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Lind, Torbjörn
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Publications (10 of 39) Show all publications
Waernbaum, I., Dahlquist, G. & Lind, T. (2019). Perinatal risk factors for type 1 diabetes revisited: a population-based register study. Diabetologia, 62(7), 1173-1184
Open this publication in new window or tab >>Perinatal risk factors for type 1 diabetes revisited: a population-based register study
2019 (English)In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 62, no 7, p. 1173-1184Article in journal (Refereed) Published
Abstract [en]

Aims/hypothesis: Single-centre studies and meta-analyses have found diverging results as to which early life factors affect the risk of type 1 diabetes during childhood. We wanted to use a large, nationwide, prospective database to further clarify and analyse the associations between perinatal factors and the subsequent risk for childhood-onset type 1 diabetes using a case–control design.

Methods: The Swedish Childhood Diabetes Register was linked to the Swedish Medical Birth Register and National Patient Register, and 14,949 cases with type 1 diabetes onset at ages 0–14 years were compared with 55,712 matched controls born from the start of the Medical Birth Register in 1973 to 2013. After excluding confounders (i.e. children multiple births, those whose mother had maternal diabetes and those with a non-Nordic mother), we used conditional logistic regression analyses to determine risk factors for childhood-onset type 1 diabetes. We used WHO ICD codes for child and maternal diagnoses.

Results: In multivariate analysis, there were small but statistically significant associations between higher birthweight z score (OR 1.08, 95% CI 1.06, 1.10), delivery by Caesarean section (OR 1.08, 95% CI 1.02, 1.15), premature rupture of membranes (OR 1.08, 95% CI 1.01, 1.16) and maternal urinary tract infection during pregnancy (OR 1.39, 95% CI 1.04, 1.86) and the subsequent risk of childhood-onset type 1 diabetes. Birth before 32 weeks of gestation was associated with a lower risk of childhood-onset type 1 diabetes compared with full-term infants (OR 0.54, 95% CI 0.38, 0.76), whereas birth between 32 and 36 weeks’ gestation was associated with a higher risk (OR 1.24, 95% CI 1.14, 1.35). In subgroup analyses (birth years 1992–2013), maternal obesity was independently associated with subsequent type 1 diabetes in the children (OR 1.27, 95% CI 1.15, 1.41) and rendered the association with Caesarean section non-significant. In contrast to previous studies, we found no association of childhood-onset type 1 diabetes with maternal–child blood-group incompatibility, maternal pre-eclampsia, perinatal infections or treatment of the newborn with phototherapy for neonatal jaundice. The proportion of children with neonatal jaundice was significantly higher in the 1973–1982 birth cohort compared with later cohorts.

Conclusions/interpretation: Perinatal factors make small but statistically significant contributions to the overall risk of childhood-onset type 1 diabetes. Some of these risk factors, such as maternal obesity, may be amendable with improved antenatal care. Better perinatal practices may have affected some previously noted risk factors over time.

Place, publisher, year, edition, pages
Springer, 2019
Keywords
Birthweight, Case-control study, Diabetes mellitus type 1, Perinatal risk factors, Urinary tract infection
National Category
Endocrinology and Diabetes Pediatrics
Identifiers
urn:nbn:se:umu:diva-161440 (URN)10.1007/s00125-019-4874-5 (DOI)000471176200008 ()31041471 (PubMedID)
Funder
Swedish Research Council, 2016-00703Swedish Research Council, 2014-07531
Available from: 2019-07-10 Created: 2019-07-10 Last updated: 2019-07-10Bibliographically approved
Johansson, U., Öhlund, I., Hernell, O., Lönnerdal, B., Lindberg, L. & Lind, T. (2019). Protein-Reduced Complementary Foods Based on Nordic Ingredients Combined with Systematic Introduction of Taste Portions Increase Intake of Fruits and Vegetables in 9 Month Old Infants: A Randomised Controlled Trial. Nutrients, 11(6), Article ID 1255.
Open this publication in new window or tab >>Protein-Reduced Complementary Foods Based on Nordic Ingredients Combined with Systematic Introduction of Taste Portions Increase Intake of Fruits and Vegetables in 9 Month Old Infants: A Randomised Controlled Trial
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2019 (English)In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 11, no 6, article id 1255Article in journal (Refereed) Published
Abstract [en]

Fruits and vegetables are healthy foods but under-consumed among infants and children. Approaches to increase their intake are urgently needed. This study investigated the effects of a systematic introduction of taste portions and a novel protein-reduced complementary diet based on Nordic foods on fruit and vegetable intake, growth and iron status to 9 months of age. Healthy, term infants (n = 250) were recruited and randomly allocated to either a Nordic diet group (NG) or a conventional diet group (CG). Infants were solely breast- or formula-fed at study start. From 4 to 6 months of age, the NG followed a systematic taste portions schedule consisting of home-made purées of Nordic produce for 24 days. Subsequently, the NG was supplied with baby food products and recipes of homemade baby foods based on Nordic ingredients but with reduced protein content compared to the CG. The CG was advised to follow current Swedish recommendations on complementary foods. A total of 232 participants (93%) completed the study. The NG had significantly higher intake of fruits and vegetables than the CG at 9 months of age; 225 ± 109 g/day vs. 156 ± 77 g/day (p < 0.001), respectively. Energy intake was similar, but protein intake was significantly lower in the NG (−26%, p < 0.001) compared to the CG. This lower protein intake was compensated for by higher intake of carbohydrate from fruits and vegetables. No significant group differences in growth or iron status were observed. The intervention resulted in significantly higher consumption of fruits and vegetables in infants introduced to complementary foods based on Nordic ingredients.

Place, publisher, year, edition, pages
MDPI, 2019
Keywords
infant feeding, Nordic diet, eating behaviour, repeated exposure
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-161926 (URN)10.3390/nu11061255 (DOI)000474936700061 ()31159495 (PubMedID)2-s2.0-85067185540 (Scopus ID)
Available from: 2019-08-06 Created: 2019-08-06 Last updated: 2019-08-06Bibliographically approved
Möllsten, A., Toppe, C., Eeg-Olofsson, K. & Lind, T. (2019). Sex Differences in Treatment With ACE Inhibitors and Angiotensin Receptor Blockers in Patients With Type 1 Diabetes [Letter to the editor]. Diabetes Care, 42(5), E73-E74
Open this publication in new window or tab >>Sex Differences in Treatment With ACE Inhibitors and Angiotensin Receptor Blockers in Patients With Type 1 Diabetes
2019 (English)In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 42, no 5, p. E73-E74Article in journal, Letter (Refereed) Published
Place, publisher, year, edition, pages
AMER DIABETES ASSOC, 2019
National Category
Social and Clinical Pharmacy
Identifiers
urn:nbn:se:umu:diva-158939 (URN)10.2337/dc18-2542 (DOI)000465238900002 ()30885953 (PubMedID)
Available from: 2019-05-27 Created: 2019-05-27 Last updated: 2019-05-27Bibliographically approved
Lind, T., Johansson, U., Öhlund, I., Lindberg, L., Lonnerdal, B., Tennefors, C. & Hernell, O. (2019). Study protocol: optimized complementary feeding study (OTIS): a randomized controlled trial of the impact of a protein-reduced complementary diet based on Nordic foods. BMC Public Health, 19, Article ID 134.
Open this publication in new window or tab >>Study protocol: optimized complementary feeding study (OTIS): a randomized controlled trial of the impact of a protein-reduced complementary diet based on Nordic foods
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2019 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, article id 134Article in journal (Refereed) Published
Abstract [en]

Background: What we eat as infants and children carries long-term consequences. Apart from breastfeeding, the composition of the complementary diet, i.e. the foods given to the infant during the transition from breast milk/infant formula to regular family foods affects the child's future health. A high intake of protein, a low intake of fruits, vegetables and fish and an unfavorable distribution between polyunsaturated and saturated fats are considered to be associate with health risks, e.g. obesity, type 2 diabetes and dyslipidemia later in life.

Methods: In a randomized, controlled study from 6 to 18months of age we will compare the currently recommended, Swedish complementary diet to one based on Nordic foods, i.e. an increased intake of fruits, berries, vegetables, tubers, whole-grain and game, and a lower intake of sweets, dairy, meat and poultry, with lower protein content (30% decrease), a higher intake of vegetable fats and fish and a systematic introduction of fruits and greens. The main outcomes are body composition (fat and fat-free mass measured with deuterium), metabolic and inflammatory biomarkers (associated with the amount of body fat) in blood and urine, gut microbiota (thought to be the link between early diet, metabolism and diseases such as obesity and insulin resistance) and blood pressure.We will also measure the participants' energy and nutrient intake, eating behavior and temperament through validated questionnaires, acceptance of new and unfamiliar foods through video-taped test meals and assessment of cognitive development, which we believe can be influenced through an increased intake of fish and milk fats, notably milk fat globule membranes (MFGM).

Discussion: If the results are what we expect, i.e. improved body composition and a less obesogenic, diabetogenic and inflammatory metabolism and gut microbiota composition, a more sustainable nutrient intake for future health and an increased acceptance of healthy foods, they will have a profound impact on the dietary recommendations to infants in Sweden and elsewhere, their eating habits later in life and subsequently their long-term health.

Trial registration: NCT02634749. Registration date 18 December 2015.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Infant food, Child nutrition physiology, Body composition, Growth, Obesity, Insulin resistance, Hypertension, Child development, Microbiota, Feeding behavior, Food preference
National Category
Pediatrics Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-162772 (URN)10.1186/s12889-019-6466-1 (DOI)000457471800007 ()30704429 (PubMedID)
Available from: 2019-09-05 Created: 2019-09-05 Last updated: 2019-09-05Bibliographically approved
Johansson, U., Venables, M., Öhlund, I. & Lind, T. (2018). Active Image-Assisted Food Records in Comparison to Regular Food Records: A Validation Study against Doubly Labeled Water in 12-Month-Old Infants. Nutrients, 10(12), Article ID 1904.
Open this publication in new window or tab >>Active Image-Assisted Food Records in Comparison to Regular Food Records: A Validation Study against Doubly Labeled Water in 12-Month-Old Infants
2018 (English)In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 10, no 12, article id 1904Article in journal (Refereed) Published
Abstract [en]

Overreporting of dietary intake in infants is a problem when using food records (FR), distorting possible relationships between diet and health outcomes. Image-assisted dietary assessment may improve the accuracy, but to date, evaluation in the pediatric setting is limited. The aim of the study was to compare macronutrient and energy intake by using an active image-assisted five-day FR against a regular five-day FR, and to validate image-assistance with total energy expenditure (TEE), was measured using doubly labeled water. Participants in this validation study were 22 healthy infants randomly selected from the control group of a larger, randomized intervention trial. The parents reported the infants’ dietary intake, and supplied images of main course meals taken from standardized flat-surfaced plates before and after eating episodes. Energy and nutrient intakes were calculated separately using regular FR and image-assisted FRs. The mean (± standard deviations) energy intake (EI) was 3902 ± 476 kJ/day from the regular FR, and 3905 ± 476 kJ/day from the FR using active image-assistance. The mean EI from main-course meals when image-assistance was used did not differ (1.7 ± 55 kJ, p = 0.89) compared to regular FRs nor did the intake of macronutrients. Compared to TEE, image-assisted FR overestimated EI by 10%. Without validation, commercially available software to aid in the volume estimations, food item identification, and automation of the image processing, image-assisted methods remain a more costly and burdensome alternative to regular FRs in infants. The image-assisted method did, however, identify leftovers better than did regular FR, where such information is usually not readily available. View Full-Text

Place, publisher, year, edition, pages
MDPI, 2018
Keywords
energy intake, dietary assessment, image-assisted method, infant, food record, doubly labeled water
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-155779 (URN)10.3390/nu10121904 (DOI)000455073200085 ()30518042 (PubMedID)
Available from: 2019-01-28 Created: 2019-01-28 Last updated: 2019-01-28Bibliographically approved
Uggla, C., Lindh, V., Lind, T. & Lindkvist, M. (2018). IMPACT-III is a valid and reliable questionnaire for assessing health-related quality of life in Swedish children with inflammatory bowel disease. Acta Paediatrica, 107(2), 347-353
Open this publication in new window or tab >>IMPACT-III is a valid and reliable questionnaire for assessing health-related quality of life in Swedish children with inflammatory bowel disease
2018 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, no 2, p. 347-353Article in journal (Refereed) Published
Abstract [en]

Aim: This study examined the reliability, validity and factor structure of the Swedish version of the IMPACT-III questionnaire for assessing health-related quality of life in children with inflammatory bowel disease.

Methods: We recruited 202 participants aged eight to 18years, who were enrolled from 16 of the 23 paediatric gastroenterology clinics across Sweden during 2010-2013. This cross-sectional study compared two versions of the IMPACT-III questionnaire - one with six factors and 35 items and one with four factors and 19 items - plus the Paediatric Quality of Life Inventory 4.0 Generic Core Scale. Disease activity was assessed and defined as active or inactive.

Results: The mean total score for the six-factor IMPACT-III scale was 143.7/175, with a standard deviation (SD) of 17.9. There was a significant difference in mean total scores between the 133 children with inactive disease (147.8, SD: 14.9) and the 52 with active disease (133.0, SD: 20.3). Confirmatory factor analysis showed that the four-factor scale was more robust than the original six-factor scale. Concurrent validity and discriminant validity were high for both versions.

Conclusion: The Swedish version of the IMPACT-III questionnaire was valid and reliable, but the shorter, four-factor version is quicker and may be more convenient in clinical settings.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
health-related quality of life, IMPACT-III, paediatric inflammatory bowel disease, Sweden, validity
National Category
Pediatrics
Identifiers
urn:nbn:se:umu:diva-144391 (URN)10.1111/apa.14119 (DOI)000419768200031 ()29032599 (PubMedID)
Available from: 2018-02-13 Created: 2018-02-13 Last updated: 2018-06-09Bibliographically approved
Åkeson, P. K., Åkesson, K. E., Lind, T., Hernell, O., Silfverdal, S.-A. & Öhlund, I. (2018). Vitamin D Intervention and Bone: A Randomized Clinical Trial in Fair- and Dark-skinned Children at Northern Latitudes. Journal of Pediatric Gastroenterology and Nutrition - JPGN, 67(3), 388-394
Open this publication in new window or tab >>Vitamin D Intervention and Bone: A Randomized Clinical Trial in Fair- and Dark-skinned Children at Northern Latitudes
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2018 (English)In: Journal of Pediatric Gastroenterology and Nutrition - JPGN, ISSN 0277-2116, E-ISSN 1536-4801, Vol. 67, no 3, p. 388-394Article in journal (Refereed) Published
Abstract [en]

Objectives: The aim of the study was to evaluate vitamin D status and effects of vitamin D intervention on bone mineral density (BMD) and content (BMC) in children with fair and dark skin in Sweden during winter.

Methods: In a 2-center prospective double-blinded randomized intervention study 5- to 7-year-old children (n = 206) with fair and dark skin in Sweden (55 degrees N-63 degrees N) received daily vitamin D supplements of 25 mu g, 10 mu g, or placebo (2 mu g) during 3 winter months. We measured BMD and BMC for total body (TB), total body less head (TBLH), femoral neck (FN), and spine at baseline and 4 months later. Intake of vitamin D and calcium, serum 25-hydroxy vitamin D (S-25 [OH]D), and related parameters were analyzed.

Results: Despite lower S-25(OH)D in dark than fair-skinned children, BMD of TB (P = 0.012) and TBLH (P = 0.002) and BMC of TBLH (P = 0.04) were higher at baseline and follow-up in those with dark skin. Delta (Delta) BMD and BMC of TB and TBLH did not differ between intervention and placebo groups, but FN-BMC increased more among dark-skinned children in the 25 mu g (P = 0.038) and 10 mu g (P = 0.027) groups compared to placebo. We found no associations between Delta S-25(OH)D, P-parathyroid hormone, P-alkaline phosphatase, and Delta BMD and BMC, respectively.

Conclusions: BMD and BMC remained higher in dark- than fair-skinned children despite lower vitamin D status. Even though no difference in general was found in BMD or BMC after vitamin D intervention, the increase in FN-BMC in dark-skinned children may suggest an influence on bone in those with initially insufficient vitamin D status.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2018
Keywords
bone mineral content, bone mineral density, child, 25-hydroxyvitamin D, skin color
National Category
Orthopaedics Pediatrics
Identifiers
urn:nbn:se:umu:diva-152216 (URN)10.1097/MPG.0000000000002031 (DOI)000442252100024 ()29851760 (PubMedID)
Available from: 2018-10-25 Created: 2018-10-25 Last updated: 2018-10-25Bibliographically approved
Söderberg, L., Lind, T., Åkeson, P. K., Sandström, A.-K., Hernell, O. & Öhlund, I. (2017). A Validation Study of an Interviewer-Administered Short Food Frequency Questionnaire in Assessing Dietary Vitamin D and Calcium Intake in Swedish Children. Nutrients, 9(7), Article ID 682.
Open this publication in new window or tab >>A Validation Study of an Interviewer-Administered Short Food Frequency Questionnaire in Assessing Dietary Vitamin D and Calcium Intake in Swedish Children
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2017 (English)In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 9, no 7, article id 682Article in journal (Refereed) Published
Abstract [en]

Vitamin D and calcium are essential nutrients with a range of biological effects of public health relevance. This study aimed to validate a short food frequency questionnaire (SFFQ) against a three-day food record (3D record), assessing the intake of vitamin D and calcium in Swedish children during wintertime. In a double-blinded, randomized food-based intervention study on the effect of feeding different daily doses of vitamin D supplement to 5-7-year-old children (n = 85), 79 (93%) participants completed SFFQ1 at baseline and SFFQ2 after the intervention, and 72 were informed to fill in a 3D record. The 28 (39%) children who completed the 3D record were included in this validation study. The baseline level of serum-25 hydroxy vitamin D [S-25(OH)D] was used as a biomarker. The correlation between all three instruments were moderate to strong. SFFQ2 and the 3D record correlated moderately to S-25(OH)D. Bland-Altman analysis showed that SFFQ2 overestimated vitamin D intake by on average 0.6 mu g/day, (limits of agreement (LOA) 5.7 and -4.6 mu g/day), whereas the intake of calcium was underestimated by on average 29 mg/day, (LOA 808 and -865 mg/day). Finally, the validity coefficient calculated for vitamin D using the method of triad was high (0.75). In conclusion, this SFFQ, assessed by a dietician, is a valid tool to assess dietary vitamin D and calcium intake in groups of young children.

Place, publisher, year, edition, pages
MDPI AG, 2017
Keywords
dietary assessments, three-day food record, child, 25-hydroxy vitamin D
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-138608 (URN)10.3390/nu9070682 (DOI)000406679700039 ()
Available from: 2017-09-07 Created: 2017-09-07 Last updated: 2018-06-09Bibliographically approved
Persson, E., Waernbaum, I. & Lind, T. (2017). Estimating marginal causal effects in a secondary analysis of case-control data. Statistics in Medicine, 36(15), 2404-2419
Open this publication in new window or tab >>Estimating marginal causal effects in a secondary analysis of case-control data
2017 (English)In: Statistics in Medicine, ISSN 0277-6715, E-ISSN 1097-0258, Vol. 36, no 15, p. 2404-2419Article in journal (Refereed) Published
Abstract [en]

When an initial case-control study is performed, data can be used in a secondary analysis to evaluate the effect of the case-defining event on later outcomes. In this paper, we study the example in which the role of the event is changed from a response variable to a treatment of interest. If the aim is to estimate marginal effects, such as average effects in the population, the sampling scheme needs to be adjusted for. We study estimators of the average effect of the treatment in a secondary analysis of matched and unmatched case-control data where the probability of being a case is known. For a general class of estimators, we show the components of the bias resulting from ignoring the sampling scheme and demonstrate a design-weighted matching estimator of the average causal effect. In simulations, the finite sample properties of the design-weighted matching estimator are studied. Using a Swedish diabetes incidence register with a matched case-control design, we study the effect of childhood onset diabetes on the use of antidepressant medication as an adult.

Place, publisher, year, edition, pages
Hoboken: Wiley-Blackwell, 2017
Keywords
design-weighted estimation, matched case-control study, propensity score
National Category
Probability Theory and Statistics Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Statistics
Identifiers
urn:nbn:se:umu:diva-94965 (URN)10.1002/sim.7277 (DOI)000402799900007 ()28276084 (PubMedID)
Funder
Swedish Research Council, 07531Riksbankens Jubileumsfond, P11-0814:1
Available from: 2014-10-20 Created: 2014-10-20 Last updated: 2018-06-07Bibliographically approved
Öhlund, I., Lind, T., Hernell, O., Silfverdal, S.-A. & Karlsland Åkeson, P. (2017). Increased vitamin D intake differentiated according to skin color is needed to meet requirements in young Swedish children during winter: a double-blind randomized clinical trial. American Journal of Clinical Nutrition, 106(1), 105-112
Open this publication in new window or tab >>Increased vitamin D intake differentiated according to skin color is needed to meet requirements in young Swedish children during winter: a double-blind randomized clinical trial
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2017 (English)In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 106, no 1, p. 105-112Article in journal (Refereed) Published
Abstract [en]

Background: Dark skin and low exposure to sunlight increase the risk of vitamin D insufficiency in children. Objective: The aim of the study was to evaluate the amount of vitamin D needed to ascertain that most children >4 y of age attain sufficient serum25-hydroxyvitamin D [S-25(OH) D; i.e., >= 50 nmol/L] during winter regardless of latitude and skin color. Design: In a longitudinal, double-blind, randomized, food-based intervention study, 5- to 7-y-old children from northern (638 degrees N) and southern (558 degrees N) Sweden with fair (n = 108) and dark (n = 98) skin were included. Children, stratified by skin color by using Fitzpa-trick's definition, were randomly assigned to receive milk-based vitamin D-3 supplements that provided 2 (placebo), 10, or 25 mu g/d during 3 winter months. Results: Mean daily vitamin D intake increased from 6 to 17 mu g and 26 mu g in the intervention groups supplemented with 10 and 25 mu g, respectively. In the intention-to-treat analysis, 90.2% (95% CI: 81.1%, 99.3%) of fair-skinned children randomly assigned to supplementation of 10 mu g/d attained sufficient concentrations, whereas 25 mu g/d was needed in dark-skinned children to reach sufficiency in 95.1% (95% CI: 88.5%, 100%). In children adherent to the study product, 97% (95% CI: 91.3%, 100%) and 87.9% (95% CI: 76.8%, 99%) of fair-and dark-skinned children, respectively, achieved sufficient concentrations if supplemented with 10 mu g/d. By using 95% prediction intervals for 30 and 50 nmol S-25(OH) D/L, intakes of 6 and 20 mu g/d are required in fair-skinned children, whereas 14 and 28 mu g/d are required in children with dark skin. Conclusion: Children with fair and dark skin require vitamin D intakes of 20 and 28 mu g/d, respectively, to maintain S-25(OH) D >= 50 nmol/L, whereas intakes of 6 and 14 mu g/d, respectively, are required to maintain concentrations >= 30 nmol/L during winter.

Place, publisher, year, edition, pages
American Society for Nutrition, 2017
Keywords
serum 25-hydroxyvitamin D, intervention, season, latitude, vitamin D, child
National Category
Pediatrics Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-138554 (URN)10.3945/ajcn.116.147108 (DOI)000404593900015 ()28615261 (PubMedID)
Available from: 2017-09-14 Created: 2017-09-14 Last updated: 2018-06-09Bibliographically approved
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