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Karlsson, T., Winkvist, A., Strid, A., Lindahl, B. & Johansson, I. (2024). Associations of dietary choline and betaine with all-cause mortality: a prospective study in a large Swedish cohort. European Journal of Nutrition, 63, 785-796
Öppna denna publikation i ny flik eller fönster >>Associations of dietary choline and betaine with all-cause mortality: a prospective study in a large Swedish cohort
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2024 (Engelska)Ingår i: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 63, s. 785-796Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Purpose: Investigate the association between choline and betaine intake and all-cause mortality in a large Swedish cohort.

Methods: Women (52,246) and men (50,485) attending the Västerbotten Intervention Programme 1990–2016 were included. Cox proportional hazard regression models adjusted for energy intake, age, BMI, smoking, education, and physical activity were used to estimate mortality risk according to betaine, total choline, phosphatidylcholine, glycerophosphocholine, phosphocholine, sphingomyelin, and free choline intakes [continuous (per 50 mg increase) and in quintiles].

Results: During a median follow-up of 16 years, 3088 and 4214 deaths were registered in women and men, respectively. Total choline intake was not associated with all-cause mortality in women (HR 1.01; 95% CI 0.97, 1.06; P = 0.61) or men (HR 1.01; 95% CI 0.98, 1.04; P = 0.54). Betaine intake was associated with decreased risk of all-cause mortality in women (HR 0.95; 95% CI 0.91, 0.98; P < 0.01) but not in men. Intake of free choline was negatively associated with risk of all-cause mortality in women (HR 0.98; 95% CI 0.96, 1.00; P = 0.01). No other associations were found between intake of the different choline compounds and all-cause mortality. In women aged ≥ 55 years, phosphatidylcholine intake was positively associated with all-cause mortality. In men with higher folate intake, total choline intake was positively associated with all-cause mortality.

Conclusion: Overall, our results do not support that intake of total choline is associated with all-cause mortality. However, some associations were modified by age and with higher folate intake dependent on sex. Higher intake of betaine was associated with lower risk of all-cause mortality in women.

Ort, förlag, år, upplaga, sidor
Springer Nature, 2024
Nyckelord
Betaine, Choline, Mortality, Phosphatidylcholine, Prospective cohort, Västerbotten Intervention Programme
Nationell ämneskategori
Näringslära
Identifikatorer
urn:nbn:se:umu:diva-219531 (URN)10.1007/s00394-023-03300-y (DOI)001136188700002 ()38175250 (PubMedID)2-s2.0-85181520811 (Scopus ID)
Tillgänglig från: 2024-01-19 Skapad: 2024-01-19 Senast uppdaterad: 2024-04-26Bibliografiskt granskad
Strid, A., Hallström, E., Lindroos, A. K., Lindahl, B., Johansson, I. & Winkvist, A. (2023). Adherence to the Swedish dietary guidelines and the impact on mortality and climate in a population-based cohort study. Public Health Nutrition, 26(11), 2333-2342
Öppna denna publikation i ny flik eller fönster >>Adherence to the Swedish dietary guidelines and the impact on mortality and climate in a population-based cohort study
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2023 (Engelska)Ingår i: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 26, nr 11, s. 2333-2342Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objective: To assess the associations between adherence to the Swedish dietary guidelines and all-cause mortality and thus assessing the index' ability to predict health outcomes, as well as levels of dietary greenhouse gas emissions (GHGEs).

Design: A longitudinal study 1990-2016 within the population-based cohort Västerbotten Intervention Programme. Dietary data were based on food frequency questionnaires. Diet quality was assessed by the Swedish Healthy Eating Index for Adults 2015 (SHEIA15), based on the 2015 Swedish dietary guidelines. Dietary GHGEs were estimated from life cycle assessment data including emissions from farm to industry gate. Hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause mortality were evaluated with Cox proportional hazards regression, and differences in median GHGEs were tested using the Kruskal-Wallis one-way ANOVA test, between quintiles of SHEIA15 score.

Setting: Northern Sweden.

Participants: In total, 49,124 women and 47,651 men, aged 35-65 years.

Results: Median follow-up times were 16.0 years for women and 14.7 years for men, during which time 3074 women and 4212 men died. A consistent trend of lower all-cause mortality HRs for both sexes with higher SHEIA15 scores was demonstrated. For women, the all-cause mortality HR was 0.81 [(95% CI 0.71-0.92); p=0.001] and for men 0.90 [(95% CI 0.81-0.996); p=0.041] between the quintile with the highest SHEIA15 score compared with the quintile with the lowest SHEIA15 score. A consistent trend of lower estimated dietary GHGEs among both sexes with higher SHEIA15 scores was also found.

Conclusions: Adherence to Swedish dietary guidelines, estimated by SHEIA15, seems to promote longevity and reduce dietary climate impact.

Ort, förlag, år, upplaga, sidor
Cambridge University Press, 2023
Nyckelord
diet quality, dietary indices, food-based dietary guidelines, sustainability, sustainable diets
Nationell ämneskategori
Näringslära
Identifikatorer
urn:nbn:se:umu:diva-212414 (URN)10.1017/S1368980023001295 (DOI)001030346400001 ()37395057 (PubMedID)2-s2.0-85165115881 (Scopus ID)
Tillgänglig från: 2023-07-28 Skapad: 2023-07-28 Senast uppdaterad: 2023-12-18Bibliografiskt granskad
Nordin, S., Norberg, M., Braf, I., Johansson, H., Lindahl, B., Lindvall, K., . . . Näslund, U. (2023). Associations between emotional support and cardiovascular risk factors and subclinical atherosclerosis in middle-age. Psychology and Health
Öppna denna publikation i ny flik eller fönster >>Associations between emotional support and cardiovascular risk factors and subclinical atherosclerosis in middle-age
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2023 (Engelska)Ingår i: Psychology and Health, ISSN 0887-0446, E-ISSN 1476-8321Artikel i tidskrift (Refereegranskat) Epub ahead of print
Abstract [en]

Objective: To test the hypothesis of low emotional support being associated with lifestyle and biomedical cardiovascular disease (CVD) risk factors, estimated risk of CVD morbidity and mortality, and subclinical atherosclerosis in middle-aged healthy adults.

Methods and measures: Cross-sectional data were obtained from participants aged 40–60 years who had one or more conventional CVD risk factor. They underwent assessment based on questionnaires, clinical examination, blood sampling, and carotid ultrasound of plaque formation and carotid intima-media wall thickness (cIMT). Based on the Interview Schedule for Social Interaction, the participants were categorised as either low in emotional support (n = 884) or as a referent (n = 2570). Logistic regression analyses were conducted to study the associations.

Results: Logistic regression analyses showed that low emotional support was significantly associated with smoking, alcohol consumption and physical inactivity (OR = 1.53 − 1.94), estimated risk of CVD morbidity and mortality (OR = 1.56 − 1.68), and plaque formation (OR = 1.39). No significant associations were found regarding biomedical CVD risk factors or cIMT.

Conclusion: The findings suggest that low social support is associated with lifestyle CVD risk factors, estimated risk of CVD morbidity and mortality, and subclinical atherosclerosis in middle-aged healthy adults, encouraging causal evaluation with longitudinal data investigating an impact of emotional support on mechanisms underlying CVD.

Ort, förlag, år, upplaga, sidor
Routledge, 2023
Nyckelord
Cardiovascular disease, cardiovascular risk score, carotid artery plaque, carotid vascular ultrasound, social support
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi Kardiologi
Identifikatorer
urn:nbn:se:umu:diva-217344 (URN)10.1080/08870446.2023.2286296 (DOI)37994844 (PubMedID)2-s2.0-85177567916 (Scopus ID)
Tillgänglig från: 2023-12-01 Skapad: 2023-12-01 Senast uppdaterad: 2023-12-01
Hesselink, A., Winkvist, A., Lindahl, B., Ueland, P. M., Schneede, J., Johansson, I. & Karlsson, T. (2023). Healthy Nordic diet and associations with plasma concentrations of metabolites in the choline oxidation pathway: a cross-sectional study from Northern Sweden. Nutrition Journal, 22(1), Article ID 26.
Öppna denna publikation i ny flik eller fönster >>Healthy Nordic diet and associations with plasma concentrations of metabolites in the choline oxidation pathway: a cross-sectional study from Northern Sweden
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2023 (Engelska)Ingår i: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 22, nr 1, artikel-id 26Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: The choline oxidation pathway and metabolites involved have been linked to diseases including cardiovascular disease, type 2 diabetes and cancer. A healthy Nordic diet is a recently defined dietary pattern associated with decreased risk for these diseases. Our aim was to explore associations between adherence to a healthy Nordic diet and plasma concentrations of metabolites of the choline oxidation pathway.

Methods: The Healthy Nordic Food Index (HNFI) and Baltic Sea Diet Score (BSDS) were applied to cross-sectional data (n = 969) from the Västerbotten Intervention Programme in Northern Sweden to score adherence to a healthy Nordic diet. Data included responses to a dietary questionnaire and blood sample analyses (1991–2008). Associations of diet scores with plasma concentrations of metabolites of the choline oxidation pathway and total homocysteine (tHcy), seven metabolites in total, were evaluated with linear regression, adjusting for age, BMI, education and physical activity.

Results: HNFI scores showed linear relationships with plasma choline (β = 0.11), betaine (β = 0.46), serine (β = 0.98) and tHcy (β = − 0.38), and BSDS scores with betaine (β = 0.13) and tHcy (β = − 0.13); unstandardized beta coefficients, all significant at P < 0.05. The regression models predicted changes in plasma metabolite concentrations (± 1 SD changes in diet score) in the range of 1–5% for choline, betaine, serine and tHcy. No other statistically significant associations were observed.

Conclusions: A healthy Nordic diet was associated with plasma concentrations of several metabolites of the choline oxidation pathway. Although relationships were statistically significant, effect sizes were moderate. Further research is warranted to explore the underlying mechanisms and associations with health outcomes.

Ort, förlag, år, upplaga, sidor
BioMed Central (BMC), 2023
Nyckelord
Baltic Sea Diet Score, Choline oxidation pathway, Healthy Nordic diet, Healthy Nordic Food Index, One-carbon metabolism, Västerbotten Intervention Programme
Nationell ämneskategori
Näringslära
Identifikatorer
urn:nbn:se:umu:diva-209270 (URN)10.1186/s12937-023-00853-w (DOI)000989184000001 ()37198607 (PubMedID)2-s2.0-85159701990 (Scopus ID)
Forskningsfinansiär
Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2007-0925Wilhelm och Martina Lundgrens Vetenskapsfond
Tillgänglig från: 2023-06-08 Skapad: 2023-06-08 Senast uppdaterad: 2023-09-05Bibliografiskt granskad
Strid, A., Johansson, I., Lindahl, B., Hallström, E. & Winkvist, A. (2023). Toward a more climate-sustainable diet: possible deleterious impacts on health when diet quality is ignored. Journal of Nutrition, 153(1), 242-252
Öppna denna publikation i ny flik eller fönster >>Toward a more climate-sustainable diet: possible deleterious impacts on health when diet quality is ignored
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2023 (Engelska)Ingår i: Journal of Nutrition, ISSN 0022-3166, E-ISSN 1541-6100, Vol. 153, nr 1, s. 242-252Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND: Nutritional quality, and health and climate impacts are important considerations in the design of sustainable diets.

OBJECTIVES: To investigate the association between diets varying in nutrient density and climate impact and MI and stroke HRs.

METHODS: Dietary data of 41,194 women and 39,141 men (35-65 y) who participated in a Swedish population-based cohort study were employed. Nutrient density was calculated using the Sweden-adapted Nutrient Rich Foods 11.3 index. Dietary climate impact was calculated with data from life cycle assessments, including greenhouse gas emissions from primary production to industry gate. HRs and 95% CIs for MI and stroke were assessed with multivariable Cox proportional hazards regression, comparing a least-desirable diet scenario reference group (lower nutrient density, higher climate impact) with three diet groups that varied with respect to higher/lower nutrient density and higher/lower climate impact.

RESULTS: Median follow-up time from the baseline study visit to MI or stroke diagnosis was 15.7 y for women and 12.8 y for men. The MI hazard was significantly higher for the men with diets of lower nutrient density and lower climate impact (HR: 1.19; 95% CI: 1.06, 1.33; P = 0.004), compared with the reference group. No significant association with MI was observed for any of the diet groups of women. No significant association with stroke was observed among any of the diet groups of women or men.

CONCLUSIONS: The results among men suggest some adverse health effects for men when diet quality is not considered in the pursuit of more climate-sustainable diets. For women, no significant associations were detected. The mechanism underlying this association for men needs further investigation.

Ort, förlag, år, upplaga, sidor
Elsevier, 2023
Nyckelord
carbon dioxide equivalents, cardiovascular disease, climate impact, diet quality, food frequency questionnaire, myocardial infarction, NRF index, nutrient density, nutrient profiling, stroke
Nationell ämneskategori
Näringslära
Identifikatorer
urn:nbn:se:umu:diva-206036 (URN)10.1016/j.tjnut.2022.10.004 (DOI)000948430400001 ()36913458 (PubMedID)2-s2.0-85150143358 (Scopus ID)
Forskningsfinansiär
Forskningsrådet Formas, FR-2019/0007
Tillgänglig från: 2023-03-27 Skapad: 2023-03-27 Senast uppdaterad: 2023-09-05Bibliografiskt granskad
Franklin, K. A., Lindberg, E., Svensson, J., Larsson, C., Lindahl, B., Mellberg, C., . . . Ryberg, M. (2022). Effects of a palaeolithic diet on obstructive sleep apnoea occurring in females who are overweight after menopause: a randomised controlled trial. International Journal of Obesity, 46(10), 1833-1839
Öppna denna publikation i ny flik eller fönster >>Effects of a palaeolithic diet on obstructive sleep apnoea occurring in females who are overweight after menopause: a randomised controlled trial
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2022 (Engelska)Ingår i: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 46, nr 10, s. 1833-1839Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background/Objectives: Obesity is the main risk factor for obstructive sleep apnoea, commonly occurring in females who are overweight after menopause. We aimed to study the effect of a palaeolithic diet on sleep apnoea in females with overweight after menopause from the population.

Methods: Seventy healthy, non-smoking females with a mean age of 60 years and a mean BMI of 33 kg/m2 were randomised to a palaeolithic diet or to a control low-fat diet according to Nordic Nutritional Recommendations, for 2 years. The apnoea-hypopnoea index was measured and daytime sleepiness was estimated during the intervention.

Results: The mean apnoea-hypopnoea index at baseline was 11.6 (95% CI 8.6–14.5). The mean weight loss was 7.2 kg (95% CI 5.3–9.2 kg) in the palaeolithic diet group and 3.9 kg in the control group (95% CI 1.9–5.9 kg); p < 0.021 for the group difference. The reduction in weight corresponded to a reduction in the apnoea-hypopnoea index in the palaeolithic diet group (r = 0.38, p = 0.034) but not in the control group (r = 0.08, p = 0.69). The apnoea-hypopnoea index was reduced in the palaeolithic diet group when the weight was reduced by more than 8 kg. Daytime sleepiness according to the Epworth Sleepiness Scale score and the Karolinska Sleepiness Scale score was unaffected by dietary group allocation.

Conclusions: A substantial decrease in body weight of 8 kg was needed to achieve a reduction in sleep apnoea in this small trial of women who are overweight after menopause. The palaeolithic diet was more effective for weight reduction than a control low-fat diet and the reduction in sleep apnoea was related to the degree of weight decrement within this diet group.

Trial registration: Clinicaltrials.gov: NCT00692536.

Ort, förlag, år, upplaga, sidor
Springer Nature, 2022
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
urn:nbn:se:umu:diva-198343 (URN)10.1038/s41366-022-01182-4 (DOI)000829692700001 ()35879528 (PubMedID)2-s2.0-85134643819 (Scopus ID)
Forskningsfinansiär
Hjärt-LungfondenVetenskapsrådetForte, Forskningsrådet för hälsa, arbetsliv och välfärdRegion Västerbotten
Tillgänglig från: 2022-08-01 Skapad: 2022-08-01 Senast uppdaterad: 2023-09-26Bibliografiskt granskad
Schulz, P. J., Lindahl, B., Hartung, U., Näslund, U., Norberg, M. & Nordin, S. (2022). The right pick: Does a self-assessment measurement tool correctly identify health care consumers with inadequate health literacy?. Patient Education and Counseling, 105(4), 926-932
Öppna denna publikation i ny flik eller fönster >>The right pick: Does a self-assessment measurement tool correctly identify health care consumers with inadequate health literacy?
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2022 (Engelska)Ingår i: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 105, nr 4, s. 926-932Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objectives: The aim of this study was to investigate whether a self-report measurement instrument (the Brief Health Literacy Screen, BHLS) correctly identifies healthcare consumers with inadequate health literacy. The yardstick for assessing the tool was the Newest Vital Sign (NVS).

Methods: The study used baseline data from the Västerbotten Intervention Programme - VIsualiZation of Asymptomatic Atherosclerotic disease for Optimum Cardiovascular Prevention (VIPVIZA), a randomized controlled trial that is nested within the Västerbotten Intervention Program (VIP) in Sweden. Our analyses were computed on a subsample of 460 persons who underwent the measure of both health literacy scales. ROC analysis was used for the crucial computations.

Results: The potential of the BHLS to identify healthcare consumers with inadequate health literacy remained unsatisfying for the complete sample, but reached an acceptable level for women and persons with only basic education.

Conclusions: The relationship is somewhat weaker than in comparable research in various other European countries. The differences might partly have been caused by the use of self-perception questions. Self-delusions, invariably a part of self-perception, may have affected the respective measure. Practice implications: Caution is advised when patients’ health literacy is assessed by only a few questions for self-report.

Ort, förlag, år, upplaga, sidor
Elsevier, 2022
Nyckelord
Brief Health Literacy Screen (BHLS), Health literacy, Self-report measures, Newest Vital Signs (NVS), Performance-based measures
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
urn:nbn:se:umu:diva-186967 (URN)10.1016/j.pec.2021.07.045 (DOI)000803703100017 ()34366227 (PubMedID)2-s2.0-85112665821 (Scopus ID)
Forskningsfinansiär
Hjärt-Lungfonden, 20170481Region Västerbotten, ALFVLL- 298001Region Västerbotten, ALFVLL-643391Hjärt-Lungfonden, 20150369Vetenskapsrådet, 521-2013-2708Vetenskapsrådet, 2016-01891Vetenskapsrådet, 2017-02246
Tillgänglig från: 2021-08-27 Skapad: 2021-08-27 Senast uppdaterad: 2022-08-04Bibliografiskt granskad
Strid, A., Johansson, I., Bianchi, M., Sonesson, U., Hallström, E., Lindahl, B. & Winkvist, A. (2021). Diets benefiting health and climate relate to longevity in northern Sweden. American Journal of Clinical Nutrition, 114(2), 515-529
Öppna denna publikation i ny flik eller fönster >>Diets benefiting health and climate relate to longevity in northern Sweden
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2021 (Engelska)Ingår i: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 114, nr 2, s. 515-529Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND: Diets combining adequate nutritional quality and low climate impact are highly needed for human and planet health.

OBJECTIVES: We aimed to 1) evaluate nutrient density indexes' ability to predict mortality, and 2) assess the effects of diets varying in nutrient density and climate impact on total mortality.

METHODS: Dietary data from 49,124 women and 47,651 men aged 35-65 y in the population-based prospective study Västerbotten Intervention Programme (Sweden) were used. Greenhouse gas emissions (GHGEs) were estimated using data from life cycle assessments. Fifteen variants of nutrient density indexes were evaluated and the index that best predicted mortality was used to estimate participants' nutrient density. GHGEs and nutrient density were adjusted for energy intakes. Total mortality risk was estimated by Cox proportional hazards models for 4 groups of women and men, respectively, i.e., higher nutrient density, lower climate impact (HNutr/LClim); higher nutrient density, higher climate impact (HNutr/HClim); lower nutrient density, lower climate impact (LNutr/LClim); and lower nutrient density, higher climate impact (LNutr/HClim-reference group).

RESULTS: NRF11.3, a Sweden-adapted variant of the Nutrient Rich Foods index, was identified to have the best ability to predict mortality in the study population. Median follow-up times for women and men were 16.0 and 14.7 y, respectively. For women a significantly lower mortality risk was found for HNutr/LClim (HR: 0.87; 95% CI: 0.79, 0.96; P = 0.008) and HNutr/HClim (HR: 0.87; 95% CI: 0.78, 0.97; P = 0.011) than for LNutr/HClim. Among men LNutr/LClim had a significantly higher mortality risk (HR: 1.10; 95% CI: 1.01, 1.21; P = 0.033) than LNutr/HClim.

CONCLUSIONS: Diets beneficial for both health and climate are feasible and associated with lower mortality risk in women. Further studies are needed to understand how men may transition into diets that are more sustainable from a combined health and climate perspective.

Ort, förlag, år, upplaga, sidor
Oxford University Press, 2021
Nyckelord
carbon dioxide equivalents, climate impact, diet quality, food frequency questionnaire, mortality, nutrient density index
Nationell ämneskategori
Näringslära
Identifikatorer
urn:nbn:se:umu:diva-183236 (URN)10.1093/ajcn/nqab073 (DOI)000685072000019 ()33871543 (PubMedID)2-s2.0-85103856814 (Scopus ID)
Forskningsfinansiär
Forskningsrådet Formas, 2019/0007Forte, Forskningsrådet för hälsa, arbetsliv och välfärdVetenskapsrådet
Tillgänglig från: 2021-05-19 Skapad: 2021-05-19 Senast uppdaterad: 2023-03-24Bibliografiskt granskad
Bengtsson, A., Norberg, M., Ng, N., Carlberg, B., Grönlund, C., Hultdin, J., . . . Näslund, U. (2021). The beneficial effect over 3 years by pictorial information to patients and their physician about subclinical atherosclerosis and cardiovascular risk: results from the VIPVIZA randomized clinical trial. American Journal of Preventive Cardiology, 7, Article ID 100199.
Öppna denna publikation i ny flik eller fönster >>The beneficial effect over 3 years by pictorial information to patients and their physician about subclinical atherosclerosis and cardiovascular risk: results from the VIPVIZA randomized clinical trial
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2021 (Engelska)Ingår i: American Journal of Preventive Cardiology, ISSN 2666-6677, Vol. 7, artikel-id 100199Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objective: Non-adherence to guidelines and preventive measures is a major challenge, particularly so to ob- tain long-term adherence to lifestyle changes and recommended medication. The objective was to investigate if pictorial information regarding subclinical carotid atherosclerosis provided to individuals and physicians gave sustained effects on cardiovascular risk beyond the previously reported effect after 1 year and up to 3 years. 

Methods: A Prospective Randomized Open Blinded End-point (PROBE) trial. Within a CVD prevention program in Västerbotten County, Sweden, 3532 healthy individuals aged 40, 50 or 60 years were enrolled and 1:1 ran- domized to intervention ( n = 1749; pictorial information with additional prevention materials to participants and physicians) or control group ( n = 1783; no pictorial information to participants and physicians). Preventive measures were managed within primary care. Participants were investigated at baseline during 2013–2016 and at follow-up after 1 and 3 years. 

Results: A beneficial effect on cardiovascular risk was observed at 3-year follow-up; Framingham Risk Score (FRS) was 13.38 for the intervention group and 14.08 for the control group ( p = 0.047) and SCORE was 1.69 vs. 1.82 ( p = 0.022). The effect observed at 1-year was sustained over 3 years after adjustment for sex and education and more pronounced among participants with a severe atherosclerotic picture at baseline.

Conclusions: This study provides evidence of sustained beneficial effects on the adherence to prevention guidelines over 3 years of pictorial information about subclinical carotid atherosclerosis, resulting in lower cardiovascular risk regardless of sex and educational level. Direct visualization of the underlying still subclinical atherosclerotic disease, rather than just indirect information about risk factors and statistical risk of future myocardial infarction, stroke and death, is one way to tackle the problem of non-adherence to prevention of cardiovascular diseases.

Ort, förlag, år, upplaga, sidor
Elsevier, 2021
Nyckelord
Atherosclerosis, Cardiovascular disease, Carotid ultrasound, Prevention
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi Kardiologi
Identifikatorer
urn:nbn:se:umu:diva-186686 (URN)10.1016/j.ajpc.2021.100199 (DOI)000906609200009 ()34611639 (PubMedID)2-s2.0-85130772460 (Scopus ID)
Anmärkning

Originally included in thesis in manuscript form.

Tillgänglig från: 2021-08-18 Skapad: 2021-08-18 Senast uppdaterad: 2023-07-07Bibliografiskt granskad
Hjorth, T., Huseinovic, E., Hallström, E., Strid, A., Johansson, I., Lindahl, B., . . . Winkvist, A. (2020). Changes in dietary carbon footprint over ten years relative to individual characteristics and food intake in the Västerbotten Intervention Programme. Scientific Reports, 10(1), Article ID 20.
Öppna denna publikation i ny flik eller fönster >>Changes in dietary carbon footprint over ten years relative to individual characteristics and food intake in the Västerbotten Intervention Programme
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2020 (Engelska)Ingår i: Scientific Reports, E-ISSN 2045-2322, Vol. 10, nr 1, artikel-id 20Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

The objective was to examine 10-year changes in dietary carbon footprint relative to individual characteristics and food intake in the unique longitudinal Västerbotten Intervention Programme, Sweden. Here, 14 591 women and 13 347 men had been followed over time. Food intake was assessed via multiple two study visits 1996-2016, using a 64-item food frequency questionnaire. Greenhouse gas emissions (GHGE) related to food intake, expressed as kg carbon dioxide equivalents/1000 kcal and day, were estimated. Participants were classified into GHGE quintiles within sex and 10-year age group strata at both visits. Women and men changing from lowest to highest GHGE quintile exhibited highest body mass index within their quintiles at first visit, and the largest increase in intake of meat, minced meat, chicken, fish and butter and the largest decrease in intake of potatoes, rice and pasta. Women and men changing from highest to lowest GHGE quintile exhibited basically lowest rates of university degree and marriage and highest rates of smoking within their quintiles at first visit. Among these, both sexes reported the largest decrease in intake of meat, minced meat and milk, and the largest increase in intake of snacks and, for women, sweets. More research is needed on how to motivate dietary modifications to reduce climate impact and support public health.

Ort, förlag, år, upplaga, sidor
Nature Publishing Group, 2020
Nationell ämneskategori
Näringslära
Identifikatorer
urn:nbn:se:umu:diva-167833 (URN)10.1038/s41598-019-56924-8 (DOI)000511420200002 ()31913331 (PubMedID)2-s2.0-85077597900 (Scopus ID)
Tillgänglig från: 2020-02-05 Skapad: 2020-02-05 Senast uppdaterad: 2023-03-24Bibliografiskt granskad
Organisationer
Identifikatorer
ORCID-id: ORCID iD iconorcid.org/0000-0002-6677-1866

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