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Biomedical subjects

L Ovesen

Publications and source records attributed to L Ovesen.

At least 37 records · Page 2Linked to original sources
PubMed2001

A six months' prospective follow-up of 65+-y-old patients from general practice classified according to nutritional risk by the Mini Nutritional Assessment.

OBJECTIVE: To assess the prevalence of old people at risk of undernutrition according to the Mini Nutritional Assessment (MNA), characterise the at risk group with regard to nutritional state, energy intake, and physical and mental functioning, and to assess the consequences of the MNA score over a 6 month period. DESIGN: A cross-sectional prospective study. SETTING: The clinic of a general practitioner. SUBJECTS: Ninety-four patients 65+-y-old with no acute illness contacted at the clinic. Sixty-one subjects (65%) agreed to participate at baseline and 34 (56%) showed up at the follow-up 6 months later. RESULTS: At baseline, 23 (38%) participants were assessed as being at risk of undernutrition (17-23.5 MNA points). The remaining were classified as well-nourished (>23.5 MNA points). The 23 participants at risk had a higher prevalence of body mass index (BMI) <20 kg/m(2) (44 vs 11%, P<0.001) and insufficient energy intake (36 vs 9%, P<0.05), compared with the well-nourished group. Also, they had a higher need of meals-on-wheels (39 vs 8%, P<0.01) and home-care for shopping (48 vs 18%, P<0.05) at baseline. At the 6 months' follow-up, there was a tendency to a higher non-participation rate among the participants assessed at risk of undernutrition at baseline (44 vs 18%, 0.05<P<0.1), compared with the well-nourished group. There was a tendency to a higher prevalence of hospitalisation (38 vs 19%, 0.05<P<0.1) in the at risk group. CONCLUSION: MNA seems to be a useful tool to identify old people who need help from the public sector. However, many in the group at risk of undernutrition already have low BMI values. This might have influenced the findings.

Aged↗
PubMed2001

Alcohol consumption is associated with reduced prevalence of goitre and solitary thyroid nodules.

OBJECTIVE: Goitre prevalence is dependent on iodine intake and smoking habits, but further risk factors have only been examined briefly. We examined the association between alcohol consumption and the prevalence of thyroid enlargement and nodularity. DESIGN: Cross-sectional population study with ultrasonography of the thyroid gland and assessment of alcohol intake and smoking habits from questionnaires. SUBJECTS: Four thousand six-hundred and forty-nine men and women aged 18-65 years, randomly selected from the Danish Civil Registration System. MEASUREMENTS: Thyroid volume and prevalence of thyroid enlargement, multiple nodules or a solitary nodule in the thyroid. RESULTS: Abstainers and participants with a low alcohol consumption (< 7 drinks/week) had the same prevalence of thyroid enlargement and nodularity, but participants with moderate (8-28 drinks/week for women, 8-42 for men) or high (> 28/42 drinks/week) alcohol consumption had much lower prevalence of thyroid abnormalities. Possible confounding by sex, age, iodine status and smoking was considered in all models. Odds ratios compared to abstainers for thyroid enlargement were 0.74 [95% confidence interval (CI) 0.57-0.96] for moderate- and 0.44 (95% CI 0.22-0.88) for high alcohol consumption. Odds ratios compared to abstainers for a solitary nodule were 0.64 (95% CI 0.42-0.96) for moderate- and 0.41 (95% CI 0.12-1.37) for high alcohol consumption. Mean thyroid volume was 13.5 ml among abstainers compared to 10.9 ml among participants with high alcohol consumption (P < 0.001). Both wine- and beer consumption were associated to lower prevalence of thyroid abnormalities. CONCLUSIONS: Increasing levels of alcohol consumption were associated to lower prevalence of thyroid enlargement and to lower prevalence of a solitary nodule in the thyroid, and indications of a causal relationship were found.

Adolescent↗
PubMed2001

TSH-receptor antibody measurement for differentiation of hyperthyroidism into Graves' disease and multinodular toxic goitre: a comparison of two competitive binding assays.

OBJECTIVES: Graves' disease is characterized by stimulating autoantibodies to the TSH-receptor (TRAb). The aim of this study was to compare the performance of a new TRAb assay based on competitive binding to recombinant human TSH-receptors (H-TRAb) with an assay employing purified porcine TSH-receptors (P-TRAb). Furthermore, to evaluate the applicability of the H-TRAb assay to discriminate between patients with hyperthyroidism due to Graves' disease (GD) and multinodular toxic goitre (MNTG). DESIGN AND MEASUREMENTS: H-TRAb and P-TRAb were measured in patients with newly diagnosed hyperthyroidism due to GD (n = 106) and MNTG (n = 94). For comparison, TRAb was measured in patients with primary autoimmune hypothyroidism, euthyroid subjects with an enlarged thyroid gland by ultrasound, and healthy controls (n = 100 for each group). Patients were consecutively included from a population survey. RESULTS: If the cut-off values recommended by the manufacturer for TSH-receptor antibody positivity were used for evaluation, the sensitivity of the H-TRAb assay vs. the P-TRAb assay in diagnosing GD was: 95.3/67.9% (P < 0.001). Specificity was (H/P-TRAb): 99/99%. The sensitivity of P-TRAb was increased if the upper 97.5% limit of measurements in controls was used as cut-off (H-TRAb vs. P-TRAb: 95.3/80.2%, P < 0.001). Specificity (H/P-TRAb): 98/98%. The difference between assay performance may partly be due to a better technical performance of the H-TRAb assay with more reliable results in the low range of measurements. However, even in GD patients with clearly measurable TRAb, 25% had a P-TRAb < 50% of the value expected from the H-TRAb measurement. This suggests that a subgroup of patients produce TRAb with a higher affinity for the human than the porcine TSH receptor. A relatively high proportion of patients with MNTG were TRAb positive (H-TRAb/P-TRAb: 17/9%). Characteristics of H-TRAb positive and negative MNTG patients were compared. There was no difference between size of thyroid gland and number of nodules by ultrasonography. H-TRAb positive patients had significantly higher serum T4 and T3 and a greater number were TPO-Ab positive. CONCLUSIONS: H-TRAb diagnosed Graves' disease with a high sensitivity and specificity than P-TRAb. The high occurrence of TRAb in multinodular toxic goitre might in part reflect an overlap between Graves' disease and multinodular toxic goitre in some patients.

Adult↗
PubMed2001

Food and nutritional care in hospitals: how to prevent undernutrition--report and guidelines from the Council of Europe.

In 1999 the Council of Europe decided to collect information regarding Nutrition programmes in hospitals and for this purpose a network consisting of national experts from eight of the Partial Agreement member states was established. The aim was to review the current practice in Europe regarding hospital food provision, to highlight deficiencies and to issue guidelines to improve the nutritional care and support of hospitalized patients. Five major problems seemed to be common in this context: 1) lack of clearly defined responsibilities; 2) lack of sufficient education; 3) lack of influence of the patients; 4) lack of co-operation among all staff groups; and 5) lack of involvement from the hospital management. To solve the problems highlighted, a combined 'team-effort' is needed from national authorities and all staff involved in the nutritional care and support, including hospital managers.

Europe↗
PubMed2001

A critical assessment of some biomarker approaches linked with dietary intake.

In this review many examples are given of the complexities involved in using some biomarkers in relation to assessing the effects of dietary exposure, when there is frequently a need to determine changes following long-term low level exposure to dietary components. These range from understanding why the biomarker might be valuable and how best it can be measured, to the pitfalls which can occur in the interpretation of data. Analytical technique is considered in relation to folate and selenium, and flavonoid and carotenoid species are used to illustrate how the metabolism of a compound may alter the validity or adequacy of a marker. Vitamin A is discussed in relation to the difficulties which can arise when there are several biomarkers that may be available to assess exposure to one nutrient. Vitamin B12 is discussed in relation to the dietary choices made by individuals. Possible interactions and the role of measuring total antioxidant capacity is considered in some detail. In contrast to most nutrients, there is a marked lack of biomarkers of either exposure or effect for most non-nutrients. The role of biological effect monitoring is considered for dietary contaminants, fumonisins and polyhalogenated aromatic hydrocarbons. Aflatoxins are discussed to exemplify food contaminants for which the biomarker approach has been extensively studied. Finally some compounds which are deliberately added to foods and some which appear as processing contaminants are each considered briefly in relation to the requirement for a biomarker of exposure to be developed.

Aflatoxins↗
PubMed2001

Environmental iodine intake affects the type of nonmalignant thyroid disease.

The relationship between the iodine intake level of a population and the occurrence of thyroid diseases is U-shaped with an increase in risk from both low and high iodine intakes. Developmental brain disorders and endemic goiter caused by severe iodine deficiency may seriously deteriorate overall health status and economic performance of a population. Severe iodine deficiency with a median 24-hour urinary iodine excretion of the population below 25 microg needs immediate attention and correction. Less severe iodine deficiency with median urinary iodine excretion below 120 microg per 24 hours is associated with multinodular autonomous growth and function of the thyroid gland leading to goiter and hyperthyroidism in middle aged and elderly subjects. The lower the iodine intake, the earlier and more prominent are the abnormalities. At the other end of the spectrum, severely excessive iodine intake starting at median urinary iodine excretion levels around 800 microg per 24 hours is associated with a higher prevalence of thyroid hypofunction and goiter in children. A number of studies indicate that moderate and mild iodine excess (median urinary iodine >220 microg per 24 hours) are associated with a more frequent occurrence of hypothyroidism, especially in elderly subjects. The exact mechanism leading to this has not been clarified, and more studies are needed to define the limits of excessive iodine intake precisely. Due to the frequent occurrence of thyroid disorders, proper monitoring and control of the population iodine intake level is a cost-effective alternative to diagnosing, therapy and control of the many individual cases of thyroid diseases that might have been prevented.

Aging↗
PubMed2001

Validation of the Resident Assessment Instrument triggers in the detection of under-nutrition.

OBJECTIVE: To test the validity of Resident Assessment Instrument triggers for people in Danish nursing homes and subjects receiving home care by exploring their ability to identify older people with insufficient energy and protein intake. DESIGN: Regression analysis of insufficient energy or protein intake on each of the Resident Assessment Instrument triggers alone or in combination. SUBJECTS: 38 people receiving home care and 41 living in nursing homes. METHODS: A 4 day estimated dietary record, assessment of energy and protein intake, calculation of body mass index. RESULTS: Food remaining on the plate, weight loss and any trigger present significantly influenced the energy or protein intake of the nursinghome subjects. No triggers reflected the energy or protein intake of the subjects at home. CONCLUSION: Observation of food intake seems to be the best way to detect which older Danish people living in nursing homes or receiving home care have insufficient energy or protein intake.

Aged↗
PubMed2001

Coke is not it.

Explore the source record for details and available documents.

Carbonated Beverages↗
PubMed2001

Serum Tg--a sensitive marker of thyroid abnormalities and iodine deficiency in epidemiological studies.

Serum Tg is widely used in the control of thyroid cancer but also in the diagnosis of certain other thyroid diseases. Serum Tg may be useful in the characterization of the iodine status of a population, but little is known about determinants of serum Tg levels. We examined a random selection of 4,649 subjects from 2 regions in Denmark with different iodine status. Thyroid volume and structure were determined with ultrasonography, and thyroid function tests and Tg analysis were performed. The factor with the closest association with serum Tg levels was thyroid volume at ultrasonography (P < 0.001). Also thyroid nodularity (P < 0.001) and iodine excretion (P < 0.001) had close associations to serum Tg, even after adjusting for the influence of the other parameters. Thyroid dysfunction had a less pronounced but still highly significant association with serum Tg (P < 0.001), but no relation was found to serum TSH in general. The association with age seemed to rely on differences in the prevalence of thyroid abnormalities, and men had lower Tg levels than women of the same age. There was a marked difference in serum Tg between the two regions with slightly different iodine excretion also after adjusting for the other factors. In conclusion, serum Tg reflects thyroid abnormalities and thyroid function and is a sensitive marker of iodine deficiency in a population.

Adolescent↗
PubMed2001

Quality control including validation in dietary surveys of elderly subjects. The validation of a dietary history method (the SENECA-method) used in the 1914-population study in Glostrup of Danish men and women aged 80 years.

BACKGROUND: Quality control including validation in dietary surveys is needed to reduce and detect errors which would lead to an attenuated scientific foundation for the diet-disease relationship. Especially studies in the elderly are needed because of limited knowledge of reference values, cut-off values etc. OBJECTIVE: To validate a modified dietary history method (the SENECA-method) in elderly subjects. DESIGN: A survey of Danish men and women aged 80 years, who participated in the 1914-population study in Glostrup. SUBJECTS AND METHOD: A pilot study (n = 34) validated the dietary history against 24-h urine collections; a main study (n = 240) compared dietary history with a 3-day estimated food record. RESULTS: Protein intake from dietary history was 10% higher than calculated protein intake from 24-h urine collections. Differences in intakes of energy and macronutrients between dietary history and 3-day food record were generally small and non-significant, and there was good agreement between the methods in classifying nutrient intakes into same tertiles. A Bland & Altman plot indicated increasing differences in energy intake between methods with increased energy intake. Evidence for under-reporting of energy intake and/or over-reporting of the physical activity level was further made plausible when physical activity ratio was compared to recognized cut-off limits. CONCLUSIONS: The modified dietary history method can be used to estimate dietary intake in 80 year old subjects, but some degree of misreporting, especially under-reporting, appears to be present. Keeping this in mind it is, however, possible to analyse dietary intake against other survey data.

Aged↗
PubMed2001

Towards a strategy for optimal vitamin D fortification (OPTIFORD).

The research project "Towards a Strategy for Optimal Vitamin D Fortification (OPTIFORD)" has received financial support from the 5th framework programme of the EC. Vitamin D deficiency is a serious health problem among large population groups in Europe. Subjects segregated from sun exposure for social or religious reasons, or because of disability are at risk for vitamin D deficiency. Vitamin D is essential for proper bone mineralisation and vitamin D deficiency is recognised to be an important risk factor for hip fracture. Fortification and/or supplementation strategies could be effective and inexpensive ways of arresting preventable health consequences. However, fortification policies in Europe differ and this reflects the many unknowns in relation to the strategy of vitamin D fortification of food, particularly concerning the levels achieving optimal effects without toxicity. The overall objective of OPTIFORD is to investigate if fortification of food with vitamin D is a feasible strategy to remedy the insufficient vitamin D status of large population groups in Europe, and to determine at what level fortification should be pitched. An important outcome is to reinforce the scientific basis for recommendations on vitamin D as a nutrient.

Bone Development↗
PubMed2000

Iron status in Danes 1994. II: Prevalence of iron deficiency and iron overload in 1319 Danish women aged 40-70 years. Influence of blood donation, alcohol intake and iron supplementation.

Iron status, i.e. serum ferritin and haemoglobin (Hb) levels, was assessed in a population survey in 1994 (Dan-Monica 10) comprising 1319 Caucasian Danish women in age cohorts of 40, 50, 60 and 70 years. In the entire series, ferritin levels increased significantly from 40 years to 60 years of age. The prevalence of small iron stores (ferritin 16-32 microg/l), depleted iron stores (ferritin < 16 microg/l) and of iron deficiency anaemia (ferritin < 13 microg/l and Hb < 121 g/l) decreased steadily with age. Blood donors (n = 109) had lower ferritin levels than non-donors (P<0.0001). Ferritin levels in donors were inversely correlated with the cumulated number of lifetime phlebotomies (r(s) = -0.25, P<0.01). Ferritin levels in non-donors (n = 1208) were low in 40-year-old women (median 40 microg/l) and increased to a median of 95 microg/l in 60- and 70-year-old women (P<0.0001). In non-donors 40 years of age, the prevalence of small iron stores was 40.4%, the prevalence of depleted iron stores 10.8% and the prevalence of iron deficiency anaemia 2.16%. The prevalence of iron overload (ferritin >300 microg/l) was 1.54%. Ferritin levels in 60- and 70-year-old non-donors were correlated with the body mass index (r(s) =0.11, P=0.01). Ferritin levels in 50- to 60-year-old non-donors were correlated with alcohol intake (r(s)=0.23, P<0.0001). In the entire series, 37.5% of non-donors took supplemental ferrous iron (median 14 mg iron per day). Iron supplements had a significant positive influence on iron status in 40-year-old premenopausal non-donors but no effect in postmenopausal women or in donors. Non-donors (n = 170) treated with acetylsalicylic acid had lower ferritin levels (median 55 microg/l) than non-treated (n = 1038; median 75 microg/l) (P<0.0001). Compared with the Dan-Monica 1 iron status survey in 1984, the prevalence of iron deficiency and iron deficiency anaemia was unchanged, whereas the prevalence of iron overload displayed a slight increase. The 1987 abolition of the mandatory iron fortification of flour apparently had no negative effect on iron status.

Adult↗
PubMed2000

Iodine content in drinking water and other beverages in Denmark.

OBJECTIVE: To investigate the variation in iodine content in drinking water in Denmark and to determine the difference in iodine content between organic and non-organic milk. Further, to analyse the iodine content in other beverages. DESIGN AND SETTING: Tap water samples were collected from 41 evenly distributed localities in Denmark. Organic and non-organic milk was collected at the same time (twice summer and twice winter). Soft drinks, beers and juice were collected from different Danish producers and wine from different countries. All samples were analysed for iodine using inductively coupled mass spectrometry. RESULTS: Iodine in tap water varied from 2.1 to 30.2 microg/l; the iodine content was in general highest in the eastern part of Denmark and lowest in the western part of Denmark. Organic milk was found to have a lower iodine content than non-organic milk. CONCLUSIONS: Large geographical (and seasonal) variations in iodine concentrations were found in different beverages supplying an appreciable part of the iodine in the Danish diet. This knowledge is important when calculating the iodine intake from dietary intake studies. SPONSORSHIP: The 1991 Farmacy Foundation and Danish Veterinary and Food Administration. European Journal of Clinical Nutrition (2000) 54, 57-60

Animals↗
PubMed2000

Goitre prevalence and thyroid abnormalities at ultrasonography: a comparative epidemiological study in two regions with slightly different iodine status.

OBJECTIVE: The association between severe iodine deficiency and endemic goitre is well established, but little information is available on the relation between milder degrees of iodine deficiency and goitre prevalence. SUBJECTS: In a comparative epidemiological study performed in two regions in Denmark, we examined 4649 subjects from the general population, women aged 18-65 years and men aged 60-65 years. METHODS: Ultrasonography and palpation of the thyroid was performed in all participants. Iodine excretion was measured in casual urine samples. Previous thyroid disease was detected by questionnaires, personal interviews and tracing of records. RESULTS: The median iodine excretion was 61 microg/l (mild iodine deficiency (ID)) and 45 microg/l (moderate ID) in the two regions. Median thyroid volume at ultrasonography was 11. 9 ml (mild ID) and 13.6 ml (moderate ID), P <0.001, and thyroid enlargement was found in 15.0% (mild ID) and 22.6% (moderate ID), P<0.001. Goitre prevalence increased in both regions with age to the age group 40-45 years, but not after that age. Subjects who had moved from the moderate ID to the mild ID area had the same prevalence of thyroid enlargement as the subjects staying permanently in the mild ID area. Thyroid nodules at ultrasonography were found in 30% in both regions, but nodules were larger and more often palpable in the moderate ID area. Palpable goitre was found in 9.8% (mild ID) and 14.6% (moderate ID), P<0.001. The greatest regional difference in thyroid abnormalities was found among men. CONCLUSION: Marked differences in the prevalence of thyroid abnormalities were found in these regions with modest differences in iodine excretion.

Adult↗
PubMed2000

Vitamin D: should the supply in the Danish population be increased?

A working group was established to evaluate the need for an increased vitamin D intake in the Danish population. Vitamin D is primarily important for calcium homeostasis, calcium absorption in the intestine and calcium content in bones, and thereby for the strength of the bones. Only a few foods provide vitamin D and the intake in the Danish population is low compared to the recommendation. However, vitamin D is also produced by the skin from solar exposure. How much vitamin D is provided this way is not known but it is said to be the most important source. Measures of vitamin D status and clinical signs of vitamin D status are therefore important when assessing the possible need for increased vitamin D intake. Measures of vitamin D status have shown a low status in the elderly but not in the young. More than 50% of nursing-home residents have low blood vitamin D levels and many have biochemical signs of osteomalacia. Vitamin D deficiency increases the risk of osteoporosis. In Denmark, for instance, 13,000 admissions each year are caused by hip fractures alone, almost all among elderly people. Dark-skinned women often constitute a problem with respect to vitamin D sufficiency because of reduced production from the skin secondary to extensive covering, skin pigmentation and many hours spent indoors. It is concluded that the elderly and dark-skinned (veiled) women will benefit from an increased vitamin D supply. Four strategies to increase vitamin D supply were considered: dietary changes, increased solar exposure, dietary supplements with vitamin D and food fortification with vitamin D. It is concluded that the best solution is to recommend dietary supplements with vitamin D to elderly over 65 years, dark-skinned and veiled women and people who, because of disease, are unable to spend time outdoors.

Age Factors↗