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Biomedical subjects

Birgitta Strandvik

Publications and source records attributed to Birgitta Strandvik.

At least 19 recordsLinked to original sources

Food choice, socio-economic characteristics and health in 4-year olds in a well-educated urban Swedish community.

BACKGROUND AND AIMS: Dietary habits founded early in life might influence development of welfare diseases. The aim was to analyse food choice, socio-economic characteristics and health by questionnaires in healthy 4-year olds. METHODS: Two hundred and thirty children were invited and 79% completed all questionnaires. Anthropometry was measured in 131 subjects. RESULTS: The sample was characteristic for Swedish children except that more parents had university education. Most children attended pre-school; 52% >30 h/week. Almost all had been breast-fed until a mean age of 5 months. Fifteen per cent were overweight and 2% obese according to the IOTF cut-offs. A, D vitamin supplementation was not given to a third. Full fat dairy products, minced meat and sausages predominated, and only a fourth was served fat fish. Olive or rape seed oil was consumed regularly by 40% and a third consumed "junk food" regularly. Maternal immigrant status influenced the food choice. CONCLUSION: In a Swedish urban community of 4-year olds, 17% were overweight or obese. The intake of vegetables, oils and "junk food" seemed to have increased, while the intake of dairy products, fruit, meat and fish seemed to be similar to earlier studies. Food choice was influenced by maternal origin.

Anthropometry↗

Serum phospholipid fatty acids, adipose tissue, and metabolic markers in obese adolescents.

OBJECTIVE: Fatty acid (FA) composition has a role in adipogenesis. The objective was to study serum phospholipid (PL) FAs in adolescents and their relation to abdominal adipose tissue (AT) compartments and metabolic markers. RESEARCH METHODS AND PROCEDURES: Abdominal AT was measured by magnetic resonance imaging and FA pattern was determined in serum PL of 10 obese adolescents (5 females), median age 12.0 years (range, 10.4 to 16.4) and BMI 30.7 (26.8 to 40.4), and 15 lean control subjects (9 females), median age 12.6 years (range, 11.3 to 15.4), and BMI 19.5 (17.1 to 23.4). RESULTS: Obese adolescents had relatively higher levels of saturated FA (SFA) and nervonic acid compared with controls. Serum PL concentration of n-3 polyunsaturated fatty acids (PUFA) was lower in the obese vs. lean females (p = 0.01), including docosahexaenoic acid (DHA) (p = 0.01). The ratios of arachidonic acid to DHA and total n-6/n-3 FA were increased in obese children (p = 0.02 and 0.01, respectively). n-3 PUFAs were inversely correlated to all subcutaneous AT compartments except visceral AT. The homeostasis model assessment index of beta-cell function related inversely to DHA concentration (p = 0.03). All changes were more marked in the females. DISCUSSION: Serum FA pattern in obese adolescents differed significantly from that in age-matched lean controls, reflecting a decrease in n-3 PUFA, especially DHA, and an increase in SFA. The subcutaneous AT, but not visceral AT, correlated to the changes in PUFA and SFA, suggesting an abnormal essential FA metabolism in obese adolescents.

Abdominal Fat↗

Serum phospholipid fatty acid pattern is associated with bone mineral density in children, but not adults, with cystic fibrosis.

Essential fatty acids (EFA) have proved to be important for normal bone mineral density (BMD) and bone growth in animal studies. Patients with cystic fibrosis often have low serum EFA levels, and low BMD has also been reported in patients with normal anthropometry. The aim of the present study was to analyse if BMD during a 2-year period was related to fatty acid status in patients with cystic fibrosis. Fifty-four patients, aged 6-33 years, were studied prospectively. BMD was measured with dual X-ray absorptiometry, and fatty acid concentrations in serum phospholipids were determined with capillary GLC. The cystic fibrosis patients showed low linoleic acid concentration and a high arachidonic acid (AA):DHA ratio in serum. The high eicosatrienoic acid:AA ratio, an indicator of EFA deficiency, increased further over 2 years, as did the total concentration of saturated fatty acids. In the adults there were no significant changes in fatty acids during the study. In the children, positive correlations were found between palmitic acid and bone mineral content in the lumbar spine and femoral neck. The lumbar spine BMD Z score correlated negatively with the AA:DHA ratio. No correlation was seen in adults except for a positive correlation between EFA deficiency index and the areas of lumbar spine and femoral neck. The present results imply that fatty-acid status influenced BMD in cystic fibrosis children, but not in adults, indicating that fatty-acid status would be important for bone growth.

Absorptiometry, Photon↗

Mediterranean-inspired diet lowers the ratio of serum phospholipid n-6 to n-3 fatty acids, the number of leukocytes and platelets, and vascular endothelial growth factor in healthy subjects.

BACKGROUND: Reduced cardiovascular mortality and morbidity have been shown in persons adhering to Mediterranean-inspired diets (MIDs). Although the underlying mechanisms of this association are poorly understood, the importance of increasing dietary amounts of polyunsaturated fatty acids of the n-3 series has been emphasized. OBJECTIVE: We investigated whether a MID provided to healthy subjects would affect 1) the inflammatory process and endothelial indexes such as vasoregulation and vascular endothelial growth factor (VEGF) and 2) serum phospholipid fatty acid composition. DESIGN: A total of 22 subjects (10 women) received a MID or an ordinary Swedish diet (OSD) for 4 wk in a crossover fashion. Concentrations of lipids and fatty acids, high-sensitivity C-reactive protein, and interleukin 6, both before and after lipopolysaccharide stimulation; the number of leukocytes and platelets; and VEGF and monocyte chemoattractant protein 1 were analyzed. RESULTS: The plasma ratio of n-6 to n-3 fatty acids was substantially lower after the MID than after the OSD (x +/- SEM: 4.72 +/- 0.19 and 2.60 +/- 0.17, respectively; P < 0.0001). Neither C-reactive protein nor interleukin 6 concentrations changed significantly after the MID compared with the OSD. The total number of leukocytes and platelets was 10% (P < 0.05) and 15% (P < 0.001) lower, respectively, after the MID than after the OSD. Serum VEGF concentrations were lower after the MID than after the OSD (237 +/- 30 and 206 +/- 25 pg/mL, respectively; P = 0.0014). CONCLUSIONS: A MID reduces the number of platelets and leukocytes and VEGF concentrations in healthy subjects. This may be linked to higher serum concentrations of n-3 fatty acids, which promote a favorable composition of phospholipids.

Adult↗

Metabolic markers in relation to nutrition and growth in healthy 4-y-old children in Sweden.

BACKGROUND: The worldwide increase in overweight and obesity probably involves dietary factors, and early indicators of risk must be identified. OBJECTIVE: We aimed to analyze metabolic markers in relation to dietary intake and anthropometry in healthy 4-y-old children. DESIGN: A cross-sectional study of nutritional intake was performed in 95 children by use of 7-d food records. Fasting blood samples were analyzed for glucose, insulin, and lipids. RESULTS: The study population was representative of Swedish children except that more parents than the average had a university education. The boys' mean energy intake was higher (6.6 +/- 0.75 MJ) than the girls' (5.7 +/- 0.79 MJ). Significant associations were found between the percentage of energy from carbohydrates and that from fat (r = -0.91) and sucrose (r = 0.59). High body mass index was associated with a low percentage of energy from fat (r = -0.32). Serum triacylglycerol, insulin, and the HOMA (homeostatic model assessment) index were higher in girls than in boys. In girls, HOMA beta-cell function was significantly negatively associated with fat intake and serum fasting insulin, and HOMA insulin resistance indexes were significantly associated with the increment in z scores for height and weight from birth to age 4 y. Compared with children with fasting insulin concentrations below the group mean + SD, the children with concentrations above that value were smaller as newborns and had larger increments in growth z scores from birth to age 4 y. CONCLUSION: In healthy Swedish 4-y-olds from well-educated families, low fat intake was related to high body mass index. Upward weight and height percentile crossings were related to insulin resistance, especially in girls.

Anthropometry↗

Abnormal fatty acid pattern in intestinal mucosa of children with celiac disease is not reflected in serum phospholipids.

OBJECTIVE: Celiac disease (CD) is characterized by chronic inflammation of the small intestinal mucosa with disturbed epithelial transport. The fatty acid (FA) composition of intestinal membranes is important for epithelial function, and disturbances may contribute to the pathophysiology of the disease. We aimed to evaluate whether the intestinal mucosal FA status was reflected in serum phospholipids of patients with CD. PATIENTS AND METHODS: Samples were obtained from 7 pediatric patients with active CD showing mucosal atrophy, 6 pediatric patients with CD in remission, and 11 control pediatric patients with morphologically healthy intestinal mucosa. Small intestinal biopsies were obtained using a Watson biopsy capsule under fluoroscopic control. Blood samples were collected on the same morning after an overnight fast. Tissue phospholipids were isolated by high-performance liquid chromatography, and FAs were analyzed by capillary gas-liquid chromatography. RESULTS: Serum phospholipid FA showed marginal differences between the patients with CD and the controls. Significant differences were observed in mucosa with active CD compared with controls. Linoleic acid (18:2n-6) level was decreased, whereas those of its derivatives were elevated, indicating increased transformation of n-6 FA. Mead acid (20:3n-9) level was increased, with an increased ratio of Mead acid to arachidonic acid (20:4n-6) levels, suggesting essential fatty acid deficiency. The n-3 FA levels were not significantly changed. During remission, the FA pattern of the intestinal mucosa was mainly similar to that in controls. CONCLUSIONS: The FA abnormality of intestinal mucosa in patients with active CD was not reflected in serum values. Altered FA content may contribute to the pathophysiology of the disease because FAs are important for enzymes and for the transport and receptor functions of epithelial membranes.

Adolescent↗

Epithelial electrical resistance as a measure of permeability changes in pediatric duodenal biopsies.

OBJECTIVES: Intestinal permeability measured with medium-sized oral probes is increased in cystic fibrosis (CF) and celiac disease (CD), probably reflecting reduced tight junction resistance. The aim of this study was to evaluate whether square-pulse analysis of duodenal biopsies from children can be used to determine electrical tight junction resistance. METHODS: Intestinal biopsies from children with different stages of CD and from patients with CF were studied in a modified Ussing chamber. The epithelium was assumed to act as an electrical circuit consisting of a current generator parallel with a resistance and a capacitance. Subepithelial and epithelial resistances were determined by square-pulse analysis, and the generated current was calculated. RESULTS: Confirming data using permeability probes, reduced epithelial electrical resistance was found both in patients with CF and CD. Only the CF patients had reduced resting current as well. The secretagogues prostaglandin E2, cyclic adenosine monophosphate and acetylcholine increased the current in both control biopsies and biopsies with villous atrophy but had no significant effect on epithelial resistance. CONCLUSIONS: Measurement of electrical resistance in duodenal biopsies can be used as an alternative method of quantifying permeability in pediatric biopsies.

Adolescent↗

Cysteinyl leukotrienes are secretagogues in atrophic coeliac and in normal duodenal mucosa of children.

OBJECTIVE: The pathophysiology of intestinal inflammation and diarrhoea is complex and involves the arachidonic acid cascade. Prostaglandins induce chloride secretion in healthy subjects and in patients with coeliac disease. Leukotrienes (LTs) are also known inflammatory mediators which have been shown to stimulate ion secretion in ileum and colon of rats and rabbits. The aim of this study was to determine the effects of leukotrienes C(4) (LTC(4)) and D(4) (LTD(4)) in normal and atrophic intestinal mucosa in children. MATERIAL AND METHODS: Routine paediatric intestinal biopsies were obtained from 109 children. Sixty-seven control biopsies and 42 biopsies from children with different stages of coeliac disease were mounted in a modified Ussing chamber. Potential difference (Pd) was measured continuously and tissue resistance (R(t)) and the generated current (I(m)) were calculated. RESULTS: In morphologically normal mucosa of duodenum, LTC(4) and LTD(4) increased Pd and I(m) in a dose-dependent manner. The increase was more pronounced in the distal than in the proximal part, similar to the response to prostaglandin E(2). The induced current was chloride-mediated, since replacement of Cl(-) with SO(4)(2-) in the bathing solution eliminated the response to the LTs. The LTC(4)-induced secretion was significantly decreased in atrophic mucosa, but the response was partially restored after preincubation with the cyclooxygenase inhibitor indomethacin. CONCLUSIONS: The results showed that LTC(4) and LTD(4) are secretagogues in the duodenal mucosa from healthy children by inducing a net chloride secretion. Restoration of the response in coeliac disease by cyclooxygenase inhibition suggests interactions between the different pathways of the arachidonic cascade in the intestinal mucosa.

Atrophy↗

Ultraviolet B radiation improves serum levels of vitamin D in patients with cystic fibrosis.

BACKGROUND: Ultraviolet B (UVB) radiation can be used in the prevention and treatment of vitamin D deficiency. AIM: To investigate, in a controlled study of patients with cystic fibrosis (CF), whether regular UVB radiation would improve serum levels of calcidiol during the dark season (October-April). METHODS: Thirty patients with mild to moderate disease were included (aged 9-40 y). All patients had cholecalciferol supplementation. One group (15 patients) was given UVB one to three times a week for 6 mo and one group (15 sex- and age-matched patients) served as controls. The radiation source consisted of three TL 12/40W UVB fluorescent lamps. Initial treatment duration was 1 min, subsequently increased by 0.5-1 min/treatment to a maximum of 10 min. RESULTS: The mean initial serum calcidiol levels were 21 ng/ml in the controls and 22 ng/ml in the intervention group. Serum calcidiol levels increased to 44 ng/ml after 8 wk and to 50 ng/ml after 24 wk of UVB radiation; the corresponding serum levels in the controls were 19 and 25 ng/ml, respectively. The mean serum calcitriol levels increased in the treated group and were unaltered in the control group. CONCLUSIONS: UVB radiation was effective in increasing vitamin D levels in patients with CF. The study results imply that UVB radiation is valuable in chronic conditions associated with vitamin D deficiency.

Adolescent↗

Cost-effectiveness of alendronate in the prevention of osteoporotic fractures in Danish women.

Pharmacological interventions for osteoporosis may reduce morbidity and mortality, but they incur additional health care costs. The aim was to quantify the additional costs and health benefits of prescribing alendronate 10 mg and calcium/vitamin D daily for 71-year-old women with a fracture risk twice that of the population average in stead of calcium/vitamin D alone. A state transition model based primarily on Scandinavian data was developed. Women were followed from age of 71 years until 100. Alendronate was assumed to reduce the fracture risk by 50%. Health benefits from the interventions were expressed in terms of life years, quality adjusted life years, and fractures avoided. Societal costs were estimated using literature estimates and Danish tariffs. All costs were measured in 2002 Danish Kroner (DKK). Future costs and benefits were discounted at 5% per year. The incremental cost per QALY gained was DKK125,000 while the cost per life year gained was DKK 374,000. The use of alendronate was cost-saving when 1) the treatment was extended to five years, 2) the risk of fracture was four times the population average, 3) the effect of alendronate was assumed to persist for three years after discontinuation of treatment, 4) a greater proportion had severe sequelae after a hip fracture, or 5) the start of therapy was delayed until age of 77 years. In conclusion, the use of alendronate compares well with other well established therapies in terms of cost-effectiveness in older women with high risk of fracture.

Aged↗

Gender-related long-term effects in adult rats by perinatal dietary ratio of n-6/n-3 fatty acids.

Epidemiological studies in humans have shown that perinatal nutrition affects health later in life. We have previously shown that the ratio of n-6 to n-3 polyunsaturated fatty acids (PUFA) in the maternal diet affects serum leptin levels and growth of the suckling pups. The aim of the present study was to investigate the long-term effects of various ratios of the dietary n-6 and n-3 PUFA during the perinatal period on serum leptin, insulin, and triacylglycerol, as well as body growth in the adult offspring. During late gestation and throughout lactation, rats were fed an isocaloric diet containing 7 wt% fat, either as linseed oil (n-3 diet), soybean oil (n-6/n-3 diet), or sunflower oil (n-6 diet). At 3 wk of age, the n-6/n-3 PUFA ratios in the serum phospholipids of the offspring were 2.5, 8.3, and 17.5, respectively. After weaning, all pups were given a standard chow. At the 28th postnatal wk, mean body weight and fasting insulin levels were significantly increased in the rats fed the n-6/n-3 diet perinatally compared with the other groups. The systolic blood pressure and serum triacylglycerol levels were only increased in adult male rats of the same group. These data suggest that the balance between n-6 and n-3 PUFA during perinatal development affects several metabolic parameters in adulthood, especially in the male animals.

Aging↗

Muscular strength and function in patients with cystic fibrosis.

BACKGROUND: For 20 years, physical activity has been an important component in the treatment of cystic fibrosis (CF) patients in Sweden. Data concerning physical performance in terms of muscular strength in these patients are limited OBJECTIVE: To compare muscular strength and function in patients with CF with those aspects in a healthy control group (CG). DESIGN: Thirty-three patients with CF (16 women) aged 16 to 35 years and 20 healthy individuals matched for age and gender were included in the study. All participants had undertaken regular physical training two to three times per week. The following tests were performed: vertical jumping ability; hand-grip strength; abdominal strength; arm/shoulder strength; quadriceps muscle strength; and a functional test of leg muscle endurance. RESULTS: Patients with CF showed decreased muscle strength and function compared to control subjects (women: maximal hand-grip strength in the right [p = 0.02] and the left hand [p = 0.001]; sustained hand-grip strength in the left hand [p = 0.002]; and in leg muscle endurance [p = 0.02]; men: the number of sit-ups performed within 30 s [p = 0.03]; and left leg isokinetic quadriceps strength at 180 degrees per second [p = 0.02]). The differences were not related to pancreatic or pulmonary function. There was no significant difference between the CF group and the CG in any other test results. CONCLUSIONS: Our study showed few differences in muscular performance between patients with CF and healthy control subjects. Both groups had regular moderate-to-high activity levels. Further studies are needed to evaluate whether the small but significant differences might be related to metabolic abnormalities in skeletal muscles in CF patients.

Adolescent↗

Frederic Chopin--the man, his music and his illness.

Frédéric Chopin's unique position in the history of music relies on a surprisingly limited and special production. However, the artistic level is invariably high and the musical language is both universal and unmistakably personal. A nearly life-long suffering from illness marked his life and influenced his artistry, as composer and pianist. Chopin's struggle with a fateful disease, and his instinctive understanding that he would loose, made imprints on some of his works that carry a sombre intensity, bordering on desperation. The emotional tension of these compositions, that appear already from youth and henceforward, goes far beyond the musical conventions of the time. The nature of Chopin's disease has been subject to numerous speculations. This is not surprising, considering the wide spectrum of symptoms and the dynamics of his illness--or illnesses. Taking into account all reported symptoms and signs since childhood and henceforth, it is postulated that Chopin suffered from cystic fibrosis by heriditariness, possibly superimposed by tuberculosis or atypical mycobacteria. This would explain all his symptoms, and to some extent also the ambivalence of contemporary physicians. By available gene technology it would be possible to investigate, for proof or dismissal, if this hypothesis is true.

Cystic Fibrosis↗

Modulation of neonatal immunological tolerance to ovalbumin by maternal essential fatty acid intake.

The present study examines whether dietary essential fatty acid (EFA) intake influences the induction of oral tolerance to ovalbumin (OA) in neonatal and adult rats. During late gestation and throughout lactation Sprague-Dawley rats were fed a diet supplemented (S) with EFA (7% soybean oil), or a diet deficient (D) in EFA (7% hydrogenated lard). The rat offspring were subsequently exposed to OA either via the milk at 10-16 days (neonatal rats), or as adults via the drinking water at 7-9 wk of age. Oral administration of OA to the adult rats lead to suppression of the delayed-type hypersensitivity (DTH) reactivity and IgG antibody response against OA, which was not influenced by their diets. In the offspring of the dams fed the D diet antigen exposure via the milk resulted in suppression of the serum antibody levels and DTH reaction against OA indicating induction of oral tolerance. Higher transforming growth factor beta (TGF-beta) mRNA levels in the draining lymph nodes suggested this to be mediated by regulatory T cells. In contrast, OA exposure of the dams fed the S diet did not result in a suppressed OA response of their offspring. Thus, the quality of FA ingested by the mother may have effects on the development of immunological tolerance to dietary antigens in the offspring. Our results might have importance for the understanding of the increase in allergy related to the Western type of diet.

Age Factors↗