la comprensión de alérgenos alimentarios y su gestión desde la redacción original de la GSLPF. Por lo tanto, en respuesta a la solicitud del Codex de asesoramiento científico, incluida la actual evidencia de la comprensión del consumidor de los alérgenos, la FAO y la OMS convocaron una serie de tres reuniones de expertos para proporcionar asesoramiento científico sobre este tema. El propósito de la primera reunión de la Consulta Conjunta Especial de Expertos FAO/OMS sobre evaluación de riesgos de los alérgenos alimentarios fue revisar y validar la prioridad del Codex lista de alérgenos a través de la evaluación de riesgos. Este informe se centra en las deliberaciones y conclusiones de esta reunión.Instituto de Investigación de Tecnología de Alimentos (ITA)Fil: Baumert, Joseph. Universidad de Nebraska-Lincoln. Departamento de Ciencia y Tecnología de Alimentos; Estados UnidosFil: Brooke-Taylor, Simon. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Che, Huilian. Universidad de Agricultura de China. Facultad de Ciencias de la Alimentación e Ingeniería Nutricional; China.Fil: Chen, Hongbing. Nanchang Universidad. Instituto Conjunto de Investigación Chino-Alemán; China.Fil: Crevel, René W.R. René Crevel Consulting Limited; Reino Unido.Fil: Houben, Geert F. Alergia alimentaria e inmunotoxicología. Científico principal de TNO; Países Bajos.Fil: Jackson, Lauren. Administración de Alimentos y Medicamentos. División de Ciencia y Tecnología del Procesamiento de Alimentos. Ingeniería de Procesos; Estados UnidosFil: Kyriakidis, Symeon. Autoridad Independiente de Ingresos Públicos. Laboratorio Estatal de Química General; Grecia.Fil: La Vieille, Sébastien. Salud Canadá. Dirección de Alimentos; Canadá.Fil: Lee, N Alice. Universidad de Nueva Gales del Sur. Escuela de Química e Ingeniería. Ciencia e ingeniería de los alimentos; Australia.Fil: López, María Cristina. Universidad Nacional de San Martín. Ingeniería de Alimentos; Argentina.Fil: Luccioli, Stefano. Administración de Alimentos y Medicamentos. Centro de Seguridad Alimentaria y Nutrición Aplicada; Estados UnidosFil: O’Mahony, Patrick. Autoridad de Seguridad Alimentaria de Irlanda . Ciencia y Tecnología de los Alimentos; Irlanda.Fil: Polenta, Gustavo Alberto. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Investigación Tecnología de Alimentos; Argentina.Fil: Pöpping, Bert. Food Consulting Strategically (FOCO); Alemania.Fil: Remington, Benjamin C. Grupo BV. Consultoría Remington; Holanda.Fil: Södergren, Eva. Agencia Sueca de Alimentos. Equipo de Encuestas Dietéticas y Departamento de Nutrición para Beneficio de Riesgo Evaluación; Suecia.Fil: Srikulnath, Sirinrat. Universidad de Kasetsart (UKaset). Instituto de Investigación y Desarrollo de Productos Alimentarios. Centro de Servicio de Aseguramiento de la Calidad de los Alimentos. Unidad de Alérgenos Alimentarios; Tailandia.Fil: Taylor, Stephen L. Universidad de Nebraska-Lincoln. Departamento de Ciencia y Tecnología de Alimentos; Estados UnidosFil: Turner, Paul J. Colegio Imperial de Ciencia, Tecnología y Medicina. Alergia e Inmunología Pediátricas; Inglaterra

Peanut Can Be Used as a Reference Allergen for Hazard Characterization in Food Allergen Risk Management: A Rapid Evidence Assessment and Meta-Analysis

Regional and national legislation mandates the disclosure of “priority” allergens when present as an ingredient in foods, but this does not extend to the unintended presence of allergens due to shared production facilities. This has resulted in a proliferation of precautionary allergen (“may contain”) labels (PAL) that are frequently ignored by food-allergic consumers. Attempts have been made to improve allergen risk management to better inform the use of PAL, but a lack of consensus has led to variety of regulatory approaches and nonuniformity in the use of PAL by food businesses. One potential solution would be to establish internationally agreed “reference doses,” below which no PAL would be needed. However, if reference doses are to be used to inform the need for PAL, then it is essential to characterize the hazard associated with these low-level exposures. For peanut, there are now published data relating to over 3000 double-blind, placebo-controlled challenges in allergic individuals, but a similar level of evidence is lacking for other priority allergens. We present the results of a rapid evidence assessment and meta-analysis for the risk of anaphylaxis to a low-level allergen exposure for priority allergens. On the basis of this analysis, we propose that peanut can and should be considered an exemplar allergen for the hazard characterization at a low-level allergen exposure. Resumen: La legislación regional y nacional exige la divulgación de alérgenos "prioritarios" cuando están presentes como ingrediente en los alimentos, pero esto no se extiende a la presencia involuntaria de alérgenos debido a instalaciones de producción compartidas. Esto ha dado lugar a una proliferación de etiquetas de precaución para alérgenos ("pueden contener") (PAL) que los consumidores alérgicos a los alimentos suelen ignorar. Se han hecho intentos para mejorar la gestión del riesgo de alérgenos para informar mejor el uso de PAL, pero la falta de consenso ha llevado a una variedad de enfoques regulatorios y a la falta de uniformidad en el uso de PAL por parte de las empresas alimentarias. Una posible solución sería establecer “dosis de referencia” acordadas internacionalmente, por debajo de las cuales no se necesitaría PAL. Sin embargo, si se van a utilizar dosis de referencia para informar la necesidad de PAL, entonces es esencial caracterizar el peligro asociado con estas exposiciones de bajo nivel. Para el maní, ahora hay datos publicados relacionados con más de 3000 desafíos doble ciego controlados por placebo en individuos alérgicos, pero falta un nivel similar de evidencia para otros alérgenos prioritarios. Presentamos los resultados de una evaluación rápida de la evidencia y un metanálisis del riesgo deanafilaxia a una exposición a alérgenos de bajo nivel para alérgenos prioritarios. Sobre la base de este análisis, proponemos que el cacahuete puede y debe considerarse un alérgeno ejemplar para la caracterización del peligro en una exposición a un alérgeno de bajo nivel.Instituto de Investigación de Tecnología de AlimentosFil: Turner, Paul J. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Patel, Nandinee. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Ballmer-Weber, Barbara K. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Ballmer-Weber, Barbara K. Clínica de Dermatología y Alergología. Kantonsspital; Suiza.Fil: Baumert, Joe L. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Blom, W. Marty. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Brooke-Taylor, Simon. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Brough, Helen. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Brough, Helen. King's College London. Departamento de Alergia Pediátrica; Reino Unido.Fil: Campbell, Dianne E. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Campbell, Dianne E. Tecnologías DBV. Montrouge; Francia.Fil: Chen, Hongbing. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Chinthrajah, R. Sharon. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Crevel, René W.R. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Dubois, Anthony E.J. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Ebisawa, Motohiro. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Elizur, Arnon. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Elizur, Arnon. Universidad de Tel Aviv. Facultad de Medicina Sackler. Departamento de Pediatría; Israel.Fil: Gerdts, Jennifer D. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Gowland, M. Hazel. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Houben, Geert F. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Hourihane, Jonathan O.B. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Knulst, André C. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: La Vieille, Sébastien. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: López, María Cristina. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Mills, E.N. Clare. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Polenta, Gustavo Alberto. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Investigación Tecnología de Alimentos; Argentina.Fil: Polenta, Gustavo Alberto. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Purington, Natasha. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Said, María. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Sampson, Hugh A. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Sampson, Hugh A. Escuela de Medicina Icahn. División de Alergia e Inmunología Pediátricasen. Nueva York. Estados Unidos de América.Fil: Schnadt, Sabine. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Södergren, Eva. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Södergren, Eva. ThermoFisher Scientific; Suecia.Fil: Taylor, Stephen L. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Remington, Benjamin C. Imperial College London. Instituto Nacional del Corazón y los Pulmones; Reino Unido.Fil: Remington, Benjamin C. Grupo BV. Consultoría Remington; Holanda

Parenthood and factors that influence outdoor recreational physical activity from a gender perspective

Background: A physically active life promotes both physical and mental health, increasing well-being and quality of life. Physical activity (PA) performed outdoors has been found to be particularly good for promoting well-being. However, participation in PA can change during the course of a lifetime. Parenthood has been found to be a life event associated with decreased PA, especially among women, although studies in the field are sparse. The aim of this study was to investigate participation in outdoor recreational PA, and factors influencing participation among parents-to-be, with and without previous children, from a gender perspective. Methods: This study included baseline data from parents-to-be, 224 women and 208 men, from the municipality of Karlskrona in south-east Sweden. Data collection was carried out during 2008-2009. We measured the self-reported amount of outdoor recreational PA undertaken during the last year and analysed the probability of participating in this PA using 25 variables covering individual and socioeconomic factors. Results: Seventy-six per cent of the women and 65% of the men had participated in outdoor recreational PA, varying from several times per month to every day, over a 12-month period prior to one month before pregnancy. Participation in PA indoors and owning a dog or a horse emerged as the most important factors associated with the probability of participation in outdoor recreational PA. Men were affected by a greater number of factors than women, for example men who had a family situation that permitted outdoor recreational PA participated in activities to a greater extent than men without such a family situation. The physical aspect, i.e. improved physical condition, staying power and vigour, also played a significant role with regard to participation among men. Conclusions: Becoming a parent is a life-changing event that affects participation in PA. By offering family-oriented PA choices that involve both parents and children, midwives and health promoters can encourage parents to be active and to support each other. The promotion of outdoor recreational PA, which also has restorative effects on well-being, needs to focus on activities which are attractive and affordable for the majority of both women and men

Lipid peroxidation in vivo : Evaluation and application of methods for measurement

Lipid peroxidation is thought to be an important factor in the pathophysiology of a number of diseases and in the process of ageing, but its measurement in vivo has been difficult. The aim of this thesis was to evaluate methods for measurement of lipid peroxidation in vivo that are suitable for clinical investigations, and to apply these methods in animal and human studies investigating basal conditions and situations associated with increased lipid peroxidation. The ferrous oxidation in xylenol orange assay for quantification of total plasma lipid hydroperoxides was re-evaluated regarding sample handling and storage. It was shown to be a useful tool for analyses of fresh but not stored plasma samples. A methodology for measurement of the total amount (sum of free and esterified) of an F2-isoprostane, 8-iso-prostaglandin F2α, in tissues using alkaline hydrolysis in combination with an existing radioimmunoassay was developed. High levels of 8-iso-prostaglandin F2α in rat liver tissue were quantified by this technique both at basal conditions and in an experimental model of increased lipid peroxidation induced by carbon tetrachloride. Supplementation with vitamin E to rats decreased both non-enzymatic and enzymatic lipid peroxidation as measured by 8-iso-prostaglandin F2α and a major prostaglandin F2α metabolite. This was verified both in the urine at basal conditions, and in the urine and liver tissue after carbon tetrachloride induced lipid peroxidation. In a randomised cross-over study in humans, a rapeseed oil-based diet with an increased proportion of easily oxidised polyunsaturated fatty acids was compared to a control diet rich in saturated fats. The rapeseed oil-based diet did not seem to increase the degree of lipid peroxidation in plasma and urine as measured by 8-iso-prostaglandin F2α, hydroperoxides and malondialdehyde, presumably due to a sufficient content of antioxidants in the rapeseed oil diet. In conclusion, the simultaneous measurement of several biomarkers of lipid peroxidation is a promising approach for future studies investigating the possible role of lipid peroxidation in vivo under basal conditions and in the pathology of diseases

Does mindfulness increase weight loss when treating overweight or obesity?

Bakgrund: Övervikt och fetma är en av dagens ledande orsaker till ökad morbiditet och mortalitet. Över hälften av den svenska vuxna befolkningen har övervikt eller fetma, vilket ställer stora krav på sjukvården. Övervikt och fetma kan orsaka psykiskt lidande som depression, ångest och stigma. Behandlingen behöver därför även ett psykologiskt perspektiv, där mindfulness skulle kunna minska de psykiska problemen och stärka förmågan till självreglering och bibehållande av nya vanor. Detta skulle potentiellt kunna leda till ökad viktminskning och bibehållande av en viktnedgång över tid. Syfte: Syftet med denna systematiska litteraturöversikt är att utvärdera om tillägg av mindfulness till kostbehandling av övervikt eller fetma ger större viktminskningseffekt än traditionell behandling i Sverige. Sökväg: Litteratursökning gjordes i databaserna PubMed och Scopus. Sökord var obesity, overweight, weight gain, weight loss, weight reduction, body mass index, body weight maintenance, obese, overweight, Quetelet index, BMI>30, mindfulness, conscious presence, attentive presence, mindful eating, mindful behaviour, mindful behavior, mindful meditation, random*, blind*. Urvalskriterier: Inklusionskriterier var RCT, vuxna >18 år, BMI>25 kg/m2, samma kost- och träningsprogram hos interventions- och kontrollgrupp. Intervention med en av följande: MBSR, MB-EAT, Self-Acceptance and Loving Kindness Practices. Kontrollbehandling i form av annan relevant behandling i tidsmässigt likartad omfattning. Exklusionskriterierna var graviditet, amning, bulimi, anorexi, läkemedel för viktnedgång. Datainsamling och analys: Sökning gjordes 2019-01-29. Artiklarna granskades av två oberoende granskare utifrån title/abstract. Inkluderade artiklar lästes i fulltext. Kvalitetsgranskning utfördes enligt SBU’s ”Mall för kvalitetsgranskning av randomiserade studier”. Separata evidensgraderingar gjordes enligt GRADE. Meningskiljaktigheter löstes med konsensus. Resultat: Två studier mötte inklusionskriterierna; en högkvalitativ studie med ett viktminskningsprogram med traditionella fysiska möten och en studie av medelhög kvalitet med ett telefonbaserat koncept. Ingen av de två interventionsmodellerna visade en statistisk signifikant skillnad mellan interventions- och kontrollgruppens effekt på viktminskning. Däremot fick den ena studien statistiskt signifikant förbättrat resultat i binge-eating hos interventionsgruppen. Slutsats: Det finns måttligt stark evidens för att effekten av mindfulnessbaserad fetmabehandling är jämförbar med effekten som erhålls med traditionell behandling av fetma (+++). Mindfulness som beteendeterapi istället för KBT, vid en telefonbaserad traditionell behandling av övervikt eller fetma, tycks inte ge någon ökad viktminskningseffekt (++). Det går inte att dra några slutsatser när det gäller effekten bland män, då det saknas tillräckligt underlag. Background: Overweight and obesity are one of the leading causes of increased morbidity and mortality. Over 50% of the Swedish adult population are overweight or obese, which places great demands on health care. Overweight and obesity can cause mental illness such as depression, anxiety and stigma. The treatment therefore also needs a psychological perspective, where mindfulness could reduce the psychological problems and strengthen the ability to selfregulate and maintain new habits. This could potentially lead to increased weight loss and maintenance of a weight loss over time. Objective: The purpose of this systematic literature review is to evaluate whether the addition of mindfulness to dietary treatment of overweight or obesity has a greater weight loss effect than traditional treatment in Sweden. Search strategy: A literature search was made in the databases PubMed and Scopus. Keywords were obesity, overweight, weight gain, weight loss, weight reduction, body mass index, body weight maintenance, obese, overweight, Quetelet index, BMI>30, mindfulness, conscious presence, attentive presence, mindful eating, mindful behavior, mindful behavior, mindful meditation, random*, blind*. Selection criteria: Inclusion criteria were RCT, adults >18 years, BMI>25 kg/m2, the same diet and exercise program in the intervention and control group. Intervention with one of the following: MBSR, MB-EAT, Self-Acceptance and Loving Kindness Practices. Control treatment in the form of other relevant treatment in a time-like extent. The exclusion criteria were pregnancy, breastfeeding, bulimia, anorexia, weight loss drugs. Data collection and analysis: Search was made January 29, 2019. The articles were reviewed by two independent reviewers based on title/abstract. Included articles were read in full text. Quality review was carried out according to SBU’s “Template for quality review of randomized studies”. Separate evidence ratings were made according to GRADE. Disagreements were resolved by consensus. Main results: Two studies met the inclusion criteria; a high quality study with a weight loss program with traditional physical meetings and a study of medium quality with a telephonebased concept. None of the two intervention models showed a statistically significant difference between the effect of the intervention and the control group on weight loss. However, the highquality study obtained a statistically significant improvement in binge eating among the participants in the intervention group. Conclusions: There is moderately strong evidence that the effect of mindfulness-based obesity treatment is comparable to the effect obtained with traditional treatment of obesity (+++). Mindfulness as behavioral therapy instead of CBT, in a telephone-based traditional treatment of obesity or obesity, does not appear to give any increased weight loss effect (++). It is not possible to draw any conclusions regarding the effect among men, because of insufficient data

Copingstrategier vid åldrandet : En litteraturöversikt

 Att åldras kan innebära stora genomgripande förändringar i den äldre personens liv. Som sjuksköterska i hemsjukvård är erfarenheten att det behövs ökade kunskaper om hur den äldre klarar av åldrandet. Syftet med litteraturöversikten var att belysa äldre personers copingstrategier för att klara av åldrandet. Sökningar via databaserna resulterade i 11 artiklar med kvalitativ design som analyserats med fokus på syftet. Den kvalitativa analysen av artiklarna resulterade i flera copingstrategier vilka bildade ett huvudtema, Att skapa ny tillvaro och sex underteman, Att acceptera nya förhållanden, Att tänka positivt och kämpa, Att resignera inför omständigheterna, Att ta hjälp av andra, Att ha struktur i tillvaron samt Att hålla igång och använda tekniska lösningar. Åldrandet tillhör livet och innebär bland annat förluster eller hot om förlust vilka behövde klaras av genom att skapa ny tillvaro. Viktigast för de personer som vårdar äldre är att visa respekt för den äldres önskningar och att ha tid att lära känna den äldres behov samt vårda i en lugn miljö. Meningsfulla aktiviteter var betydelsefullt, dels för stimulans och distraktion men också för social samvaro. Kunskapen om äldres copingstrategier ger sjuksköterskan bättre förutsättningar att vårda äldre personer och stödja ett gott åldrande. Aging can mean large changes for the older person’s life. The experience as a community care nurse is that there is a need for more knowledge of how the elderly cope with aging. The aim of this literature review was to investigate the strategies of coping with aging in the elderly. The review was based on 11 articles with qualitative design which had been focusing on the aim. The result of the quality analysis of the research articles resulted in several coping strategies as formed one mainthemes: To create a new existence and six subthemes: To accept new environments, To think in a positive way and fight, To resign ourselves circumstances, To accept help from others, To have a routine in day-to-day life and To keep active and use technical solutions. Ageing is past of life and losses or threat of loss is part of ageing and to be able to cope the need to create a new way is important. The literature review showed that the most important thing to consider for staff working with the elderly is to show respect for their wishes, to allow time to get to know their needs and to care for them in a calm environment. Meaningful activities were important to stimulate and distract but also for social interaction. The knowledge of the elderly persons way of coping gives the nurse a better way of caring for the individual and to support them in ageing.

Copingstrategier vid åldrandet : En litteraturöversikt

 Att åldras kan innebära stora genomgripande förändringar i den äldre personens liv. Som sjuksköterska i hemsjukvård är erfarenheten att det behövs ökade kunskaper om hur den äldre klarar av åldrandet. Syftet med litteraturöversikten var att belysa äldre personers copingstrategier för att klara av åldrandet. Sökningar via databaserna resulterade i 11 artiklar med kvalitativ design som analyserats med fokus på syftet. Den kvalitativa analysen av artiklarna resulterade i flera copingstrategier vilka bildade ett huvudtema, Att skapa ny tillvaro och sex underteman, Att acceptera nya förhållanden, Att tänka positivt och kämpa, Att resignera inför omständigheterna, Att ta hjälp av andra, Att ha struktur i tillvaron samt Att hålla igång och använda tekniska lösningar. Åldrandet tillhör livet och innebär bland annat förluster eller hot om förlust vilka behövde klaras av genom att skapa ny tillvaro. Viktigast för de personer som vårdar äldre är att visa respekt för den äldres önskningar och att ha tid att lära känna den äldres behov samt vårda i en lugn miljö. Meningsfulla aktiviteter var betydelsefullt, dels för stimulans och distraktion men också för social samvaro. Kunskapen om äldres copingstrategier ger sjuksköterskan bättre förutsättningar att vårda äldre personer och stödja ett gott åldrande. Aging can mean large changes for the older person’s life. The experience as a community care nurse is that there is a need for more knowledge of how the elderly cope with aging. The aim of this literature review was to investigate the strategies of coping with aging in the elderly. The review was based on 11 articles with qualitative design which had been focusing on the aim. The result of the quality analysis of the research articles resulted in several coping strategies as formed one mainthemes: To create a new existence and six subthemes: To accept new environments, To think in a positive way and fight, To resign ourselves circumstances, To accept help from others, To have a routine in day-to-day life and To keep active and use technical solutions. Ageing is past of life and losses or threat of loss is part of ageing and to be able to cope the need to create a new way is important. The literature review showed that the most important thing to consider for staff working with the elderly is to show respect for their wishes, to allow time to get to know their needs and to care for them in a calm environment. Meaningful activities were important to stimulate and distract but also for social interaction. The knowledge of the elderly persons way of coping gives the nurse a better way of caring for the individual and to support them in ageing.