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12. EU-wide exposure data of 11 chemical substance groups from the HBM4EU Aligned Studies (2014–2021)

Author

Govarts, Eva, Gilles, Liese, Rodriguez Martin, Laura, Santonen, Tiina, Apel, Petra, Alvito, Paula, Anastasi, Elena, Andersen, Helle Raun, Andersson, Anna Maria, Andryskova, Lenka, Antignac, Jean Philippe, Appenzeller, Brice, Barbone, Fabio, Barnett-Itzhaki, Zohar, Barouki, Robert, Berman, Tamar, Bil, Wieneke, Borges, Teresa, Buekers, Jurgen, Cañas-Portilla, Ana, Covaci, Adrian, Csako, Zsofia, Den Hond, Elly, Dvorakova, Darina, Fabelova, Lucia, Fletcher, Tony, Frederiksen, Hanne, Gabriel, Catherine, Ganzleben, Catherine, Göen, Thomas, Halldorsson, Thorhallur I., Haug, Line S., Horvat, Milena, Huuskonen, Pasi, Imboden, Medea, Jagodic Hudobivnik, Marta, Janasik, Beata, Janev Holcer, Natasa, Karakitsios, Spyros, Katsonouri, Andromachi, Klanova, Jana, Kokaraki, Venetia, Kold Jensen, Tina, Koponen, Jani, Laeremans, Michelle, Laguzzi, Federica, Lange, Rosa, Lemke, Nora, Lignell, Sanna, Lindroos, Anna Karin, Lobo Vicente, Joana, Luijten, Mirjam, Makris, Konstantinos C., Mazej, Darja, Melymuk, Lisa, Meslin, Matthieu, Mol, Hans, Montazeri, Parisa, Murawski, Aline, Namorado, Sónia, Niemann, Lars, Nübler, Stefanie, Nunes, Baltazar, Olafsdottir, Kristin, Palkovicova Murinova, Lubica, Papaioannou, Nafsika, Pedraza-Diaz, Susana, Piler, Pavel, Plichta, Veronika, Poteser, Michael, Probst-Hensch, Nicole, Rambaud, Loïc, Rauscher-Gabernig, Elke, Rausova, Katarina, Remy, Sylvie, Riou, Margaux, Rosolen, Valentina, Rousselle, Christophe, Rüther, Maria, Sarigiannis, Denis, Silva, Maria J., Šlejkovec, Zdenka, Snoj Tratnik, Janja, Stajnko, Anja, Szigeti, Tamas, Tarazona, José V., Thomsen, Cathrine, Tkalec, Žiga, Tolonen, Hanna, Trnovec, Tomas, Uhl, Maria, Van Nieuwenhuyse, An, Vasco, Elsa, Verheyen, Veerle J., Viegas, Susana, Vinggaard, Anne Marie, Vogel, Nina, Vorkamp, Katrin, Wasowicz, Wojciech, Weber, Till, Wimmerova, Sona, Woutersen, Marjolijn, Zimmermann, Philipp, Zvonar, Martin, Koch, Holger, Kolossa-Gehring, Marike, Esteban López, Marta, Castaño, Argelia, Stewart, Lorraine, Sepai, Ovnair, Schoeters, Greet, and NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)

Subjects
HBM4EU, SDG 3 - Good Health and Well-being, Public Health, Environmental and Occupational Health, Adults, Exposure biomarkers, Children, Teenagers, Human biomonitoring (HBM)
Abstract

Funding Information: The authors would like to thank everybody who contributed to the HBM4EU Aligned Studies: the participating children, teenagers, adults and their families, the fieldworkers that collected the samples and database managers that made the information available to HBM4EU, the HBM4EU project partners, especially those from WP7 for developing all materials supporting the fieldwork, WP9 for organizing the QA/QC scheme under HBM4EU and all laboratories who performed the analytical measurements. We would like to acknowledge Sun Kyoung Jung from the National Institute of Environmental Research of South-Korea for providing the KoNEHS Cycle III results (crt adjusted). HBM4EU is co-financed under Horizon 2020 (grant agreement No 733032). The authors thank all principal investigators of the contributing studies for their participation and contribution to the HBM4EU Aligned Studies and the national program owners for their financial support. Further details on funding for all the participating studies can be found in the Supplemental Material, Table S12. As one of the core elements of the European Human Biomonitoring Initiative (HBM4EU) a human biomonitoring (HBM) survey was conducted in 23 countries to generate EU-wide comparable HBM data. This survey has built on existing HBM capacity in Europe by aligning national or regional HBM studies, referred to as the HBM4EU Aligned Studies. The HBM4EU Aligned Studies included a total of 10,795 participants of three age groups: (i) 3,576 children aged 6–12 years, (ii) 3,117 teenagers aged 12–18 years and (iii) 4,102 young adults aged 20–39 years. The participants were recruited between 2014 and 2021 in 11–12 countries per age group, geographically distributed across Europe. Depending on the age group, internal exposure to phthalates and the substitute DINCH, halogenated and organophosphorus flame retardants, per- and polyfluoroalkyl substances (PFASs), cadmium, bisphenols, polycyclic aromatic hydrocarbons (PAHs), arsenic species, acrylamide, mycotoxins (deoxynivalenol (total DON)), benzophenones and selected pesticides was assessed by measuring substance specific biomarkers subjected to stringent quality control programs for chemical analysis. For substance groups analyzed in different age groups higher average exposure levels were observed in the youngest age group, i.e., phthalates/DINCH in children versus teenagers, acrylamide and pesticides in children versus adults, benzophenones in teenagers versus adults. Many biomarkers in teenagers and adults varied significantly according to educational attainment, with higher exposure levels of bisphenols, phthalates, benzophenones, PAHs and acrylamide in participants (from households) with lower educational attainment, while teenagers from households with higher educational attainment have higher exposure levels for PFASs and arsenic. In children, a social gradient was only observed for the non-specific pyrethroid metabolite 3-PBA and di-isodecyl phthalate (DiDP), with higher levels in children from households with higher educational attainment. Geographical variations were seen for all exposure biomarkers. For 15 biomarkers, the available health-based HBM guidance values were exceeded with highest exceedance rates for toxicologically relevant arsenic in teenagers (40%), 3-PBA in children (36%), and between 11 and 14% for total DON, Σ (PFOA + PFNA + PFHxS + PFOS), bisphenol S and cadmium. The infrastructure and harmonized approach succeeded in obtaining comparable European wide internal exposure data for a prioritized set of 11 chemical groups. These data serve as a reference for comparison at the global level, provide a baseline to compare the efficacy of the European Commission's chemical strategy for sustainability and will give leverage to national policy makers for the implementation of targeted measures. publishersversion published

Published
2023

13. Adherence to the Swedish dietary guidelines and the impact on mortality and climate in a population-based cohort study.

Author

Strid, Anna, Hallström, Elinor, Lindroos, Anna Karin, Lindahl, Bernt, Johansson, Ingegerd, and Winkvist, Anna

Subjects
GREENHOUSE gases, COHORT analysis, PRODUCT life cycle assessment, MORTALITY, FOOD habits
Abstract

Objective: To assess the associations between adherence to the Swedish dietary guidelines and all-cause mortality (i.e. assessing the index' ability to predict health outcomes), as well as levels of dietary greenhouse gas emissions (GHGEs). Design: A longitudinal study 1990–2016 within the population-based cohort Västerbotten Intervention Programme. Dietary data were based on FFQs. Diet quality was assessed by the Swedish Healthy Eating Index for Adults 2015 (SHEIA15), based on the 2015 Swedish dietary guidelines. Dietary GHGEs were estimated from life cycle assessment data including emissions from farm to industry gate. Hazard ratios (HR) and 95 % CI of all-cause mortality were evaluated with Cox proportional hazards regression, and differences in median GHGEs were tested between quintiles of SHEIA15 score using the Kruskal–Wallis one-way ANOVA test. Setting: Northern Sweden. Participants: In total, 49 124 women and 47 651 men, aged 35–65 years. Results: Median follow-up times were 16·0 years for women and 14·7 years for men, during which time 3074 women and 4212 men died. A consistent trend of lower all-cause mortality HR for both sexes with higher SHEIA15 scores was demonstrated. For women, the all-cause mortality HR was 0·81 ((95 % CI 0·71, 0·92); P = 0·001) and for men 0·90 ((95 % CI 0·81, 0·996); P = 0·041) between the quintile with the highest SHEIA15 score compared with the quintile with the lowest SHEIA15 score. A consistent trend of lower estimated dietary GHGEs among both sexes with higher SHEIA15 scores was also found. Conclusions: Adherence to Swedish dietary guidelines, estimated by SHEIA15, seems to promote longevity and reduce dietary climate impact. [ABSTRACT FROM AUTHOR]

Published
2023
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14. Current exposure to phthalates and DINCH in European children and adolescents - Results from the HBM4EU Aligned Studies 2014 to 2021

Author

Vogel, Nina, Schmidt, Phillipp, Lange, Rosa, Gerofke, Antje, Sakhi, Amrit K, Haug, Line S, Jensen, Tina Kold, Frederiksen, Hanne, Szigeti, Tamás, Csákó, Zsófia, Murinova, Lubica Palkovicova, Sidlovska, Miroslava, Janasik, Beata, Wasowicz, Wojciech, Tratnik, Janja Snoj, Mazej, Darja, Gabriel, Catherine, Karakitsios, Spyros, Barbone, Fabio, Rosolen, Valentina, Rambaud, Loïc, Riou, Margaux, Murawski, Aline, Leseman, Daan, Koppen, Gudrun, Covaci, Adrian, Lignell, Sanna, Lindroos, Anna Karin, Zvonar, Martin, Andryskova, Lenka, Fabelova, Lucia, Richterova, Denisa, Horvat, Milena, Kosjek, Tina, Sarigiannis, Denis, Maroulis, Marios, Pedraza-Diaz, Susana, Cañas, Ana, Verheyen, Veerle J, Bastiaensen, Michiel, Gilles, Liese, Schoeters, Greet, Esteban-López, Marta, Castaño, Argelia, Govarts, Eva, Koch, Holger M, and Kolossa-Gehring, Marike

Subjects
HBM4EU, Phthalates, DINCH, Adolescents, Children, HBM, Exposure
Published
2023

15. Children’s and adolescents’ rising animal-source food intakes in 1990–2018 were impacted by age, region, parental education and urbanicity

Author

Miller, Victoria, Webb, Patrick, Cudhea, Frederick, Zhang, Jianyi, Reedy, Julia, Shi, Peilin, Erndt-Marino, Josh, Coates, Jennifer, Micha, Renata, Mozaffarian, Dariush, Bas, Murat, Ali, Jemal Haidar, Abumweis, Suhad, Krishnan, Anand, Misra, Puneet, Hwalla, Nahla Chawkat, Janakiram, Chandrashekar, Liputo, Nur Indrawaty, Musaiger, Abdulrahman, Pourfarzi, Farhad, Alam, Iftikhar, DeRidder, Karin, Termote, Celine, Memon, Anjum, Turrini, Aida, Lupotto, Elisabetta, Piccinelli, Raffaela, Sette, Stefania, Anzid, Karim, Vossenaar, Marieke, Mazumdar, Paramita, Rached, Ingrid, Rovirosa, Alicia, Zapata, María Elisa, Asayehu, Tamene Taye, Oduor, Francis, Boedecker, Julia, Aluso, Lilian, Ortiz-Ulloa, Johana, Meenakshi, J.V., Castro, Michelle, Grosso, Giuseppe, Waskiewicz, Anna, Khan, Umber S., Thanopoulou, Anastasia, Malekzadeh, Reza, Calleja, Neville, Ocke, Marga, Etemad, Zohreh, Nsour, Mohannad Al, Waswa, Lydiah M., Nurk, Eha, Arsenault, Joanne, Lopez-Jaramillo, Patricio, Sibai, Abla Mehio, Damasceno, Albertino, Arambepola, Carukshi, Lopes, Carla, Severo, Milton, Lunet, Nuno, Torres, Duarte, Tapanainen, Heli, Lindstrom, Jaana, Virtanen, Suvi, Palacios, Cristina, Roos, Eva, Agdeppa, Imelda Angeles, Desnacido, Josie, Capanzana, Mario, Misra, Anoop, Khouw, Ilse, Ng, Swee Ai, Delgado, Edna Gamboa, Caballero, Mauricio, Otero, Johanna, Lee, Hae-Jeung, Koksal, Eda, Guessous, Idris, Lachat, Carl, De Henauw, Stefaan, Rahbar, Ali Reza, Tedstone, Alison, Naska, Androniki, Mathee, Angie, Ling, Annie, Tedla, Bemnet, Hopping, Beth, Ginnela, Brahmam, Leclercq, Catherine, Duante, Charmaine, Haerpfer, Christian, Hotz, Christine, Pitsavos, Christos, Rehm, Colin, van Oosterhout, Coline, Cerdena, Corazon, Bradshaw, Debbie, Trichopoulos, Dimitrios, Gauci, Dorothy, Fernando, Dulitha, Sygnowska, Elzbieta, Vartiainen, Erkki, Farzadfar, Farshad, Zajkas, Gabor, Swan, Gillian, Ma, Guansheng, Pekcan, Gulden, Ibrahim, Hajah Masni, Sinkko, Harri, Barbieri, Helene Enghardt, Sioen, Isabelle, Myhre, Jannicke, Gaspoz, Jean-Michel, Odenkirk, Jillian, Bundhamcharoen, Kanitta, Nelis, Keiu, Zarina, Khairul, Biro, Lajos, Johansson, Lars, Steingrimsdottir, Laufey, Riley, Leanne, Yap, Mabel, Inoue, Manami, Szabo, Maria, Ovaskainen, Marja-Leena, Lee, Meei-Shyuan, Chan, Mei Fen, Cowan, Melanie, Kandiah, Mirnalini, Kally, Ola, Jonsdottir, Olof, Palmer, Pam, Vollenweider, Peter, Orfanos, Philippos, Asciak, Renzo, Templeton, Robert, Don, Rokiah, Yaakub, Roseyati, Selamat, Rusidah, Yusof, Safiah, Al-Zenki, Sameer, Hung, Shu-Yi, Beer-Borst, Sigrid, Wu, Suh, Lukito, Widjaja, Hadden, Wilbur, Becker, Wulf, Cao, Xia, Ma, Yi, Lai, Yuen, Hjdaud, Zaiton, Ali, Jennifer, Gravel, Ron, Tao, Tina, Veerman, Jacob Lennert, Chiplonkar, Shashi, Arici, Mustafa, Ngoan, Le Tran, Panagiotakos, Demosthenes, Li, Yanping, Trichopoulou, Antonia, Barengo, Noel, Khadilkar, Anuradha, Ekbote, Veena, Mohammadifard, Noushin, Kovalskys, Irina, Laxmaiah, Avula, Rachakulla, Harikumar, Rajkumar, Hemalatha, Meshram, Indrapal, Avula, Laxmaiah, Arlappa, Nimmathota, Hemalatha, Rajkumar, lacoviello, Licia, Bonaccio, Marialaura, Costanzo, Simona, Martin-Prevel, Yves, Castetbon, Katia, Jitnarin, Nattinee, Hsieh, Yao-Te, Olivares, Sonia, Tejeda, Gabriela, Hadziomeragic, Aida, de Moura Souza, Amanda, Pan, Wen-Harn, Huybrechts, Inge, de Brauw, Alan, Moursi, Mourad, Maghroun, Maryam, Zeba, Augustin Nawidimbasba, Sarrafzadegan, Nizal, Keinan-Boker, Lital, Goldsmith, Rebecca, Shimony, Tal, Jordan, Irmgard, Mastiholi, Shivanand C., Mwangi, Moses, Kombe, Yeri, Bukania, Zipporah, Alissa, Eman, Al-Daghri, Nasser, Sabico, Shaun, Gulliford, Martin, Diba, Tshilenge S., Oh, Kyungwon, Kweon, Sanghui, Park, Sihyun, Cho, Yoonsu, Al-Hooti, Suad, Luangphaxay, Chanthaly, Douangvichit, Daovieng, Siengsounthone, Latsamy, Marques-Vidal, Pedro, Rybak, Constance, Luke, Amy, Piaseu, Noppawan, Rojroongwasinkul, Nipa, Sundram, Kalyana, Baykova, Donka, Abedi, Parvin, Sandjaja, Sandjaja, Fadzil, Fariza, Bukhary, Noriklil Bukhary Ismail, Bovet, Pascal, Chen, Yu, Sawada, Norie, Tsugane, Shoichiro, Rangelova, Lalka, Petrova, Stefka, Duleva, Vesselka, Lindroos, Anna Karin, Sipinen, Jessica Petrelius, Moraeus, Lotta, Bergman, Per, Siamusantu, Ward, Szponar, Lucjan, Chang, Hsing-Yi, Sekiyama, Makiko, Le Nguyen Bao, Khanh, Nagalla, Balakrishna, Polasa, Kalpagam, Boindala, Sesikeran, El Ati, Jalila, Silva, Ivonne Ramirez, Dommarco, Juan Rivera, Barquera, Simon, Ramírez, Sonia Rodríguez, Illescas-Zarate, Daniel, Sanchez-Romero, Luz Maria, Ikeda, Nayu, Zaghloul, Sahar, Houshiar-rad, Anahita, Mohammadi-Nasrabadi, Fatemeh, Abdollahi, Morteza, Chuah, Khun-Aik, Mahdy, Zaleha Abdullah, Eldridge, Alison, Ding, Eric L., Kruger, Herculina, Henjum, Sigrun, Fernandez, Anne, Suarez-Ortegon, Milton Fabian, Hamad, Nawal Al, Janská, Veronika, Tayyem, Reema, Mirmiran, Parvin, Kelishadi, Roya, Lemming, Eva Warensjo, Richter, Almut, Mensink, Gert, Wieler, Lothar, Hoffman, Daniel, Salanave, Benoit, Kim, Cho-il, Kuriyan-Raj, Rebecca, Swaminathan, Sumathi, Garriguet, Didier, Dastgiri, Saeed, Vaask, Sirje, Karupaiah, Tilakavati, Zohoori, Fatemeh Vida, Esteghamati, Alireza, Hashemian, Maryam, Noshad, Sina, Mwaniki, Elizabeth, Yakes-Jimenez, Elizabeth, Chileshe, Justin, Mwanza, Sydney, Marques, Lydia Lera, Preston, Alan Martin, Aguero, Samuel Duran, Oleas, Mariana, Posada, Luz, Ochoa, Angelica, Shamsuddin, Khadijah, Shariff, Zalilah Mohd, Jan Bin Jan Mohamed, Hamid, Manan, Wan, Nicolau, Anca, Tudorie, Cornelia, Poh, Bee Koon, Abbott, Pamela, Pakseresht, Mohammadreza, Sharma, Sangita, Strand, Tor Arne, Alexy, Ute, Nöthlings, Ute, Carmikle, Jan, Brown, Ken, Koster, Jeremy, Waidyatilaka, Indu, Lanerolle, Pulani, Jayawardena, Ranil, Long, Julie M., Hambidge, K. Michael, Krebs, Nancy F., Haque, Aminul, Keding, Gudrun B., Korkalo, Liisa, Erkkola, Maijaliisa, Freese, Riitta, Eleraky, Laila, Stuetz, Wolfgang, Thorsdottir, Inga, Gunnarsdottir, Ingibjorg, Serra-Majem, Lluis, Moy, Foong Ming, Anderson, Simon, Jeewon, Rajesh, Zugravu, Corina Aurelia, Adair, Linda, Ng, Shu Wen, Skeaff, Sheila, Marchioni, Dirce, Fisberg, Regina, Henry, Carol, Ersino, Getahun, Zello, Gordon, Meyer, Alexa, Elmadfa, Ibrahim, Mitchell, Claudette, Balfour, David, Geleijnse, Johanna M., Manary, Mark, El-kour, Tatyana, Nikiema, Laetitia, Mirzaei, Masoud, and Hakeem, Rubina

Abstract

Animal-source foods (ASF) provide nutrition for children and adolescents’ physical and cognitive development. Here, we use data from the Global Dietary Database and Bayesian hierarchical models to quantify global, regional and national ASF intakes between 1990 and 2018 by age group across 185 countries, representing 93% of the world’s child population. Mean ASF intake was 1.9 servings per day, representing 16% of children consuming at least three daily servings. Intake was similar between boys and girls, but higher among urban children with educated parents. Consumption varied by age from 0.6 at

Published
2023

16. Incident type 2 diabetes attributable to suboptimal diet in 184 countries

Author

O’Hearn, Meghan, Lara-Castor, Laura, Cudhea, Frederick, Miller, Victoria, Reedy, Julia, Shi, Peilin, Zhang, Jianyi, Wong, John B., Economos, Christina D., Micha, Renata, Mozaffarian, Dariush, Bas, Murat, Ali, Jemal Haidar, Abumweis, Suhad, Krishnan, Anand, Misra, Puneet, Hwalla, Nahla Chawkat, Janakiram, Chandrashekar, Liputo, Nur Indrawaty, Musaiger, Abdulrahman, Pourfarzi, Farhad, Alam, Iftikhar, DeRidder, Karin, Termote, Celine, Memon, Anjum, Turrini, Aida, Lupotto, Elisabetta, Piccinelli, Raffaela, Sette, Stefania, Anzid, Karim, Vossenaar, Marieke, Mazumdar, Paramita, Rached, Ingrid, Rovirosa, Alicia, Zapata, María Elisa, Asayehu, Tamene Taye, Oduor, Francis, Boedecker, Julia, Aluso, Lilian, Ortiz-Ulloa, Johana, Meenakshi, J.V., Castro, Michelle, Grosso, Giuseppe, Waskiewicz, Anna, Khan, Umber S., Thanopoulou, Anastasia, Malekzadeh, Reza, Calleja, Neville, Ocke, Marga, Etemad, Zohreh, Nsour, Mohannad Al, Waswa, Lydiah M., Nurk, Eha, Arsenault, Joanne, Lopez-Jaramillo, Patricio, Sibai, Abla Mehio, Damasceno, Albertino, Arambepola, Carukshi, Lopes, Carla, Severo, Milton, Lunet, Nuno, Torres, Duarte, Tapanainen, Heli, Lindstrom, Jaana, Virtanen, Suvi, Palacios, Cristina, Roos, Eva, Agdeppa, Imelda Angeles, Desnacido, Josie, Capanzana, Mario, Misra, Anoop, Khouw, Ilse, Ng, Swee Ai, Delgado, Edna Gamboa, Caballero, Mauricio, Otero, Johanna, Lee, Hae-Jeung, Koksal, Eda, Guessous, Idris, Lachat, Carl, De Henauw, Stefaan, Rahbar, Ali Reza, Tedstone, Alison, Naska, Androniki, Mathee, Angie, Ling, Annie, Tedla, Bemnet, Hopping, Beth, Ginnela, Brahmam, Leclercq, Catherine, Duante, Charmaine, Haerpfer, Christian, Hotz, Christine, Pitsavos, Christos, Rehm, Colin, van Oosterhout, Coline, Cerdena, Corazon, Bradshaw, Debbie, Trichopoulos, Dimitrios, Gauci, Dorothy, Fernando, Dulitha, Sygnowska, Elzbieta, Vartiainen, Erkki, Farzadfar, Farshad, Zajkas, Gabor, Swan, Gillian, Ma, Guansheng, Pekcan, Gulden, Ibrahim, Hajah Masni, Sinkko, Harri, Barbieri, Helene Enghardt, Sioen, Isabelle, Myhre, Jannicke, Gaspoz, Jean-Michel, Odenkirk, Jillian, Bundhamcharoen, Kanitta, Nelis, Keiu, Zarina, Khairul, Biro, Lajos, Johansson, Lars, Steingrimsdottir, Laufey, Riley, Leanne, Yap, Mabel, Inoue, Manami, Szabo, Maria, Ovaskainen, Marja-Leena, Lee, Meei-Shyuan, Chan, Mei Fen, Cowan, Melanie, Kandiah, Mirnalini, Kally, Ola, Jonsdottir, Olof, Palmer, Pam, Vollenweider, Peter, Orfanos, Philippos, Asciak, Renzo, Templeton, Robert, Don, Rokiah, Yaakub, Roseyati, Selamat, Rusidah, Yusof, Safiah, Al-Zenki, Sameer, Hung, Shu-Yi, Beer-Borst, Sigrid, Wu, Suh, Lukito, Widjaja, Hadden, Wilbur, Becker, Wulf, Cao, Xia, Ma, Yi, Lai, Yuen, Hjdaud, Zaiton, Ali, Jennifer, Gravel, Ron, Tao, Tina, Veerman, Jacob Lennert, Chiplonkar, Shashi, Arici, Mustafa, Ngoan, Le Tran, Panagiotakos, Demosthenes, Li, Yanping, Trichopoulou, Antonia, Barengo, Noel, Khadilkar, Anuradha, Ekbote, Veena, Mohammadifard, Noushin, Kovalskys, Irina, Laxmaiah, Avula, Rachakulla, Harikumar, Rajkumar, Hemalatha, Meshram, Indrapal, Avula, Laxmaiah, Arlappa, Nimmathota, Hemalatha, Rajkumar, lacoviello, Licia, Bonaccio, Marialaura, Costanzo, Simona, Martin-Prevel, Yves, Castetbon, Katia, Jitnarin, Nattinee, Hsieh, Yao-Te, Olivares, Sonia, Tejeda, Gabriela, Hadziomeragic, Aida, de Moura Souza, Amanda, Pan, Wen-Harn, Huybrechts, Inge, de Brauw, Alan, Moursi, Mourad, Maghroun, Maryam, Zeba, Augustin Nawidimbasba, Sarrafzadegan, Nizal, Keinan-Boker, Lital, Goldsmith, Rebecca, Shimony, Tal, Jordan, Irmgard, Mastiholi, Shivanand C., Mwangi, Moses, Kombe, Yeri, Bukania, Zipporah, Alissa, Eman, Al-Daghri, Nasser, Sabico, Shaun, Gulliford, Martin, Diba, Tshilenge S., Oh, Kyungwon, Kweon, Sanghui, Park, Sihyun, Cho, Yoonsu, Al-Hooti, Suad, Luangphaxay, Chanthaly, Douangvichit, Daovieng, Siengsounthone, Latsamy, Marques-Vidal, Pedro, Rybak, Constance, Luke, Amy, Piaseu, Noppawan, Rojroongwasinkul, Nipa, Sundram, Kalyana, Baykova, Donka, Abedi, Parvin, Sandjaja, Sandjaja, Fadzil, Fariza, Bukhary, Noriklil Bukhary Ismail, Bovet, Pascal, Chen, Yu, Sawada, Norie, Tsugane, Shoichiro, Rangelova, Lalka, Petrova, Stefka, Duleva, Vesselka, Lindroos, Anna Karin, Sipinen, Jessica Petrelius, Moraeus, Lotta, Bergman, Per, Siamusantu, Ward, Szponar, Lucjan, Chang, Hsing-Yi, Sekiyama, Makiko, Le Nguyen Bao, Khanh, Nagalla, Balakrishna, Polasa, Kalpagam, Boindala, Sesikeran, El Ati, Jalila, Silva, Ivonne Ramirez, Dommarco, Juan Rivera, Barquera, Simon, Rodríguez-Ramírez, Sonia, Illescas-Zarate, Daniel, Sanchez-Romero, Luz Maria, Ikeda, Nayu, Zaghloul, Sahar, Houshiar-rad, Anahita, Mohammadi-Nasrabadi, Fatemeh, Abdollahi, Morteza, Chuah, Khun-Aik, Mahdy, Zaleha Abdullah, Eldridge, Alison, Ding, Eric L., Kruger, Herculina, Henjum, Sigrun, Fernandez, Anne, Suarez-Ortegon, Milton Fabian, Al-Hamad, Nawal, Janská, Veronika, Tayyem, Reema, Mirmiran, Parvin, Kelishadi, Roya, Lemming, Eva Warensjo, Richter, Almut, Mensink, Gert, Wieler, Lothar, Hoffman, Daniel, Salanave, Benoit, Kim, Cho-il, Kuriyan-Raj, Rebecca, Swaminathan, Sumathi, Garriguet, Didier, Dastgiri, Saeed, Vaask, Sirje, Karupaiah, Tilakavati, Zohoori, Fatemeh Vida, Esteghamati, Alireza, Hashemian, Maryam, Noshad, Sina, Mwaniki, Elizabeth, Yakes-Jimenez, Elizabeth, Chileshe, Justin, Mwanza, Sydney, Marques, Lydia Lera, Preston, Alan Martin, Aguero, Samuel Duran, Oleas, Mariana, Posada, Luz, Ochoa, Angelica, Shamsuddin, Khadijah, Shariff, Zalilah Mohd, Jan Bin Jan Mohamed, Hamid, Manan, Wan, Nicolau, Anca, Tudorie, Cornelia, Poh, Bee Koon, Abbott, Pamela, Pakseresht, Mohammadreza, Sharma, Sangita, Strand, Tor Arne, Alexy, Ute, Nöthlings, Ute, Carmikle, Jan, Brown, Ken, Koster, Jeremy, Waidyatilaka, Indu, Lanerolle, Pulani, Jayawardena, Ranil, Long, Julie M., Hambidge, K. Michael, Krebs, Nancy F., Haque, Aminul, Keding, Gudrun B., Korkalo, Liisa, Erkkola, Maijaliisa, Freese, Riitta, Eleraky, Laila, Stuetz, Wolfgang, Thorsdottir, Inga, Gunnarsdottir, Ingibjorg, Serra-Majem, Lluis, Moy, Foong Ming, Anderson, Simon, Jeewon, Rajesh, Zugravu, Corina Aurelia, Adair, Linda, Ng, Shu Wen, Skeaff, Sheila, Marchioni, Dirce, Fisberg, Regina, Henry, Carol, Ersino, Getahun, Zello, Gordon, Meyer, Alexa, Elmadfa, Ibrahim, Mitchell, Claudette, Balfour, David, Geleijnse, Johanna M., Manary, Mark, El-kour, Tatyana, Nikiema, Laetitia, Mirzaei, Masoud, and Hakeem, Rubina

Abstract

The global burden of diet-attributable type 2 diabetes (T2D) is not well established. This risk assessment model estimated T2D incidence among adults attributable to direct and body weight-mediated effects of 11 dietary factors in 184 countries in 1990 and 2018. In 2018, suboptimal intake of these dietary factors was estimated to be attributable to 14.1 million (95% uncertainty interval (UI), 13.8–14.4 million) incident T2D cases, representing 70.3% (68.8–71.8%) of new cases globally. Largest T2D burdens were attributable to insufficient whole-grain intake (26.1% (25.0–27.1%)), excess refined rice and wheat intake (24.6% (22.3–27.2%)) and excess processed meat intake (20.3% (18.3–23.5%)). Across regions, highest proportional burdens were in central and eastern Europe and central Asia (85.6% (83.4–87.7%)) and Latin America and the Caribbean (81.8% (80.1–83.4%)); and lowest proportional burdens were in South Asia (55.4% (52.1–60.7%)). Proportions of diet-attributable T2D were generally larger in men than in women and were inversely correlated with age. Diet-attributable T2D was generally larger among urban versus rural residents and higher versus lower educated individuals, except in high-income countries, central and eastern Europe and central Asia, where burdens were larger in rural residents and in lower educated individuals. Compared with 1990, global diet-attributable T2D increased by 2.6 absolute percentage points (8.6 million more cases) in 2018, with variation in these trends by world region and dietary factor. These findings inform nutritional priorities and clinical and public health planning to improve dietary quality and reduce T2D globally. publishedVersion

Published
2023

18. PFAS and Phthalate/DINCH Exposure in Association with Age at Menarche in Teenagers of the HBM4EU Aligned Studies.

Author

Cox, Bianca, Wauters, Natasha, Rodríguez-Carrillo, Andrea, Portengen, Lützen, Gerofke, Antje, Kolossa-Gehring, Marike, Lignell, Sanna, Lindroos, Anna Karin, Fabelova, Lucia, Murinova, Lubica Palkovicova, Desalegn, Anteneh, Iszatt, Nina, Schillemans, Tessa, Åkesson, Agneta, Colles, Ann, Den Hond, Elly, Koppen, Gudrun, Van Larebeke, Nicolas, Schoeters, Greet, and Govarts, Eva

Subjects
POLYCHLORINATED biphenyls, MENARCHE, PHTHALATE esters, FLUOROALKYL compounds, TEENAGERS, ENDOCRINE disruptors, BODY mass index
Abstract

Early puberty has been found to be associated with adverse health outcomes such as metabolic and cardiovascular diseases and hormone-dependent cancers. The decrease in age at menarche observed during the past decades has been linked to an increased exposure to endocrine-disrupting compounds (EDCs). Evidence for the association between PFAS and phthalate exposure and menarche onset, however, is inconsistent. We studied the association between PFAS and phthalate/DINCH exposure and age at menarche using data of 514 teenagers (12 to 18 years) from four aligned studies of the Human Biomonitoring for Europe initiative (HBM4EU): Riksmaten Adolescents 2016–2017 (Sweden), PCB cohort (follow-up; Slovakia), GerES V-sub (Germany), and FLEHS IV (Belgium). PFAS concentrations were measured in blood, and phthalate/DINCH concentrations in urine. We assessed the role of each individual pollutant within the context of the others, by using different multi-pollutant approaches, adjusting for age, age- and sex-standardized body mass index z-score and household educational level. Exposure to di(2-ethylhexyl) phthalate (DEHP), especially mono(2-ethyl-5-hydroxyhexyl) phthalate (5OH-MEHP), was associated with an earlier age at menarche, with estimates per interquartile fold change in 5OH-MEHP ranging from −0.34 to −0.12 years in the different models. Findings from this study indicated associations between age at menarche and some specific EDCs at concentrations detected in the general European population, but due to the study design (menarche onset preceded the chemical measurements), caution is needed in the interpretation of causality. [ABSTRACT FROM AUTHOR]

Published
2023
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20. Consumption of foods with the Keyhole front-of-pack nutrition label: potential impact on energy and nutrient intakes of Swedish adolescents.

Author

Wanselius, Julia, Larsson, Christel, Berg, Christina, Öhrvik, Veronica, Lindroos, Anna Karin, and Lissner, Lauren

Subjects
NUTRITIONAL status, DIETARY fats, NUTRITION, POTENTIAL energy, TEENAGERS, INGESTION, FOOD consumption, READY meals
Abstract

Objective: The Keyhole is an internationally recognised front-of-pack nutrition label, guiding consumers to healthier food options. It indicates products in accordance with specific criteria for dietary fats, sugars, fibres, salt and wholegrains. The objective of this study was to simulate the potential impact of the Keyhole on adolescents' energy and nutrient intakes by modelling a shift from reported food intakes to foods meeting the Keyhole criteria.Design: Self-reported dietary intake data were derived from a cross-sectional survey. Multiple replacement scenarios were calculated, where foods meeting the Keyhole criteria replaced reported non-compliant foods with varying proportions of replacement.Setting: Dietary survey 'Riksmaten Adolescents 2016-2017' in schools across Sweden.Participants: A nationally representative sample of 3099 adolescents in school years 5, 8 and 11 (55 % girls).Results: Overall, replacement with foods meeting the Keyhole criteria led to more adolescents meeting nutrition recommendations. Largest median intake improvements were seen for wholegrains (+196 %), SFA (-13 %), PUFA (+17 %) and fibres (+15 %). Smallest improvements were seen for free sugars (-3 %) and salt (-2 %), partly explained by the ineligibility of main food sources of free sugars for the Keyhole, and non-inclusion of ready meals that are often high in salt. Most micronutrient intakes were stable or improved. Unintentional effects included decreases in vitamin A, MUFA and energy intakes. Largest potential improvements in fat and fibre sources were observed in the youngest age group.Conclusions: A shift to Keyhole alternatives for everyday foods would improve adolescents' nutrient intakes, even with smaller exchanges. [ABSTRACT FROM AUTHOR]

Published
2022
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21. Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): a prospective, controlled intervention trial

Author

Sjöström, Lars, Gummesson, Anders, Sjöström, C David, Narbro, Kristina, Peltonen, Markku, Wedel, Hans, Bengtsson, Calle, Bouchard, Claude, Carlsson, Björn, Dahlgren, Sven, Jacobson, Peter, Karason, Kristjan, Karlsson, Jan, Larsson, Bo, Lindroos, Anna-Karin, Lönroth, Hans, Näslund, Ingmar, Olbers, Torsten, Stenlöf, Kaj, Torgerson, Jarl, and Carlsson, Lena MS

Published
2009
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22. Nordic network on dietary survey methodology 2019-2020

Author

Fagt, Sisse, Andersen, Lene Frost, Birgisdóttir, Bryndís Eva, Kaartinen, Niina, Warensjö Lemming, Eva, Lindroos, Anna Karin, Ólafsdóttir , Anna S, Rautanen , Jenna, Sipinen , Jessica Petrelius, Þorgeirsdóttir, Hólmfríður, Trolle, Ellen, Valsta, Liisa, and Biltoft-Jensen, Anja Pia

Abstract

In 2019, the Nordic network on dietary surveys compared results regarding 24 h recalls, if the method was used in a systematic Nordic set up. A standardized central food list for 7 days was entered into national nutrients calculation systems and the intakes of individual food groups and nutrients on each day and as a daily average of the 7 days were compared. Results were presented at an online workshop on November 20th, 2020. In addition to the country specific presentations of the analysis, each country also gave a presentation on the latest national dietary survey. Despite standardized input, there were many differences in the results. The presentations on national dietary surveys showed differences and similarities of conducting dietary surveys and elucidated a lot of the common challenges researchers face. Many topics could be further elucidated on future network meetings.

Published
2021

23. Leisure-time organised physical activity and dietary intake among Swedish adolescents.

Author

Fröberg, Andreas, Lindroos, Anna-Karin, Moraeus, Lotta, Patterson, Emma, Warensjö Lemming, Eva, and Nyberg, Gisela

Subjects
*LEISURE, *FOOD habits, *PATIENT participation, *ANALYSIS of variance, *VEGETABLES, *PHYSICAL activity, *SURVEYS, *ADOLESCENT health, *QUESTIONNAIRES, *FRUIT
Abstract

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. [ABSTRACT FROM AUTHOR]

Published
2022
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24. Vitamin D status and associations with diet, objectively measured physical activity patterns and background characteristics among adolescents in a representative national cross-sectional survey.

Author

Warensjö Lemming, Eva, Petrelius Sipinen, Jessica, Nyberg, Gisela, Moraeus, Lotta, and Lindroos, Anna Karin

Subjects
VITAMINS, CROSS-sectional method, DIET, VITAMIN D, DISEASE prevalence, EXERCISE, VITAMIN D deficiency
Abstract

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 were collected in a National Dietary Survey, Riksmaten adolescents 2016-2017. The participants completed dietary assessments and questionnaires on the web and wore accelerometers. (25(OH)D) was measured with a MS 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 % 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. [ABSTRACT FROM AUTHOR]

Published
2022
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26. Effects of bariatric surgery on mortality in Swedish obese subjects

Author

Sjostrom, Lars, Narbro, Kristina, Sjostrom, David, Karason, Kristjan, Larsson, Bo, Wedel, Hans, Lystig, Ted, Sullivan, Marianne, Bouchard, Claude, Carlsson, Bjorn, Bengtsson, Calle, Dahlgren, Sven, Gummesson, Anders, Jacobson, Peter, Karlsson, Jan, Lindroos, Anna-Karin, Lonroth, Hans, Naslund, Ingmar, Olbers, Torsten, Stenlof, Kaj, Torgerson, Jarl, Agren, Goran, and Carlsson, Lena M.S.

Subjects
Obesity -- Care and treatment, Obesity -- Surgery, Obesity -- Patient outcomes, Obesity -- Health aspects
Abstract

The effect of bariatric surgery on mortality was studied. Results concluded that bariatric surgery is favorable for treating severe obesity thereby decreasing overall mortality.

Published
2007

27. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery

Author

Sjostrom, Lars, Lindroos, Anna-Karin, Peltonen, Markku, Torgerson, Jarl, Bouchrad, Cluade, Carlsson, Bjorn, Larsson, Bo, Dahlgren, Sven, Narbro, Kristina, Sjostrom, Carl David, Sullivan, Marianne, and Wedel, Hans

Subjects
Obesity -- Risk factors, Obesity -- Care and treatment, Cardiovascular system -- Surgery, Cardiovascular system -- Methods
Abstract

Swedish Obese subjects (SOS) study is conducted to examine changes in cardiovascular risk factors over follow-up periods of 2 and 10 years in surgically treated subjects and contemporaneously matched, conventionally treated control subjects. The findings indicate that bariatric surgery is a viable option for the treatment of severe obesity, resulting in long-term weights loss and improved lifestyle.

Published
2004

29. Bariatric Surgery and Long-term Cardiovascular Events

Author

Sjöström, Lars, Peltonen, Markku, Jacobson, Peter, Sjöström, C. David, Karason, Kristjan, Wedel, Hans, Ahlin, Sofie, Anveden, Åsa, Bengtsson, Calle, Bergmark, Gerd, Bouchard, Claude, Carlsson, Björn, Dahlgren, Sven, Karlsson, Jan, Lindroos, Anna-Karin, Lönroth, Hans, Narbro, Kristina, Näslund, Ingmar, Olbers, Torsten, Svensson, Per-Arne, and Carlsson, Lena M.

Published
2012
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33. Organised physical activity during leisure time is associated with more objectively measured physical activity among Swedish adolescents.

Author

Fröberg, Andreas, Lindroos, Anna‐Karin, Ekblom, Örjan, Nyberg, Gisela, and Lindroos, Anna-Karin

Subjects
*PHYSICAL activity, *LEISURE, *TEENAGERS, *NUTRITION surveys, *RESEARCH, *CROSS-sectional method, *RESEARCH methodology, *SELF-evaluation, *MEDICAL cooperation, *EVALUATION research, *ACCELEROMETRY, *COMPARATIVE studies, *EXERCISE, *RESEARCH funding, *HEALTH self-care
Abstract

Aim: The aim of this study was to investigate associations between participation in organised physical activity (PA), such as sport and exercise during leisure time, and objectively measured PA and sedentary time in a large representative sample of Swedish adolescents.Methods: This study was part of the school-based cross-sectional Swedish national dietary survey Riksmaten Adolescents 2016-17. Data from 3477 adolescents aged 11-12, 14-15 and 17-18 years were used in the analyses. Participation in organised PA and parental education were reported in questionnaires. PA and sedentary time were objectively measured through accelerometry during seven consecutive days.Results: Adolescents who participated in organised PA had significantly higher total PA (14%, P < .001), more time spent on moderate-to-vigorous PA (MVPA) (8 minutes, P < .001) and had less sedentary time (15 minutes, P < .001). Those who participated in organised PA were more likely to reach recommended PA levels. Total PA and MVPA did not differ by parental education among those who participated in organised PA.Conclusion: Adolescents who participated in organised PA were more physically active, less sedentary and more likely to reach PA recommendations than those who did not. [ABSTRACT FROM AUTHOR]

Published
2020
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34. Results From Sweden's 2016 Report Card on Physical Activity for Children and Youth.

Author

Nyström, Christine Delisle, Larsson, Christel, Ehrenblad, Bettina, Eneroth, Hanna, Eriksson, Ulf, Friberg, Marita, Hagströmer, Maria, Lindroos, Anna Karin, Reilly, John J., and Löf, Marie

Subjects
PHYSICAL activity, PHYSICAL fitness for children, YOUTH health, PLAY, PHYSIOLOGY
Abstract

Background: The 2016 Swedish Report Card on Physical Activity (PA) for Children and Youth is a unique compilation of the existing physical and health related data in Sweden. The aim of this article is to summarize the procedure and results from the report card. Methods: Nationally representative surveys and individual studies published between 2005-2015 were included. Eleven PA and health indicators were graded using the Active Healthy Kids Canada grading system. Grades were assigned based on the percentage of children/youth meeting a defined benchmark (A: 81% to 100%, B: 61% to 80%, C: 41% to 60%, D: 21% to 40%, F: 0% to 20%, or incomplete (INC). Results: The assigned grades were Overall Physical Activity, D; Organized Sport Participation, B+; Active Play, INC; Active Transportation, C+; Sedentary Behaviors, C; Family and Peers, INC; School, C+; Community and the Built Environment, B; Government Strategies and Investments, B; Diet, C-; and Obesity, D. Conclusion: The included data provides some support that overall PA is too low and sedentary behavior is too high for almost all age groups in Sweden, even with the many national policies as well as an environment that is favorable to the promotion of PA. [ABSTRACT FROM AUTHOR]

Published
2016
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35. Self-reported physical activity and sedentary behaviour amongst adolescents in Sweden vary depending on sex, age and parental education.

Author

Fröberg, Andreas, Kjellenberg, Karin, Lindroos, Anna Karin, and Nyberg, Gisela

Subjects
SEDENTARY behavior, TEENAGERS, PHYSICAL activity, BIOLOGICAL transport, PHYSICAL education, SELF-evaluation, CROSS-sectional method, EXERCISE, RESEARCH funding, PARENTS
Abstract

Aim: The aim of this study was to investigate self-reported physical activity and sedentary behaviour by sex, age and parental education in a large representative sample of Swedish adolescents.Methods: This study is based on data from the national dietary survey Riksmaten Adolescents, which was conducted by the Swedish Food Agency in 2016-2017. In total, 3477 students from grade five (11-12 years), eight (14-15 years) and eleven (17-18 years) were included. A web questionnaire was used to collect information about physical activity and sedentary behaviour.Results: In total, 53% reported active transport to and from school, 93% that they usually participate in the physical education, 76% reported a physically active leisure time, and 66% reported that they participated in organised physical activities. In addition, 12% and 6% reported two hours or less of screen time on weekdays and weekends, respectively. Participation in physical activity was generally lower amongst girls, older adolescents and for those from families with low-parental education.Conclusion: This study provide reference values for self-reported physical activities and sedentary behaviours amongst adolescents in Sweden. Strategies to increase physical activity and reduce screen time are needed, particularly amongst girls, older adolescents and amongst those with low-parental education. [ABSTRACT FROM AUTHOR]

Published
2021
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40. Human biomonitoring at food authorities : Human biomonitoring as a tool in policy making

Author

Mattisson, Irene, Abramsson, Lilianne, Eneroth, Hanna, and Lindroos, Anna Karin

Subjects
Food Engineering, Livsmedelsteknik
Abstract

Human biomonitoring (HBM) can be defined as the systematic standardized measurement of a concentration of a substance or its metabolites in human tissues and is an important tool in evaluating exposure to chemicals. This report maps HBM studies performed at or initiated by food safety authorities in the Nordic countries and discuss problems and options for further work. The report shows that only few studies have been performed and it differs among the countries. Reasons for this could be that sampling blood and urine is demanding, there are ethical and privacy issues and analytical costs are high. More cooperation with researchers and between countries is needed. Food safety authorities have special responsibilities in cases of emergencies and disasters. In these cases HBM provides a good tool for exposure measurement but cooperation and infrastructure should be established beforehand.

Published
2018

41. A national survey showed low levels of physical activity in a representative sample of Swedish adolescents.

Author

Nyberg, Gisela, Kjellenberg, Karin, Fröberg, Andreas, and Lindroos, Anna Karin

Subjects
PHYSICAL activity, TEENAGERS, AGE groups
Abstract

Aim: This study investigated objectively measured physical activity and sedentary time by sex, age and socioeconomic status in a large representative sample of Swedish adolescents.Methods: In this cross-sectional national survey between 2016 and 2017, students aged 11-12, 14-15 and 17-18 years from 131 schools were invited to participate. Physical activity and sedentary time were measured objectively with accelerometers for seven consecutive days. Socioeconomic status (parental education) and country of birth were self-reported in a questionnaire. Weight and height were measured by trained staff.Results: A total of 3477 adolescents participated in the study, and 2419 (73%) had at least 3 days of valid accelerometer data. The results showed that 43% of boys and 23% of girls reached the recommendation of 60 minutes of daily moderate-to-vigorous physical activity. Boys were more physically active than girls in all age groups. Girls with high socioeconomic status were more physically active than girls with low socioeconomic status (P < .001), and this difference was not found in boys.Conclusion: The majority of Swedish adolescents did not reach the physical activity recommendation, and boys were more active than girls. Effective strategies to increase physical activity, especially among girls with low socioeconomic status, are urgently needed. [ABSTRACT FROM AUTHOR]

Published
2020
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42. Diet diversity score and healthy eating index in relation to diet quality and socio-demographic factors: results from a cross-sectional national dietary survey of Swedish adolescents.

Author

Moraeus, Lotta, Lindroos, Anna Karin, Warensjö Lemming, Eva, and Mattisson, Irene

Subjects
*SUGAR content of beverages, *NUTRITION surveys, *TEENAGE boys, *FOOD habits, *DIET, *TEENAGERS, *TEENAGE pregnancy
Abstract

Objective: Groups with low socio-economic status have less healthy diets and higher prevalence of non-communicable diseases. Using the latest Swedish national dietary survey data, we developed a healthy eating index and a diet diversity score with the aim to explore associations between the scores and socio-demographic factors.Design: Cross-sectional national dietary survey. A web-based retrospective registration of food and beverages during 2 d was used to assess dietary intake. This information was used to construct the Swedish Healthy Eating Index for Adolescents 2015 (SHEIA15) and the Riksmaten Adolescents Diet Diversity Score (RADDS). The scores were based on the latest Swedish dietary guidelines from 2015. Intakes of food and nutrients across the scores were examined. Mixed-effects multilevel models were used to assess associations between the scores and household education, sex, school grade, weight status and school municipality.Setting: School-based survey in Sweden.Participants: 2905 adolescents in grades 5, 8 and 11, 56 % girls.Results: High scores on SHEIA15 and RADDS were associated with higher intake of vegetables, fish and several nutrients, and lower intake of sugar-sweetened beverages and red meat. Boys and participants in households with lower education level scored lower on both indices. Individuals with overweight/obesity scored lower on RADDS.Conclusions: The newly developed indices can be used to identify healthy eating patterns among Swedish adolescents. Both indices show that boys and adolescents from households with lower education level have poorer dietary habits. Lower diet diversity was related to overweight/obesity, but the overall healthy eating index was not. [ABSTRACT FROM AUTHOR]

Published
2020
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43. The importance of school lunches to the overall dietary intake of children in Sweden: a nationally representative study.

Author

Eustachio Colombo, Patricia, Patterson, Emma, Elinder, Liselotte S, and Lindroos, Anna Karin

Subjects
SCHOOL food, NUTRIENT density, FOOD habits, PARENTING education, SCHOOL children, FOOD consumption, VEGETABLES, PROCESSED foods, FOOD service statistics, SCHOOL health services, LUNCHEONS, CROSS-sectional method, INGESTION, REGRESSION analysis, SEX distribution, COMPARATIVE studies, STUDENTS, SCHOOLS, PARENTS, EDUCATIONAL attainment
Abstract

Objective: School lunches have potential to foster healthy diets in all children, but data on their importance are relatively scarce. The current study aimed to describe the dietary intake from school lunches by sex and school grade, and to assess how the daily intake, school lunch intake and the daily intake provided by lunch differ by sex and parental education.Design: Cross-sectional. All foods and drinks consumed for 1-3 weekdays were self-reported. Energy, absolute and energy-adjusted intakes of nutrients and food groups were calculated per weekday and per school lunch. Mixed-effects linear models assessed sociodemographic differences in dietary intakes. Nutrient and energy density at lunch and during the rest of the day were compared.Setting: Seventy-nine Swedish primary schools.Participants: Pupils in grades 5 and 8 (N 2002), nationally representative.Results: Lunch provided around half of daily vegetable intake and two-thirds of daily fish intake. Nutrient density was higher and energy density lower at lunch compared with the rest of the day (P < 0·001). Boys had greater energy-adjusted intakes of red/processed meat and lower intakes of vegetables and dietary fibre compared with girls (P < 0·001), overall and at lunch. Daily energy-adjusted intakes of most nutrients/food groups were lower for pupils of lower-educated parents compared with pupils of parents with higher education, but at lunch, only Fe and fibre intakes were significantly lower in this group.Conclusions: School lunches are making a positive contribution to the diets of Swedish children and may mitigate well-established sex differences and social inequalities in dietary intake. [ABSTRACT FROM AUTHOR]

Published
2020
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44. Discovery and characterisation of dietary patterns in two Nordic countries : Using non-supervised and supervised multivariate statistical techniques to analyse dietary survey data

Author

Edberg, Anna, Freyhult, Eva, Sand, Salomon, Fagt, Sisse, Knudsen, Vibeke Kildegaard, Frost Andersen, Lene, Lindroos, Anna Karin, Soeria-Atmadja, Daniel Soeria, Gustafsson , Mats G., and Hammerling, Ulf

Subjects
Velferd, Velfærd, Menntun, Tilastot, Heilsa, Hyvinvointi, elintarvikkeet, Rannsóknir, Forskning, Helse, Koulutus, Uddannelse, Næringsmidler, Velferð, Tölfræðiupplýsingar, Utdanning, Statistikk, Statistik, Matvæli, tutkimus, Fødevarer, terveys, Sundhed
Abstract

The study outlined in this report strived at disclosing pertinent patterns in dietary surveys by means of an array of multivariate data analysis (MDA) techniques. The overall purpose was thus to unveil embedded patterns in selected data material, but also to generally demonstrate feasibility of new computational technology in this area. The material selected for this purpose encompasses food consumption survey data from Sweden and Denmark. The first among those compilations is known as Riksmaten – barn 2003, harbouring children of three age groups (four, eight and eleven years of age), whereas the latter data set is an excerpt – holding preschool children (four to five years of age) – of the Danish National Survey of Diet and Physical Activity, compiled over several years until 2008. These sets of food consumption data have previously been subjected to classical statistical analysis, but were – prior to embarking on this exercise – devoid of scrutiny by means of more advanced computational techniques. The analytical exercises described in this report encompass two major fields of MDA, which can be summarised as Unsupervised Learning/Descriptive modelling, on the one hand, and Supervised Learning/Predictive Modelling, on the other. The first among the unsupervised analyses involved inspection largely by, but not restricted to, an in-house implemented multi-branching hierarchical clustering algorithm (OMB-DHC), thereby revealing various aggregations of reasonably coherent consumers in unabridged and agedefined sub-populations. Notably, a hierarchical OMB-DHC design of operation tied to a palatable output display, unlike earlier reports in the dietary survey area, helped identifying the degree of heterogeneity of clusters appearing at several segregation levels, thereby also supporting the judicious selection of aggregations for further compilation and scrutiny. Numbers and salient features of such dietary sub-populations were found to largely, but not exactly, commensurate with those of various scientific reports in the area. Thus, 4–5 dietary clusters – in this report also referred to as dietary prototypes – emerged from our data sets at the highest hierarchical level and three among them – Traditional, Soft beverages/Buns & cakes and Varied (healthy) – roughly match those commonly reported elsewhere. Accordingly identified aggregations underwent further processing, i.e. the prototypes were used as input to either of two distinct downstream (of OMB-DHC) clustering algorithms.The first among these composite procedures, here designated Hierarchical Prototype Bi-Cluster Analysis (HPBCA), enabled creation of an indeed very instructive two-dimensional display of pertinent dissimilarities between Danish and Swedish age-matched consumption data as well as across the Swedish preschool and elementary school consumers. As anticipated, overall dietary patterns of the two oldest age categories of Riksmaten – barn 2003 were mutually closer, relative to those of fouryear old children. More intriguingly, however, the analysis revealed rather drastic disparity between consumption patterns of Danish and Swedish preschool children. The second composite technique, here referred to as Dietary Prototype CMDS Analysis (DPCA), enabled the delineation and visualization of multidimensional distances across the various dietary prototypes and thus helped identifying overarching interrelationships between aggregated consumer groups. Furthermore, Principal Component Analysis (PCA) provided support to the hierarchical cluster analysis so as to explain major direct and inverse relationships between key food groups in the several intra- and inter-national data excerpts. For example, major PCA loadings helped deciphering both shared and disparate features, relating to food groups, across Danish and Swedish preschool consumers. Data interrogation, reliant on the above-mentioned composite techniques, disclosed one outlier dietary prototype in each of the two Swedish elementary school children data subsets. This pair of groupdetached prototypes showed, however, notable mutual resemblance and featured consumption of low-fat foods (largely with respect to dairy products) and besides quite healthy eating patterns. Moreover, these exercises unveiled another set of interrelated dietary prototypes, one in each of all Swedish age categories, but mutually most similar in the two older age groups. Common features are relatively low intake of Vegetables and Fruit & berries likewise fairly high consumption of Soft beverages (sweetened). A dietary prototype with the latter property was identified also in the Danish data material, but without low consumption of Vegetables or Fruit & berries. The second MDA-type of data interrogation involved Supervised Learning, also known as Predictive Modelling. These exercises involved the Random Forest (RF) and Nearest Shrunken Centroid (NSC) classification algorithms. Briefly, collections of classifiers were created to predict low and high consumers of each among a wide excerpt of food groups, subsequent to elimination of that particular food. Frequency histograms of the remaining foods (in each case) were accordingly de rived from these elaborations, displaying patterns of key food groups that thus jointly are indicative of discriminating such bi-partite (low/high) categories, in the absence of the targeted (outstanding) food. Very instructing displays of deeply embedded relationships inherent to the survey data emerged from these procedures, in many cases also enhancing findings derived from the unsupervised MDA work. Actually, intriguing frequency pattern similarities and discrepancies were also seen across the respective national consumption data subsets among preschool children. For example, Potato is firmly connected with Rice in the Danish data set, but rather associated with Sausage and Fish in that of Sweden. Unlike Swedish preschool children, who show tight linkage between Bread and both Cheese and Cereals, Danish age-matched consumers of Bread are tethered to Sugar (marmalade) and Vegetables. Marked trans-national disparity was also seen in dietary habits associated with Milk and Meat & poultry.Some overarching observations are: i) certain healthy and less healthy foods tend to appear in disjoint clusters, ii) two (mutually similar and relatively prudent) dietary prototypes, one in each of the two Swedish elementary school consumer data sets, appear quite remote from those of the remaining age-matched consumers, iii) Danish and Swedish preschool consumers show notable trans-national disparity, for example the Milk food group as well as that of Bread are tethered to quite distinct (nationality-specific) consumption patterns, iv) among the several dietary prototypes identified across the trans-national data set, including age-matched excerpts of Swedish data, prototypes with the shared feature of being high in the Soft beverages (sweetened) food group emerged, and v) although not elaborated on in-depth, output from several analyses suggests a preference for energy-based consumption data for Cluster Analysis and Predictive Modelling, over those appearing as weight.

Published
2013

45. Riksmaten Adolescents 2016-17: A national dietary survey in Sweden -- design, methods, and participation.

Author

Moraeus, Lotta, Hursti, Ulla-Kaisa Koivisto, Arnemo, Marianne, Sipinen, Jessica Petrelius, Lemming, Eva Warensjö, and Lindroos, Anna-Karin

Subjects
SURVEYS, ACCELEROMETERS, BIOMARKERS, BLOOD testing, BODY weight, CHILDREN'S health, HIGH school students, INGESTION, INTERNET, HEALTH policy, NUTRITIONAL assessment, PUBLIC health, QUESTIONNAIRES, RISK assessment, SCHOOL children, STATURE, STUDENT health, ADOLESCENT health, URINALYSIS, SOCIOECONOMIC factors, CROSS-sectional method, PHYSICAL activity
Abstract

Background: Nationally representative information on food consumption data is essential to evaluate dietary habits, inform policy-making and nutritional guidelines, as well as forming a basis for risk assessment and identification of risk groups. Objective: To describe the methods used in the Swedish national dietary survey of adolescents, Riksmaten Adolescents 2016-2017. Design: Students in grades 5, 8, and 11 (mean ages 12, 15, and 18 years) were recruited in this school-based cross-sectional survey. A new, validated, web-based method was used to assess dietary intake. Information on physical activity, health, and socioeconomic background was collected through web questionnaires. Physical activity was also evaluated by accelerometers. Weight and height were measured in all participants, while blood and urine samples were collected in a subsample of 40% of the participants. Results: A total of 3,477 (68%) respondents participated and 3,099 (60%) had complete dietary information. In the subsample, 1,305 (55%) respondents participated and 1,105 (46%) had complete dietary information. The participants were overall representative for the population with regard to socioeconomic background and school organization (public or independent). All types of municipalities were represented in the survey and overall, the geographic distribution corresponded to the underlying population. Some differences by school grade were observed. Sample weights were calculated for the total sample and the subsample. Conclusion: The Riksmaten Adolescents 2016-2017 provides valuable national data on diet, physical activity, and markers of exposure in age groups where data have been lacking. The data will provide a valuable basis for risk assessment, public health policy, and in-depth analyses. [ABSTRACT FROM AUTHOR]

Published
2018
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46. Results from Sweden's 2018 Report Card on Physical Activity for Children and Youth.

Author

Delisle Nyström, Christine, Larsson, Christel, Alexandrou, Christina, Ehrenblad, Bettina, Eriksson, Ulf, Friberg, Marita, Hagströmer, Maria, Lindroos, Anna Karin, Nyberg, Gisela, and Löf, Marie

Subjects
PHYSICAL activity, SPORTS participation, TRANSPORTATION, SEDENTARY behavior
Abstract

The article presents results from Sweden's 2018 Report Card on Physical Activity for Children and Youth. It mentions indicators on the basis of which grades are assigned including organized sport participation, active transportation, and sedentary behavior. The report card reveals that overall physical activity is low and sedentary behavior is high despite the conducive environment for physical activity in Sweden.

Published
2018
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47. The EuroFIR Food Platform: Further integration, refinement and exploitation for its long-term self-sustainability-Report on Framework for certification Scheme

Author

Roe, Mark, Finglas, Paul, Lindroos, Anna-Karin, Isabel Castanheira, Turzova, Anna, Westenbrink, Susanne, and Beernaert, Hedwig

Subjects
Software_PROGRAMMINGLANGUAGES, Materiais e Métodos de Referência, Composição dos Alimentos
Abstract

Certification of compiler organizations is an issue that is part of Workpackage1 on quality standards, certification and thesauri support. Task 1.2.2 requires assessment of 20 national FCDB compiler organisations during the EuroFIR Nexus project. This report describes a framework for the process of evaluating quality assurance procedures related to the process of compilation, management and publication of food composition data. Each compiler organization will be organized and work in different ways but compilers are expected to work within the general framework described by the EuroFIR generic compilation flowchart and will compile data that is compatible with the Eurofir technical annex and with the CEN standard. The aim of the evaluation audits will be to identify strengths and weaknesses of each compiler organisation and improve quality systems through identification and dissemination of ‘best practice’ processes. FP7

Published
2011

48. Fatty Acid Proportions in Plasma Cholesterol Esters and Phospholipids Are Positively Correlated in Various Swedish Populations.

Author

Marklund, Matti, Pingel, Ronnie, Rosqvist, Fredrik, Lindroos, Anna Karin, Eriksson, Jan W., Vessby, Bengt, Oscarsson, Jan, Lind, Lars, and Risérus, Ulf

Subjects
FATTY acids, CHOLESTEROL esters, PHOSPHOLIPIDS, META-analysis, LIPIDS, BODY composition, CHOLESTEROL, COMPARATIVE studies, DIET, RESEARCH methodology, MEDICAL cooperation, RESEARCH, WHITE people, EVALUATION research, BODY mass index
Abstract

Background: Fatty acid (FA) proportions in cholesterol esters (CEs) and plasma phospholipids are widely used as dietary biomarkers. Information on how proportions in these fractions correlate could have implications for interpretation and use of FA biomarkers in observational and interventional studies.Objective: We investigated correlations between FA proportions in CEs and phospholipids in free-living individuals and assessed how diet-induced alterations of FA proportions correlate between fractions.Methods: Spearman's rank correlation coefficients (rs) between FA proportions (percentage of total FAs) in circulating CEs and phospholipids were calculated separately in 8 individual study populations including Swedish females and males (N = 2052; age range: 11-84 y), and pooled by inverse-variance weighted meta-analysis. In addition, study populations were stratified by age, sex, body mass index (BMI; in kg/m2), and diabetes status, and strata-specific rs were pooled by meta-analysis. In 2 randomized trials (N = 79) in which dietary saturated FAs were isocalorically replaced with unsaturated FAs, treatment-wise calculations of rs were conducted between FA changes in CEs and phospholipids.Results: Overall, FA proportions in CEs and phospholipids correlated well and especially strongly for polyunsaturated FAs (PUFAs), with pooled rs (95% CIs) ranging from 0.74 (0.72, 0.76) for α-linolenic acid to 0.92 (0.91, 0.93) for eicosapentaenoic acid. Weak correlations (pooled rs < 0.4) were observed only for palmitic acid and stearic acid, with pooled rs (95% CIs): 0.29 (0.24, 0.33) and 0.30 (0.25, 0.34), respectively. Overall, correlations were not affected by age, sex, BMI, or diabetes status. Strong correlations (rs ≥ 0.6) between diet-induced FA changes in CEs and phospholipids were observed for most PUFAs.Conclusions: Proportions of most FAs in CEs and phospholipids ranked individuals similarly, suggesting that FA proportions in these fractions can be used interchangeably in populations of diverse age, sex, body composition, and diabetes status. Caution is advised, however, when comparing results from studies assessing palmitic acid or stearic acid in different lipid fractions. [ABSTRACT FROM AUTHOR]

Published
2017
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49. Sociodemographic and lifestyle factors as determinants of energy intake and macronutrient composition: a 10-year follow-up after bariatric surgery.

Author

Kanerva, Noora, Larsson, Ingrid, Peltonen, Markku, Lindroos, Anna-Karin, and Carlsson, Lena M.

Abstract

Background Early identification of the potential to adopt a long-term unhealthy diet, could improve weight outcomes for patients having undergone bariatric surgery. Objectives We explored whether presurgical sociodemographic and lifestyle characteristics, together with the type of surgery, could predict 10-year changes in dietary intake after bariatric surgery. Setting Surgical departments and primary healthcare centers, nationwide. Methods Participants were from the Swedish Obese Subjects study, a matched (nonrandomized) prospective trial comparing bariatric surgery with standard care for obese patients. This study included the 1695 surgery patients with complete information on presurgery diet. Questionnaires were completed before and 6 months, 1–4, 6, 8, and 10 years after surgery. Analyses were conducted with linear mixed-model. Results Dietary changes were observed in 1561, 1298, and 1243 participants, at the 2-, 6-, and 10-year follow-ups, respectively. Sex and treatment type predicted changes in energy, carbohydrate, protein, and fiber intake over the follow-up ( P <.05). Furthermore, male sex, younger age, a sedentary behavior, and gastric bypass predicted increased alcohol consumption ( P <.001). Two important phases for intervening bariatric patients’ diet were identified. The first was 6 months after surgery, when the maximal changes in diet were achieved. The second, stretched from 6 months until 4 years after surgery, during which earlier commitments to dietary changes were largely abandoned. Conclusions Male sex and banding surgery in particular predicted unfavorable post-surgery changes in energy and macronutrient intake. Furthermore, gastric bypass, a younger age, and an unhealthy lifestyle presurgery, may predispose individuals to increased alcohol intake after surgery. [ABSTRACT FROM AUTHOR]

Published
2017
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50. Cross-sectional associations between exposure to per- and polyfluoroalkyl substances and body mass index among European teenagers in the HBM4EU aligned studies.

Author

Schillemans, Tessa, Iszatt, Nina, Remy, Sylvie, Schoeters, Greet, Fernández, Mariana F., D'Cruz, Shereen Cynthia, Desalegn, Anteneh, Haug, Line S., Lignell, Sanna, Lindroos, Anna Karin, Fábelová, Lucia, Murinova, Lubica Palkovicova, Kosjek, Tina, Tkalec, Žiga, Gabriel, Catherine, Sarigiannis, Denis, Pedraza-Díaz, Susana, Esteban-López, Marta, Castaño, Argelia, and Rambaud, Loïc

Subjects
FLUOROALKYL compounds, BODY mass index, TEENAGERS, OVERWEIGHT children
Abstract

Per- and polyfluoroalkyl substances (PFAS) are widespread pollutants that may impact youth adiposity patterns. We investigated cross-sectional associations between PFAS and body mass index (BMI) in teenagers/adolescents across nine European countries within the Human Biomonitoring for Europe (HBM4EU) initiative. We used data from 1957 teenagers (12–18 yrs) that were part of the HBM4EU aligned studies, consisting of nine HBM studies (NEBII, Norway; Riksmaten Adolescents 2016–17, Sweden; PCB cohort (follow-up), Slovakia; SLO CRP, Slovenia; CROME, Greece; BEA, Spain; ESTEBAN, France; FLEHS IV, Belgium; GerES V-sub, Germany). Twelve PFAS were measured in blood, whilst weight and height were measured by field nurse/physician or self-reported in questionnaires. We assessed associations between PFAS and age- and sex-adjusted BMI z-scores using linear and logistic regression adjusted for potential confounders. Random-effects meta-analysis and mixed effects models were used to pool studies. We assessed mixture effects using molar sums of exposure biomarkers with toxicological/structural similarities and quantile g-computation. In all studies, the highest concentrations of PFAS were PFOS (medians ranging from 1.34 to 2.79 μg/L). There was a tendency for negative associations with BMI z-scores for all PFAS (except for PFHxS and PFHpS), which was borderline significant for the molar sum of [PFOA and PFNA] and significant for single PFOA [β-coefficient (95% CI) per interquartile range fold change = −0.06 (−0.17, 0.00) and −0.08 (−0.15, −0.01), respectively]. Mixture assessment indicated similar negative associations of the total mixture of [PFOA, PFNA, PFHxS and PFOS] with BMI z-score, but not all compounds showed associations in the same direction: whilst [PFOA, PFNA and PFOS] were negatively associated, [PFHxS] associated positively with BMI z-score. Our results indicated a tendency for associations of relatively low PFAS concentrations with lower BMI in European teenagers. More prospective research is needed to investigate this potential relationship and its implications for health later in life. [Display omitted] • Per- and polyfluoroalkyl substances (PFAS) may impact youth adiposity patterns. • We used data from teenagers in nine European countries (HBM4EU initiative). • PFOA associated cross-sectionally with lower body mass index (BMI) in teenagers. • The mixture of [PFOA, PFNA, PFHxS and PFOS] associated with lower BMI. • PFHxS had opposite effects from [PFOA, PFNA and PFOS]. [ABSTRACT FROM AUTHOR]

Published
2023
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