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Nyström Hagfors, LindaORCID iD iconorcid.org/0000-0001-9720-834X
Alternative names
Publications (10 of 20) Show all publications
Hagström, H., Nyström Hagfors, L., Hedelin, R., Brunström, M. & Lindmark, K. (2025). Low carbohydrate high fat-diet in real life: a descriptive analysis of cardiovascular risk factors. International Journal of Cardiology: Cardiovascular Risk and Prevention, 25, Article ID 200384.
Open this publication in new window or tab >>Low carbohydrate high fat-diet in real life: a descriptive analysis of cardiovascular risk factors
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2025 (English)In: International Journal of Cardiology: Cardiovascular Risk and Prevention, E-ISSN 2772-4875, Vol. 25, article id 200384Article in journal (Refereed) Published
Abstract [en]

Aims: Low Carbohydrate High Fat (LCHF) diets are popular for weight loss or glucose control. The main source of energy in such diets is fat but the composition of nutrients varies. This study aims to investigate dietary variations in a real-world LCHF population and its associations with cardiovascular risk factors.

Methods: We recruited 100 volunteers who considered themselves adherent to a LCHF diet. Their last 14 days of dietary intake was assessed using diet history interviews. Validation of energy intake against expenditure was made using activity monitors. Predictive variables for the linear regression models were selected using stepwise bidirectional assessment of Akaike information criterion (AIC).

Results: Energy intake (E%) from carbohydrates was low, 8.7 E%, and fat was the main replacement. Dietary cholesterol was associated with higher total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL). Dietary sodium intake was associated with higher blood pressure. Protein intake was associated with lower diastolic blood pressure but also with lower HDL. The intake of dietary fibre was associated with lower LDL and total cholesterol but with higher hemoglobin A1c (HbA1c). The intake of carbohydrates and saturated fatty acids (SFA) was not associated with any of the outcome variables.

Conclusion: In this LCHF population, variations in intake of carbohydrates and saturated fatty acids could not predict any aspects of the cardiovascular risk profile. Lower fibre intake and higher cholesterol and sodium intake predicted a less favorable cardiovascular risk profile.

Place, publisher, year, edition, pages
Elsevier, 2025
Keywords
"Diet, carbohydrate-Restricted", "Diet, high-fat", "Diet, ketogenic", "Heart disease risk factors"
National Category
Cardiology and Cardiovascular Disease Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-237692 (URN)10.1016/j.ijcrp.2025.200384 (DOI)001448244900001 ()40166766 (PubMedID)2-s2.0-86000503326 (Scopus ID)
Available from: 2025-04-17 Created: 2025-04-17 Last updated: 2026-07-02Bibliographically approved
Hagström, H., Nyström Hagfors, L., Tellström, A., Hedelin, R. & Lindmark, K. (2023). Low carbohydrate high fat-diet in real life assessed by diet history interviews. Nutrition Journal, 22(1), Article ID 14.
Open this publication in new window or tab >>Low carbohydrate high fat-diet in real life assessed by diet history interviews
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2023 (English)In: Nutrition Journal, E-ISSN 1475-2891, Vol. 22, no 1, article id 14Article in journal (Refereed) Published
Abstract [en]

Background: Low carbohydrate high fat (LCHF) diet has been a popular low carbohydrate diet in Sweden for 15 years. Many people choose LCHF to lose weight or control diabetes, but there are concerns about the effect on long-term cardiovascular risks. There is little data on how a LCHF diet is composed in real-life. The aim of this study was to evaluate the dietary intake in a population with self-reported adherence to a LCHF diet.

Methods: A cross-sectional study of 100 volunteers that considered themselves eating LCHF was conducted. Diet history interviews (DHIs) and physical activity monitoring for validation of the DHIs were performed.

Results: The validation shows acceptable agreement of measured energy expenditure and reported energy intake. Median carbohydrate intake was 8.7 E% and 63% reported carbohydrate intake at potentially ketogenic levels. Median protein intake was 16.9 E%. The main source of energy was dietary fats (72.0 E%). Intake of saturated fat was 32 E% and cholesterol was 700 mg per day, both of which exceeded the recommended upper limits according to nutritional guidelines. Intake of dietary fiber was very low in our population. The use of dietary supplements was high, and it was more common to exceed the recommended upper limits of micronutrients than to have an intake below the lower limits.

Conclusions: Our study indicates that in a well-motivated population, a diet with very low carbohydrate intake can be sustained over time and without apparent risk of deficiencies. High intake of saturated fats and cholesterol as well as low intake of dietary fiber remains a concern.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Low carbohydrate diet, Low Carbohydrate High Fat, LCHF, Diet history interview, Saturated fatty acids, Cholesterol, Fiber
National Category
Nutrition and Dietetics
Research subject
Nutrition
Identifiers
urn:nbn:se:umu:diva-205602 (URN)10.1186/s12937-023-00847-8 (DOI)000942804500001 ()36864479 (PubMedID)2-s2.0-85149275759 (Scopus ID)
Available from: 2023-03-09 Created: 2023-03-09 Last updated: 2025-02-11Bibliographically approved
Patomella, L., Nyström Hagfors, L. & Norderyd, O. (2018). PR156 – Dietary intake in relation to oral health in adults with severe periodontitis. Paper presented at EuroPerio9 - June 20-23 2018, Amsterdam. Journal of Clinical Periodontology, 45(S19), 172-173
Open this publication in new window or tab >>PR156 – Dietary intake in relation to oral health in adults with severe periodontitis
2018 (English)In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 45, no S19, p. 172-173Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background & Aim: Periodontitis is a chronic disease which can result in progressive loss of the teeth's supportive tissue. About 40% of the world's population is affected by periodontitis of which approximately 10% have a severe form. Periodontitis can affect the dietary intake for diseased individuals due to mobile teeth that making it painful to eat or by missing teeth. The aim of the study was to investigate self-assessed oral health in relation to dietary intake in adult individuals with severe periodontitis treated in specialist-dental care. The aim was also to study self-assessed oral health and dietary intake in relation to the number of teeth, age and sex.

Methods: The study was a cross-sectional study including 62 participants. The material was collected via questionnaires regarding background and the areas of oral health and dietary intake. Participants were recruited via a special-dental care clinic in Sweden during September 2017. Referred patients diagnosed with severe periodontitis were invited to participate in the study and the participation was confidential. Chi-square test, Fisher's exact test and Mann Whitney U test were used. Alpha was set at p<0.05.

Results: Half of the participants reported that their oral health condition constituted an obstacle to eating the foods they wanted. Participants who had ≥20 teeth ate fruits and berries, red meat, fish and poultry more often than participants with fewer teeth. Participants with ≤19 teeth assessed their chewing and biting ability as poorer than individuals with ≥20 teeth.

Conclusion: The result shows that a large proportion of the participants with periodontitis experience that their oral health affects dietary intake . Multidisciplinary collaboration between dental care and dietitian clinic could increase the ability to prevent and/or treat further ill-health in individuals with periodontitis that adversely affects the energy and nutritional intake due to oral health condition.

Disclosure: No significant relationships.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
National Category
Nutrition and Dietetics
Research subject
Food and Nutrition
Identifiers
urn:nbn:se:umu:diva-156979 (URN)10.1111/jcpe.157_12915 (DOI)
Conference
EuroPerio9 - June 20-23 2018, Amsterdam
Available from: 2019-03-04 Created: 2019-03-04 Last updated: 2025-02-11Bibliographically approved
Kautto, E., Rydén, P., Ivarsson, A., Olsson, C., Norström, F., Högberg, L., . . . Hörnell, A. (2014). What happens to food choices when a gluten-free diet is required?: A prospective longitudinal population-based study among Swedish adolescent with coeliac disease and their peers. Journal of Nutritional Science, 3(e2)
Open this publication in new window or tab >>What happens to food choices when a gluten-free diet is required?: A prospective longitudinal population-based study among Swedish adolescent with coeliac disease and their peers
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2014 (English)In: Journal of Nutritional Science, E-ISSN 2048-6790, Vol. 3, no e2Article in journal (Refereed) Published
Abstract [en]

A dietary survey was performed during a large screening study in Sweden among 13-year-old adolescents. The aim was to study how the intake of food groups was affected by a screening-detected diagnosis of celiac disease (CD) and its gluten-free (GF) treatment. Food intake, was reported using a food frequency questionnaires (FFQ) and intake reported by the adolescents who was screened to CD was compared with the intake of two same-aged referent groups: i) adolescents diagnosed to CD prior screening and ii) adolescents without CD.. The food intake groups were measured at baseline before the screening-detected cases were aware of their CD, and 12-18 months later.

The result showed that the food intakes are affected by a screen detected CD and its dietary treatment. Many flour-based foods were reduced such as pizza, fish fingers, and pastries. The result also indicated that the bread intake was lower before the screened diagnosis compared to the other studied groups, but increased afterwards. Specially manufactured GF-products (e.g. pasta and bread) were frequently used in the screened CDgroup after changing to a GF-diet. Our results suggest that changing to a GF-diet reduces the intake of some popular foods, and the ingredients on the plate are altered, but this do not necessarily include a change of food groups. The availability of manufactured GF-replacement products makes it possible for adolescents to keep many of their old food habits when diagnosed with CD in Sweden.

Place, publisher, year, edition, pages
Cambridge University Press, 2014
Keywords
celiac disease, gluten-free diet, food choices, screening
National Category
Gastroenterology and Hepatology
Identifiers
urn:nbn:se:umu:diva-86027 (URN)10.1017/jns.2013.24 (DOI)
Available from: 2014-02-17 Created: 2014-02-14 Last updated: 2025-02-11Bibliographically approved
Rydén, P. & Hagfors, L. (2011). Diet cost, diet quality and socio-economic position: how are they related and what contributes to differences in diet costs?. Public Health Nutrition, 14(9), 1680-1692
Open this publication in new window or tab >>Diet cost, diet quality and socio-economic position: how are they related and what contributes to differences in diet costs?
2011 (English)In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 14, no 9, p. 1680-1692Article in journal (Refereed) Published
Abstract [en]

Objective: To examine diet costs in relation to dietary quality and socio-economic position, and to investigate underlying reasons for differences in diet costs.

Design: Dietary intake was assessed by a 4 d food diary and evaluated using the 2005 Healthy Eating Index (HEI). National consumer food prices collected by Statistics Sweden and from two online stores/supermarkets were used to estimate diet costs.

Setting: Sweden.

Subjects: A nationally representative sample of 2160 children aged 4, 8 or 11 years.

Results: Higher scores on the HEI resulted in higher diet costs and, conversely, higher diet costs were linked to increased total HEI scores. Children who consumed the most healthy and/or expensive diets ate a more energy-dilute and varied diet compared with those who ate the least healthy and/or least expensive diets. They also consumed more fish, ready meals and fruit. Regression analysis also linked increased food costs to these food groups. There was a positive, but weak, relationship between HEI score and diet cost, parental education and parental occupation respectively.

Conclusions: Healthy eating is associated with higher diet cost in Swedish children, in part because of price differences between healthy and less-healthy foods. The cheapest and most unhealthy diets were found among those children whose parents were the least educated and had manual, low-skill occupations. Our results pose several challenges for public health policy makers, as well as for nutrition professionals, when forming dietary strategies and providing advice for macro- and microlevels in society.

Place, publisher, year, edition, pages
Cambridge University Press, 2011
Keywords
Diet cost, Food prices, Diet quality, Healthy eating index, Socio-economic position
National Category
Nutrition and Dietetics Public Health, Global Health and Social Medicine
Research subject
Food and Nutrition
Identifiers
urn:nbn:se:umu:diva-39359 (URN)10.1017/S1368980010003642 (DOI)2-s2.0-82555173824 (Scopus ID)
Note
FirstView Article,Published online: 24 January 2011 Available from: 2011-02-01 Created: 2011-01-25 Last updated: 2025-02-20Bibliographically approved
Ryden, P., Mattsson Sydner, Y. & Hagfors, L. (2008). Counting the cost of healthy eating: a Swedish comparison of Mediterranean-style and ordinary diets. International Journal of Consumer Studies, 32(2), 138-146
Open this publication in new window or tab >>Counting the cost of healthy eating: a Swedish comparison of Mediterranean-style and ordinary diets
2008 (English)In: International Journal of Consumer Studies, ISSN 1470-6423, E-ISSN 1470-6431, Vol. 32, no 2, p. 138-146Article in journal (Refereed) Published
Abstract [en]

The aim of this research was to examine the cost of a diet generally regarded as healthy, a Swedish version of the Mediterranean diet, and to compare it with the cost of an ordinary Swedish diet. A total of 30 individuals provided detailed dietary data collected in a randomized intervention study, examining the effect of dietary change to a Mediterranean-style diet in patients with rheumatoid arthritis (Mediterranean group, n = 16, control group, n = 14). The data, covering 1-month dietary intake, were examined with three different diet quality indicators to see whether the Mediterranean group consumed a healthier diet than the control group. All diet quality indicators showed that the Mediterranean group consumed a healthier diet than the control group. Consumer food prices were used to analyse the cost of the different diets. In immediate consumer cost terms, eating a healthier diet was more expensive when differences in energy intake were discounted. However, non-energy adjusted costs showed no significant difference between the groups. Hence, if one of the reasons for choosing a healthier diet is to achieve weight loss – by consuming less energy – it is possible that healthier eating is not more expensive.

Keywords
Healthy diet, Mediterranean diet, Food cost, Economics, Sweden, Healthy diet index
National Category
Food Science
Research subject
Food and Nutrition
Identifiers
urn:nbn:se:umu:diva-9093 (URN)10.1111/j.1470-6431.2007.00656.x (DOI)2-s2.0-74449083330 (Scopus ID)
Available from: 2008-03-28 Created: 2008-03-28 Last updated: 2024-07-02Bibliographically approved
Sundström, B., Stålnacke, K., Hagfors, L. & Johansson, G. (2006). Supplementation of Omega-3 fatty acids in patients with ankylosing spondylitis. Scandinavian Journal of Rheumatology, 35, 359-362
Open this publication in new window or tab >>Supplementation of Omega-3 fatty acids in patients with ankylosing spondylitis
2006 (English)In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 35, p. 359-362Article in journal (Refereed) Published
Abstract [en]

Objective: To study the effect of supplementation with omega‐3 fatty acids on disease variables and drug consumption in patients with ankylosing spondylitis (AS).

Methods: Twenty‐four patients were randomized to either a low‐dose (1.95 g omega‐3/day) or a high‐dose (4.55 g omega‐3/day) supplement. Disease activity, functional impairment, erythrocyte sedimentation rate (ESR), and drug consumption were assessed during visits at baseline and at weeks 7, 14, and 21.

Results: Eighteen patients completed the study, nine patients from each group. The patients in the high‐dose group exhibited a significant decrease in disease activity according to the Bath Ankylosing Disease Activity Index (BASDAI; p = 0.038), which was not seen in the low‐dose group. Significant differences were not found on drug consumption or in functional capacity in either of the groups. No significant differences were found when comparing the results between the high‐ and low‐dose groups.

Conclusion: Omega‐3 fatty acids in adequate doses may have the capacity to decrease the disease activity of AS. However, larger and better controlled studies are needed before any further conclusions can be made on the extent of this capacity.

Read More: http://informahealthcare.com/doi/abs/10.1080/03009740600844357

National Category
Clinical Medicine
Research subject
Food and Nutrition
Identifiers
urn:nbn:se:umu:diva-13549 (URN)10.1080/03009740600844357 (DOI)2-s2.0-33750158774 (Scopus ID)
Available from: 2007-05-11 Created: 2007-05-11 Last updated: 2025-02-18Bibliographically approved
Hagfors, L., Westerterp, K., Sköldstam, L. & Johansson, G. (2006). Validity of the reported energy expenditure and the reported dietary intake of rheumatoid arthritis patients in a dietary intervention study. In: Paper presented at Sixth International Conference on Dietary Assessment Methods, Köpenhamn, Danmark 27-29 april 2006. Köpenhamn, Danmark
Open this publication in new window or tab >>Validity of the reported energy expenditure and the reported dietary intake of rheumatoid arthritis patients in a dietary intervention study
2006 (English)In: Paper presented at Sixth International Conference on Dietary Assessment Methods, Köpenhamn, Danmark 27-29 april 2006, Köpenhamn, Danmark, 2006Conference paper, Published paper (Refereed)
Place, publisher, year, edition, pages
Köpenhamn, Danmark: , 2006
Series
International Conference on Dietary Assessment Methods ; 6
Research subject
Food and Nutrition
Identifiers
urn:nbn:se:umu:diva-13554 (URN)
Note
Paper presented at Sixth International Conference on Dietary Assessment Methods, Köpenhamn, Danmark 27-29 april 2006Available from: 2007-05-11 Created: 2007-05-11 Last updated: 2024-07-02
Hagfors, L. (2005). A Mediterranean dietary intervention study of patients with rheumatoid arthritis. Scandinavian Journal of Nutrition/Næringsforskning, 49(1), 42
Open this publication in new window or tab >>A Mediterranean dietary intervention study of patients with rheumatoid arthritis
2005 (English)In: Scandinavian Journal of Nutrition/Næringsforskning, ISSN 1102-6480, E-ISSN 1651-2359, Vol. 49, no 1, p. 42-Article in journal (Other academic) Published
Place, publisher, year, edition, pages
Taylor & Francis, 2005
Research subject
Food and Nutrition
Identifiers
urn:nbn:se:umu:diva-13568 (URN)10.1080/11026480510011370 (DOI)2-s2.0-17144363629 (Scopus ID)
Available from: 2007-05-11 Created: 2007-05-11 Last updated: 2024-07-02
Hagfors, L., Nilsson, I., Sköldstam, L. & Johansson, G. (2005). Fat intake and composition of fatty acids in serum phospholipids in a randomized, controlled, parallel, Mediterranean dietary intervention study on patients with rheumatoid arthritis. Nutrition and Metabolism
Open this publication in new window or tab >>Fat intake and composition of fatty acids in serum phospholipids in a randomized, controlled, parallel, Mediterranean dietary intervention study on patients with rheumatoid arthritis
2005 (English)In: Nutrition and MetabolismArticle in journal (Refereed) Published
Research subject
Food and Nutrition
Identifiers
urn:nbn:se:umu:diva-5397 (URN)
Available from: 2007-05-14 Created: 2007-05-14 Last updated: 2024-07-02
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-9720-834X

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