Gymnastik- och idrottshögskolan, GIH

Syfte och frågeställning

Studiens syfte är att studera kostråd genom att empiriskt följa en och samma litteraturkälla; Vår Föda, från utgivningsstart 1949 och fram till 2005.

Frågeställningarna är:

• Finns det skillnader i kostråden under tidsperioden?
• Vilken målgrupp vänder sig texterna främst till?

Metod

Tidskriften Vår Föda tar upp frågor främst kring matsäkerhet och kostvanor och presenterar artiklar skrivna främst av myndigheten Livsmedelsverkets experter inom olika områden. Genom en textanalys innefattande alla årgångar från 1949 till och med 2005 av denna tidskrift, har ett antal artiklar som tar upp kost och dess betydelse för en god hälsa legat till grund för hela studien. Valet av denna tidskrift grundar sig i dess unika kontinuitet över tid och valet av artiklar har gjorts efter en genomgång av artiklar, utifrån deras rubriker kring kost och hälsa.

Resultat

Studien gör gällande att kostråden under perioden är relativt konstanta, med fokus på blandad kost med begränsat fett- och sockerintag. Målgruppen är främst institutioner med yrkesverksamma personer inom kostområdet, skolor samt främst under senare år även privatpersoner som intresserar sig för kostfrågor.

Slutsats

De rekommendationer som ges kring kost i Vår Föda under de 56 åren som studien sträcker sig över har förändrats i ganska liten mån. Artiklarna är på senare tid skrivna för att kunna läsas av fler intressenter än enbart fackfolk inom kost och näringslära. Slutsatsen blir således att skillnaderna i rekommendationerna är små.

Sammanfattning

Syfte och frågeställningar

Syftet med denna uppsats var att undersöka hurvida en LCHF (Low Carb High Fat) kost skulle kunna vara en hälsosam livsstil utifrån hur den påverkar olika hälsomarkörer hos normalviktiga personer där en viktminskning ej har eftersträvats. Frågeställningen var följande: Hur påverkar en LCHF-kost med maximalt 30 gram kolhydrater per dag under 3 veckor normalviktiga kvinnors BMR (Basal Metabolic Rate), blodlipider, blodglukos, blodtryck, kroppssammansättning, midje- och höftmått samt deras kroppsvikt?

Metod

En experimentell studie har genomförts på 8 normalviktiga kvinnor mellan 20 och 35 år. Samtliga försökspersoners BMR, blodlipider, blodglukos, blodtryck, kroppssammansättning, midje- och höftmått samt kroppsvikt mättes vid normala levnadsförhållanden innan studiens start samt efter 3 veckor av en strikt LCHF-kost med endast 30 gram kolhydrater per dag.

Resultat

BMR sänktes i genomsnitt med 4,4% vilket var signifikant (P<0,05). HDL (High-density lipoproteins), LDL (Low-density lipoproteins) samt totalkolesterol höjdes signifikant (P<0,01) med 21%, 25% respektive 22%. Ingen signifikant skillnad i LDL/HDL-kvot, triglycerider eller blodtryck erhölls. Blodglukos sänktes med 12%, skillnaden var dock ej signifikant. Andel kroppsfett sänktes signifikant med 8,7% (P<0,01) och fettmassan med 11% (P<0,01). Den fettfria massan visade ingen signifikant skillnad. Midjemåttet minskade signifikant med 2,3% (P<0,05) och kroppsvikten i genomsnittt med 1,24 kg (P<0,05). Höftmåttet visade ingen signifikant skillnad mellan mätningen före och efter 3 veckors LCHF-kost.

Slutsats

Studiens resultat tyder på övervägande negativa effekter av 3 veckors LCHF-kost på olika hälsomarkörer, vilket skulle kunna få allvarliga följder så som kardiovaskulära sjukdomar och depression förutsatt att verkan successivt ökar.

In this consensus statement on immunonutrition and exercise, a panel of knowledgeable contributors from across the globe provides a consensus of updated science, including the background, the aspects for which a consensus actually exists, the controversies and, when possible, suggested directions for future research.

In this text, we will examine how the body uses the nutrients in food to produce energy during exercise, and whether these processes differ between the sexes. If they do, does this mean that the nutritional requirements should be different for men and women? We will also present current knowledge on the effects of nutrition on recovery after physical activity, a topic that has attracted much interest in the sports world. finally, we will briefl y discuss the nutritional requirements of physically active women and the common nutritional problems they encounter.

This investigation was designed to evaluate changes in plasma and muscle levels of free amino acids during an ultra-endurance exercise and following recovery. Nine male ultra-endurance trained athletes participated in a 24-h standardized endurance trial with controlled energy intake. The participants performed 12 sessions of running, kayaking and cycling (4 x each discipline). Blood samples were collected before, during and after exercise, as well as after 28 h of recovery. Muscle biopsies were taken 1 week before the test and after exercise, as well as after 28 h of recovery. During the 24-h exercise, plasma levels of branched-chain (BCAA), essential amino acids (EAA) and glutamine fell 13%, 14% and 19% (P<0.05) respectively, whereas their concentrations in muscle were unaltered. Simultaneously, tyrosine and phenylalanine levels rose 38% and 50% (P<0.05) in the plasma and 66% and 46% (P<0.05) in muscle, respectively. After the 24-h exercise, plasma levels of BCAA were positively correlated with muscle levels of glycogen (r2=0.73, P<0.05), as was the combined concentrations of muscle tyrosine and phenylalanine with plasma creatine kinase (r2=0.55, P<0.05). Following 28-h of recovery, plasma and muscle levels of amino acids had either returned to their initial levels or were elevated. In conclusion, ultra-endurance exercise caused significant changes elevations in plasma and muscle levels of tyrosine and phenylalanine, which suggest an increase in net muscle protein breakdown during exercise. There was a reduction in plasma concentrations of EAA and glutamine during exercise, whereas no changes were detected in their muscle concentration after exercise.

Introduction: The first period of military service consists of a physically and mentally challenging basic combat training (BCT) program. Factors like demanding physical exercise, limited recovery time, and restricted diet choice and food intake may challenge iron intake and homeostasis in recruits undergoing BCT. Iron-deficient individuals may experience reduced work capacity, fatigue, weakness, frequent infections, and increased injury risk. Limited knowledge is available on the extent of this potential health risk among military recruits. The aim of the present study was to systematically review published studies on the prevalence and change in prevalence of anemia, iron deficiency (ID), and ID anemia (IDA) among recruits undergoing BCT.

Materials and methods: Electronic searches were conducted in the databases Medline (Ovid), Embase (Embase.com), and Web of Science (Clarivate Analytics) from database inception up until April 16, 2024. Inclusion criteria were observational studies with both cross-sectional and observational longitudinal designs that examined the effects of BCT (intervention) on iron status (outcome) in military recruits (population). Extracted data were the number of participants (n), age, sex, country/population, BCT duration, and relevant measures of prevalence and changes in prevalence of anemia, ID, and IDA (primary outcome) and physical performance, mood state, stress fractures, attrition rate, and nutritional supplements (secondary outcomes). The study quality and risk of bias were assessed using the JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data and The National Institutes of Health Quality Assessment Tool for Before-After (Pre-Post) Studies With No Control Group. Meta-analyses were performed using restricted maximum-likelihood models, and the effect size was calculated as Cohen's h with 95% CI.

Results: Twenty-two articles were systematically reviewed (n = 111,764 men and 12,650 women), and six of these papers (n = 388 men and 773 women) were included in the meta-analysis. There was a varying prevalence of anemia, ID, and IDA among military recruits at the start of BCT. Results from meta-analyses showed negligible and nonsignificant effects of BCT on the prevalence of anemia, ID, and IDA. The quality of the included cross-sectional studies ranging from fair to good, whereas a large proportion of the included longitudinal studies were classified as poor. No sign of publication bias was found.

Conclusions: The prevalence of anemia, ID, and IDA in military recruits seems not to be affected by the completion of BCT shorter than 16 weeks, whereas the effects of longer BCT durations remain unclear. Even though body iron homeostasis seems unaffected, adequate energy and nutritional intake should remain a priority. Future research could focus on dietary interventions to determine the optimal diet among female recruits in specifically exposed populations.

BACKGROUND: Green leafy vegetables (GLV) contain inorganic nitrate, an anion with potential prebiotic effects on the oral microbiome. However, it remains unclear whether GLV and pharmacological supplementation [potassium nitrate (PN)] with a nitrate salt induce similar effects on the oral microbiome.

OBJECTIVES: This study aimed to compare the effect of GLV with PN supplementation on the oral microbiome composition and salivary biomarkers in individuals with high blood pressure.

METHODS: Seventy individuals were randomly allocated to 3 different groups to follow a 5-wk dietary intervention. Group 1 consumed 300 mg/d of nitrate in form of GLV. Group 2 consumed pills with 300 mg/d of PN and low-nitrate vegetables. Group 3 consumed pills with potassium chloride (placebo: PLAC) and low-nitrate vegetables. The oral microbiome composition and salivary biomarkers of oral health were analyzed before and after the dietary intervention.

RESULTS: The GLV and PN groups showed similar microbial changes, probably nitrate-dependent, including an increase in the abundance of Neisseria, Capnocytophaga, Campylobacter species, and a decrease in Veillonella, Megasphaera, Actinomyces, and Eubacterium species after the treatment. Increased abundance of Rothia species, and reduced abundance of Streptococcus, Prevotella, Actinomyces, and Mogibacterium species were observed in the GLV group, which could be nitrate-independent. GLV and PN treatments increased salivary pH, but only GLV treatment showed an increase in the salivary buffering capacity and a reduction of lactate.

CONCLUSION: The combination of nitrate-dependent and nitrate-independent microbial changes in the GLV group has a stronger effect to potentially improve oral health biomarkers compared with PN.

Background

In the cross-sectional Lifestyle, Biomarkers, and Atherosclerosis study (LBA study) we have previously reported a high prevalence (15%) of homeostasis model assessment of insulin resistance (HOMA-IR) in Swedish, young adults. The aim of the present study was to report the dietary habits of subjects 18.0–25.9 years, and to associate dietary habits to body composition measures; body mass index (BMI), body fat (%), waist circumference and to HOMA-IR, a risk marker for diabetes.

Method

The subjects (577 women and 257 men) filled in a validated computerized food frequency questionnaire. The questionnaire was based on recommendations from the Swedish national food administration. To associate the dietary habits to BMI, body fat (%), waist circumference and to HOMA-IR the subjects were divided in two groups. Subjects "eating as recommended" and subjects "eating less/more than recommended".

Results

Recommended intake of fish and seafood (P < 0.05), fruit and vegetables (P < 0.001), and sweets (P < 0.05) were associated to lower HOMA-IR values compared to subjects not eating as recommended. When split by sex no difference in HOMA-IR was detected with recommended intake of fish and seafood, but women eating fish and seafood as recommended had less body fat (%) (P < 0.05) compared to women not eating fish and seafood as recommended. Recommended intake of fruit and vegetables was associated to lower HOMA-IR in women (P < 0.01), and in women and men to less body fat (%) (P < 0.05) compared to subjects not eating the recommended 500 g of fruit and vegetables per day. Both women and men with higher consumption of sweets than recommended had higher HOMA-IR (P < 0.05), but no difference in the body composition measures BMI, body fat (%) or waist circumference compared to subjects eating sweets as recommended.

Conclusion

The results highlight the importance of reducing a high intake of sweets and to increase the intake of fish, fruit and vegetables, in young adults, to reduce the risk of future diabetes.

This study aimed to investigate associations between participation in leisure-time organised physical activity (LTOPA) and dietary intake in a large representative sample of Swedish adolescents participating in the national dietary survey Riksmaten Adolescents 2016-2017. A sample of 2807 participants aged 11-12, 14-15 and 17-18 years were included. Information about LTOPA and dietary intake were collected through questionnaires and two 24-hour recalls on the web (RiksmatenFlex). For dietary intake, overall healthy eating index, intake of fruit, vegetables, candy, sugar-sweetened beverages, and the proportion of added sugar to total energy intake were analysed. Significance-testing for associations was performed with analysis of covariance. LTOPA was associated with lower sugar-sweetened beverages intake among adolescent boys (p < 0.001, ηp2 = 0.012) and girls (p = 0.007, ηp2 = 0.005), higher fruit intake among boys (p = 0.043, ηp2 = 0.003), and lower vegetable intake among girls (p < 0.001, ηp2 = 0.009). However, LTOPA was unrelated to the overall healthy eating index, candy intake, and the proportion of added sugar to total energy intake (p > 0.05). LTOPA was only associated with some healthy eating behaviours, and there is much room for improvement in the diets of Swedish adolescents.

Sammanfattning

Syfte

Syftet med denna undersökning var att ta reda på hur unga konsumenter födda mellan 1975-85, som flyttat hemifrån uppfattar symbolen ”Nyckelhålet”. Syftet är vidare att ta reda på om det föreligger skillnader mellan en lågprisbutiks respektive normalprisbutiks kunder samt mellan män och kvinnor. För att utröna syftet har jag tagit hjälp av totalt fem frågeställningar: 1. Känner konsumenterna igen symbolen? 2. Hur beskriver konsumenterna sin förståelse för symbolen? 3. Vilka egenskaper tillskriver konsumenterna symbolen? 4. Av vilken anledning väljer respektive väljer inte konsumenten varor märkta med Nyckelhålet? 5. Varifrån har konsumenterna fått kännedom om Nyckelhålet?

Metod

60 respondenter, 30 stycken från en normalprisbutik och 30 stycken från en lågprisbutik, har besvarat en enkät med totalt 21 frågor. 36 av respondenterna var kvinnor och 24 stycken var män. Enkäten utformades med både öppna och slutna frågor. Urvalsgruppen är född mellan 1975-85 och har alla flyttat hemifrån. Enkäten har delats ut i anslutning till varor märkta med Nyckelhålet och där har jag då funnit mina respondenter. Enligt en uppskattning av kundunderlaget nådde jag ut till 33% av kundunderlaget för min urvalsgrupp i lågprisbutiken, och 29% i normalprisbutiken.

Resultat

Alla respondenter utom en kände igen symbolen Nyckelhålet. Konsumenterna förstår Nyckelhålet som en symbol som förmedlar nyttiga/hälsosamma/sunda samt fettsnåla produkter. Konsumenterna beskriver symbolens egenskaper som fettsnål och nyttig/hälsosam. De valde också att köpa produkter med dessa egenskaper. Konsumenterna valde ibland bort dessa varor p.g.a. priset. Media förefaller vara den informationskanal där konsumenterna vanligen fått kännedom om symbolen. Det fanns inga klara skillnader i svaren mellan män och kvinnor eller mellan konsumenter från de olika butikerna.

Slutsats

Unga konsumenter födda 1975-85 som har flyttat hemifrån har förstått Nyckelhålets egenskaper väl. Så gott som alla respondenter känner igen symbolen. Majoriteten av respondenterna uppfattar symbolens innebörd som fettsnål, nyttig och hälsosam. Det är också orsaken till att de konsumerar varor märkta med Nyckelhålet. En stor andel av konsumenterna väljer bort nyckelhålsmärkta produkter på grund av priset. Media förefaller vara den kanal som konsumenterna till störst del fått kännedom om Nyckelhålet. Överlag så skiljer sig män och kvinnors kunskaper om Nyckelhålets egenskaper marginellt. Detsamma gäller för kunderna från lågprisbutiken respektive normalprisbutiken. Tidigare forskning har pekat på att en stor andel av respondenterna tror att Nyckelhålet är en form av miljömärkning, så även i denna undersökning.

Purpose: Beneficial acute effects of dietary nitrate have been demonstrated on working memory in adults, with changes in cerebral blood flow (CBF) being a potential mechanism. However, these effects have not been studied in adolescents. Moreover, having breakfast compared to skipping may also exhibit positive effects on working memory. Therefore, this randomized crossover trial investigated the acute effects of nitrate and breakfast on working memory and changes in task-related CBF in adolescents.  Methods: This trial will recruit at least 43 adolescents (13–15 years old). There were three experimental breakfast conditions: (1) none, (2) regular, and (3) regular breakfast with high nitrate in the form of concentrated beetroot juice. Working memory (1-, 2-, 3-back tests) and task-related CBF (prefrontal cortex oxygenated and deoxygenated-hemoglobin changes estimated using functional near-infrared spectroscopy) were measured immediately after breakfast and 130 min later. The data collection for this study is ongoing, thus results for 35 adolescents are presented here and due to blinding of the researcher we are unable to report at this time in which condition these effects occurred, but will be revealed by the time of the conference, as well as for the results on changes in CBF.  Results: Preliminary results from the ongoing study showed that from pretest to posttest there was a statistically significant improvement in reaction time in all three conditions for all three n-back tests, but no intervention effects. Accuracy, however, improved from pretest to posttest in only one condition, for all three nback tests (β [95% confidence interval] from linear mixed-effects models with subject as random effect: 1-back 2.8[1.2-4.3], 2-back 2.6[0.9-4.2], 3-back 3.6[2.2-5.0]), and there was a tendency towards an intervention effect between this breakfast condition and another on the accuracy of the 3-back test (P for time-by-condition interaction 0.07).   Conclusions: The results from this study will increase our understanding into the effects of breakfast and its composition (i.e., nitrate-rich) on acutely improving working memory in adolescents and the potential mechanisms. In turn, the results will inform on whether policies on providing breakfast in schools should be considered to improve students' cognitive performance.

It remains unknown whether dietary nitrate and breakfast may enhance working memory (WM) performance by augmenting physiological mechanisms and subjective psychological well-being. We performed a 3-arm randomised within-subject crossover study, with pretest-posttest comparisons, to test whether nitrate consumption via breakfast with a beetroot juice shot or regular breakfast compared to no breakfast improved WM (measured with n-back tests) and cognitive task-related changes in prefrontal cortical haemodynamic response (oxygenated- and deoxygenated-haemoglobin derived from functional near-infrared spectroscopy). In addition, effects on peripheral vascular function and self-reported psychological factors were assessed. In 60 adolescents (13-15 years old; 66% girls), WM improved in all conditions, with no intervention effects. Intervention effects were seen for oxygenated-haemoglobin changes, such that it increased after the breakfast with a nitrate shot during the WM tests and decreased after the regular breakfast. Thus, different neurophysiological mechanisms may be at play to preserve WM in adolescents depending on their breakfast composition. The trial was registered in the ISRCTN registry (ISRCTN16596056) on 21/02/2022.

Sammanfattning

Syfte och frågeställningar

Syftet med studien är att genom ett hälso- och miljöpsykologiskt perspektiv ta reda på vad elever i årskurs sex och åtta har för lunchvanor under skoltid och vad som kan påverka dessa. För att uppnå vårt syfte har vi valt följande frågeställningar:

1. På vilket sätt skiljer sig elevernas lunchvanor åt i olika åldrar i studien?
2. Hur skiljer sig elevernas lunchvanor åt på olika skolor i studien beroende på vilken tillgång de har till närliggande matalternativ?
3. Hur upplever eleverna i studien att de olika skolornas policy angående lunchvanor ser ut?

Metod

Studien är av både kvantitativ och kvalitativ karaktär och bygger på en enkät som undersökningsmetod.  Enkätundersökningen genomfördes i åtta klasser av totalt 177 elever i årskurs sex och åtta på två skolor i centrala Stockholm. Skolornas namn är fingerade till Ekorrens respektive Grävlingens skola.

Resultat

Ur ett övergripande perspektiv var det inte så stor skillnad mellan de olika skolorna, däremot kunde en tydlig skillnad ses mellan de olika årskurserna. De yngre eleverna tenderade att ha sämre matvanor än vad de äldre eleverna hade. Generellt har eleverna en oklar bild av de båda skolornas policy när det kommer till lunchvanor. De är inte många elever som är insatta i frågorna kring matråd, hur många maträtter som skolorna erbjuder samt tidsaspekten kring skollunchen.

Slutsats

Ur ett hälso- och miljöpsykologiskt perspektiv kan en skillnad ses i vad eleverna har för lunchvanor när det kommer till skollunchen. De största faktorerna som påverkar elevernas lunchvanor är enligt vår studie skolmatsalens miljö,  tillgången till närliggande matalternativ och det sociala trycket ifrån omgivningen.

Syfte och frågeställningar

Syftet med undersökningen är att kartlägga kostvanorna hos gymnasieelever i årskurs 3.

Frågeställning 1

– Finns det några skillnader i kostvanor mellan icke idrottande elever och idrottande elever? Vilka är i så fall skillnaderna?

Frågeställning 2

– Finns det några skillnader i kostvanor utifrån följande faktorer: Kön, föräldrarnas utbildning, betyg från högstadiet, socioekonomisk status, rökning och religiöst engagemang? Vilka är i så fall skillnaderna?

Metod

Vi har använt enkätundersökning som metod. 283 elever från sex slumpvist utvalda Nationella Idrottsutbildningsgymnasieskolor (NIU) från Stockholms län fyllde i enkäten. Resultaten har sammanställts i SPSS och jämförts med tidigare studier.

Resultat

Idrottande elever åt mer regelbundet än icke idrottande elever. Bland övriga faktorer skiljde det sig mellan pojkar och flickor vad gäller intag av frukt, grönsaker (flickor oftare än pojkar) och protein (pojkar oftare än flickor). Elever som bodde i radhus åt mer regelbundet och en bättre sammansatt kost än de som bodde i hyresrätt, bostadsrätt eller villa. De som bodde i hyresrätt åt mindre regelbundet än övriga grupper och hade en sämre näringssammansättning i kosten. De elever som hade lägre betyg från högstadiet åt mindre regelbundet frukost, frukt och grönsaker än elever med högre betyg. Elever som rökt cigaretter veckan innan undersökningen åt sämre än de som inte rökt.

Slutsats

Överlag hade eleverna idag mer regelbundna kostvanor än i tidigare studier. Dock så äter de fysiskt aktiva eleverna för få mål mat om dagen, jämfört med rekommendationer som finns i vårt forskningsläge, då speciellt mellanmål. Konsumtionen av frukt var den minst regelbundna enligt våra resultat. De elever som idrottade, bodde i radhus/kedjehus, hade bra betyg från högstadiet och inte rökte, hade bäst kostvanor. De som åt sämst var de som inte idrottade, hade mindre bra betyg, bodde i hyresrätt och rökte. Vi har en idé om att en ökad fruktkonsumtion kan leda till att eleverna äter fler mellanmål om dagen.

Syfte och frågeställningar

Huvudsyftet med denna studie var att klargöra huruvida intaget av mättat fett påverkar risken för att drabbas av, eller avlida i hjärt- och kärsjukdom. Ett annat syfte var att undersöka om intaget av fleromättat fett eller en kost med hög kvot av fleromättat fett/mättat fett (FM/M) fungerar som prevention mot hjärt- och kärlsjukdomar. Frågeställningarna var följande;

Påverkar intaget av mättat fett risken att drabbas av hjärt- och kärlsjukdom?

Påverkar intaget av mättat fett risken att dö i hjärt- och kärlsjukdom?

Kan intag av fleromättat fett eller en kost med hög FM/M kvot fungera som prevention mot hjärt- och kärlsjukdomar?

Metod

Litteratur utgivna fr.o.m. 1 januari 1999 t.o.m. 11 februari 2010 har sökts i databaserna MEDLINE, Global Health och Swemed+. Sökord som har används är "saturated fat”, ”saturated fatty", mortality, CHD, och mättat fett. Sökningarna gjordes vid enstaka tillfällen fr.o.m. 2010-01-26 t.o.m. 2010-02-11. Inklusionskriterier för artiklar var att testgruppen utgjordes av människor samt att undersökning av intaget av fettsyror och risken att drabbas av eller dö i hjärt- och kärlsjukdom har gjorts på individnivå samt var skriva på svenska eller engelska. Sammanlagt hittades 14 studier, varav fem stycken svarat på flera frågeställningar.

Resultat

Sex av åtta studier visar att konsumtionen mättat fett inte utgör en signifikant riskfaktor för att drabbas av hjärt- och kärlsjukdom. De resterande två visar att mättat fett utgör en riskfaktor för att drabbas av hjärt- och kärlsjukdom. En av fem studier visar på att mättat fett inte utgör en signifikant riskfaktor för att dö i hjärt- och kärlsjukdom. De resterande fyra visar att mättat fett utgör en riskfaktor för att dö i hjärt- och kärlsjukdom. Fyra av sju studier visar att fleromättat fett eller en hög FM/M kvot är en skyddsfaktor mot hjärt- och kärlsjukdomar. De resterande tre studierna visar att fleromättat fett eller hög FM/M kvot inte är en skyddsfaktor mot hjärt och kärlsjukdom.

Slutsats

Konsumtion av mättat fett tycks inte utgöra en signifikant risk för att drabbas av hjärt- och kärlsjukdom däremot kan intaget av mättat fett utgöra en ökad risk för att dö i hjärt- och kärlsjukdom. Intag av fleromättat fett eller kost med hög FM/M kvot kan utgöra en skyddsfaktor mot risken att drabbas av eller dö i hjärt- och kärlsjukdom.

BACKGROUND: Nitrate, which is an inorganic anion abundant in vegetables, increases the efficiency of isolated human mitochondria. Such an effect might be reflected in changes in the resting metabolic rate (RMR) and formation of reactive oxygen species. The bioactivation of nitrate involves its active accumulation in saliva followed by a sequential reduction to nitrite, nitric oxide, and other reactive nitrogen species.

OBJECTIVE: We studied effects of inorganic nitrate, in amounts that represented a diet rich in vegetables, on the RMR in healthy volunteers.

DESIGN: In a randomized, double-blind, crossover study, we measured the RMR by using indirect calorimetry in 13 healthy volunteers after a 3-d dietary intervention with sodium nitrate (NaNO3) or a placebo (NaCl). The nitrate dose (0.1 mmol · kg(-1) · d(-1)) corresponded to the amount in 200-300 g spinach, beetroot, lettuce, or other vegetable that was rich in nitrate. Effects of direct nitrite exposure on cell respiration were studied in cultured human primary myotubes.

RESULTS: The RMR was 4.2% lower after nitrate compared with placebo administration, and the change correlated strongly to the degree of nitrate accumulation in saliva (r(2) = 0.71). The thyroid hormone status, insulin sensitivity, glucose uptake, plasma concentration of isoprostanes, and total antioxidant capacity were unaffected by nitrate. The administration of nitrite to human primary myotubes acutely inhibited respiration.

CONCLUSIONS: Dietary inorganic nitrate reduces the RMR. This effect may have implications for the regulation of metabolic function in health and disease.

Background: Multimodal lifestyle interventions can benefit overall health, including cognition, in populations at-risk for dementia. However, little is known about the effect of lifestyle interventions in patients with prodromal Alzheimer's disease (AD). Even less is known about dietary intake and adherence to dietary recommendations within this population making it difficult to design tailored interventions for them.

Method: A 6-month MIND-ADmini pilot randomized controlled trial (RCT) was conducted among 93 participants with prodromal AD in Sweden, Finland, Germany, and France. Three arms were included in the RCT: 1) multimodal lifestyle intervention (nutritional guidance, exercise, cognitive training, vascular/metabolic risk management, and social stimulation); 2) multimodal lifestyle intervention + medical food product; and 3) regular health advice (control group). Adherence to dietary advice was assessed with a brief food intake questionnaire by using the Healthy Diet Index (HDI) and Mediterranean Diet Adherence Screener (MEDAS). The intake of macro- and micronutrients were analyzed on a subsample using 3-day food records.

Results: The dietary quality in the intervention groups, pooled together, improved compared to that of the control group at the end of the study, as measured with by HDI (p = 0.026) and MEDAS (p = 0.008). The lifestyle-only group improved significantly more in MEDAS (p = 0.046) and almost significantly in HDI (p = 0.052) compared to the control group, while the lifestyle + medical food group improved in both HDI (p = 0.042) and MEDAS (p = 0.007) during the study. There were no changes in macro- or micronutrient intake for the intervention groups at follow-up; however, the intakes in the control group declined in several vitamins and minerals when adjusted for energy intake.

Conclusion: These results suggest that dietary intervention as part of multimodal lifestyle interventions is feasible and results in improved dietary quality in a population with prodromal AD. Nutrient intakes remained unchanged in the intervention groups while the control group showed a decreasing nutrient density.

BACKGROUND: A Web-based dietary assessment tool-RiksmatenFlex-was developed for the national dietary survey of adolescents in Sweden.

OBJECTIVE: This study aimed to describe the Web-based method RiksmatenFlex and to test the validity of the reported dietary intake by comparing dietary intake with 24-hour dietary recalls (recall interviews), estimated energy expenditure, and biomarkers.

METHODS: Adolescents aged 11-12, 14-15, and 17-18 years were recruited through schools. In total, 78 students had complete dietary information and were included in the study. Diet was reported a few weeks apart with either RiksmatenFlexDiet (the day before and a random later day) or recall interviews (face-to-face, a random day later by phone) in a cross-over, randomized design. At a school visit, weight and height were measured and blood samples were drawn for biomarker analyses. Students wore an accelerometer for 7 days for physical activity measurements. Dietary intake captured by both dietary methods was compared, and energy intake captured by both methods was compared with the accelerometer-estimated energy expenditure (EEest). Intake of whole grain wheat and rye and fruit and vegetables by both methods was compared with alkylresorcinol and carotenoid concentrations in plasma, respectively.

RESULTS: The mean of the reported energy intake was 8.92 (SD 2.77) MJ by RiksmatenFlexDiet and 8.04 (SD 2.67) MJ by the recall interviews (P=.01). Intake of fruit and vegetables was 224 (169) g and 227 (150) g, and whole grain wheat and rye intake was 12.4 (SD 13.2) g and 12.0 (SD 13.1) g, respectively; the intakes of fruit and vegetables as well as whole grain wheat and rye did not differ between methods. Intraclass correlation coefficients ranged from 0.57 for protein and carbohydrates to 0.23 for vegetables. Energy intake by RiksmatenFlexDiet was overreported by 8% (P=.03) but not by the recall interviews (P=.53) compared with EEest. The Spearman correlation coefficient between reported energy intake and EEest was 0.34 (P=.008) for RiksmatenFlexDiet and 0.16 (P=.21) for the recall interviews. Spearman correlation coefficient between whole grain wheat and rye and plasma total alkylresorcinol homologs was 0.36 (P=.002) for RiksmatenFlexDiet and 0.29 (P=.02) for the recall interviews. Spearman correlations between intake of fruit and vegetables and plasma carotenoids were weak for both dietary tools. The strongest correlations were observed between fruit and vegetable intake and lutein/zeaxanthin for RiksmatenFlexDiet (0.46; P<.001) and for recall interviews (0.28; P=.02).

CONCLUSIONS: RiksmatenFlexDiet provides information on energy, fruit, vegetables, and whole grain wheat and rye intake, which is comparable with intake obtained from recall interviews in Swedish adolescents. The results are promising for cost-effective dietary data collection in upcoming national dietary surveys and other studies in Sweden. Future research should focus on how, and if, new technological solutions could reduce dietary reporting biases.

Syfte, hypoteser och frågeställning:

Syftet med studien är att undersöka hur kostsammansättning påverkar prestation, upplevelse och fysiologiska parametrar hos unga män, i samband med högintensiv fysisk aktivitet. 

H1 Fysisk prestation, här definierat som total producerad energi under testtiden (J),

maximal kraftutveckling (W) samt ett medelvärde på kraftutveckling (W), på hög

intensitet är lägre efter intag enligt LCHF-kost jämfört med SNR.

H2 Upplevd ansträngning under fysisk prestation skattas högre vid LCHF-kost jämfört med

SNR.

H3 RER (Respiratory Exchange Ratio) är lägre vid LCHF-kost jämfört med SNR.

H4 Laktatnivån i blodet är lägre vid LCHF-kost jämfört med SNR.

F Hur påverkas sinnesstämningen av en kosthållning enligt LCHF jämför med SNR?

Metod:

En experimentell crossover-studie utfördes på nio friska, träningsvana män i åldern 22-25 år. Samtliga deltagare genomgick en kostintervention under två femdagars-perioder på kosthållning enligt LCHF och Svenska Näringsrekommendationer (SNR), separerade med en nio dagars washout-period. Efter respektive kostperiod utfördes tester bestående av RER- mätning på ergometercykel samt upprepade Wingate-test (2 st) då de fick skatta upplevd ansträngning enligt CR100-skalan. I samband med testerna mättes även vikt, fettprocent och laktatvärden. Deltagarna skattade sin sinnestämning med POMS-test.

Resultat:

Varken maximal kraftutveckling, medelvärdet på kraftutveckling, total producerad energi, upplevd ansträngning eller uppmätta laktatvärden skiljde sig mellan kosthållningarna. Uppmätt RER-värde var signifikant lägre vid LCHF jämfört med SNR. Vid analys av POMS- testet sågs att kraftfullhet/vigör skattades signifikant högre vid SNR och att övriga kategorier inte skiljde sig åt.

Slutsats:

Högintensiv fysisk prestation, upplevelse och fysiologiska parametrar verkar inte skilja sig avsevärt åt beroende av kostsammansättning med fokus på fördelning av andel kolhydrater och fett i kosten.

Det är vanligt att multisportare hamnar i negativ energibalans. Det tycks vara svårt att äta tillräckligt för att täcka det enormt stora energibehovet. Kostrekommendationer för uthållighetsidrottare är heller inte helt gångbara inom multisport.

The paper aims to, together with youth, create knowledge regarding their relation to health, food choices, and how these can be expressions of their ability to achieve desired health-related goals.  A specific focus is how youths experience that their health goals and food choices are affected by social, political and commercial determinants of health and how resulting health literacy capabilities relate to the sustainability challenge of antimicrobial resistance.  To this end, a structured observational study was conducted in a region of Zimbabwe to explore youth's health literacy capabilities.

BACKGROUND: Dietary assessment methods that are user-friendly, simple, yet valid are of interest to both researchers and participants, particularly for use in disadvantaged settings, where language barriers and low levels of education are often present. We tested if parents taking photos of what children ate, using mobile phones, would be a feasible, acceptable method that could still provide information with adequate relative validity.

METHODS: We used a mixed-methods design, with parents of 21 5- to 7-year-olds from disadvantaged areas in Sweden. Parents reported all dietary intake, during non-school hours, on three days (two weekdays) using a photo method (PM). The PM consisted of simple instructions and a fiduciary card, but no training, equipment or software. Text messages could be sent if necessary. As a reference method, parents completed three 24-h recalls (24HRs) with an interviewer each following day. The next week, parents completed a 9-item semi-FFQ regarding the preceding week. The outcomes were intakes (in dl) of 9 food groups, categorised as fruits and vegetables, energy-dense sweet/salty foods, and sweet drinks. Agreement with the reference 24HRs was assessed using correlations, median differences and Bland-Altman plots. Parents completed an open-ended questionnaire on barriers and facilitators. Data collectors provided complementary information. Qualitative data was analysed using qualitative manifest analysis.

RESULTS: Nineteen parents (90%) provided complete data. The majority (n = 13) spoke Swedish as a second language, few (n = 4) were proficient. Compared to 24HRs, intakes measured by PM correlated well for all categories (Spearman's rho = 0.609-0.845). However, intakes were underreported, significantly so for fruits and vegetables; Bland-Altman plots indicated that the underestimation was fairly constant across intake levels. When the FFQ was compared to the 24HRs, parameters of agreement were generally inferior than for the PM. Parents found the PM a positive experience, primarily facilitated by its simplicity and familiarity. Barriers, mainly related to time and logistics, can inform further methodological refinements.

CONCLUSIONS: The PM was an acceptable and feasible way to measure children's diet outside of school hours in this population of parents from disadvantaged areas. While the absolute validity should be evaluated further, this relatively simple method has potential for assessing intakes of well-defined foods at group level.

Health promotion from an early age is key to preventing unhealthy weight development in childhood, and parental involvement is essential. The school-based Healthy School Start intervention aims to promote healthy dietary and activity habits in the home environment and prevent child obesity through parental support. This study evaluated the effectiveness of the third iteration of the programme on children's dietary and activity behaviours, and body composition through a cluster-randomised controlled trial. The trial included 17 schools (8 intervention) in disadvantaged areas in mid-Sweden with 353 families with 5- to 7-year-old children. The primary outcomes were intake of selected healthy and unhealthy foods and beverages measured using photography. Secondary outcomes were physical activity and sedentary time measured by accelerometry, and measured weight and height. All outcomes were assessed at baseline and post-intervention (8 months). Linear multi-level regression showed significant favourable effects of the intervention for intake of sweet beverages (b =  - 0.17, p = 0.04), intake of healthy foods (b = 0.11, p = 0.04), and more time in moderate to vigorous physical activity during weekdays (b = 5.68, p = 0.02). An unfavourable sub-group effect of the intervention was found for children from families with low education regarding sedentary time on weekends (b = 23.04, p = 0.05). The results align with the previous two trials of the programme, indicating that school-based parental support is a useful approach for health promotion in young children in disadvantaged areas. Trial registration: ClinicalTrials.gov: No. NCT03390725, retrospectively registered on January 4, 2018, https://clinicaltrials.gov/ct2/show/NCT03390725 .

BACKGROUND: A social gradient is evident in the prevalence of childhood overweight and obesity, to the disadvantage of children with low socioeconomic status (SES). Parents have a substantial influence on their children's dietary behaviours and weight development through the way they interact with the children around food. This study aims to explore the variation of how parents with low SES influence their child's dietary behaviours.

METHODS: A phenomenographic design and analysis was used on 29 sessions of motivational interviewing with mothers and fathers participating in the Healthy School Start intervention study in 2012. The parents had a maximum of 12 years of education and resided in areas targeted for socioeconomic development. In the sessions, parents explored changes that they wanted to make in the home environment regarding their child's dietary behaviours.

RESULTS: Five categories of guidance of children's dietary habits were found ranging from silently guiding to enforcement. The categories of guidance were structurally related to each other through positive to negative impact of parental recognition of responsibility for the child's behaviours, level of trust in the child's satiety response, and level of parental emotional distress.

CONCLUSION: The results suggest that parents use situation-specific guidance with both negative and positive impacts on child behaviours. Depending on the type of guidance used, parents are in need of different supporting strategies to enhance positive parent-child interplay. Suggestions for intervention strategies are provided where specific focus on parental responsibility recognition, emotional self-regulation, increased responsiveness, and cooperation between parents are highlighted.

Food and health have long had a dominant position within the subject of Home economics (HE) in Sweden. HE, has food and health at its core; and is characterized by the fact that students actually are expected to learn how to prepare healthy food. According to the Swedish national syllabus, the broad aim of the school subject is to help students achieve the ability to make informed choices from an environment, economic and health perspective, and to develop practical knowledge of food, nutrition and cooking in relation to health (National Agency for Education, 2011). The aim of the subject states that food and health is to be taught, but what content do the teachers actually choose to teach?

BACKGROUND: Inorganic nitrate has been shown to acutely improve working memory in adults, potentially by altering cerebral and peripheral vasculature. However, this remains unknown in adolescents. Furthermore, breakfast is important for overall health and psychological well-being. Therefore, this study will investigate the acute effects of nitrate and breakfast on working memory performance, task-related cerebral blood flow (CBF), arterial stiffness, and psychological outcomes in Swedish adolescents.

METHODS: This randomised crossover trial will recruit at least 43 adolescents (13-15 years old). There will be three experimental breakfast conditions: (1) none, (2) low-nitrate (normal breakfast), and (3) high-nitrate (concentrated beetroot juice with normal breakfast). Working memory (n-back tests), CBF (task-related changes in oxygenated and deoxygenated haemoglobin in the prefrontal cortex), and arterial stiffness (pulse wave velocity and augmentation index) will be measured twice, immediately after breakfast and 130 min later. Measures of psychological factors and salivary nitrate/nitrite will be assessed once before the conditions and at two-time points after the conditions.

DISCUSSION: This study will provide insight into the acute effects of nitrate and breakfast on working memory in adolescents and to what extent any such effects can be explained by changes in CBF. This study will also shed light upon whether oral intake of nitrate may acutely improve arterial stiffness and psychological well-being, in adolescents. Consequently, results will indicate if nitrate intake from beetroot juice or if breakfast itself could acutely improve cognitive, vascular, and psychological health in adolescents, which can affect academic performance and have implications for policies regarding school meals.

TRIAL REGISTRATION: The trial has been prospectively registered on 21/02/2022 at https://doi.org/10.1186/ISRCTN16596056. Trial number: ISRCTN16596056.

Syfte och frågeställningar

Syftet med denna litteraturstudie är att undersöka om det finns stöd i nuvarande forskning för att en fettrik kost är mer effektiv som nutritionsstrategi vid uthållighetsprestationer jämfört med en kolhydratrik kost. Studiens frågeställningar är:

• Förbättras uthållighetsprestationen av en fettrik kost jämfört med en kolhydratrik kost?
• Hur påverkas kolhydrat- och fettmetabolismen av en högfett- och lågkolhydratkost?

Metod

Litteratursökningen genomfördes i databaserna Ebsco, Pubmed och Cinahl. Totalt inkluderades 16 artiklar, 11 artiklar från litteratursökningen i databaserna och 5 artiklar från valda referenslistor. Studierna kvalitetsgranskades med hjälp av SBU:s granskningsmall för randomiserade kontrollerade studier.

Resultat

I 3 av 16 studier förbättrades uthållighetprestationen vid intag av högfett- och lågkolhydratkost, i 4 av 16 studier försämrades prestationen och i resterande 9 studier sågs ingen signifikant skillnad i prestationen mellan kostinterventionerna. Majoriteten av studierna fick en förhöjd fettoxidation som resultat av en högfett- och lågkolhydratkost men ingen signifikant skillnad gällande blodglukos-, blodinsulin- eller blodlaktatvärde mellan kostinterventionerna.

Slutsats

Trots en förhöjd fettoxidation och välfyllda glykogenlager finns inte tillräcklig evidens för att påvisa en generell prestationshöjning vid uthållighetsprestationer av en högfettkost jämfört med en högkolhydratkost. Detta troligtvis på grund av nedsatt förmåga hos musklerna att använda glykogen. Resultaten från de studier som ingick i denna systematiska litteraturstudie visar konsekvent en försämrad prestation efter intag av högfett- och lågkolhydratkost vid arbetsintensiteter över 80% av VO2max. Vid arbetsintensiteter omkring 60-70% av VO2max kan prestationen eventuellt förbättras efter intag av högfettkost bestående av 60-70% fett och mindre än 15% kolhydrater. 

INTRODUCTION: Dietary inorganic nitrate is a popular nutritional supplement, which increases nitric oxide bioavailability and may improve exercise performance. Despite over a decade of research into the effects of dietary nitrate supplementation during exercise there is currently no expert consensus on how, when and for whom this compound could be recommended as an ergogenic aid. Moreover, there is no consensus on the safe administration of dietary nitrate as an ergogenic aid. This study aimed to address these research gaps.

METHODS: The modified Delphi technique was used to establish the views of 12 expert panel members on the use of dietary nitrate as an ergogenic aid. Over three iterative rounds (two via questionnaire and one via videoconferencing), the expert panel members voted on 222 statements relating to dietary nitrate as an ergogenic aid. Consensus was reached when > 80% of the panel provided the same answer (i.e. yes or no). Statements for which > 80% of the panel cast a vote of insufficient evidence were categorised as such and removed from further voting. These statements were subsequently used to identify directions for future research.

RESULTS: The 12 panel members contributed to voting in all three rounds. A total of 39 statements (17.6%) reached consensus across the three rounds (20 yes, 19 no). In round one, 21 statements reached consensus (11 yes, 10 no). In round two, seven further statements reached consensus (4 yes, 3 no). In round three, an additional 11 statements reached consensus (5 yes, 6 no). The panel agreed that there was insufficient evidence for 134 (60.4%) of the statements, and were unable to agree on the outcome of the remaining statements.

CONCLUSIONS: This study provides information on the current expert consensus on dietary nitrate, which may be of value to athletes, coaches, practitioners and researchers. The effects of dietary nitrate appear to be diminished in individuals with a higher aerobic fitness (peak oxygen consumption [V̇O_2peak] > 60 ml/kg/min), and therefore, aerobic fitness should be taken into account when considering use of dietary nitrate as an ergogenic aid. It is recommended that athletes looking to benefit from dietary nitrate supplementation should consume 8-16 mmol nitrate acutely or 4-16 mmol/day nitrate chronically (with the final dose ingested 2-4 h pre-exercise) to maximise ergogenic effects, taking into consideration that, from a safety perspective, athletes may be best advised to increase their intake of nitrate via vegetables and vegetable juices. Acute nitrate supplementation up to ~ 16 mmol is believed to be safe, although the safety of chronic nitrate supplementation requires further investigation. The expert panel agreed that there was insufficient evidence for most of the appraised statements, highlighting the need for future research in this area.

BACKGROUND: A diet rich in fruits and vegetables is associated with lowering of blood pressure (BP), but the nutrient(s) responsible for these effects remain unclear. Research suggests that inorganic nitrate present in leafy green vegetables is converted into NO in vivo to improve cardiovascular function.

OBJECTIVE: In this study, we evaluated the effect of leafy green vegetables on BP in subjects with elevated BP, with the aim of elucidating if any such effect is related to their high nitrate content.

DESIGN: We enrolled 243 subjects, 50-70 y old, with a clinic systolic BP (SBP) of 130-159 mm Hg. After a 2-wk run-in period on a nitrate-restricted diet the subjects were randomly assigned to receive 1 of the following 3 interventions daily for 5 wk: low-nitrate vegetables + placebo pills, low-nitrate vegetables + nitrate pills (300 mg nitrate), or leafy green vegetables containing 300 mg nitrate + placebo pills. The primary end point measure was the difference in change in 24 h ambulatory SBP between the groups.

RESULTS: A total of 231 subjects (95%) completed the study. The insignificant change in ambulatory SBP (mean ± standard deviation) was -0.6 ± 6.2 mm Hg in the placebo group, -1.2 ± 6.8 mm Hg in the potassium nitrate group, and -0.5 ± 6.6 mm Hg in the leafy green vegetable group. There was no significant difference in change between the 3 groups.

CONCLUSIONS: A 5-wk dietary supplementation with leafy green vegetables or pills containing the same amount of inorganic nitrate does not decrease ambulatory SBP in subjects with elevated BP. This trial was registered at clinicaltrials.gov as NCT02916615.

AIM: Little is known about how parental migration status may be associated with children's diets. We examined whether the intake of selected foods by six-year-old children differed according to their parents' migration status, taking education level into account.

METHODS: This study used pooled baseline data from two clustered randomised controlled trials of A Healthy School Start, conducted in municipalities of low-to-medium socio-economic status in Stockholm County, Sweden. The children's intake of selected healthy and unhealthy foods was reported by parents using the Eating and Physical Activity Questionnaire, and the children's height and weight were measured. Parental education and country of birth were self-reported.

RESULTS: Data were available for 520 children. Low parental education was associated with significantly higher intakes of fruit, higher intakes of several unhealthy foods and lower intakes of vegetables. Children of parents born outside the Nordic region had higher intakes of all unhealthy foods as well as fruit and vegetables, even when adjusted for education. A negative association between high education and overweight was only seen in children of Nordic-born parents.

CONCLUSION: Parental migration status was a strong predictor of the intake of selected foods and was a stronger predictor than parental education.

BACKGROUND: The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) showed cognitive benefits from a multidomain lifestyle intervention in at-risk older people. The LipiDiDiet trial highlighted benefits of medical food in prodromal Alzheimer's disease (AD). However, the feasibility and impact of multimodal interventions combining lifestyle with medical food in prodromal AD is unclear.

METHODS: MIND-AD_mini was a 6-month multinational (Sweden, Finland, Germany, France) proof-of-concept randomized controlled trial (RCT). Participants were 60-85 years old, had prodromal AD (International Working Group-1 criteria), and vascular/lifestyle risk factors. The parallel-group RCT had three arms: multimodal lifestyle intervention (nutritional guidance, exercise, cognitive training, vascular/metabolic risk management and social stimulation); multimodal lifestyle intervention + medical food (Fortasyn Connect); and regular health advice/care (control). Participants were randomized 1:1:1 (computer-generated allocation at each site). Outcome evaluators were blinded to randomization. Primary outcome was feasibility of the multimodal intervention, evaluated by recruitment rate during a 6-month recruitment phase, overall adherence in each intervention arm, and 6-month retention rate. Successful adherence was pre-specified as attending ≥ 40% of sessions/domain in ≥ 2/4 domains (lifestyle intervention), and consuming ≥ 60% of the medical food (lifestyle intervention + medical food). The secondary outcomes included adherence/participation to each intervention component and overall adherence to healthy lifestyle changes, measured using a composite score for healthy lifestyle. Cognitive assessments were included as exploratory outcomes, e.g. Clinical Dementia Rating scale.

RESULTS: During September 2017-May 2019, 93 individuals were randomized (32 lifestyle intervention, 31 lifestyle + medical food, and 30 control group). Overall recruitment rate was 76.2% (64.8% during the first 6 months). Overall 6-month retention rate was 91.4% (lifestyle intervention 87.5%; lifestyle + medical food 90.3%; control 96.7%). Domain-specific adherence in the lifestyle intervention group was 71.9% to cognitive training, 78.1% exercise, 68.8% nutritional guidance, and 81.3% vascular risk management; and in the lifestyle + medical food group, 90.3% to cognitive training, 87.1% exercise, 80.7% nutritional guidance, 87.1% vascular risk management, and 87.1% medical food. Compared with control, both intervention arms showed healthy diet improvements (β_{Lifestyle×Time} = 1.11, P = 0.038; β_{Lifestyle+medical food×Time} = 1.43, P = 0.007); the lifestyle + medical food group also showed vascular risk reduction (P = 0.043) and less cognitive-functional decline (P < 0.05, exploratory analysis). There were 5 serious adverse events (control group: 1; lifestyle intervention: 3; lifestyle + medical food: 1) unrelated to interventions.

CONCLUSIONS: The multidomain lifestyle intervention, alone or combined with medical food, had good feasibility and adherence in prodromal AD. Longer-term cognitive and other health benefits should be further investigated in a larger-scale trial.

TRIAL REGISTRATION: ClinicalTrials.gov NCT03249688.

OBJECTIVE: To report on vitamin D status, measured as plasma 25-hydroxyvitamin D concentration (25(OH)D), the prevalence of vitamin D insufficiency and deficiency, and to explore associations between Vitamin D status and background characteristics.

DESIGN: Data was collected in a national dietary survey, Riksmaten adolescents 2016-17. The participants completed dietary assessment and questionnaires on the web and wore accelerometers. [25(OH)D] was measured with a mass spectrometry method.

SETTING: Representative survey conducted in schools throughout Sweden.

PARTICIPANTS: Participants attended school years 5 (Y5, mean age 12. 5 years), 8 (Y8, mean age 14. 5 years) and 11(Y11, mean age 18 years), and included 1100 participants.

RESULTS: Overall, there was no difference in plasma 25(OH)D between girls and boys. Vitamin D insufficiency differed between the three school years. The prevalence of insufficiency in Y5 was 32 (boys) and 48 (girls) percent, while in Y11 62 (boys) and 43 (girls) percent. The prevalence of deficiency in Y11 was 16 and 15 percent in boys and girls, respectively. Being born outside of Sweden was associated with a 10-fold increased risk of being vitamin D deficient. Deficiency was also associated with longer time spent in sedentary intensity, a lower consumption of fortified dairy products, and fats and oils.

CONCLUSIONS: Vitamin D deficiency was most common in the oldest age group and being born outside of Sweden increased the risk of being deficient. The present study will form a baseline for future follow-up studies of the implementation of a new mandatory vitamin D fortification policy in 2018.