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Cederholm T, Bosaeus I, Brummer R, Ellegård L, Irving GF, Larsson J, Thorell A, Rothenberg E. [SBU report "misses" persuasive evidence. Dietary supplements extends the life of malnourished elderly]. Lakartidningen 2014; 111:2299-2300. [PMID: 25584567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Tommy Cederholm
- Uppsala universitet - Institutionen för folkhälso- och vårdvetenskap, klinisk nutrition och metabolism Uppsala, Sweden Uppsala universitet - Institutionen för folkhälso- och vårdvetenskap, klinisk nutrition och metabolism Uppsala, Sweden
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202
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Adamsson V, Cederholm T, Vessby B, Risérus U. Influence of a healthy Nordic diet on serum fatty acid composition and associations with blood lipoproteins - results from the NORDIET study. Food Nutr Res 2014; 58:24114. [PMID: 25476792 PMCID: PMC4256522 DOI: 10.3402/fnr.v58.24114] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 10/30/2014] [Accepted: 10/31/2014] [Indexed: 11/16/2022] Open
Abstract
Background The fatty acid (FA) composition of serum lipids is related to the quality of dietary fat intake. Objective To investigate the effects of a healthy Nordic diet (ND) on the FA composition of serum cholesterol esters (CE-FA) and assess the associations between changes in the serum CE-FA composition and blood lipoproteins during a controlled dietary intervention. Design The NORDIET trial was a 6-week randomised, controlled, parallel-group dietary intervention study that included 86 adults (53±8 years) with elevated low-density lipoprotein cholesterol (LDL-C). Serum CE-FA composition was measured using gas chromatography. Diet history interviews were conducted, and daily intake was assessed using checklists. Results Food and nutrient intake data indicated that there was a reduction in the intake of fat from dairy and meat products and an increase in the consumption of fatty fish with the ND. The levels of saturated fatty acids in cholesterol esters (CE-SFA) 14:0, 15:0, and 18:0, but not 16:0, showed a significant decrease after intake of ND compared to the control diet (p<0.01). Also, a significant increase in serum 22:6n – 3 was observed compared with the control diet (p<0.01). The changes in CE-SFA 14:0, 15:0, and 18:0 correlated positively with changes in LDL-C, HDL-C, LDL-C/HDL-C, ApoA1, and ApoB (p<0.01), respectively, whereas the changes in polyunsaturated fatty acids in cholesterol esters (CE-PUFA) 22:6n – 3 were negatively correlated with changes in the corresponding serum lipids. Conclusions The decreased intake of saturated fat and increased intake of n-3 PUFA in a healthy ND is partly reflected by changes in the serum CE-FA composition, which are associated with an improved serum lipoprotein pattern.
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Affiliation(s)
- Viola Adamsson
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Bengt Vessby
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Ulf Risérus
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden;
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203
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Cruz-Jentoft AJ, Landi F, Schneider SM, Zúñiga C, Arai H, Boirie Y, Chen LK, Fielding RA, Martin FC, Michel JP, Sieber C, Stout JR, Studenski SA, Vellas B, Woo J, Zamboni M, Cederholm T. Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS). Age Ageing 2014; 43:748-59. [PMID: 25241753 PMCID: PMC4204661 DOI: 10.1093/ageing/afu115] [Citation(s) in RCA: 1203] [Impact Index Per Article: 120.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objective: to examine the clinical evidence reporting the prevalence of sarcopenia and the effect of nutrition and exercise interventions from studies using the consensus definition of sarcopenia proposed by the European Working Group on Sarcopenia in Older People (EWGSOP). Methods: PubMed and Dialog databases were searched (January 2000–October 2013) using pre-defined search terms. Prevalence studies and intervention studies investigating muscle mass plus strength or function outcome measures using the EWGSOP definition of sarcopenia, in well-defined populations of adults aged ≥50 years were selected. Results: prevalence of sarcopenia was, with regional and age-related variations, 1–29% in community-dwelling populations, 14–33% in long-term care populations and 10% in the only acute hospital-care population examined. Moderate quality evidence suggests that exercise interventions improve muscle strength and physical performance. The results of nutrition interventions are equivocal due to the low number of studies and heterogeneous study design. Essential amino acid (EAA) supplements, including ∼2.5 g of leucine, and β-hydroxy β-methylbutyric acid (HMB) supplements, show some effects in improving muscle mass and function parameters. Protein supplements have not shown consistent benefits on muscle mass and function. Conclusion: prevalence of sarcopenia is substantial in most geriatric settings. Well-designed, standardised studies evaluating exercise or nutrition interventions are needed before treatment guidelines can be developed. Physicians should screen for sarcopenia in both community and geriatric settings, with diagnosis based on muscle mass and function. Supervised resistance exercise is recommended for individuals with sarcopenia. EAA (with leucine) and HMB may improve muscle outcomes.
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Affiliation(s)
- Alfonso J Cruz-Jentoft
- Servicio de Geriatría, Hospital Universitario Ramón y Cajal, Ctra. Colmenar km 9, 1, 28034 Madrid, Spain
| | - Francesco Landi
- Istituto di Medicina Interna e Geriatria, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Stéphane M Schneider
- Gastroentérologie et Nutrition Clinique, CHU de Nice, Université de Nice Sophia-Antipolis, Nice, France
| | - Clemente Zúñiga
- Universidad Autonoma de Baja California, Tijuana Baja California Mexico, Mexico
| | - Hidenori Arai
- Department of Human Health Sciences, Kyoto University, Graduate School of Medicine, Kyoto, Japan
| | - Yves Boirie
- Unité de Nutrition Humaine, UMR 1019, INRA, Université Clermont-Ferrand, CHU de Clermont-Ferrand, France
| | - Liang-Kung Chen
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Roger A Fielding
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Finbarr C Martin
- Department of Ageing and Health, Guys and St Thomas' NHS Foundation Trust, London, UK
| | - Jean-Pierre Michel
- Département de Réhabilitation et Gériatrie, Hôpitaux Universitaires de Genève-Suisse, Geneva, Switzerland
| | - Cornel Sieber
- Institut for Biomedicine of Ageing, University Erlangen-Nürnberg, Erlangen, Germany
| | - Jeffrey R Stout
- Institute for Exercise Physiology and Wellness Research, University of Central Florida, Orlando, FL, USA
| | | | - Bruno Vellas
- Department of Geriatric Medicine, Inserm U558 Le Centre Hospitalier Universitaire de Toulouse (CHU) - Gérontopôle, Toulouse, France
| | - Jean Woo
- Department of Medicine and Therapeutics, Prince of Wales, Hospital, Chinese University of Hong Kong, Hong Kong SAR, The People's Republic of China
| | - Mauro Zamboni
- Division of Geriatrics, Department of Medicine, University of Verona, Verona, Italy
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences/Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
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204
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Olsson E, Karlström B, Kilander L, Byberg L, Cederholm T, Sjögren P. Dietary Patterns and Cognitive Dysfunction in a 12-Year Follow-up Study of 70 Year Old Men. ACTA ACUST UNITED AC 2014; 43:109-19. [DOI: 10.3233/jad-140867] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Erika Olsson
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Brita Karlström
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Lena Kilander
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, Uppsala, Sweden
| | - Liisa Byberg
- Department of Surgical Sciences, Orthopedics, Uppsala University, Uppsala, Sweden
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Per Sjögren
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
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205
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Andersson P, Bratt J, Heimbürger M, Cederholm T, Palmblad J. Inhibition of Neutrophil-Dependent Cytotoxicity for Human Endothelial Cells by ACE Inhibitors. Scand J Immunol 2014; 80:339-45. [DOI: 10.1111/sji.12218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2013] [Accepted: 07/31/2014] [Indexed: 12/19/2022]
Affiliation(s)
- P. Andersson
- Department of Medicine; Stockholm Soder Hospital; Stockholm Sweden
| | - J. Bratt
- Department of Rheumatology; Karolinska University Hospital; Stockholm Sweden
| | - M. Heimbürger
- Department of Rheumatology; Karolinska University Hospital; Stockholm Sweden
| | - T. Cederholm
- Departments of Clinical Nutrition and Metabolism and of Geriatrics; Uppsala University; Uppsala Sweden
| | - J. Palmblad
- Department of Hematology; Karolinska University Hospital; Center for Inflammation and Hematology Research; Stockholm Sweden
- Department of Medicine; Karolinska Institute; Stockholm Sweden
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206
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Xu H, Huang X, Risérus U, Krishnamurthy VM, Cederholm T, Arnlöv J, Lindholm B, Sjögren P, Carrero JJ. Dietary fiber, kidney function, inflammation, and mortality risk. Clin J Am Soc Nephrol 2014; 9:2104-10. [PMID: 25280496 DOI: 10.2215/cjn.02260314] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND OBJECTIVES In the United States population, high dietary fiber intake has been associated with a lower risk of inflammation and mortality in individuals with kidney dysfunction. This study aimed to expand such findings to a Northern European population. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Dietary fiber intake was calculated from 7-day dietary records in 1110 participants aged 70-71 years from the Uppsala Longitudinal Study of Adult Men (examinations performed during 1991-1995). Dietary fiber was adjusted for total energy intake by the residual method. Renal function was estimated from the concentration of serum cystatin C, and deaths were registered prospectively during a median follow-up of 10.0 years. RESULTS Dietary fiber independently and directly associated with eGFR (adjusted difference, 2.6 ml/min per 1.73 m(2) per 10 g/d higher; 95% confidence interval [95% CI], 0.3 to 4.9). The odds of C-reactive protein >3 mg/L were lower (linear trend, P=0.002) with higher fiber quartiles. During follow-up, 300 participants died (incidence rate of 2.87 per 100 person-years at risk). Multiplicative interactions were observed between dietary fiber intake and kidney dysfunction in the prediction of mortality. Higher dietary fiber was associated with lower mortality in unadjusted analysis. These associations were stronger in participants with kidney dysfunction (eGFR<60 ml/min per 1.73 m(2)) (hazard ratio [HR], 0.58; 95% CI, 0.35 to 0.98) than in those without (HR, 1.30; 95% CI, 0.76 to 2.22; P value for interaction, P=0.04), and were mainly explained by a lower incidence of cancer-related deaths (0.25; 95% CI, 0.10 to 0.65) in individuals with kidney dysfunction versus individuals with an eGFR≥60 ml/min per 1.73 m(2) (1.61; 95% CI, 0.69 to 3.74; P value for interaction, P=0.01). CONCLUSIONS High dietary fiber was associated with better kidney function and lower inflammation in community-dwelling elderly men from Sweden. High dietary fiber was also associated with lower (cancer) mortality risk, especially in individuals with kidney dysfunction.
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Affiliation(s)
- Hong Xu
- Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, and Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaoyan Huang
- Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, and Division of Nephrology, Peking University Shenzhen Hospital, Peking University, Shenzhen, China
| | - Ulf Risérus
- Sections of Clinical Nutrition and Metabolism and
| | - Vidya M Krishnamurthy
- Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, and
| | | | - Johan Arnlöv
- Geriatrics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; and School of Health and Social Studies, Dalarna University, Falun, Sweden
| | - Bengt Lindholm
- Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, and
| | - Per Sjögren
- Sections of Clinical Nutrition and Metabolism and
| | - Juan Jesús Carrero
- Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, and Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden;
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207
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Biolo G, Cederholm T, Muscaritoli M. Muscle contractile and metabolic dysfunction is a common feature of sarcopenia of aging and chronic diseases: From sarcopenic obesity to cachexia. Clin Nutr 2014; 33:737-48. [DOI: 10.1016/j.clnu.2014.03.007] [Citation(s) in RCA: 201] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 03/17/2014] [Accepted: 03/24/2014] [Indexed: 12/18/2022]
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208
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Freund-Levi Y, Vedin I, Hjorth E, Basun H, Faxén Irving G, Schultzberg M, Eriksdotter M, Palmblad J, Vessby B, Wahlund LO, Cederholm T, Basu S. Effects of Supplementation with Omega-3 Fatty Acids on Oxidative Stress and Inflammation in Patients with Alzheimer's Disease: The OmegAD Study. ACTA ACUST UNITED AC 2014; 42:823-31. [DOI: 10.3233/jad-132042] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Yvonne Freund-Levi
- Section of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Department of Geriatrics Karolinska University Hospital Stockholm, Sweden
| | - Inger Vedin
- Division of Haematology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital at Huddinge, Stockholm, Sweden
| | - Erik Hjorth
- Division of Neurodegeneration, Department of Neurobiology, Care Sciences & Society, Karolinska Institutet, Stockholm, Sweden
| | - Hans Basun
- Division of Geriatrics, Uppsala University, Uppsala, Sweden and Chaire d'Excellence Program, Department of Biochemistry, Molecular Biology and Nutrition, Universite d'Auvergne, Clermont-Ferrand, France
| | - Gerd Faxén Irving
- Divisions of Clinical Nutrition, Karolinska Institutet, Karolinska University Hospital at Huddinge, Stockholm, Sweden
| | - Marianne Schultzberg
- Division of Neurodegeneration, Department of Neurobiology, Care Sciences & Society, Karolinska Institutet, Stockholm, Sweden
| | - Maria Eriksdotter
- Section of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Department of Geriatrics Karolinska University Hospital Stockholm, Sweden
| | - Jan Palmblad
- Division of Haematology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital at Huddinge, Stockholm, Sweden
| | - Bengt Vessby
- Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Lars-Olof Wahlund
- Section of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Department of Geriatrics Karolinska University Hospital Stockholm, Sweden
| | - Tommy Cederholm
- Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Samar Basu
- Division of Oxidative Stress and Inflammation, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden and Chaire d'Excellence Program, Department of Biochemistry, Molecular Biology and Nutrition, Universite d'Auvergne, Clermont-Ferrand, France
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209
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Koochek A, von Berens Å, Gustafsson T, Kirn D, Laussen J, Reid K, Åberg A, Nydahl M, Cederholm T, Fielding R. LB008-SUN: Serum 25-OH Vitamin D (25OH-VITD) and Physical Performance in Community-Dwelling Old Mobility Limited Adults. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50634-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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210
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Sobestiansky S, Åberg A, Fugmann A, Cederholm T. PP049-MON: Sarcopenia, Anthropometry and Malnutrition in Relation to 2-Y Mortality in Geriatric Patients. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50384-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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211
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Kirn D, Koochek A, Reid K, von Berens A, Travison T, Folta S, Sacheck J, Nelson M, Liu C, Phillips E, Aberg A, Nydahl M, Gustafsson T, Cederholm T, Fielding R. P384: The Vitality, Independence, and Vigor in the Elderly 2 Study (VIVE2): design and methods. Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70548-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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212
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Maggio M, de Vita F, Lauretani F, Giacomini V, Dall’Aglio E, Cederholm T, Lind L, Ceda G. P357: Determinants of lean body mass in older hypogonadal men: data from ULSAM 88. Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70521-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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213
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Maggio M, Lauretani F, de Vita F, Volpi E, Giallauria F, de Cicco G, Cattabiani C, Melhus H, Michaëlsson K, Cederholm T, Lind L, Ceda G. O4.21: Vitamin D and endothelial vasodilation in older individuals: the PIVUS Study. Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70174-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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214
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Verlaan S, Bauer J, Sieber C, Cederholm T. O4.10: Muscle mass, strength, and function effects of a high-whey, leucine-enriched nutritional intervention in sarcopenic elderly in a double blind, randomised controlled trial. Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70163-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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215
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Maggio M, De Vita F, Lauretani F, Ceda GP, Volpi E, Giallauria F, De Cicco G, Cattabiani C, Melhus H, Michaëlsson K, Cederholm T, Lind L. Vitamin D and endothelial vasodilation in older individuals: data from the PIVUS study. J Clin Endocrinol Metab 2014; 99:3382-9. [PMID: 24892991 PMCID: PMC4154089 DOI: 10.1210/jc.2014-1536] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
CONTEXT Vitamin D plays a role in a wide range of extraskeletal processes, including vascular function. Endothelial dysfunction is a predictor of cardiovascular disease, especially in older subjects. However, the relationship between vitamin D levels and indexes of endothelial vasodilation has never been fully addressed in older individuals. OBJECTIVE The objective of this study was to examine the association between vitamin D and endothelial function in a large community-based sample of older subjects. METHODS This cross-sectional study involved 852 community-dwelling men and women aged 70 years from the Prospective Study of the Vasculature in Uppsala Seniors (PIVUS), with complete data on vascular function and 25-hydroxyvitamin D. We evaluated endothelium-dependent vasodilation by an invasive forearm technique with acetylcholine, endothelium-independent vasodilation by sodium nitroprussiate, flow-mediated vasodilation, and the pulse wave analysis (reflectance index). Vitamin D levels were measured by chemiluminescence. We used multivariate regression models adjusted for body mass index (model 1) and for multiple confounders (high-sensitivity C-reactive protein, insulin, total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, smoking, sex hormones, season of blood collection, hypertension, diabetes, cardiovascular medications and diseases, statin usage, plasma calcium and calcium intake, PTH, physical exercise, liver and kidney function tests, albumin; model 2). RESULTS In women, but not in men, vitamin D levels were positively associated with endothelium-independent vasodilation in both model 1 (β ± SE = 1.41 ± 0.54; P = .001), and model 2 (β ± SE = 2.01 ± 0.68; P = .003).We found no significant relationship between vitamin D levels and endothelium-dependent vasodilation, flow-mediated vasodilation, and reflectance index in both sexes. CONCLUSIONS In older women, but not in men, vitamin D is positively and independently associated with EIDV.
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Affiliation(s)
- Marcello Maggio
- Geriatric Rehabilitation Department (M.M., F.D.V., F.L., G.P.C.), University Hospital of Parma, 43126 Parma, Italy; Department of Clinical and Experimental Medicine (M.M., G.P.C.), Section of Geriatrics, University of Parma, 43126 Parma, Italy; Department of Internal Medicine (E.V.), Division of Geriatrics, and Sealy Center on Aging, University of Texas Medical Branch, Galveston, Galveston, Texas 77555-0264; Department of Clinical Medicine, Cardiovascular and Immunological Sciences (F.G.), University of Naples Federico II, 80138 Napoli, Italy; Cardiac Surgery Unit (G.D.C.), Community Hospital of Brescia, 25123 Brescia, Italy; Azienda USL Piacenza (C.C.), 23121 Piacenza, Italy; Department of Medical Sciences (H.M.), Uppsala University, 751 85 Uppsala, Sweden; Department of Surgical Sciences (K.M.), Uppsala University, 751 85 Uppsala, Sweden; Department of Medicine (T.C.), Uppsala University Hospital, 751 85 Uppsala, Sweden; and Department of Public Health and Caring Sciences (L.L.), Section of Clinical Nutrition and Metabolism, Uppsala University, 751 85 Uppsala, Sweden
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216
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Xu H, Jia T, Huang X, Risérus U, Cederholm T, Arnlöv J, Sjögren P, Lindholm B, Carrero JJ. Dietary acid load, insulin sensitivity and risk of type 2 diabetes in community-dwelling older men. Diabetologia 2014; 57:1561-8. [PMID: 24875749 DOI: 10.1007/s00125-014-3275-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 05/06/2014] [Indexed: 10/25/2022]
Abstract
AIMS/HYPOTHESIS We tested the hypothesis that dietary acid load may increase the risk of type 2 diabetes, and studied the association between acid load and insulin sensitivity as a possible mechanism involved. METHODS An observational survey with prospective follow-up including 911 non-diabetic Swedish men aged 70-71 years was carried out. The gold standard euglycaemic-hyperinsulinaemic clamp technique and the OGTT were used to determine insulin sensitivity and beta cell function, respectively. Diabetes incidence was assessed during 18 years of follow-up. Renal function was estimated from serum cystatin C concentrations. Dietary acid load was calculated as potential renal acid load (PRAL) and net endogenous acid production (NEAP) algorithms from 7 day food records. Adequate dietary reporters were identified by Goldberg cut-offs. RESULTS PRAL and NEAP were not associated with insulin sensitivity or beta cell function. Underlying kidney function or consideration of dietary adequate reporters did not modify these null findings. During follow-up, 115 new cases of diabetes were validated. Neither PRAL nor NEAP was associated with diabetes incidence. CONCLUSIONS/INTERPRETATION Our results do not support the hypothesis that dietary acid load influences insulin sensitivity, beta cell function or diabetes risk. Interventional studies modifying acid-base dietary intake are needed to further elucidate a possible role of acid load in the development of type 2 diabetes.
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Affiliation(s)
- Hong Xu
- Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska University Hospital K56, Karolinska Institutet, 14186, Stockholm, Sweden
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217
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Isoyama N, Qureshi AR, Avesani CM, Lindholm B, Bàràny P, Heimbürger O, Cederholm T, Stenvinkel P, Carrero JJ. Comparative associations of muscle mass and muscle strength with mortality in dialysis patients. Clin J Am Soc Nephrol 2014; 9:1720-8. [PMID: 25074839 DOI: 10.2215/cjn.10261013] [Citation(s) in RCA: 340] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND OBJECTIVES Reduced muscle mass and strength are prevalent conditions in dialysis patients. However, muscle strength and muscle mass are not congruent; muscle strength can diminish even though muscle mass is maintained or increased. This study addresses phenotype and mortality associations of these muscle dysfunction entities alone or in combination (i.e., concurrent loss of muscle mass and strength/mobility, here defined as sarcopenia). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS This study included 330 incident dialysis patients (203 men, mean age 53±13 years, and mean GFR 7±2 ml/min per 1.73 m(2)) recruited between 1994 and 2010 and followed prospectively for up to 5 years. Low muscle mass (by dual-energy x-ray absorptiometry appendicular mass index) and low muscle strength (by handgrip) were defined against young reference populations according to the European Working Group on Sarcopenia in Older People. RESULTS Whereas 20% of patients had sarcopenia, low muscle mass and low muscle strength alone were observed in a further 24% and 15% of patients, respectively. Old age, comorbidities, protein-energy wasting, physical inactivity, low albumin, and inflammation associated with low muscle strength, but not with low muscle mass (multivariate ANOVA interactions). During follow-up, 95 patients (29%) died and both conditions associated with mortality as separate entities. When combined, individuals with low muscle mass alone were not at increased risk of mortality (adjusted hazard ratio [HR], 1.23; 95% confidence interval [95% CI], 0.56 to 2.67). Individuals with low muscle strength were at increased risk, irrespective of their muscle stores being appropriate (HR, 1.98; 95% CI, 1.01 to 3.87) or low (HR, 1.93; 95% CI, 1.01 to 3.71). CONCLUSIONS Low muscle strength was more strongly associated with aging, protein-energy wasting, physical inactivity, inflammation, and mortality than low muscle mass. Assessment of muscle functionality may provide additional diagnostic and prognostic information to muscle-mass evaluation.
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Affiliation(s)
- Naohito Isoyama
- Divisions of Renal Medicine and Baxter Novum, and Department of Urology, Yamaguchi University, Yamaguchi, Japan
| | | | - Carla Maria Avesani
- Department of Applied Nutrition, Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil; and
| | | | - Peter Bàràny
- Divisions of Renal Medicine and Baxter Novum, and
| | | | - Tommy Cederholm
- Division of Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | | | - Juan Jesús Carrero
- Divisions of Renal Medicine and Baxter Novum, and Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden;
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Flodin L, Sääf M, Cederholm T, Al-Ani AN, Ackermann PW, Samnegård E, Dalen N, Hedström M. Additive effects of nutritional supplementation, together with bisphosphonates, on bone mineral density after hip fracture: a 12-month randomized controlled study. Clin Interv Aging 2014; 9:1043-50. [PMID: 25045257 PMCID: PMC4094579 DOI: 10.2147/cia.s63987] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background After a hip fracture, a catabolic state develops, with increased bone loss during the first year. The aim of this study was to evaluate the effects of postoperative treatment with calcium, vitamin D, and bisphosphonates (alone or together) with nutritional supplementation on total hip and total body bone mineral density (BMD). Methods Seventy-nine patients (56 women), with a mean age of 79 years (range, 61–96 years) and with a recent hip fracture, who were ambulatory before fracture and without severe cognitive impairment, were included. Patients were randomized to treatment with bisphosphonates (risedronate 35 mg weekly) for 12 months (B; n=28), treatment with bisphosphonates along with nutritional supplementation (40 g protein, 600 kcal daily) for the first 6 months (BN; n=26), or to controls (C; n=25). All participants received calcium (1,000 mg) and vitamin D3 (800 IU) daily. Total hip and total body BMD were assessed with dual-energy X-ray absorptiometry at baseline, 6, and 12 months. Marker of bone resorption C-terminal telopeptide of collagen I and 25-hydroxy vitamin D were analyzed in serum. Results Analysis of complete cases (70/79 at 6 months and 67/79 at 12 months) showed an increase in total hip BMD of 0.7% in the BN group, whereas the B and C groups lost 1.1% and 2.4% of BMD, respectively, between baseline and 6 months (P=0.071, between groups). There was no change in total body BMD between baseline and 12 months in the BN group, whereas the B group and C group both lost BMD, with C losing more than B (P=0.009). Intention-to-treat analysis was in concordance with the complete cases analyses. Conclusion Protein-and energy-rich supplementation in addition to calcium, vitamin D, and bisphosphonate therapy had additive effects on total body BMD and total hip BMD among elderly hip fracture patients.
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Affiliation(s)
- Lena Flodin
- Department of Geriatric Medicine, Karolinska University Hospital Stockholm, Sweden ; Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Maria Sääf
- Department of Endocrinology, Metabolism, and Diabetes, Karolinska University Hospital, Stockholm, Sweden
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Amer N Al-Ani
- Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden ; Department of Orthopedics, Karolinska University Hospital, Stockholm, Sweden
| | - Paul W Ackermann
- Department of Orthopedics, Karolinska University Hospital, Stockholm, Sweden ; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Eva Samnegård
- Department of Clinical Science, Division of Orthopedics, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden
| | - Nils Dalen
- Department of Clinical Science, Division of Orthopedics, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden
| | - Margareta Hedström
- Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden ; Department of Orthopedics, Karolinska University Hospital, Stockholm, Sweden
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Eriksdotter M, Falahati F, Vedin I, Freund‐Levi Y, Hjorth E, Faxen‐Irving G, Wahlund L, Schultzberg M, Basun H, Cederholm T, Palmblad J. P1‐384: EFFECTS OF OMEGA‐3 FATTY ACID SUPPLEMENTATION ON PLASMA FATTY ACIDS, GENDER EFFECTS, AND EFFECTS ON COGNITION IN ALZHEIMER'S PATIENTS: THE OMEGAD STUDY. Alzheimers Dement 2014. [DOI: 10.1016/j.jalz.2014.05.626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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220
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Cederholm T. [Fat intake and heart disease in controversial meta-analysis. Study with too many shortcomings--former fat recommendation remains unchanged]. Lakartidningen 2014; 111:1112-1113. [PMID: 25072073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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221
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Nyberg L, Cederholm T, Bendrik R, Klässbo M, Eriksson M. [Primary health care plays a key role in early diagnosis and follow-up]. Lakartidningen 2014; 111:939-942. [PMID: 24946498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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222
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Xu H, Huang X, Riserus U, Cederholm T, Lindholm B, Arnlov J, Carrero JJ, Leiba A, Vivante A, Bulednikov Y, Golan E, Skorecki K, Shohat T, Mjoen G, Zannad F, Jardine A, Schmieder R, Fellstrom B, Holdaas H, Zager P, Miskulin D, Gassman J, Kendrick C, Ploth D, Jhamb M, Jankowski V, Schulz A, Mischak H, Zidek W, Jankowski J, Lee YK, Cho A, Kim JK, Choi MJ, Kim SJ, Yoon JW, Koo JR, Kim HJ, Noh JW, Itano S, Satoh M, Kidokoro K, Sasaki T, Kashihara N, Koutroumpas G, Sarafidis P, Georgianos P, Karpetas A, Protogerou A, Syrganis C, Malindretos P, Raptopoulou K, Panagoutsos S, Pasadakis P, Zager P, Miskulin D, Gassman J, Kendrick C, Jhamb M, Ploth D, Vink EE, De Boer A, Verloop WL, Spiering W, Voskuil M, Vonken EJ, Hoogduin JM, Leiner T, Bots ML, Blankestijn PJ, Sarafidis PA, Karpetas AV, Georgianos PI, Bikos A, Sklavenitis-Pistofidis R, Tzimou R, Raptis V, Vakianis P, Tersi M, Liakopoulos V, Lasaridis AN, Protogerou A, Ribeiro S, Fernandes J, Garrido P, Sereno J, Vala H, Bronze Da Rocha E, Belo L, Costa E, Reis F, Santos-Silva A, Kalaitzidis R, Skapinakis P, Karathanos V, Karasavvidou D, Katatsis G, Pappas K, Hatzidakis S, Siamopoulos K, Margulis F, Sabbatiello R, Castro C, Ramallo S, Martinez M, Schiavelli R, Ganem D, Nakhoul F, Roth A, Farber E, Kim CS, Kim HY, Kang YU, Choi JS, Bae EH, Ma SK, Kim SW, Koutroumpas G, Sarafidis P, Georgianos P, Karpetas A, Protogerou A, Malindretos P, Syrganis C, Tzanis G, Panagoutsos S, Pasadakis P, Jankowski M, Kasztan M, Kowalski R, Piwkowska A, Rogacka D, Szczepa Ska-Konkel M, Angielski S, Evangelou D, Naka K, Kalaitzidis R, Lakkas L, Bechlioulis A, Gkirdis I, Nakas G, Zarzoulas F, Kotsia A, Balafa O, Tzeltzes G, Pappas K, Katsouras C, Dounousi E, Michalis L, Siamopoulos K, Maciorkowska D, Zbroch E, Koc-Zorawska E, Malyszko J, Karabay Bayazit A, Yuksekkaya I, Aynaci S, Anarat A, Nakai K, Fujii H, Ishida R, Utaka C, Awata R, Goto S, Ito J, Nishi S, Elsurer R, Afsar B, Lepar Z, Radulescu D, David C, Peride I, Niculae A, Checherita IA, Ciocalteu A, Sungur CI, Kanbay M, Siriopol D, Nistor I, Elcioglu OC, Telci O, Johnson R, Covic A, Vettoretti S, Gallazzi E, Meazza R, Gagliardi V, Villarini A, Alfieri CM, Floreani R, Messa P, Vettoretti S, Alfieri CM, Gallazzi E, Gagliardi V, Villarini A, Meazza R, Floreani R, Messa P, Kotovskaya Y, Villevalde S, Kobalava Z, Circiumaru A, Rusu E, Zilisteanu D, Atasie T, Cirstea F, Ecobici M, Voiculescu M, Rosca M, Tanase C, Baoti I, Vidjak V, Prka in I, Bulum T, Arslan E, Sarlak H, Cakar M, Demirbas S, Akhan M, Kurt O, Balta S, Yesilkaya S, Bulucu F, Chan CK, Lin YH, Wu VC, Wu KD, De Beus E, Bots ML, Van Zuilen AD, Wetzels JF, Blankestijn PJ, Mohaupt M, Straessle K, Baumann M, Raio L, Sirbek D, Nascimento MA, Mouro MG, Punaro GR, Mello MT, Tufik S, Higa EMS. HYPERTENSION. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Yoshifuji A, Wakino S, Irie J, Minakuchi H, Hasegawa K, Tokuyama H, Hayashi K, Itoh H, Xu H, Huang X, Riserus U, Cederholm T, Arnlov J, Sjogren P, Lindholm B, Carrero JJ, Poesen R, Windey K, Evenepoel P, De Preter V, Verbeke K, Meijers B, De Roij Van Zuijdewijn CL, Nube MJ, Bots ML, Blankestijn PJ, Van Den Dorpel MA, Ter Wee PM, Grooteman MP, Poesen R, Windey K, Masereeuw R, Van Den Broek PH, Evenepoel P, Meijers B, Verbeke K. CKD NUTRITION. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Deutz NEP, Bauer JM, Barazzoni R, Biolo G, Boirie Y, Bosy-Westphal A, Cederholm T, Cruz-Jentoft A, Krznariç Z, Nair KS, Singer P, Teta D, Tipton K, Calder PC. Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN Expert Group. Clin Nutr 2014; 33:929-36. [PMID: 24814383 DOI: 10.1016/j.clnu.2014.04.007] [Citation(s) in RCA: 902] [Impact Index Per Article: 90.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 04/09/2014] [Indexed: 12/12/2022]
Abstract
The aging process is associated with gradual and progressive loss of muscle mass along with lowered strength and physical endurance. This condition, sarcopenia, has been widely observed with aging in sedentary adults. Regular aerobic and resistance exercise programs have been shown to counteract most aspects of sarcopenia. In addition, good nutrition, especially adequate protein and energy intake, can help limit and treat age-related declines in muscle mass, strength, and functional abilities. Protein nutrition in combination with exercise is considered optimal for maintaining muscle function. With the goal of providing recommendations for health care professionals to help older adults sustain muscle strength and function into older age, the European Society for Clinical Nutrition and Metabolism (ESPEN) hosted a Workshop on Protein Requirements in the Elderly, held in Dubrovnik on November 24 and 25, 2013. Based on the evidence presented and discussed, the following recommendations are made (a) for healthy older people, the diet should provide at least 1.0-1.2 g protein/kg body weight/day, (b) for older people who are malnourished or at risk of malnutrition because they have acute or chronic illness, the diet should provide 1.2-1.5 g protein/kg body weight/day, with even higher intake for individuals with severe illness or injury, and (c) daily physical activity or exercise (resistance training, aerobic exercise) should be undertaken by all older people, for as long as possible.
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Affiliation(s)
- Nicolaas E P Deutz
- Center for Translational Research in Aging & Longevity, Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA.
| | - Jürgen M Bauer
- Department of Geriatric Medicine, Carl von Ossietzky University, Klinikum, Oldenburg, Germany
| | - Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, Internal Medicine, University of Trieste, Trieste, Italy
| | - Gianni Biolo
- Department of Medical, Surgical and Health Sciences, Internal Medicine, University of Trieste, Trieste, Italy
| | - Yves Boirie
- Université d'Auvergne, INRA, CRNH, Centre Hospitalier Universitaire, Clermont-Ferrand, France
| | - Anja Bosy-Westphal
- Institut für Ernährungsmedizin, Universität Hohenheim, Stuttgart, Germany
| | - Tommy Cederholm
- Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Sweden; Department of Geriatric Medicine, Uppsala University Hospital, Sweden
| | | | - Zeljko Krznariç
- Department of Clinical Nutrition, University Hospital Center and School of Medicine, Zagreb, Croatia
| | | | - Pierre Singer
- Department of Intensive Care, Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Sackler School of Medicine, Tel Aviv University, Israel
| | - Daniel Teta
- Centre Hospitalier Universitaire Vaudois, Service de Néphrologie, Lausanne, Switzerland
| | - Kevin Tipton
- Health and Exercise Sciences Research Group, University of Stirling, Stirling, Scotland
| | - Philip C Calder
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, United Kingdom
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Freund Levi Y, Vedin I, Cederholm T, Basun H, Faxén Irving G, Eriksdotter M, Hjorth E, Schultzberg M, Vessby B, Wahlund LO, Salem N, Palmblad J. Transfer of omega-3 fatty acids across the blood-brain barrier after dietary supplementation with a docosahexaenoic acid-rich omega-3 fatty acid preparation in patients with Alzheimer's disease: the OmegAD study. J Intern Med 2014; 275:428-36. [PMID: 24410954 DOI: 10.1111/joim.12166] [Citation(s) in RCA: 102] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Little is known about the transfer of essential fatty acids (FAs) across the human blood-brain barrier (BBB) in adulthood. In this study, we investigated whether oral supplementation with omega-3 (n-3) FAs would change the FA profile of the cerebrospinal fluid (CSF). METHODS A total of 33 patients (18 receiving the n-3 FA supplement and 15 receiving placebo) were included in the study. These patients were participants in the double-blind, placebo-controlled randomized OmegAD study in which 204 patients with mild Alzheimer's disease (AD) received 2.3 g n-3 FA [high in docosahexaenoic acid (DHA)] or placebo daily for 6 months. CSF FA levels were related to changes in plasma FA and to CSF biomarkers of AD and inflammation. RESULTS At 6 months, the n-3 FA supplement group displayed significant increases in CSF (and plasma) eicosapentaenoic acid (EPA), DHA and total n-3 FA levels (P < 0.01), whereas no changes were observed in the placebo group. Changes in CSF and plasma levels of EPA and n-3 docosapentaenoic acid were strongly correlated, in contrast to those of DHA. Changes in DHA levels in CSF were inversely correlated with CSF levels of total and phosphorylated tau, and directly correlated with soluble interleukin-1 receptor type II. Thus, the more DHA increased in CSF, the greater the change in CSF AD/inflammatory biomarkers. CONCLUSIONS Oral supplementation with n-3 FAs conferred changes in the n-3 FA profile in CSF, suggesting transfer of these FAs across the BBB in adults.
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Affiliation(s)
- Y Freund Levi
- Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
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Vahlberg B, Cederholm T, Lindmark B, Zetterberg L, Hellström K. Effects of progressive resistance and balance training 1‐3 years after stroke: a randomized controlled trial (706.14). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.706.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Tommy Cederholm
- Dept of Public Health and Caring Sciences Clinical Nutrition and MetabolismUPPSALASweden
| | - B Lindmark
- Department of neuroscience PhysiotherapyUPPSALASweden
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227
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Xu H, Huang X, Risérus U, Cederholm T, Lindholm B, Ärnlöv J, Carrero JJ. Urinary albumin excretion, blood pressure changes and hypertension incidence in the community: effect modification by kidney function. Nephrol Dial Transplant 2014; 29:1538-45. [PMID: 24642418 DOI: 10.1093/ndt/gfu057] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Both increased albuminuria and reduced kidney function may predict blood pressure (BP) progression in the community, while they exacerbate each other's effects. We investigated associations and interactions between these two risk factors, BP changes and hypertension incidence in community-dwelling elderly men. METHODS Observational study from the Uppsala Longitudinal Study of Adult Men, which included 1051 men (all aged 71 years) with assessments on urinary albumin excretion rate (UAER), 24-hour ambulatory BP monitoring (ABPM) and cystatin-C estimated glomerular filtration rate (eGFR). Of these, 574 men attended re-examination after 6 years, and ABPM measurements were again recorded to assess blood pressure changes and hypertension incidence. RESULTS UAER was found to be associated with ABPM measurements both at baseline and longitudinally. In longitudinal analysis, there were significant interactions between UAER and kidney function in its association with the changes of systolic BP, mean arterial pressure and pulse pressure. After stratification for renal function state, UAER independently predicted BP changes only in those who had eGFR <60 mL/min/1.73 m(2). At re-examination, 71 new cases of hypertension were recorded. In multivariable logistic models, similar interactions were observed on hypertension incidence: UAER was an independent predictor of incident hypertension only in those with reduced renal function. These associations were evident also in the subpopulation of non-diabetics and in participants with normal range UAER (<20 µg/min). CONCLUSIONS In community-dwelling elderly men, UAER associates with BP progression and hypertension incidence, even within the normal range. Concurrent reduction of renal function modifies and exacerbates these associations.
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Affiliation(s)
- Hong Xu
- Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Xiaoyan Huang
- Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden Division of Nephrology, Peking University Shenzhen Hospital, Peking University, Shenzhen, China
| | - Ulf Risérus
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Bengt Lindholm
- Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Johan Ärnlöv
- Department of Public Health and Caring Sciences, Section of Geriatrics, Uppsala University, Uppsala, Sweden School of Health and Social Studies, Dalarna University, Falun, Sweden
| | - Juan Jesús Carrero
- Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden Center for Gender Medicine, Karolinska Institutet, Stockholm, Sweden
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Pedersen AN, Cederholm T. Health effects of protein intake in healthy elderly populations: a systematic literature review. Food Nutr Res 2014; 58:23364. [PMID: 24624051 PMCID: PMC3926464 DOI: 10.3402/fnr.v58.23364] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 11/13/2013] [Accepted: 11/13/2013] [Indexed: 11/23/2022] Open
Abstract
The purpose of this systematic review is to assess the evidence behind the dietary requirement of protein and to assess the health effects of varying protein intake in healthy elderly persons in order to evaluate the evidence for an optimal protein intake. The literature search covered year 2000–2011. Prospective cohort, case–control, and intervention studies of a general healthy population in settings similar to the Nordic countries with protein intake from food-based sources were included. Out of a total of 301 abstracts, 152 full papers were identified as potentially relevant. After careful scrutiny, 23 papers were quality graded as A (highest, n=1), B (n=18), or C (n=4). The grade of evidence was classified as convincing, probable, suggestive, or inconclusive. The evidence is assessed as: probable for an estimated average requirement (EAR) of 0.66 g good-quality protein/kg body weight (BW)/day based on nitrogen balance (N-balance) studies and the subsequent recommended dietary allowance (RDA) of 0.83 g good-quality protein/kg BW/day representing the minimum dietary protein needs of virtually all healthy elderly persons. Regarding the optimal level of protein related to functional outcomes like maintenance of bone mass, muscle mass, and strength, as well as for morbidity and mortality, the evidence is ranging from suggestive to inconclusive. Results from particularly prospective cohort studies suggest a safe intake of up to at least 1.2–1.5 g protein/kg BW/day or approximately 15–20 E%. Overall, many of the included prospective cohort studies were difficult to fully evaluate since results mainly were obtained by food frequency questionnaires that were flawed by underreported intakes, although some studies were ‘calibrated’ to correct for under- or over-reporting. In conclusion, the evidence is assessed as probable regarding the EAR based on N-balance studies and suggestive to inconclusive regarding an optimal protein intake higher than the estimated RDA assessed from N-balance studies, but an exact level cannot be determined. Potentially adverse effects of a protein intake exceeding 20–23 E% remain to be investigated.
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Affiliation(s)
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Xu H, Huang X, Arnlöv J, Cederholm T, Stenvinkel P, Lindholm B, Risérus U, Carrero JJ. Clinical correlates of insulin sensitivity and its association with mortality among men with CKD stages 3 and 4. Clin J Am Soc Nephrol 2014; 9:690-7. [PMID: 24436478 DOI: 10.2215/cjn.05230513] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Insulin resistance participates in the pathogenesis of multiple metabolic and cardiovascular diseases. CKD patients have impaired insulin sensitivity, but the clinical correlates and outcome associations of impaired insulin sensitivity in this vulnerable population are not well defined. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS The prospective cohort study was from the third examination cycle of the Uppsala Longitudinal Study of Adult Men, a population-based survey of elderly men ages 70-71 years; insulin sensitivity was assessed by glucose disposal rate as measured with euglycemic clamps. Inclusion criterion was eGFR<60 ml/min per 1.73 m(2) (n=543). Exclusion criteria were incomplete data on euglycemic clamp and diabetes (n=97), leaving 446 men with CKD stages 3 and 4 (eGFR median=51.9 ml/min per 1.73 m(2); range=20.2-59.5 ml/min per 1.73 m(2)). RESULTS The mean of glucose disposal rate was 5.4 ± 1.9 mg/kg per minute. In multivariable analysis, the independent clinical correlates of glucose disposal rate were eGFR (slope, 0.02; 95% confidence interval, 0.01 to 0.04), hypertension (-0.48; 95% confidence interval, -0.86 to -0.11), hyperlipidemia (-0.51; 95% confidence interval, -0.84 to -0.18), and body mass index (-0.32; 95% confidence interval, -0.37 to -0.27). During follow-up (median=10.0 years; interquartile range=8.7-11.0 years), 149 participants died. In Cox regression models, glucose disposal rate was not associated with all-cause or cardiovascular mortality. Multiplicative interactions (P<0.05) were observed between glucose disposal rate and physical activity or smoking in total mortality association. After subsequent stratification, glucose disposal rate was an independent correlate of all-cause mortality in smokers (adjusted hazard ratio, 0.72; 95% confidence interval, 0.54 to 0.96 per 1 mg/kg per minute glucose disposal rate increase) and physically inactive individuals (hazard ratio, 0.77; 95% confidence interval, 0.61 to 0.97) but not their counterparts. CONCLUSION eGFR, together with various components of the metabolic syndrome, contributed to explain the variance of insulin sensitivity in men with CKD stages 3 and 4. Insulin sensitivity was associated with a lower mortality risk in individuals who smoked and individuals who were physically inactive.
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Affiliation(s)
- Hong Xu
- Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden;, †Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China;, ‡Division of Nephrology, Peking University Shenzhen Hospital, Peking University, Shenzhen, China;, §Department of Public Health and Caring Sciences, Section of Geriatrics, and, ¶Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden;, ‖School of Health and Social Studies, Dalarna University, Falun, Sweden, *Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
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230
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Huang X, Sjögren P, Ärnlöv J, Cederholm T, Lind L, Stenvinkel P, Lindholm B, Risérus U, Carrero JJ. Serum fatty acid patterns, insulin sensitivity and the metabolic syndrome in individuals with chronic kidney disease. J Intern Med 2014; 275:71-83. [PMID: 24011327 DOI: 10.1111/joim.12130] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES The causes of the multiple metabolic disorders of individuals with chronic kidney disease (CKD) are not fully known. We investigated the relationships between dietary fat quality, the metabolic syndrome (MetS), insulin sensitivity and inflammation in individuals with CKD. SUBJECTS Two population-based surveys were conducted in elderly Swedish individuals (aged 70 years) with serum cystatin C-estimated glomerular filtration rate <60 mL min(-1) /1.73 m2: the Uppsala Longitudinal Study of Adult Men (ULSAM) and the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) surveys. The present population comprised 274 men and 187 subjects (63% women) from the ULSAM and PIVUS cohorts, respectively. DESIGN Factor analyses of serum fatty acids were used to evaluate dietary fat quality. Insulin sensitivity was measured by homeostasis model assessment of insulin resistance (IR) and, in ULSAM, also by euglycaemic clamp. RESULTS Factor analyses generated two fatty acid patterns of (i) low linoleic acid (LA)/high saturated fatty acid (SFA) or (ii) high n-3 polyunsaturated fatty acid (n-3 PUFA) levels. In both surveys, the low LA/high SFA pattern increased the odds of having MetS [adjusted odds ratio 0.60 [95% confidence interval (CI) 0.44-0.81] and 0.45 (95% CI 0.30-0.67) per SD decrease in factor score in the ULSAM and PIVUS surveys, respectively] and was directly associated with both IR and C-reactive protein. The n-3 PUFA pattern was not consistently associated with these risk factors. CONCLUSIONS A serum fatty acid pattern reflecting low LA and high SFA was strongly associated with MetS, IR and inflammation in two independent surveys of elderly individuals with CKD. At present, there are no specific dietary guidelines for individuals with CKD; however, these findings indirectly support current recommendations to replace SFAs with PUFAs from vegetable oils.
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Affiliation(s)
- X Huang
- Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden
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231
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Ax E, Garmo H, Grundmark B, Bill-Axelson A, Holmberg L, Becker W, Zethelius B, Cederholm T, Sjögren P. Dietary patterns and prostate cancer risk: report from the population based ULSAM cohort study of Swedish men. Nutr Cancer 2013; 66:77-87. [PMID: 24325263 DOI: 10.1080/01635581.2014.851712] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Dietary pattern analyses have increased the possibilities to detect associations between diet and disease. However, studies on dietary pattern and prostate cancer are scarce. Food intake data in the Uppsala Longitudinal Study of Adult Men cohort was determined by 7-day food records. Adherence to a modified Mediterranean Diet Score (mMDS) and a low carbohydrate-high protein (LCHP) score were grouped as low, medium, or high in the whole study population (n = 1,044) and in those identified as adequate reporters of energy intake (n = 566), respectively. Prostate cancer risk was analyzed with Cox proportional hazard regression (median follow-up 13 years) and competing risk of death was considered. There were no associations between dietary patterns and prostate cancer (n = 133) in the whole study population. Among adequate reporters the mMDS was not associated with prostate cancer (n = 72). The LCHP score was inversely related to prostate cancer in adequate reporters, adjusted hazard ratios; 0.55 (0.32-0.96) for medium and 0.47 (0.21-1.04) for high compared to low adherent participants (P-for-trend 0.04). Risk relations were not attributable to competing risk of death. In this study, a LCHP diet was associated with lower prostate cancer incidence. Relations emerged in adequate reporters, underscoring the importance of high-quality dietary data.
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Affiliation(s)
- Erika Ax
- a Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism , Uppsala University , Uppsala , Sweden
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232
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Faxén-Irving G, Freund-Levi Y, Eriksdotter-Jönhagen M, Basun H, Hjorth E, Palmblad J, Vedin I, Cederholm T, Wahlund LO. Effects on transthyretin in plasma and cerebrospinal fluid by DHA-rich n - 3 fatty acid supplementation in patients with Alzheimer's disease: the OmegAD study. J Alzheimers Dis 2013; 36:1-6. [PMID: 23563245 DOI: 10.3233/jad-121828] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Transthyretin (TTR) binds amyloid-β (Aβ) and may reduce brain Aβ, a pathological feature in Alzheimer's disease (AD). N - 3 fatty acids (FA), docosahexaenoic (DHA), and eicosapentaenoic acid (EPA) may increase TTR transcription in rat hippocampus. We studied effects of n - 3 FA supplementation on TTR-levels in patients with AD. Outpatients were randomized to receive 1.7 g DHA and 0.6 g EPA (n - 3/n - 3 group) or placebo (placebo/n - 3 group) during 6 months. After 6 months, all patients received n - 3 FA for another 6 months. TTR and FA were measured in plasma in all subjects, whereas TTR in cerebrospinal fluid (CSF) was measured in a subgroup. The study was completed by 89 patients in the n - 3/n - 3 group (75 y, 57% w) and 85 in the placebo/n - 3 group (75 y, 46% w). Baseline plasma-TTR was within normal range in both groups. After 6 months, plasma-TTR decreased in the placebo/n - 3 group (p < 0.001 within and p < 0.015 between the groups). No changes were observed in CSF TTR. From 6 to 12 months when both groups were supplemented, plasma-TTR increased significantly in both groups. Repeated measures ANOVA indicated an increase in TTR over time (p = 0.04) in those receiving n - 3 FA for 12 months. By linear regression analyses, n - 3 FA treatment was independently associated with increased plasma-TTR at 6 months (β = -0.172, p = 0.028). Thus, n - 3 FA treatment appeared to increase plasma-TTR in patients with AD. Since TTR may influence Aβ deposition in the brain, the results warrant further exploration.
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Affiliation(s)
- Gerd Faxén-Irving
- Department of NVS, Section of Clinical Nutrition, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
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Abstract
The brain is a lipid-rich organ where docosahexaenoic acid (DHA) is enriched and where eicosapentaenoic acid (EPA) may have anti-inflammatory effects. The potential role for n-3 (ω-3) fatty acids such as DHA and EPA in the prevention of cognitive decline, including Alzheimer's disease (AD) has attracted major interest for the past 20 y. This review presents our understanding of recent observational, interventional, and experimental studies, with the aim of providing some answers to the following question: Can n-3 FA intake modulate cognitive function during aging? In longitudinal observation studies we mainly observe inverse relations between fish intake or serum concentrations of DHA and cognitive impairment. Intervention studies of EPA and DHA supplementation in healthy old individuals have been negative so far (i.e., after up to 2 years of treatment, no differences in cognitive decline between treated and nontreated participants have been observed). In studies that provided EPA and DHA to adults with mild cognitive impairment or age-related cognitive impairment the data seem to be positive. However, when patients with established AD were supplemented with EPA and DHA it appears no benefit was gained. For studies on healthy individuals, a major concern is that the treatment periods may have been too short. There might also be subgroup effects because of the carriage of apolipoprotein Eε4 alleles or risk factor burden. Experimental studies appear to be consistently positive (i.e., n-3 FA supplementation in rodents over a substantial portion of their lives reduces amyloid-β deposition and hippocampal neuron loss and improves cognitive functioning). We are getting closer to providing evidence-based recommendations on fish and fish oil intake to facilitate memory function during old age. In the meantime it is advised to follow the general CDC dietary recommendations of 2-3 fish meals per week or the equivalent intake of long chain n-3 fatty acids, particularly DHA.
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Affiliation(s)
- Tommy Cederholm
- Clinical Nutrition and Metabolism, Uppsala University, and Department of Geriatric Medicine, Uppsala University Hospital, Sweden,To whom correspondence should be addressed. E-mail:
| | - Norman Salem
- Nutritional Lipids, DSM Nutritional Products, Columbia, MD; and
| | - Jan Palmblad
- Department of Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
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234
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Vahlberg B, Cederholm T, Lindmark B, Zetterberg L, Hellström K. Factors Related to Performance-Based Mobility and Self-reported Physical Activity in Individuals 1-3 Years after Stroke: A Cross-sectional Cohort Study. J Stroke Cerebrovasc Dis 2013; 22:e426-34. [DOI: 10.1016/j.jstrokecerebrovasdis.2013.04.028] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 04/22/2013] [Indexed: 12/22/2022] Open
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235
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Titova OE, Ax E, Brooks SJ, Sjögren P, Cederholm T, Kilander L, Kullberg J, Larsson EM, Johansson L, Ahlström H, Lind L, Schiöth HB, Benedict C. Mediterranean diet habits in older individuals: associations with cognitive functioning and brain volumes. Exp Gerontol 2013; 48:1443-8. [PMID: 24126083 DOI: 10.1016/j.exger.2013.10.002] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Revised: 09/04/2013] [Accepted: 10/04/2013] [Indexed: 01/09/2023]
Abstract
To examine the association between dietary habits, cognitive functioning and brain volumes in older individuals, data from 194 cognitively healthy individuals who participated in the Prospective Investigation of the Vasculature in Uppsala Seniors cohort were used. At age 70, participants kept diaries of their food intake for 1week. These records were used to calculate a Mediterranean diet (MeDi) score (comprising dietary habits traditionally found in Mediterranean countries, e.g. high intake of fruits and low intake of meat), with higher scores indicating more pronounced MeDi-like dietary habits. Five years later, participants' cognitive capabilities were examined by the seven minute screening (7MS) (a cognitive test battery used by clinicians to screen for dementia), and their brain volumes were measured by volumetric magnetic resonance imaging. Multivariate linear regression analyses were constructed to examine the association between the total MeDi score and cognitive functioning and brain volumes. In addition, possible associations between MeDi's eight dietary features and cognitive functioning and brain volumes were investigated. From the eight dietary features included in the MeDi score, pertaining to a low consumption of meat and meat products was linked to a better performance on the 7MS test (P=0.001) and greater total brain volume (i.e. the sum of white and gray matter, P=0.03) when controlling for potential confounders (e.g. BMI) in the analysis. Integrating all dietary features into the total MeDi score explained less variance in cognitive functioning and brain volumes than its single dietary component meat intake. These observational findings suggest that keeping to a low meat intake could prove to be an impact-driven public health policy to support healthy cognitive aging, when confirmed by longitudinal studies. Further, they suggest that the MeDi score is a construct that may mask possible associations of single MeDi features with brain health domains in elderly populations.
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Affiliation(s)
- Olga E Titova
- Department of Neuroscience, Uppsala University, Sweden.
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236
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Muscaritoli M, Lucia S, Molfino A, Cederholm T, Rossi Fanelli F. Muscle atrophy in aging and chronic diseases: is it sarcopenia or cachexia? Intern Emerg Med 2013; 8:553-60. [PMID: 22773188 DOI: 10.1007/s11739-012-0807-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Accepted: 06/18/2012] [Indexed: 12/24/2022]
Abstract
Cachexia and sarcopenia present several analogies in both the pathogenic mechanisms and the clinical picture. The loss of muscle mass and strength is a hallmark of these two clinical conditions. Although frequently overlapping and often indistinguishable, especially in old individuals, these two conditions should be considered distinct clinical entities. A prompt and accurate patient evaluation, guiding the physician through a proper differential diagnostic procedure and providing the best therapeutic options, is recommended. Given the several commonalities between cachexia and sarcopenia, it is likely that the therapeutic approaches may prove effective in both conditions. This review focuses on the most recent available literature and aims at providing physicians with the correct tools that are available to aid in diagnosing these two different entities that often clinically overlap. Currently available or proposed therapeutic strategies for pre-cachexia, cachexia and sarcopenia are also briefly described.
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Affiliation(s)
- Maurizio Muscaritoli
- Department of Clinical Medicine, Sapienza, University of Rome, Viale dell'Università, 37, 00185, Rome, Italy,
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237
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Vahlberg B, Zetterberg L, Hellström K, Cederholm T. LB021-MON NUTRITIONAL STATUS, BODY COMPOSITION AND PHYSICAL PERFORMANCE IN COMMUNITY-LIVING INDIVIDUALS AFTER STROKE: A CROSS-SECTIONAL STUDY. Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60623-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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238
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Lauretani F, Cattabiani C, Artoni A, Aloe R, De Vita F, Sutti E, Bondi G, Masoni S, Pedrazzoni M, Passeri G, Lippi G, Cederholm T, Lind L, Ceda G, Maggio M. OP028 VITAMIN D AND ENDOTHELIUM VASODILATION IN OLDER SUBJECTS. Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60030-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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239
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Sutti E, Maggio M, Cattabiani C, Lauretani F, Mantovani M, Buttò V, De Vita F, Artoni A, Giallauria F, Zuliani G, Aloe R, Lippi G, Ceresini G, Cederholm T, Lind L, Ceda G. Sex hormone binding globulin and endothelial function in older subjects: The PIVUS study. Eur Geriatr Med 2013. [DOI: 10.1016/j.eurger.2013.07.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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240
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Bauer J, Biolo G, Cederholm T, Cesari M, Cruz-Jentoft AJ, Morley JE, Phillips S, Sieber C, Stehle P, Teta D, Visvanathan R, Volpi E, Boirie Y. Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group. J Am Med Dir Assoc 2013; 14:542-59. [DOI: 10.1016/j.jamda.2013.05.021] [Citation(s) in RCA: 1068] [Impact Index Per Article: 97.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 05/29/2013] [Indexed: 12/20/2022]
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Titova OE, Sjögren P, Brooks SJ, Kullberg J, Ax E, Kilander L, Riserus U, Cederholm T, Larsson EM, Johansson L, Ahlström H, Lind L, Schiöth HB, Benedict C. Dietary intake of eicosapentaenoic and docosahexaenoic acids is linked to gray matter volume and cognitive function in elderly. Age (Dordr) 2013; 35:1495-1505. [PMID: 22791395 PMCID: PMC3705118 DOI: 10.1007/s11357-012-9453-3] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 06/27/2012] [Indexed: 06/01/2023]
Abstract
In the present study, we tested whether elderly with a high dietary intake of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) would have higher cognitive test scores and greater brain volume than those with low dietary intake of these fatty acids. Data were obtained from the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) cohort. The dietary intake of EPA and DHA was determined by a 7-day food protocol in 252 cognitively healthy elderly (122 females) at the age of 70 years. At age 75, participants' global cognitive function was examined, and their brain volumes were measured by magnetic resonance imaging (MRI). Three different multivariate linear regression models were applied to test our hypothesis: model A (adjusted for gender and age), model B (additionally controlled for lifestyle factors, e.g., education), and model C (further controlled for cardiometabolic factors, e.g., systolic blood pressure). We found that the self-reported 7-day dietary intake of EPA and DHA at the age of 70 years was positively associated with global gray matter volume (P < 0.05, except for model C) and increased global cognitive performance score (P < 0.05). However, no significant associations were observed between the dietary intake of EPA and DHA and global white matter, total brain volume, and regional gray matter, respectively. Further, no effects were observed when examining cognitively impaired (n = 27) elderly as separate analyses. These cross-sectional findings suggest that dietary intake of EPA and DHA may be linked to improved cognitive health in late life but must be confirmed in patient studies.
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Affiliation(s)
- Olga E. Titova
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Per Sjögren
- Department of Public Health and Caring Sciences, Section of Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | | | - Joel Kullberg
- Department of Radiology, Uppsala University, Uppsala, Sweden
| | - Erika Ax
- Department of Public Health and Caring Sciences, Section of Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Lena Kilander
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden
| | - Ulf Riserus
- Department of Public Health and Caring Sciences, Section of Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Section of Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | | | - Lars Johansson
- Department of Radiology, Uppsala University, Uppsala, Sweden
| | - Håkan Ahlström
- Department of Radiology, Uppsala University, Uppsala, Sweden
| | - Lars Lind
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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Wallin A, Di Giuseppe D, Burgaz A, Håkansson N, Cederholm T, Michaëlsson K, Wolk A. Validity of food frequency questionnaire-based estimates of long-term long-chain n-3 polyunsaturated fatty acid intake. Eur J Nutr 2013; 53:549-55. [DOI: 10.1007/s00394-013-0563-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Accepted: 07/15/2013] [Indexed: 11/24/2022]
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Huang X, Jiménez-Moleón JJ, Lindholm B, Cederholm T, Arnlöv J, Risérus U, Sjögren P, Carrero JJ. Mediterranean diet, kidney function, and mortality in men with CKD. Clin J Am Soc Nephrol 2013; 8:1548-55. [PMID: 23744002 DOI: 10.2215/cjn.01780213] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND AND OBJECTIVES Adherence to a Mediterranean diet may link to a better preserved kidney function in the community as well as a favorable cardiometabolic profile and reduced mortality risk in individuals with manifest CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Dietary habits were determined by 7-day dietary records in a population-based cohort of 1110 Swedish men (age 70 years) from 1991 to 1995, 506 of whom were considered to have CKD because of a GFR<60 ml/min per 1.73 m(2). A Mediterranean Diet Score was calculated, and participants were categorized as having low, medium, or high adherence. Adequate dietary reporters were identified with Goldberg cutoffs (n=597). Deaths were registered during a median follow-up of 9.9 years. RESULTS Compared with low adherents, medium and high adherents were 23% and 42% less likely to have CKD, respectively (adjusted odds ratio [95% confidence interval]=0.77 [0.57 to 1.05] and 0.58 [0.38 to 0.87], respectively, P for trend=0.04). Among those individuals with CKD, phosphate intake and net endogenous acid production were progressively lower across increasing adherence groups. No differences were observed regarding other cardiometabolic risk factors across adherence groups. As many as 168 (33%) CKD individuals died during follow-up. Compared with low adherents, proportional hazards regression associated medium and high adherents to a 25% and 23% lower mortality risk, respectively (adjusted hazard ratio [95% confidence interval]=0.75 [0.52 to 1.06] and 0.77 [0.44 to 1.36], respectively, P for trend=0.10). Sensitivity analyses showed significant and stronger associations when only adequate dietary reporters were considered. CONCLUSIONS Adherence to a Mediterranean dietary pattern is associated with lower likelihood of CKD in elderly men. A greater adherence to this diet independently predicted survival in those patients with manifest CKD. Clinical trials are warranted to test the hypothesis that following such a diet could improve outcomes (independent of other healthy lifestyles) in CKD patients.
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Affiliation(s)
- Xiaoyan Huang
- Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, Stockholm, Sweden.
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Ekström W, Al-Ani AN, Sääf M, Cederholm T, Ponzer S, Hedström M. Health related quality of life, reoperation rate and function in patients with diabetes mellitus and hip fracture--a 2 year follow-up study. Injury 2013; 44:769-75. [PMID: 23122996 DOI: 10.1016/j.injury.2012.10.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Revised: 08/15/2012] [Accepted: 10/01/2012] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Diabetes mellitus confers an increased risk of hip fractures. There is a limited knowledge of how the outcome after a hip fracture in patients with diabetes affect Health Related Quality of Life (HRQoL). The primary aim of this study was to evaluate HRQoL. Secondary aims were reoperation rate, complications and functions in patients with diabetes followed for 2 years after a hip fracture. MATERIALS AND METHODS Out of 2133 patients diabetes was present in 234 patients (11%). Main outcome measurements were HRQoL evaluated with EuroQoL 5-Dindex score, reoperation rate, surgical and medical complications, function as walking ability, daily activities, living condition and pain. RESULTS Preoperatively, patients with diabetes mellitus had more pain (p=0.044), co-morbidities, reduced health status (p=0.001) and more often used a walking frame (p=0.014) than patients without diabetes, whereas Katz ADL index, cognition and body mass index did not differ. There was no difference in fracture type, surgical method or reoperation between the two groups or between patients with insulin treated or oral treated diabetes. The EQ-5Dindex score decreased from 0.64 at admission to 0.45 at 4 months, 0.49 at 12 months and 0.51 at 24 months with similar results for patients with and without diabetes. During the first postoperative year there was not more medical complications among patients with diabetes, however cardiac (p=0.023) and renal failure (p=0.032) were more frequent in patients with diabetes at 24 months. Patients with diabetes more often had severe hip pain at 4 months (p=0.031). At 12 months more diabetic patients were living independently (p=0.034). There was no difference in walking ability, ADL and living condition between the groups at 24 months. CONCLUSION The findings of this study indicate that patients with diabetes mellitus had more pain, co-morbidities, reduced health status preoperatively than patients without diabetes. Hip fracture patients with diabetes mellitus have more hip pain at 4 months. Cardiac and renal failure was more frequent in patients with diabetes at 24 months but otherwise we found a comparable re-operation rate, function and deterioration of Health Related Quality of Life as patients without diabetes within 2 years after a hip fracture.
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Affiliation(s)
- W Ekström
- Karolinska Institutet, Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska University Hospital Solna, Stockholm, Sweden.
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Hjorth E, Zhu M, Toro VC, Vedin I, Palmblad J, Cederholm T, Freund-Levi Y, Faxen-Irving G, Wahlund LO, Basun H, Eriksdotter M, Schultzberg M. Omega-3 Fatty Acids Enhance Phagocytosis of Alzheimer's Disease-Related Amyloid-β42 by Human Microglia and Decrease Inflammatory Markers. ACTA ACUST UNITED AC 2013; 35:697-713. [DOI: 10.3233/jad-130131] [Citation(s) in RCA: 158] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Erik Hjorth
- Division of Neurodegeneration, Department of Neurobiology, Care Sciences & Society, Karolinska Institutet, Stockholm, Sweden
| | - Mingqin Zhu
- Division of Neurodegeneration, Department of Neurobiology, Care Sciences & Society, Karolinska Institutet, Stockholm, Sweden
| | - Veronica Cortés Toro
- Division of Neurodegeneration, Department of Neurobiology, Care Sciences & Society, Karolinska Institutet, Stockholm, Sweden
| | - Inger Vedin
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jan Palmblad
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Tommy Cederholm
- Division of Clinical Nutrition and Metabolism, Department of Public Health & Caring Sciences, Uppsala University Hospital, Uppsala, Sweden
| | - Yvonne Freund-Levi
- Clinical Geriatrics, Department of Neurobiology, Care Sciences & Society, Karolinska Institutet, Stockholm, Sweden
| | - Gerd Faxen-Irving
- Nutrition, Department of Neurobiology, Care Sciences & Society, Karolinska Institutet, Stockholm, Sweden
| | - Lars-Olof Wahlund
- Clinical Geriatrics, Department of Neurobiology, Care Sciences & Society, Karolinska Institutet, Stockholm, Sweden
| | - Hans Basun
- Division of Geriatrics, Department of Public Health & Caring Sciences, Uppsala University Hospital, Uppsala, Sweden
| | - Maria Eriksdotter
- Clinical Geriatrics, Department of Neurobiology, Care Sciences & Society, Karolinska Institutet, Stockholm, Sweden
| | - Marianne Schultzberg
- Division of Neurodegeneration, Department of Neurobiology, Care Sciences & Society, Karolinska Institutet, Stockholm, Sweden
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246
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Hatlen G, Romundstad S, Hallan S, Carrero JJ, Huang X, Jimenez-Moleon J, Lindholm B, Cederholm T, Arnlov J, Riserus U, Sjogren P, Duzova A, Yalcinkaya F, Soylemezoglu O, Baskin E, Bakkaloglu A. Hypertension and outcomes. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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247
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Ax EH, Cederholm T, Grundmark B, Bill‐Axelson A, Becker W, Holmberg L, Zethelius B, Garmo H, Sjögren P. Dietary Patterns and prostate cancer risk: a population based cohort study in elderly Swedish men. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.847.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Erika Helena Ax
- Uppsala UniversityDept. of public health and caring sciencesUppsalaSweden
| | - Tommy Cederholm
- Uppsala UniversityDept. of public health and caring sciencesUppsalaSweden
| | - Birgitta Grundmark
- Regional Oncologic CenterUppsalaSweden
- Department of Surgical SciencesEndocrine SurgeryUppsalaSweden
| | - Anna Bill‐Axelson
- Regional Oncologic CenterUppsalaSweden
- Department of Surgical SciencesUrologyUppsalaSweden
| | - Wulf Becker
- Uppsala UniversityDept. of public health and caring sciencesUppsalaSweden
- National food agencyUppsalaSweden
| | - Lars Holmberg
- Department of Surgical SciencesEndocrine SurgeryUppsalaSweden
- The Division of Cancer StudiesSchool of MedicineLondonUnited Kingdom
| | - Björn Zethelius
- Uppsala UniversityDept. of public health and caring sciencesUppsalaSweden
- Medical Products AgencyUppsalaSweden
| | - Hans Garmo
- Regional Oncologic CenterUppsalaSweden
- The Division of Cancer StudiesSchool of MedicineLondonUnited Kingdom
| | - Per Sjögren
- Uppsala UniversityDept. of public health and caring sciencesUppsalaSweden
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248
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Holmback U, Berglund M, Cederholm T, Sundbom M. Body composition, energy metabolism and endocrine variables in weight stable gastric‐bypass patients. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.lb309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Ulf Holmback
- Department of Public Health and Caring SciencesUppsala UniversityUppsalaSweden
| | - Marie Berglund
- Department of Public Health and Caring SciencesUppsala UniversityUppsalaSweden
| | - Tommy Cederholm
- Department of Public Health and Caring SciencesUppsala UniversityUppsalaSweden
| | - Magnus Sundbom
- Department of Surgical SciencesUppsala UniversityUppsalaSweden
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249
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Vahlberg BM, Lindmark B, Zetterberg L, Hellström K, Cederholm T. Interactions between physical performance, body‐composition and nutrition in individuals one to three years after stroke. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.852.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | | | - Tommy Cederholm
- Department of Public Health and Caring SciencesClinical Nutrition and MetabolismUppsalaSweden
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250
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Vedin I, Levi YF, Cederholm T, Basun H, Hjorth E, Irving GF, Schultzberg M, Eriksdotter M, Vessby B, Wahlund L, Salem N, Palmblad J. Effects of a DHA rich n‐3 fatty acid supplementation on fatty acid composition in cerebrospinal fluid in Alzheimer disease. The OmegAD study. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.lb343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Yvonne Freund Levi
- Department of Neurobiology and Caring Sciences and SocietyStockholmSweden
| | - Tommy Cederholm
- Department of Public Health and Caring SciencesDiv of Nutrition and MetabolismUppsalaSweden
| | - Hans Basun
- Department of Public Health and Caring SciencesDiv. of GeriatricsUppsalaSweden
| | - Erik Hjorth
- Department of Neurobiology and Caring Sciences and SocietyStockholmSweden
| | - Gerd Faxén Irving
- Department of Neurobiology and Caring Sciences and SocietyStockholmSweden
| | | | - Maria Eriksdotter
- Department of Neurobiology and Caring Sciences and SocietyStockholmSweden
| | - Bengt Vessby
- Department of Public Health and Caring SciencesDiv of Nutrition and MetabolismUppsalaSweden
| | - Lars‐Olof Wahlund
- Department of Neurobiology and Caring Sciences and SocietyStockholmSweden
| | - Norman Salem
- Natl. Institute on Alcohol abuse and AlcoholismNatl. Institutes of HealthRockvilleMD
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