Ursula Schwab

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Verified

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• PhD
• Professor at University of Eastern Finland

Objective This study aimed to evaluate the effect of an individually tailored oral health intervention on the oral hygiene and health of family caregivers and their care recipients aged 60 years and older. Background Older adults are retaining their natural teeth longer. The compromised condition of teeth and oral health increases the risk of the...

Studies on longitudinal associations between diet quality and lipid and amino acid metabolism in children and adolescents are limited. We studied associations between diet quality and serum markers of lipid and amino acid metabolism in the Physical Activity and Nutrition in Children (PANIC) study. These analyses included 403 children aged 6–9 years...

Maintaining proper nutrition is crucial for preserving health and preventing diseases. However, what constitutes proper nutrition may vary among individuals; recent evidence indicates that the effects of diet and also nutrients can differ considerably, driven by unique personal characteristics. This variability is reflected in blood markers, such a...

Importance Mental health problems often arise during adolescence and early adulthood, affecting up to 25% to 30% of young people. Enhancing the ability to identify children and adolescents at increased risk of mental health problems and uncover factors that promote mental health from childhood to adolescence is important. Objective To investigate...

Background & Aims Exercise is a key component of lifestyle management in patients with metabolic dysfunction-associated steatotic liver disease (MASLD), but neither its therapeutic effect on the active stage of the disease, that is metabolic dysfunction-associated steatohepatitis (MASH) nor the mediating mechanisms have been characterized. Therefor...

Fatty acid desaturase (FADS1) variant-rs174550 strongly regulates polyunsaturated fatty acid (PUFA) biosynthesis. Additionally, the FADS1 is related to mitochondrial function. Thus, we investigated whether changes in mitochondrial function are associated with the genetic variation in FADS1 (rs174550) in human adipocytes isolated from individuals co...

This study aimed to identify differences among body mass index (BMI) categories of older family caregivers (≥60 years) and their care recipients (≥65 years). Secondly, this study aimed to examine group differences and factors associated with weight change during a nutrition and oral health intervention. This secondary analysis of a randomized contr...

Background We investigate and try to find out the optimal duration and intensity for the treatment and content useful for clinical work. The aim of our study is to evaluate the effects of lifestyle intervention on the management of childhood overweight and to explore the factors that contribute to the outcome, as well as the costs for the health ca...

Background Tenofovir disoproxil fumarate (TDF) compared to tenofovir alafenamide (TAF) leads to lower body weight and plasma lipids by an unknown mechanism. We hypothesize that TDF, when absorbed, may damage enterocytes of the proximal duodenum, leading to reduced absorption of nutrients. Methods People living with HIV, without significant gastroi...

Frailty has been linked to inflammation and changes in body composition, but the findings are inconsistent. To explore this, we used the Frailty Index (FI) definition to (1) investigate the association between levels of inflammatory markers (baseline) and change in FI score after 8 years of follow-up and (2) investigate the longitudinal association...

Background: Modern food items often contain high proportions of saturated fats and refined carbohydrates. Such dietary compositions contribute to the prevalence of obesity and metabolic disease. Food images are a valuable tool to study these diet effects on eating behavior and obesity development. Aims: Creating and validating a novel food picture...

Context Lifestyle intervention prevents or delays type 2 diabetes (T2D) in subjects at a high risk of T2D. However, it is not known whether genetic variants modify the effect on incident T2D during lifestyle intervention. Objective To investigate whether a low or high genetic risk has effects on incident T2D in a group-based lifestyle intervention...

Purpose Hyperglycemia is affected by lifestyle and genetic factors. We investigated if dietary patterns associate with glycemia in individuals with high or low genetic risk for type 2 diabetes (T2D). Methods Men (n = 1577, 51–81 years) without T2D from the Metabolic Syndrome in Men (METSIM) cohort filled a food-frequency questionnaire and particip...

Long-term lifestyle interventions in childhood and adolescence can significantly improve cardiometabolic health, but the underlying molecular mechanisms remain poorly understood. To address this knowledge gap, we conducted an 8-year diet and physical activity intervention in a general population of children. The research revealed that the intervent...

Objective: We aimed to evaluate the impact of an individually tailored preventive oral health intervention on the use of oral health care services by older family caregivers (FCs) and their care recipients (CRs). Material and methods: A randomized controlled six and 12-month oral health intervention study included FCs and CRs aged ≥65 years living...

Background: Molecular mechanisms underlying the beneficial effects of long-term lifestyle interventions on cardiometabolic health during childhood and adolescence remain largely unknown. Such information would provide valuable insights into the prevention of cardiometabolic diseases since childhood. We therefore studied for the first time the effec...

Aim The aim of this study was to investigate the prevalence of frailty and identify the demographical and clinical factors associated with frailty among older family caregivers. Method The participants of this cross-sectional study were older family caregivers (n = 125) living in Eastern Finland. Data on functional and cognitive status, depressiv...

Background Intermittent fasting (IF) has gained popularity in interventions targeting overweight, obesity and metabolic syndrome. IF may affect the gut microbiome composition and therefore have various effects on gut microbiome mediated functions in humans. Research on the effects of IF on human gut microbiome is limited. Therefore, the objective o...

Most end-stage renal disease (ESRD) patients face a risk of malnutrition, partly due to dietary restrictions on phosphorous and, in some cases, potassium intake. These restrictions aim to regulate plasma phosphate and potassium concentrations and prevent the adverse effects of hyperphosphatemia or hyperkalemia. However, individual responses to nutr...

Scope Various lifestyle and sociodemographic factors have been associated with risk factors for type 2 diabetes (T2D). However, their combined associations with T2D risk factors have been studied much less. Materials and results This study investigates cross‐sectional associations of lifestyle patterns with T2D risk factors among 2925 adults at in...

The GG genotype of the Patatin-like phosphatase domain-containing 3 (PNPLA3), dietary fat, short-chain fatty acids (SCFA) and branched-chain amino acids (BCAA) are linked with non-alcoholic fatty liver disease. We studied the impact of the quality of dietary fat on plasma (p) and fecal (f) SCFA and p-BCAA in men homozygous for the PNPLA3 rs738409 v...

Purpose To investigate the associations of overall diet quality and dietary factors with serum biomarkers for lipid and amino acid metabolism in a general population of children. Methods We studied 194 girls and 209 boys aged 6–8 years participating in the Physical Activity and Nutrition in Children study. Food consumption was assessed by 4-day fo...

We aimed to assess the social inequalities in older family caregivers’ frailty conditions, comorbidity, and cognitive functioning. A cross-sectional study was conducted. Study participants were recruited in 2019 in Finland. First, cognitive functioning was assessed with a Mini-Mental State Examination, comorbidity with the modified Functional Comor...

Background Family caregivers may experience financial vulnerabilities due to their caregiving role, affecting their ability to afford appropriate food and ensure optimal nutrient intake. Therefore, this cross-sectional study aimed to assess the extent to which there are diet-related disparities among older family caregivers. Methods We included 12...

Background Family caregiving may increase the risk of poverty, whereas poverty increases the risk of adverse health outcomes, creating health inequalities. Although the issue is significant, family caregivers’ social determinants of health are little assessed in the previous intervention studies. Therefore, we aimed to assess the effects of individ...

Most end-stage renal disease (ESRD) patients face a risk of malnutrition, partly due to dietary restrictions on phosphorous and, in some cases, potassium intake. These restrictions aim to regulate plasma phosphate and potassium concentrations and prevent the adverse effects of hyperphosphatemia or hyperkalemia. However, individual responses to nutr...

Gut microbial dysbiosis has been observed in non-alcoholic fatty liver disease (NAFLD). The beneficial impact of exercise, the recommended lifestyle change for NAFLD patients, might be mediated by the gut microbiome (GM). However, the exact taxonomic and functional signatures associated with the host’s clinical and biochemical improvement during ex...

Background: Some older family caregivers experience financial vulnerabilities due to their caregiving role, which may affect their ability to afford appropriate food. This study aimed to assess the extent to which there are diet-related disparities among older family caregivers in Eastern Finland. Methods: This study is based on the multidisciplin...

The extent to which inflammation impacts food intake remains unclear, serving as a key risk factor for malnutrition as defined by the Global Leadership Initiative on Malnutrition (GLIM). To address this, we analyzed a large, merged dataset of geriatric hospitalized patients across Europe. The study included 1650 consecutive patients aged ≥65 year f...

BACKGROUND Digital behavior change interventions (DBCI) may provide scalable and cost-effective means to support lifestyle improvements and thus help prevent type 2 diabetes (T2D). The DBCIs require some minimum amount of engagement to evoke health benefits. However, sufficient amount and type of engagement, i.e., effective engagement, is not compl...

Type 2 diabetes (T2D) is a heterogenous disease regarding its phenotype and genotype [...]

Purpose The present study aimed to determine which factors prevents the success of nutritional interventions for older family caregivers (FCs), in the form of individually tailored nutritional guidance. Methods The present study focuses on the intervention group of FCs (n = 63) of a randomized controlled trial. Older FCs (≥60 years of age) receivi...

Type 2 diabetes (T2D) can be prevented or delayed through a healthy lifestyle. Digital behavior change interventions (DBCIs) may offer cost-effective and scalable means to support lifestyle changes. This study investigated associations between user engagement with a habit-formation-based DBCI, the BitHabit app, and changes in T2D risk factors over...

Lifestyle modifications, including increased physical activity and exercise, are recommended for non-alcoholic fatty liver disease (NAFLD). Inflamed adipose tissue (AT) contributes to the progression and development of NAFLD and oxylipins such as hydroxyeicosatetraenoic acids (HETE), hydroxydocosahexanenoic acids (HDHA), prostaglandins (PEG2), and...

Diabetes management relies on effective evidence-based advice that informs and empowers individuals to manage their health. Alongside other cornerstones of diabetes management, dietary advice has the potential to improve glycaemic levels, reduce risk of diabetes complications and improve health-related quality of life. We have updated the 2004 reco...

Type 2 diabetes (T2D) can be prevented or postponed by lifestyle modifications as shown by previous intervention studies. In most of these studies, participants have received resource-demanding individual counseling. In the 3-year T2D-GENE trial with lifestyle intervention, we investigated whether a less resource-demanding form of group and interne...

Background and aims: Lipophilic index (LI) has been introduced to assess the overall fatty acid lipophilicity and as a simple estimate of membrane fluidity. However, little is known on effect of diet on LI. We tested if Camelina sativa oil (CSO) high in ALA, fatty fish (FF) or lean fish (LF) affect LI as compared to control diet and, secondarily,...

Non-alcoholic fatty liver disease (NAFLD) pathogenesis remains poorly understood due to the complex metabolic and inflammatory changes in the liver. This study aimed to elucidate hepatic events related to inflammation and lipid metabolism and their linkage with metabolic alterations during NAFLD in American lifestyle-induced obesity syndrome (ALIOS...

Background: Systemic low-grade inflammation has been proposed as an underlying pathophysiological mechanism for cardiometabolic diseases. We investigated the associations of physical fitness with systemic low-grade inflammatory state in a population sample of children. Methods: Altogether 391 children aged 6-9 years were examined. Cardiorespirat...

Purpose To study whether different hormonal phases affect appetite regulation, food intake, and concentrations of leptin, glucagon-like peptide-1 (GLP-1), and high-sensitivity C-reactive protein (hs-CRP) during a long agonist in vitro fertilization (IVF) protocol. Methods Fifty-four infertile women were encountered thrice, the first of which was a...

Background/Objectives The strong regulation of protein intake can lead to overconsumption of total energy on diets with a low proportion of energy from protein, a process referred to as protein leverage. The protein leverage hypothesis posits that protein leverage explains variation in energy intake and potentially obesity in ecological settings. H...

This study aimed to investigate the nutritional status, nutrient intake and associated factors among older home care clients, caregivers and care recipients (≥65 years) living at home. There were a total of 78 participants, with a mean age of 78 ± 7.4 years. Nutritional status was assessed with the Mini Nutritional Assessment (MNA), nutrient intake...

Aim This study aimed to determine the prevalence of malnutrition in a head and neck cancer (HNC) population according to the Global Leadership Initiative on Malnutrition (GLIM) criteria and to assess its relation to survival. The secondary aim was to compare GLIM criteria to Patient–Generated Subjective Global Assessment (PG–SGA) and Nutritional Ri...

Scope The fatty acid composition of plasma lipids, which is associated with biomarkers and risk of non‐communicable diseases, is regulated by dietary polyunsaturated fatty acids (PUFAs) and variants of fatty acid desaturase (FADS). We investigated the interactions between dietary PUFAs and FADS1 rs174550 variant. Methods and results Participants (...

Purpose To study the intake and sources of vitamin D and determinants of serum 25-hydroxyvitamin D (S-25(OH)D) in Finnish adolescents. Methods We studied 265 adolescents (117 girls) aged 15–17 years attending 8-year examinations of the PANIC Study, assessed diet using food records and other lifestyle factors by questionnaires, and analyzed S-25(OH...

Carnitine has an essential role in energy metabolism with possible neuroprotective effects. Very preterm (VPT, <32 gestation weeks) infants may be predisposed to carnitine deficiency during hospitalization. We studied the associations of carnitine intake and serum carnitine levels with growth and brain size at term equivalent age (TEA) in VPT infan...

Purpose: Age-related macular degeneration (AMD) is a neurodegenerative ophthalmic disease. The purpose of this systematic review (SR) and meta-analysis was to evaluate if dietary supplementation alone or in combinations might delay the progression of any of the stages of AMD. Methods: A SR and meta-analysis identifying cohort studies and randomized...

Background No real-world randomised controlled trials (RCTs) have explored the effectiveness of lifestyle interventions based on multiple behaviour change theories and using combined digital and group-based face-to-face delivery to improve risk factors for type 2 diabetes (T2D). Methods We conducted a one-year, multi-centre, unblinded, pragmatic R...

Introduction: Older family caregivers (FCs) are vulnerable to insufficient dietary intake and risk of malnutrition. The aim of this study was to assess the impact of individually tailored nutritional guidance on the dietary intake and nutritional status of older FCs. Methods: This study was a randomized controlled 6-month nutrition intervention in...

Objective Cardiorespiratory fitness has been inversely associated with cardiovascular risk across the lifespan. Some studies in adults suggest that higher cardiorespiratory fitness is associated with cardioprotective metabolite profile, but the evidence in children is lacking. Therefore, we investigated the cross-sectional association of cardioresp...

Background Colon cancer is one of the most common cancers in Finland and worldwide. Cancer-related malnutrition is a well-known risk factor for increased morbidity and mortality after surgery, and it is associated with complications and longer hospitalizations. There are no established recommendations on how to improve the nutritional status of col...

Aims/hypothesis Nordic dietary patterns that are high in healthy traditional Nordic foods may have a role in the prevention and management of diabetes. To inform the update of the EASD clinical practice guidelines for nutrition therapy, we conducted a systematic review and meta-analysis of Nordic dietary patterns and cardiometabolic outcomes. Meth...

We examined cross-sectional and longitudinal associations of dietary factors with caries experience in a population sample of 487 children aged 6–9 years at baseline examinations of the Physical Activity and Nutrition in Children (PANIC) Study. Altogether, 406 of these children attended 2-year follow-up examinations. Food consumption and eating fre...

Background Deeper comprehension of eating-related behaviour (how and why people eat) can reveal new aspects to support health and prevent type 2 diabetes (T2D). However, such research is largely missing in aging men. Aim The aim was to investigate suitability of the Three-Factor Eating Questionnaire-R18 (TFEQ-R18) in Finnish aging men which is wid...

Purpose Fatty acid desaturase (FADS) variants associate with fatty acid (FA) and adipose tissue (AT) metabolism and inflammation. Thus, the role of FADS1 variants in the regulation of dietary linoleic acid (LA)-induced effects on AT inflammation was investigated. Methods Subjects homozygotes for the TT and CC genotypes of the FADS1-rs174550 (TT, n...

We aimed to investigate the effects of a long-term, individualised, family-based lifestyle intervention on food consumption and nutrient intake from childhood to adolescence. We conducted an 8-year diet and physical activity intervention study in a population sample of children aged 7–9 years at baseline in 2007–2009. We allocated the participants...

Purpose Older family caregivers (FCs) are vulnerable to insufficient dietary intake and risk of malnutrition. The aim of this study was to assess the impact of individually tailored nutritional guidance on the dietary intake and nutritional status of older FCs and their care recipients’ (CRs’) nutritional status. Methods This study was a randomize...

This cross-sectional study assessed the experiences of family caregivers of older adults during the COVID-19 pandemic. Participants were recruited (n = 101) between April and December 2019. We applied a mixed-method approach. Quantitative data were analyzed using an independent samples t-test and logistic regression analysis, and qualitative experi...

Background: Frequent weight loss attempts are related to maladaptive eating behaviours and higher body mass index (BMI). We studied associations of several type 2 diabetes (T2D) risk factors with weight loss history, defined as frequency of prior weight loss attempts, among Finnish adults at increased risk for T2D. Methods: This study (n=2684, 80%...

Objective: This study aimed to describe informal caregivers' perceptions of the importance of oral care and investigate the association between these perceptions and the use of oral health services during the past year. Background: There is limited research on informal caregivers' perceptions of oral care. These perceptions presumably influence...

Abstract The mechanisms by which exercise benefits patients with non-alcoholic fatty liver disease (NAFLD), the most common liver disease worldwide, remain poorly understood. A non-targeted liquid chromatography-mass spectrometry (LC–MS)-based metabolomics analysis was used to identify metabolic changes associated with NAFLD in humans upon exercise...

Background: Colon cancer is one of the most common cancers in Finland and worldwide. Cancer-related malnutrition is a well-known risk factor for increased morbidity and mortality after surgery, and it is associated with complications and longer hospitalizations. There are no established recommendations on how to improve the nutritional status of co...

Introduction Fatty acid desaturase 1 ( FADS1 ) gene encodes for delta-5 desaturase enzyme which is needed in conversion of linoleic acid (LA) to arachidonic acid (AA). Recent studies have shown that response to dietary PUFAs differs between the genotypes in circulating fatty acids. However, interactions between the FADS1 genotype and dietary LA on...

Large population-based studies investigating the association of physical activity (PA) with the metabolite signature contribute significantly to the understanding of the effects of PA on metabolic pathways associated with the risk of type 2 diabetes. Our study included 8749 Finnish men without diabetes at baseline recruited from the Metabolic Syndr...

Background: Do different hormonal phases affect appetite regulation, food intake, and concentrations of leptin, glucagon-like peptide-1 (GLP-1), and high-sensitivity C-reactive protein (hs-CRP) during a long agonist in vitro fertilization (IVF) protocol? Does the IVF stimulation induce metabolic changes, which might impact maternal health? Methods...

Background & Aims Intake assessment in multicenter trials is challenging, yet important for accurate outcome evaluation. The present study aimed to characterize a multicenter randomized controlled trial with a healthy Nordic diet (HND) compared to a Control diet (CD) by plasma and urine metabolic profiles and to associate them with cardiometabolic...

Eating competence (EC) is characterized by positive attitudes towards food and eating, having regular meals, eating a variety of foods, and internally regulated eating. We investigated the associations of changes in EC with changes in lifestyle, anthropometrics and biomarkers of glucose and lipid metabolism in 2291 adults at increased risk of type...

We examined possible changes in endothelial function during a long agonist in vitro fertilization (IVF) protocol. We measured flow-mediated dilatation (FMD) and FMD percent (FMD%) from the brachial artery and plasma levels of high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-〈). We studied longi...

Aim: The aim of this study was to examine the reported social determinants of mental health among older caregivers in the previous caregiving literature. Design: An integrative literature review method of Whittemore and Knafl. Methods: CINAHL, MEDLINE (Ovid), PubMed, and Science Direct were searched from January 1999 to December 2019. A system...

Background: Although the academic literature has focused on family caregivers' health outcomes, little is known about the social and environmental determinants of health and the extent to which they relate to health disparities among family caregivers caring for older adults. Objectives: The purpose of the study was to describe the prevalence of...

Background: As part of the process of updating national dietary reference values (DRVs) and food-based dietary guidelines (FBDGs), the Nordic Nutrition Recommendations 2022 project (NNR2022) will select a limited number of topics for systematic reviews (SRs). Objective: To develop and transparently describe the results of a procedure for priorit...

Purpose: Genetic and lifestyle/environmental factors as well as their interplay contribute to the pathogenesis of type 2 diabetes (T2D). Several trials have shown that lifestyle intervention is effective in the prevention of T2D, but there are no trials that have taken into account the genetic risk of the participants. The aim of our T2D-GENE tria...

Background The focus of care has shifted from institutional care to home care. Family caregivers provide the majority of home care that allows an opportunity for their care recipients to live at home and avoid costly institutional care. The aim of this study is to describe the nutritional status, oral health, and quality of life of family caregiver...

Background Clinical trials have shown that type 2 diabetes (T2D) is preventable through lifestyle interventions targeting high-risk people. Nevertheless, large-scale implementation of risk identification followed by preventive interventions has proven to be challenging. Specifically, recruitment of participants into preventive interventions is an i...