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Biomedical subjects

L Hallberg

Publications and source records attributed to L Hallberg.

At least 19 recordsLinked to original sources
PubMed2003

Meal pattern, food choice, nutrient intake and lifestyle factors in The Göteborg Adolescence Study.

OBJECTIVE: To relate meal pattern of Swedish adolescents to food choice, nutrient intake and other lifestyle factors. DESIGN: Cross-sectional study including diet history and interview about smoking, ethnicity, social factors and retrospectively collected data of menarche and growth. SETTING: School setting, Göteborg, Sweden. SUBJECTS: A total of 611 boys and 634 girls in grade 9 (15-16 y). RESULTS: The majority of the students, 65% of the boys and 52% of the girls, consumed three main meals daily. The in-between meals, however, contributed the major part of the energy intake. The energy intake was 12.9+/-3.5 MJ (mean+/-s.d.) for boys and 9.0+/-2.5 MJ for girls. Irregular breakfast eating, 12% of the boys and 24% of the girls, was related to negative lifestyle factors where smoking was the strongest, odds ratio 3.8 (95% CI: 2.6-5.4) and to irregular intake of lunch and dinner. These boys and girls had a food choice including a higher percentage of energy from snack food (26% vs 20% and 19% in boys and girls respectively, all P<0.001), mostly consumed between the main meals. These groups had significantly lower intakes of micronutrients, but higher intakes of sucrose and alcohol compared to the groups with regular breakfast intake. Girls omitting breakfasts and lunches (8%) also had a less healthy food choice and the poorest nutrient intake. These girls had matured earlier, with menarche age of 12.2+/-1.1 y vs 12.9+/-1.0 y (P<0.001) in girls with regular main meal intake. CONCLUSIONS: Meal pattern with omission of breakfast or breakfast and lunch was related to a clustering of less healthy lifestyle factors and food choice leading to a poorer nutrient intake. SPONSORSHIP: The Swedish Medical Research Council (project B94-19X-04721-19A), the Swedish Mill Industry and the Wilhelm and Martina Lundgren Foundation.

Adolescent↗
PubMed2003

Energy intake in Swedish adolescents: validation of diet history with doubly labelled water.

OBJECTIVE: To compare habitual energy intake (EI) estimated from diet history (DH) with total energy expenditure (TEE) measured with doubly labelled water (DLW) in adolescents. DESIGN: DH included a detailed questionnaire and an interview. TEE was measured during a 14-day period. Adequate (AR), under- (UR) and over-reporters (OR) were defined from the ratio EI/TEE: AR 0.84-1.16, UR <0.84 and OR >1.16. SETTING: Participants were recruited from grade 9 in a compulsory school in Göteborg, Sweden. All data were collected at school and DLW dosages were distributed at Sahlgrenska University Hospital. SUBJECTS: A total of 35 adolescents (18 boys, 17 girls), 15.7 (0.4) y. RESULTS: EI was 11.0 (3.6) MJ and TEE was 11.4 (2.1) MJ (P=0.42). DH was able to rank EI compared to TEE (Spearman's r=0.59, P< or =0.001). For girls, EI was 18% lower (P=0.0067) and for boys, EI was 7% higher (P=0.26) compared to TEE. The 95% limits of agreement for difference between TEE and EI were -5.6 to 6.5 MJ. In total, 20 subjects were defined as AR (57%), nine as UR (26%) and six as OR (17%). Energy from in-between meals was 33% lower (P=0.0043) in UR girls and 57% higher (P=0.026) in OR boys, compared to adequate reporting girls and boys, respectively. In UR girls, energy-adjusted intake (10 MJ) of specific foods did not differ significantly, fat was lower and carbohydrate and vitamin C were higher compared to AR girls (all P<0.05). OR boys had no significant differences in food and nutrient intake in 10 MJ compared to AR boys. CONCLUSION: The diet history was able to capture EI for the group and to rank subjects. There was a wide individual range in reporting-accuracy related to gender. SPONSORSHIP: The Ingabritt and Arne Lundberg Foundation, The Wilhelm and Martina Lundgren Foundation.

Adolescent↗
PubMed2003

Serum iron concentration as a tool to measure relative iron absorption from elemental iron powders in man.

OBJECTIVE: To present a new method for measuring the relative bioavailability (RBV) of commercial elemental iron powders by investigating induced changes of serum iron concentration (S-Fe) in relation to ferrous sulphate (FeSO4). Earlier studies have shown that in a group of subjects there is good agreement between the increase in S-Fe and the amount of iron absorbed from a simple iron salt as FeSO4. METHODS: The study included two groups of male blood donors (n=2 x 16 subjects) who were served three meals with an interval of approximately nine weeks between each one. In one group the meal was fortified with reduced iron, ferrous sulphate or no iron at all. In the other group the meal was fortified with electrolytic iron, ferrous sulphate or no iron. The S-Fe increase was followed for 6 h. Studying the non-iron meals was necessary so that the basal diurnal variation in the S-Fe during the six hours could be measured and subtracted. RESULTS: The mean S-Fe increase calculated as the area under the curve (AUC) from the reduced iron (RBV=0.43) and the electrolytic iron (RBV=0.73) differed significantly from the AUC following FeSO4 (p=0.002 and p=0.021, respectively). The difference between the reduced and the electrolytic iron was also statistically significant (p=0.036). CONCLUSION: Measuring increases in S-Fe could be a reliable and simple method to determine the RBV in comparative studies of elemental iron powders in relation to FeSO4.

Adult↗
PubMed2002

Advantages and disadvantages of an iron-rich diet.

BACKGROUND AND OBJECTIVE: A review by invitation about advantages and disadvantages of an iron-rich diet by analyzing physiological iron requirements, dietary factors influencing iron absorption and the regulatory systems available to control iron absorption according to needs. RESULTS: The control to prevent iron deficiency is good but not perfect, as observed in previously described studies on relationships between individual iron requirements and the probability of iron deficiency developing in relation to diet. The control to prevent iron overload seems to be perfect except in the few subjects being homozygotes for hereditary hemochromatosis. CONCLUSIONS: A diet rich in easily available iron is important for covering basal iron losses, menstrual iron losses and the high iron requirements for growth from infancy to adolescence and for pregnancy.

Anemia, Iron-Deficiency↗
PubMed2001

Cancer risk in Swedish women: the relation to size at birth.

The relationship between fetal growth as indicated by weight and length at birth, and cancer risk in 1080 adult Swedish women was examined. Birth factors were retrieved from original midwife records for the years 1914, 1918, 1922 and 1930, and primary cancer cases were identified by matching with national and regional cancer registries through the year 1998. A positive and statistically significant increased risk for cancer was found with increasing birth weight or birth length for all site cancer and non-hormone related cancer, defined as all cancer sites excluding breast, uterus and ovary. Addition of factors suspected to influence cancer risk, maternal proteinuria, birth order, own parity and age at menarche, did not attenuate this relation. Previously only breast cancer has been reported to be related to size at birth in adult women and this is the first study to report that cancer sites other than the major hormone-related sites may be influenced by size at birth, as measured by either weight or length at birth; these findings warrant further investigation.

Age Factors↗
PubMed2001

Perspectives on nutritional iron deficiency.

Nutritional iron deficiency (ID) is caused by an intake of dietary iron insufficient to cover physiological iron requirements. Studies on iron absorption from whole diets have examined relationships between dietary iron bioavailability/absorption, iron losses, and amounts of stored iron. New insights have been obtained into regulation of iron absorption and expected rates of changes of iron stores or hemoglobin iron deficits when bioavailability or iron content of the diet has been modified and when losses of iron occur. Negative effects of ID are probably related to age, up to about 20 years, explaining some of earlier controversies. Difficulties in establishing the prevalence of mild ID are outlined. The degree of underestimation of the prevalence of mild ID when using multiple diagnostic criteria is discussed. It is suggested that current low-energy lifestyles are a common denominator for the current high prevalence not only of ID but also of obesity, diabetes, and osteoporosis.

Anemia, Iron-Deficiency↗
PubMed2001

GH is needed for the maturation of muscle mass and strength in adolescents.

The postpubertal period and the early years of adulthood may be of importance for continuing tissue maturation of importance in adulthood and aging. An example of this is the peak bone mass. This study has evaluated the importance of GH for lean mass and muscle strength in adolescents and young adults. GH treatment was discontinued in 40 adolescents aged 16-21 yr with GH deficiency of childhood onset. Measurements of isometric and isokinetic knee-extensor and flexor strength, handgrip strength, lean body mass, fat-free mass, and total body nitrogen were performed annually for 2 yr. Two hundred fifty healthy adolescents were randomly selected for prospective measurements of lean mass and handgrip strength between the ages of 17 and 21 yr. In the adolescents with continuing GH deficiency, lean body mass decreased, compared with the patients defined as having sufficient endogenous GH. The isometric strength in knee flexors increased in the sufficient endogenous GH group and was unchanged in the GH deficiency group during the 2 yr off GH treatment (between group, P < 0.05). The mean and peak handgrip strength increased on average by 9-15% in the group with sufficient endogenous GH and was unchanged in those with GH deficiency (P < 0.05). Lean body mass and handgrip strength (both, P < 0.001) increased in both the healthy boys and girls who were followed for 4 yr with a more marked increase in the boys. The mean increase in handgrip between the age of 17 and 21 yr was 7-9%. The increased lean mass and improved muscle performance seen in healthy adolescents did not occur in adolescents with GH deficiency. These findings suggest that GH is of importance for the maturation of lean mass and muscle strength in adolescents and young adults.

Adolescent↗
PubMed2000

Poor agreement between self-reported birth weight and birth weight from original records in adult women.

Data from an ongoing prospective population study of women in Göteborg, Sweden, were used to assess agreement between self-reported birth weight and birth weight obtained from original delivery records of women aged 44-60 years. Of the eligible population with traced delivery records (n = 693), only 28% (n = 192) could report their own birth weight. Spearman correlation between self-reported birth weight and birth weight from original records was r = 0.76. However, a difference plot, with limits of agreement at -1,028 to 1,038 g (95% confidence limits: lower limit, -1,157 to -901 g, upper limit, 910 to 1,166 g) revealed poor agreement between methods. Of the self-reported birth weights, 53% were in error by 250 g or more, and 31% were positively or negatively discordant by 500 g or more. Application in an analysis of cardiovascular risk factors in adulthood found conflicting results between self-reported and recorded birth weights. Low reporting rate, poor reporting accuracy, and misleading findings in application led to the conclusion that self-reported birth weights from middle-aged women would not be a satisfactory replacement for birth weights from original records.

Adult↗
PubMed2000

Iron stores and haemoglobin iron deficits in menstruating women. Calculations based on variations in iron requirements and bioavailability of dietary iron.

BACKGROUND: Iron stores and haemoglobin iron deficits in menstruating women can be calculated from body iron losses and absorption of dietary iron using recently developed methods. OBJECTIVE: To examine iron balance (iron status) expressed as body iron stores or haemoglobin iron deficits in menstruating women from amounts of iron lost (iron requirements) and amounts of dietary iron absorbed. Calculations are made both of stationary states and of the rate of changes in iron stores (iron status) when any of the two main factors determining iron balance are changed. DESIGN: The study is based on (1) previous and new equations describing relationships between iron absorption, iron requirements (losses), iron stores and/or haemoglobin deficits and (2) published data on iron requirements and their variation in menstruating adult women. RESULTS: Both iron stores and haemoglobin iron deficits are strongly related to iron requirements and absorption of dietary iron and follow the same equations during states of iron repletion and iron deficiency. When, for example, increasing or decreasing the bioavailability of the dietary iron, about 90% of the change in iron stores will occur within 1 y. CONCLUSIONS: There are strong relationships between iron requirements, bioavailability of dietary iron and amounts of stored iron. The observations that a reduction in iron stores and a calculated decrease of haemoglobin iron had the same increasing effect on iron absorption suggest that the control of iron absorption is mediated from a common cell, that may register both size of iron stores and hemoglobin iron deficit, eg the hepatocyte. European Journal of Clinical Nutrition (2000) 54, 650-657.

Absorption↗
PubMed2000

Prediction of dietary iron absorption: an algorithm for calculating absorption and bioavailability of dietary iron.

BACKGROUND: Dietary iron absorption from a meal is determined by iron status, heme- and nonheme-iron contents, and amounts of various dietary factors that influence iron absorption. Limited information is available about the net effect of these factors. OBJECTIVE: The objective was to develop an algorithm for predicting the effects of factors known to influence heme- and nonheme-iron absorption from meals and diets. DESIGN: The basis for the algorithm was the absorption of iron from a wheat roll (22.1 +/- 0.18%) containing no known inhibitors or enhancers of iron absorption and adjusted to a reference dose absorption of 40%. This basal absorption was multiplied by the expected effect of different amounts of dietary factors known to influence iron absorption: phytate, polyphenols, ascorbic acid, meat, fish and seafood, calcium, egg, soy protein, and alcohol. For each factor, an equation describing the dose-effect relation was developed. Special considerations were made for interactions between individual factors. RESULTS: Good agreement was seen when measurements of iron absorption from 24 complete meals were compared with results from use of the algorithm (r(2) = 0.987) and when mean iron absorption in 31 subjects served a varied whole diet labeled with heme- and nonheme-iron tracers over a period of 5 d was compared with the mean total iron absorption calculated by using the algorithm (P = 0.958). CONCLUSIONS: This algorithm has several applications. It can be used to predict iron absorption from various diets, to estimate the effects expected by dietary modification, and to translate physiologic into dietary iron requirements from different types of diets.

Alcohol Drinking↗
PubMed2000

Optimal outcome measures, research priorities, and international cooperation.

The participants in the Eriksholm Workshop on "Measuring Outcomes in Audiological Rehabilitation Using Hearing Aids" debated three issues that are reported in this article. First, it was agreed that the characteristics of an optimal outcome measure vary as a function of the purpose of the measurement. Potential characteristics of outcome self-report tools for four common goals of outcome measurement are briefly presented to illustrate this point. Second, 10 important research priorities in outcome measurement were identified and ranked. They are presented with brief discussion of the top five. Third, the concept of generating a brief universally applicable outcome measure was endorsed. This brief data set is intended to supplement existing outcome measures and to promote data combination and comparison across different social, cultural, and health-care delivery systems. A set of seven core items is proposed for further study.

Correction of Hearing Impairment↗
PubMed2000

Blood pressure and hypertension in middle-aged women in relation to weight and length at birth: a follow-up study.

OBJECTIVES: To examine the relationship between indicators at birth and adult blood pressure and risk for developing hypertension at two age levels. DESIGN: Original midwife records of 438 women born at term participating in a prospective population study in Göteborg, Sweden with blood pressure and hypertension assessment at both 50 and 60 years of age. RESULTS: Systolic blood pressure at both age levels showed a U-shaped relationship to weight and length at birth. Hypertension prevalence at 60 years was significantly and inversely related to both weight and length at birth, but not at 50 years. Significantly higher risk for hypertension was found in the lowest birth weight quintile [odds ratio (OR) = 2.0, 95% confidence interval (CI) 1.1-3.8] and lowest birth length tertile (OR = 1.8, 95% CI 1.1-3.0), in relation to the middle quintile/tertile, with or without adjustment for adult body size (as body mass index), at 60 years but not at 50 years. At 50 years, hypertension risk decreased by 3% (95% CI 0.92-1.01) for every 100 g increase in birth weight and 6% (95% CI 0.83-1.05) per cm birth length. At age 60 years, hypertension risk decreased by 4% (95% CI 0.92-0.99) per 100 g birth weight and 10% (95% CI 0.81-0.99) per cm length. CONCLUSIONS: Size at birth was a predictor of hypertension risk in women at 60 years but not 50 years. This study supports the hypothesis that poor fetal growth, as measured by low weight or length at birth, may contribute to the development of hypertension in later life and that this relationship became stronger with age.

Birth Weight↗
PubMed2000

Sociodemographic characteristics influencing birth outcome in Sweden, 1908-1930. Birth variables in the Population Study of Women in Gothenburg.

STUDY OBJECTIVE: To identify variables available in early Swedish delivery records and their relation to birth outcomes for home and hospital deliveries in Gothenburg at the early part of this century. DESIGN: A retrospective recovery of original delivery records and social variables in a cross sectional population. SETTING: Gothenburg, Sweden. PARTICIPANTS: 851 fullterm singleton female births with known gestational age born into five birth cohorts on selected dates (1908, 1914, 1918, 1922 and 1930). MAIN RESULTS: Delivery site, maternal parity, gestational age, and social group were significant factors influencing birth outcome as birth weight and length. The mean birth weight and length of hospital born infants was consistently lower than for home deliveries across all cohorts. Site of delivery changed significantly during the period of births under study, 1908-1930. CONCLUSIONS: In this study, which was based on original delivery records from the early part of this century, it was found that delivery site was an important factor influencing birth outcome across five birth cohorts. Utilisation of delivery services changed during the period of study. Thus, to avoid selection bias, the application of delivery records should reflect the birthing practice of the time period in question.

Adult↗
PubMed1999

Carboxypeptidase E (CPE) deficiency in mice with the fat mutation have reduced stomach function.

An obese mouse model (Cpefat/Cpefat) that has hyperproinsulinemia and late onset obesity has been described. Cpefat/Cpefat mice have a missense mutation in carboxypeptidase E (CPE), a processing enzyme essential for production of biologically active endocrine and neuroendocrine peptides. We have reported previously that CPE activity was absent in the antrum of the stomach and that processing of progastrin to the amidated biologically active form of gastrin is reduced. Since gastrin is a major secretagogue for gastric acid secretion, the purpose of the present experiments was to examine gastric acid secretion in Cpefat/Cpefat mice. In addition, secretion of amidated gastrin in response to inhibition of acid secretion was tested in Cpefat/Cpefat. Both gastric acid and challenged gastrin secretion are reduced in Cpefat/Cpefat mice. We conclude that stomach CPE activity is essential for gastric secretory activity and for challenged gastrin release.

Animals↗
PubMed1999

Inositol phosphates with different numbers of phosphate groups influence iron absorption in humans.

BACKGROUND: Inositol hexaphosphate (IP(6)) is a well-known inhibitor of iron absorption, whereas the effects of the less-phosphorylated derivatives of IP(6) are less known. OBJECTIVES: The objective was to investigate the effects of inositol tri-, tetra-, and pentaphosphates (IP(3), IP(4), and IP(5), respectively) on iron absorption in humans. DESIGN: Iron absorption was measured in 5 experiments from single meals by extrinsic labeling with (55)Fe and (59)Fe and determination of whole-body retention and the erythrocyte uptake of isotopes. In experiments 1-3 the meals contained white-wheat rolls to which 10 mg P as IP(5), IP(4), or IP(3), respectively, was added. Inositol 1,2,6-triphosphate [Ins(1,2, 6)P(3)] and a mixture of isomers of IP(4) and IP(5) were studied. White-wheat rolls contained 10 mg P as IP(3) + IP(4) and 2 mg P as IP(5) + IP(6) in experiment 4 and 20 mg P as IP(3) + IP(4) and 3 mg P as IP(5) + IP(6) in experiment 5; inositol phosphates were obtained via fermentation of sodium phytate. Each experiment had 8-11 subjects. RESULTS: In experiment 1, iron absorption was reduced by 39%, whereas there was no significant effect on iron absorption in experiments 2 and 3. In experiments 4 and 5, iron absorption was reduced by 54% and 64%, respectively, suggesting that IP(3) and IP(4) contributed to the inhibitory effect. CONCLUSIONS: IP(5) has an inhibitory effect on iron absorption, whereas IP(3) and IP(4) in isolated form have no such effect. IP(3) and IP(4) in processed food contribute to the negative effect on iron absorption, presumably by binding iron between different inositol phosphates. To improve iron absorption from cereals and legumes, degradation of inositol phosphates needs to be to less-phosphorylated inositol phosphates than IP(3).

Absorption↗
PubMed1998

Effect of a mild infection on serum ferritin concentration--clinical and epidemiological implications.

OBJECTIVES: To study the distribution of serum ferritin concentration in adolescent boys and girls with and without a preceding mild infection. DESIGN: The prevalence of iron deficiency was studied in two representative samples. The first sample from 1990 comprised 207 boys and 220 girls. The second sample from 1994 included 620 boys and 624 girls. In total 1675 adolescents, 15-16 y old, 827 boys and 844 girls were studied. RESULTS: A significant shift of serum ferritin concentration towards higher values was observed in those who reported an upper respiratory infection with fever during the preceding month (P<0.001). Significant differences were found between serum ferritin values in healthy, not infected adolescents and serum ferritin values in those with ongoing infection, both in boys and girls in the two materials (P < 0.01), and in those with a mild infection during the preceding three weeks. CONCLUSIONS: The prevalence of recent infection should be included as information when trying to assess the prevalence of iron deficiency on the basis of serum ferritin measurements and when examining relationships between iron status and composition of the diet. The findings imply that differences in prevalence of iron deficiency between different studies might partly be explained by differences in prevalence of simple respiratory infections. The diagnostic sensitivity of the serum ferritin assay for iron deficiency, using conventional reference limits, decreases for subjects with recent such infections; similarly, there will be a decrease in the diagnostic specificity for haemochromatosis.

Adolescent↗
PubMed1998

Iron stores in man in relation to diet and iron requirements.

OBJECTIVE: To calculate iron stores in man and their rates of changes in relation to iron requirements and dietary iron intake and bioavailability. METHOD: Newly established relationships between iron absorption from whole diets and serum ferritin (SF) and between SF and iron stores allow calculations of amounts of stored iron under different conditions (diets, losses) at stationary states when absorption equals losses. Rate of growth of stores can also be calculated. All calculations are based on observations and require no model assumptions. RESULTS: Present calculations of iron stores agree with previously observed phlebotomy values. Differences in intake and bioavailability of dietary iron and in iron requirements had marked effects on amounts of stored iron. A wide range of diets was studied, from a hypothetical high-meat diet typical for early man to diets in developing countries. A new equation is given for the translation of SF into iron stores. Analyses of growth rate of stores under different conditions showed a fast growth from zero iron stores during the first year (reaching about 80% of final amounts) followed by a much slower rate for 2-3 y. A marked inertia was seen in rate of changes in iron stores that was more marked the closer stores were to their stationary states making it difficult to use SF to estimate short term changes in iron absorption in iron replete subjects. CONCLUSIONS: Realistic Western-type diets with good bioavailability can cover iron requirements in most women and can restitute iron stores during lactation. The high prevalence of iron deficiency in menstruating Western women is thus mainly related to a further low bioavailability of iron in present diets. Present analyses also demonstrated an effective control of iron absorption preventing development of iron overload in otherwise healthy subjects even if the diet is fortified with iron and even if meat intake is high.

Absorption↗