Publications (16)30.83 Total impact
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Article: Reliability and intermethod agreement for body fat assessment among two field and two laboratory methods in adolescents.
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ABSTRACT: To increase knowledge about reliability and intermethods agreement for body fat (BF) is of interest for assessment, interpretation, and comparison purposes. It was aimed to examine intra- and inter-rater reliability, interday variability, and degree of agreement for BF using air-displacement plethysmography (Bod-Pod), dual-energy X-ray absorptiometry (DXA), bioelectrical impedance analysis (BIA), and skinfold measurements in European adolescents. Fifty-four adolescents (25 females) from Zaragoza and 30 (14 females) from Stockholm, aged 13-17 years participated in this study. Two trained raters in each center assessed BF with Bod-Pod, DXA, BIA, and anthropometry (DXA only in Zaragoza). Intermethod agreement and reliability were studied using a 4-way ANOVA for the same rater on the first day and two additional measurements on a second day, one each rater. Technical error of measurement (TEM) and percentage coefficient of reliability (%R) were also reported. No significant intrarater, inter-rater, or interday effect was observed for %BF for any method in either of the cities. In Zaragoza, %BF was significantly different when measured by Bod-Pod and BIA in comparison with anthropometry and DXA (all P < 0.001). The same result was observed in Stockholm (P < 0.001), except that DXA was not measured. Bod-Pod, DXA, BIA, and anthropometry are reliable for %BF repeated assessment within the same day by the same or different raters or in consecutive days by the same rater. Bod-Pod showed close agreement with BIA as did DXA with anthropometry; however, Bod-Pod and BIA presented higher values of %BF than anthropometry and DXA.Obesity 08/2011; 20(1):221-8. · 4.28 Impact Factor -
Article: Reliability and Intermethod Agreement for Body Fat Assessment Among Two Field and Two Laboratory Methods in Adolescents
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ABSTRACT: To increase knowledge about reliability and intermethods agreement for body fat (BF) is of interest for assessment, interpretation, and comparison purposes. It was aimed to examine intra- and inter-rater reliability, interday variability, and degree of agreement for BF using air-displacement plethysmography (Bod-Pod), dual-energy X-ray absorptiometry (DXA), bioelectrical impedance analysis (BIA), and skinfold measurements in European adolescents. Fifty-four adolescents (25 females) from Zaragoza and 30 (14 females) from Stockholm, aged 13–17 years participated in this study. Two trained raters in each center assessed BF with Bod-Pod, DXA, BIA, and anthropometry (DXA only in Zaragoza). Intermethod agreement and reliability were studied using a 4-way ANOVA for the same rater on the first day and two additional measurements on a second day, one each rater. Technical error of measurement (TEM) and percentage coefficient of reliability (%R) were also reported. No significant intrarater, inter-rater, or interday effect was observed for %BF for any method in either of the cities. In Zaragoza, %BF was significantly different when measured by Bod-Pod and BIA in comparison with anthropometry and DXA (all P < 0.001). The same result was observed in Stockholm (P < 0.001), except that DXA was not measured. Bod-Pod, DXA, BIA, and anthropometry are reliable for %BF repeated assessment within the same day by the same or different raters or in consecutive days by the same rater. Bod-Pod showed close agreement with BIA as did DXA with anthropometry; however, Bod-Pod and BIA presented higher values of %BF than anthropometry and DXA.Obesity 08/2011; 20(1):221-228. · 4.28 Impact Factor -
Article: Polyamines: total daily intake in adolescents compared to the intake estimated from the Swedish Nutrition Recommendations Objectified (SNO).
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ABSTRACT: Dietary polyamines have been shown to give a significant contribution to the body pool of polyamines. Knowing the levels of polyamines (putrescine, spermidine, and spermine) in different foods and the contribution of daily food choice to polyamine intake is of interest, due to the association of these bioactive amines to health and disease. To estimate polyamine intake and food contribution to this intake in adolescents compared to a diet fulfilling the Swedish Nutrition Recommendations. A cross-sectional study of dietary intake in adolescents and an 'ideal diet' (Swedish nutrition recommendations objectified [SNO]) list of foods was used to compute polyamine intake using a database of polyamine contents of foods. For polyamine intake estimation, 7-day weighed food records collected from 93 adolescents were entered into dietetic software (Dietist XP) including data on polyamine contents of foods. The content of polyamines in foods recommended according to SNO was entered in the same way. The adolescents' mean daily polyamine intake was 316±170 µmol/day, while the calculated contribution according to SNO was considerably higher with an average polyamine intake of 541 µmol/day. In both adolescent's intake and SNO, fruits contributed to almost half of the total polyamine intake. The reason why the intake among the adolescents was lower than the one calculated from SNO was mainly due to the low vegetable consumption in the adolescents group. The average daily total polyamine intake was similar to that previously reported in Europe. With an 'ideal' diet according to Swedish nutrition recommendations, the intake of this bioactive non-nutrient would be higher than that reported by our adolescents and also higher than that previously reported from Europe.Food & Nutrition Research 01/2011; 55. -
Article: Polyamines in foods: development of a food database.
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ABSTRACT: Knowing the levels of polyamines (putrescine, spermidine, and spermine) in different foods is of interest due to the association of these bioactive nutrients to health and diseases. There is a lack of relevant information on their contents in foods. To develop a food polyamine database from published data by which polyamine intake and food contribution to this intake can be estimated, and to determine the levels of polyamines in Swedish dairy products. Extensive literature search and laboratory analysis of selected Swedish dairy products. Polyamine contents in foods were collected using an extensive literature search of databases. Polyamines in different types of Swedish dairy products (milk with different fat percentages, yogurt, cheeses, and sour milk) were determined using high performance liquid chromatography (HPLC) equipped with a UV detector. Fruits and cheese were the highest sources of putrescine, while vegetables and meat products were found to be rich in spermidine and spermine, respectively. The content of polyamines in cheese varied considerably between studies. In analyzed Swedish dairy products, matured cheese had the highest total polyamine contents with values of 52.3, 1.2, and 2.6 mg/kg for putrescine, spermidine, and spermine, respectively. Low fat milk had higher putrescine and spermidine, 1.2 and 1.0 mg/kg, respectively, than the other types of milk. The database aids other researchers in their quest for information regarding polyamine intake from foods. Connecting the polyamine contents in food with the Swedish Food Database allows for estimation of polyamine contents per portion.Food & Nutrition Research 01/2011; 55. -
Article: Differences in prevalence of overweight and stunting in 11-year olds across Europe: The Pro Children Study.
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ABSTRACT: To assess country differences in prevalence of overweight, obesity, underweight and stunting in the Pro Children Survey. A cross-sectional study conducted in a random sample of schools in nine European countries in 2003. The subjects were 8317 11-year-old children from Austria, Belgium, Denmark, Iceland, The Netherlands, Norway, Portugal, Spain and Sweden. Parents reported height and weight of the children, and BMI values were analysed using the US Centers of Disease Control and Prevention and the International Obesity Task Force reference populations. Continuous variables were compared with one-way analysis of variance (ANOVA) with Games-Howell post hoc tests. Categorical variables were analysed using chi-square tests. The prevalence of overweight + obesity varied between the countries from 8.6% to 30.6% and 5.9% to 26.5%, respectively, depending on the reference population, with the lowest prevalence in Dutch girls, the highest in Portuguese boys. Obesity prevalence varied from 1.1% (Dutch and Danish girls) to 10.7% (Portuguese boys) and from 0.3% (Dutch girls) to 6.2% (Portuguese boys), respectively. Portugal and Spain had the highest prevalence of overweight and obesity for both genders. The ranking of the countries according to overweight and obesity prevalence was roughly the same, independent of reference population. The prevalence of underweight varied from 2.3% (Swedish boys) to 12.3% (Belgian boys), using the American reference population. The proportion of stunted children was highest in Portugal, Spain and Belgium. The highest levels of overweight, obesity and stunting in the pro children material are found in Portugal and Spain.The European Journal of Public Health 05/2008; 18(2):126-30. · 2.73 Impact Factor -
Article: Dietary intake among under-, normal- and overweight 9- and 15-year-old Estonian and Swedish schoolchildren.
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ABSTRACT: To determine the differences in macronutrient and food group contribution to total food and energy intakes between Estonian and Swedish under-, normal- and overweight schoolchildren, and to estimate the association between diet and body mass index (BMI). Cross-sectional comparison between Estonian and Swedish children and adolescents of different BMI groups. Twenty-five schools from one region in Estonia and 42 in two regions of central Sweden. In total 2308 participants (1176 from Estonia and 1132 from Sweden), including 1141 children with a mean age of 9.6 +/- 0.5 years and 1167 adolescents with a mean age of 15.5 +/- 0.6 years. Overweight was more prevalent among younger girls in Sweden (17.0 vs. 8.9%) and underweight among girls of both age groups in Estonia (7.9 vs. 3.5% in younger and 10.5 vs. 5.1% in older age group of girls). Compared with that of normal- and underweight peers, the diet of overweight Estonian children contained more energy as fat (36.8 vs. 31.7%) but less as carbohydrates, and they consumed more milk and meat products. Absolute BMI of Estonian participants was associated positively with energy consumption from eggs and negatively with energy consumption from sweets and sugar. Swedish overweight adolescents tended to consume more energy from protein and milk products. Risk of being overweight was positively associated with total energy intake and energy from fish or meat products. In both countries the association of overweight and biological factors (pubertal maturation, parental BMI) was stronger than with diet. The finding that differences in dietary intake between under-, normal- and overweight schoolchildren are country-specific suggests that local dietary habits should be considered in intervention projects addressing overweight.Public Health Nutrition 04/2007; 10(3):311-22. · 2.17 Impact Factor -
Article: A dropout analysis of the second phase of the Swedish part of the European Youth Heart Study
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ABSTRACT: The European Youth Heart Study (EYHS) addresses cardiovascular disease risk factors and their determinants in European children and adolescents. The Swedish part of the study began with cross-sectional data collection in 9- and 15-year-old schoolchildren in 1998–1999 (EYHS-I). Repeated observations of the key indicators were performed in 2004–2005 (EYHS-II). The purpose of this study was to assess potential dropout effects in EYHS-II. Participants in both EYHS-I and EYHS-II (n=459) were compared with dropouts who participated only in the EYHS-I (n=678) in relation to baseline physical activity, cardiorespiratory fitness and socioeconomic and anthropometric characteristics. Bivariate comparisons were performed using chi-square tests and gamma tests for nominal and ordinal data, respectively. Continuous data were compared by t tests and Mann−Whitney tests depending on the distribution. The Bonferroni correction was used to control for multiple hypothesis testing. Multiple logistic regression with backward elimination of variables was applied to study independent effects of variables on the probability of becoming a dropout. Analyses were performed separately for the younger and older age groups. The dropout proportion in EYHS-II was 60%. Subjects from the older age group were less likely to participate in the follow-up study (32% vs. 50%, p<0.001). In bivariate analyses, only maternal education was associated with dropout rates in the younger age group after Bonferroni correction. Males were more likely to drop out in both younger [odds ratio (OR)=1.72; 95% confidence interval (CI): 1.10, 2.96] and older (OR=1.96; 95% CI: 1.09, 3.54) age groups while basic maternal education was associated with outcome only in the younger group (OR=4.31; 95% CI: 1.78, 2.95) in regression analysis. The Swedish EYHS-II had high dropout rate after EYHS-I, but the dropouts did not differ from the participants in relation to physical activity, physical fitness, and anthropometric indices. Males were more likely to drop out than were females in both age groups. Differential dropout in relation to maternal education was observed in the younger age group.Journal of Public Health 01/2006; 14(5):261-268. · 2.06 Impact Factor -
Article: Monitoring Public Health Nutrition in Europe: nutritional indicators and determinants of health status
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ABSTRACT: Public Health Nutrition (PHN) focuses on the promotion of good health through healthy food habits, a physically active lifestyle and the prevention of related illness in the population. Monitoring PHN in Europe has been a project within the European Health Monitoring System (HMS), currently under development by the EU Commission within the Health Information Strand of the Public Health Programme 2003–2008. The project aims were to: (1) develop a theoretical framework for the selection and prioritization of indicators; (2) identify indicators relevant to the monitoring; (3) examine the nutritional aspects and proposals from other monitoring projects; (4) consider other novel proposals; (5) integrate these into a recommended list of indicators; (6) integrate the surveillance system into training and educational systems, in particular the Program for the European Masters in PHN. Seven main categories for investigation were identified: health promotion; food and nutrient intake, including breastfeeding and alcohol; nutritional status, physical activity habits and fitness; sociodemographic factors; inequality. Three working parties provided useful comments on the prioritizing of the many indicators. These comments were then fed to the coordinators in the Executive Committee, who further developed a prioritization scheme and produced the list of recommended indicators. The Report Committee took responsibility for preparing the report. Meanwhile experience was presented and discussed at several international meetings. The information was finally transferred to the coordinator project, the ECHI (European Core Health Indicator) project, for inclusion of relevant indicators in the ECHI lists. Information was also disseminated through publications and newsletters, and through training at the Masters and PhD levels across Europe. In most cases, operational measures could be defined in detail from their generic indicators. Standardized methods for data collection were also given. In future, we recommend that all European countries, and/or the HMS, should add questions to their surveys, according to the list of recommended indicators, to ensure that all the relevant areas of PHN are covered.Journal of Public Health 02/2005; 13(2):74-83. · 2.06 Impact Factor -
Article: The European Youth Heart Survey (EYHS): an international study that addresses the multi-dimensional issues of CVD risk factors.
Forum of nutrition 02/2003; 56:254-6. -
Article: Adolescent nutrition--a multidimensional challenge.
Forum of nutrition 02/2003; 56:253-4. -
Article: Physical activity in relation to aerobic fitness and body fat in 14- to 15-year-old boys and girls
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ABSTRACT: The purpose of this study was to examine the strength of the relationship between different variables of physical activity and aerobic fitness and body fat in adolescent boys and girls. Activity energy expenditure (AEE), time spent in a sedentary state, and time spent engaged in moderate and vigorous physical activity (MVPA, ≥50% peak oxygen uptake, ) were assessed by the minute-by-minute heart rate monitoring method in 82 randomly selected 14- to 15-year olds (42 boys, 40 girls). Body fat was determined by measuring skinfold thicknesses. was measured by indirect calorimetry. Somatic maturity level was determined by percentages of adult (i.e. 18years) height attained at examination. AEE was related to aerobic fitness for both genders (boys, r=0.30, P=0.056; girls, r=0.45, P=0.003). For boys, there was a significant relationship between maturity level and (r=0.48, P<0.001). For both genders, body fat was significantly and negatively related to (r=–0.48 and r=–0.43, P<0.01). Body fat and maturity explained 47% of the variation in in boys, whereas AEE and body fat explained 22% of the variation in in girls. No significant associations between physical activity variables and the data on body fat were observed. The total amount of physical activity (AEE) was related to , at least in adolescent girls. Although seems to be influenced by the maturity level in adolescent boys, the data support the promotion of a daily active lifestyle among young people.Arbeitsphysiologie 07/2001; 85(3):195-201. · 2.15 Impact Factor -
Article: Physical activity assessed by activity monitor and doubly labeled water in children
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ABSTRACT: EKELUND, U., M. SJÖSTRÖM, A. YNGVE, E. POORTVLIET, A. NILSSON, K. FROBERG, N. WEDDERKOPP, and K. WESTERTERP. Physical activity assessed by activity monitor and doubly labeled water in children. Med. Sci. Sports Exerc., Vol. 33, No. 2, pp. 275-281, 2001. Purpose: To validate the Computer Science and Application's (CSA) activity monitor for assessment of the total amount of physical activity during two school-weeks in 9-yr-old children and to develop equations to predict total energy expenditure (TEE) and activity energy expenditure (AEE) from activity counts and anthropometric variables. Methods: A total of 26 children (15 boys and 11 girls, mean age 9.1 ± 0.3 yr) were monitored for 14 consecutive days. TEE was simultaneously measured by the doubly labeled water method. Averaged activity counts (counts·min-1) were compared with data on: 1) TEE, 2) AEE = TEE minus basal metabolic rate (BMR; estimated from predictive equations), and 3) daily physical activity level (PAL = TEE/BMR). Results: Physical activity determined by activity counts was significantly related to the data on energy expenditures: TEE (r = 0.39;P < 0.05), AEE (r = 0.54;P < 0.01), and PAL (r = 0.58;P < 0.01). Multiple stepwise regression analysis showed that TEE was significantly influenced by gender, body composition (body weight or fat free mass), and activity counts (R2 = 0.54-0.60). AEE was significantly influenced by activity counts and gender (R2 = 0.45). There were no significant differences between activity counts and PAL in discriminating among activity levels with low (PAL < 1.56), moderate (1.57 ≤ PAL ≥ 1.81), and high (PAL > 1.81) intensity. Conclusion: Activity counts from the CSA activity monitor seems to be a useful measure of the total amount of physical activity in 9-yr-old children. Activity counts contributed significantly to the explained variation in TEE and was the best predictor of AEE.Medicine & Science in Sports & Exercise 01/2001; 33(2):275-281. · 4.43 Impact Factor -
Article: Heart rate as an indicator of the intensity of physical activity in human adolescents
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ABSTRACT: The aims of this study were, in a group of adolescents, firstly to identify the absolute heart rates (HR) and the percentages of maximal heart rates (HRmax) corresponding to 40%, 60% and 80% of peak oxygen uptake ( ), secondly to identify absolute and relative ( ) oxygen uptakes ( ) corresponding to HR of 120, 140 and 160beats·min–1, and thirdly to examine a possible effect of fatness and fitness on the relationship between HR and . The subjects were 127(60boys, 67girls) adolescents with a mean age of 14.8(SD0.3)years. The HR and were measured by means of an incremental exercise test to exhaustion. Linear regressions were performed for the and relationships using absolute and relative (%HRmax, ) data for each individual. From these regressions, target HR and were computed. Average target HR corresponding to 40%, 60% and 80% of were: 119(SD9), 145(SD9), 171(SD8), and 120(SD10), 146(SD8), 172(SD8)beats·min–1 for boys and girls, respectively. Average corresponding to HR of 120, 140 and 160beats·min–1 were: 22(SD5), 30(SD5), 38(SD6) and 18(SD4), 24(SD4), 31(SD4) mlO2·kg–1·min–1for boys and girls, respectively. An analysis of covariance showed a significant fitness effect (P<0.001) for predicted at all HR studied. The results suggest that the use of absolute HR to define exercise intensity levels when assessing young people's physical activity using HR monitoring detracts from the validity of the interpretation of the data.Arbeitsphysiologie 01/2001; 85(3):244-249. · 2.15 Impact Factor -
Article: Physical activity in groups of Swedish adults. Are the recommendations feasible?
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ABSTRACT: A bstract Background: Successful public health programs in the area of physical activity demand a clear understand-ing of how, and to what extent, people are physically active. Physical activity is, however, dif cult to measure accurately. Objective: We conducted tests using various methods, including an accelerometer and the International Physical Activity Questionnaire (IPAQ). Design: The results were applied on a feasibility sample, aged 41 9 10 years (N ¾ 49) and on random samples of a community in the Stockholm area (N¾ 200) and of the Swedish population (N ¾ 196), aged 47 9 14 years and 45 9 13 years respectively. Results: A majority of individuals in all samples reached the current recommendation of at least thirty minutes in total per day or more of moderate physical activity. However, based on accelerometer data this was achieved mainly through sporadic bouts of less than one minute. Few, if any, appeared to reach thirty minutes of continuous moderately intense activity or even continuous bouts of at least ten minutes three times per day. Conclusions: This study gives new insight into how, and to what extent, people are physically active, and raises a number of issues. Which is more effective for public health purposes: reaching the total recommended time in short bouts of physical activity or reaching it on one or a few sustained periods of activity? What are the implications for promoting a physically active lifestyle? Current recommendations for physical activity need to be discussed. Introduction Successful public health programs targeting the promotion of physical activity and healthy eating demand a better understanding of the art and degree of physical activity in the population than what is currently available . Unfortunately, habitual physical activity is dif cult to measure and its prevalence in a population is poorly understood (1). There are still many bene ts to be gained by improving our understanding of this issue. Health issues can more easily be identi ed and described in terms of the prevalence and nature of both activity and inactivity. Better health promotion and disease prevention strategies and policies can be formu-lated, better plans of action and programs can be adopted, implemented and evaluated. The feasibil-ity of the widespread recommendation for health-enhancing physical activity (2) can more easily be evaluated. Finally, the evidence base of the link between physical activity and health can be stronger and better understood. There are therefore strong reasons to gather more accurate information on the nature and the prevalence of habitual physical activity in the pop-ulation. Both subjective and objective methods are available for this purpose with varying validity and practical feasibility (3). -
Article: Fruit and vegetable intake in a sample of 11-year-old children in 9 European countries: The Pro Children Cross-sectional Survey.
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ABSTRACT: An adequate fruit and vegetable intake provides essential nutrients and nutritive compounds and is considered an important part of a healthy lifestyle. No simple instrument has been available for the assessment of fruit and vegetable intake as well as its determinants in school-aged children applicable in different European countries. Within the Pro Children Project, such an instrument has been developed. This paper describes the cross-sectional survey in 11-year-olds in 9 countries. The cross-sectional survey used nationally, and in 2 countries regionally, representative samples of schools and classes. The questionnaires, including a precoded 24-hour recall component and a food frequency part, were completed in the classroom. Data were treated using common syntax files for portion sizes and for merging of vegetable types into four subgroups. The results show that the fruit and vegetable intake in amounts and choice were highly diverse in the 9 participating countries. Vegetable intake was in general lower than fruit intake, boys consumed less fruit and vegetables than girls did. The highest total intake according to the 24-hour recall was found in Austria and Portugal, the lowest in Spain and Iceland. The fruit and vegetable intake in 11-year-old children was in all countries far from reaching population goals and food-based dietary guidelines on national and international levels.Annals of Nutrition and Metabolism 49(4):236-45. · 2.26 Impact Factor -
Article: Fruit and vegetable intake of mothers of 11-year-old children in nine European countries: The Pro Children Cross-sectional Survey.
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ABSTRACT: To describe and compare fruit and vegetable intakes of mothers of 11-year-old children across Europe. Cross-sectional surveys were carried out in 9 European countries in October/November 2003. Self-administered questionnaires assessing fruit and vegetable consumption were used for data collection. The current paper presents dietary intake data obtained by a precoded 24-hour recall and a food frequency questionnaire. The consumption levels of fruit and vegetables (without fruit juice) were in line with World Health Organization recommendations of > or =400 g/day for only 27% of all participating mothers. Based on both instruments, the Pro Children results showed comparatively high average fruit intake levels in Portugal, Denmark and Sweden (211, 203 and 194 g/day) and the lowest intake in Iceland (97 g/day). High vegetable intake levels were found in Portugal and Belgium (169 and 150 g/day), the lowest in Spain (88 g/day). A south-north gradient could not be observed in the Pro Children study. Fruit and vegetable intakes are low in mothers of 11-year-olds across Europe. Especially vegetable consumption can be regarded as marginal in most of the studied European countries. A high percentage of mothers indicated to eat fruit and vegetables less than once a day. The results have shown that national and international interventions are necessary to promote fruit and especially vegetable consumption in the European population of mothers.Annals of Nutrition and Metabolism 49(4):246-54. · 2.26 Impact Factor
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2001
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Karolinska Institutet
- Institutionen för biovetenskaper och näringslära
Solna, Stockholm, Sweden
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