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Biomedical subjects

Lars Ovesen

Publications and source records attributed to Lars Ovesen.

49 records · Page 3Linked to original sources
PubMed2002

Body mass index, weight loss and energy intake of old Danish nursing home residents and home-care clients.

Low body mass index (BMI) and weight loss is common among old home-care clients and nursing home residents in many countries - often in spite of an apparent sufficient intake of energy. The aim of this study was to assess whether a similar problem exists in Denmark. Information regarding height, body weight, BMI, and energy intake was collected. Besides this, 24 residents were weighed regularly during 1 year. The study was carried out in five nursing homes and two home-care districts situated in the area of Copenhagen. A total of 180 residents and 200 clients 65+ years of age participated. Main outcome measures were prevalence of BMI < 20 kg/m2, BMI < 18.5 kg/m2, acute weight loss and median energy intake. Thirty-three and thirty per cent of the residents and clients had a BMI < 20 kg/m2 and, 22 and 12% had a BMI < 18.5 kg/m2. Of the residents, who were weighed regularly, 38% had a weight loss above 5%. The median intake of energy was equal to or above the estimated median energy requirement. Hence, the prevalence of low BMI and weight loss among old Danish nursing home residents and home-care clients is high and similar to that found in other countries. There is a need for increased focus on nutritional state and risk factors in these settings.

Aged↗
PubMed2002

Practices in relation to nutritional care and support--report from the Council of Europe.

Disease-related undernutrition is significant in European hospitals but is seldom treated. 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 12 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 recommendations in improve the nutritional care and support of hospitalised patients. The data collection regarding the nutritional care providers and their practices of nutritional care and support showed that the use of nutritional risk screening and assessment, and of nutritional support and counselling was sparse and inconsistent, and that the responsibilities in these contexts were unclear. Besides, the educational level with regard to nutritional care and support was limited at all levels. All patients have the right to expect that their nutritional needs will be fulfilled during a hospitalisation. Optimal supply of food is a prerequisite for an optimal effect of the specific treatment offered to patients. Hence, the responsibilities of staff categories and the hospital management with respect to procuring nutritional care and support should be clearly assigned. Also, a general improvement in the educational level of all staff groups is needed.

Counseling↗
PubMed2002

Dietary iodine intake and urinary iodine excretion in a Danish population: effect of geography, supplements and food choice.

I deficiency diseases remain a health problem even in some developed countries. Therefore, measurement of I intake and knowledge about food choice related to I intake is important. We examined I intake in 4649 randomly selected participants from two cities in Denmark (Copenhagen and Aalborg) with an expected difference in I intake. I intake was assessed both by a food frequency questionnaire and by measuring I in casual urine samples. I excretion was expressed as a concentration and as estimated 24-h l excretion. Further, subgroups with low I intake were recognized. I intake was lower in Aalborg than in Copenhagen for all expressions, and lower than recommended in both cities if I intake from supplements was not included. Milk was the most important I source, accounting for about 44% of the I intake, and milk (P<0.001) and fish (P=0.009) intake was related to I excretion in a multiple linear regression model. Thus, risk groups for low I intake were individuals with a low milk intake, those with a low intake of fish and milk, those not taking I supplements and those living in Aalborg where the I content in drinking water is lower. Even individuals who followed the advice regarding intake of 200-300 g fish/week and 0.5 litres milk/d had an intake below the recommended level if living in Aalborg.

Adolescent↗
PubMed2002

Use of dietary supplements in Denmark is associated with health and former smoking.

OBJECTIVES: To describe the use of dietary supplements in a group of Danish adults and to investigate the differences between users and non-users with respect to age, gender, health and lifestyle factors. DESIGN: Cross-sectional study in two Danish cities. SETTING: The Danish Investigation on Iodine Intake and Thyroid Diseases, 1997-1998. SUBJECTS: Participants were 3707 women (selected age groups between 18 and 65 years) and 942 men (60-65 years). Participation rate was 50%. Supplement data were collected in a personal interview. Data on education, smoking, alcohol intake, physical activity, use of medication and self-perceived health were derived from a self-administered questionnaire. Multiple logistic regression was used for the statistical analysis. RESULTS: Participants were asked about all kinds of supplements, ranging from products containing vitamins and minerals, to fish oils and products of herbal origin. On average 59% reported use of some kind of dietary supplement. Most common were combined multivitamin/mineral products (48%) followed by single vitamin C products (10%). Twelve per cent used three or more different supplements. Supplement use was strongly associated with age and gender, being highest among elderly women (78%). Ex-smokers were more likely to use supplements than subjects who had never smoked (odds ratio (OR) 1.36, 95% confidence interval (CI) 1.09-1.76). Supplement use was more likely among subjects who had many days of illness 95% CI 1.12-1.66) and among users of medication 95% CI 1.04-1.42). Subjects who perceived their health as poor were more likely to use supplements other than just a multivitamin/mineral tablet 95% CI 1.31-3.77). CONCLUSIONS: Use of dietary supplements was related to age, gender and smoking, but also to poor self-perceived health status and absence from work. This indicates that a group of people use supplements as a form of self-medication.

Adolescent↗
PubMed2002

Risk factors for goiter and thyroid nodules.

The occurrence of thyroid diseases is determined by interplay between genetic and environmental factors. The major environmental factor that determines goiter prevalence is iodine status, but other environmental factors influencing entire populations have been identified such as goitrogens in food and drinking water. Less focus has been on individual environmental factors and the interplay between factors. The goiter prevalence is higher in certain groups in the population. The variation in goiter prevalence between the genders is well known with a higher occurrence among women. The association with age is probably dependent on iodine status, because it seems that the zenith of goiter prevalence appears earlier in life the more severe iodine deficiency the population is exposed to. The association with individual risk factors has been investigated in some studies, especially the association with tobacco smoking. In iodine-deficient areas, a strong association between tobacco smoking and goiter prevalence is found, whereas the association is less pronounced in iodine-replete areas. This was predictable from experimental studies showing thiocyanate to be the mediator of the goitrogenic effect of tobacco smoke acting as a competitive inhibitor of iodine uptake. The association with alcohol intake has only been investigated in few studies, but a low occurrence of goiter among alcohol consumers has been found. The mechanism of this association is not known. Increased goiter prevalence during pregnancy has been reported, and recently a long-term goitrogenic effect of pregnancies has also been shown. As demonstrated for tobacco smoking, this association is dependent on iodine status, because the association has only been found in areas with a suboptimal iodine intake. This indicates pregnancy-induced goiter to be the result of exacerbation of existing iodine deficiency. Recently, the use of oral contraceptives has been shown to be associated with a markedly reduced prevalence of goiter, although experimental studies have previously shown proliferative effects of estrogens on thyrocytes. Some implications for prevention of thyroid disease could be suggested. Discussion of smoking habits should be included in a consultation for goiter with a motivation to quit smoking. Iodine deficiency has particularly strong goitrogenic effects during pregnancy and for the sake of the mother as well as the fetus, sufficient iodine supply should be ensured to all pregnant women. The difference in age maximum in goiter prevalence suggests that monitoring of iodine deficiency disorders should ideally include a spectrum of age groups.

Female↗
PubMed2002

Thiocyanate in food and iodine in milk: from domestic animal feeding to improved understanding of cretinism.

Transport of iodine in the mammary gland into breast milk plays a central role in various fields of prevention of thyroid diseases. First, a sufficient content of iodine in the mother's milk is necessary for normal brain development in the breastfed child. This is attained by expression during lactation in the mammary gland of the sodium iodide symporter (NIS), also responsible for iodine transport in the thyroid. Milk iodine content varies with the iodine intake of the mother, and urinary iodine excretion in groups of mothers seems to be a valuable indicator of the iodine status of their breastfed children. Second, iodine in dairy products provides a considerable part of iodine intake in many populations. Thiocyanate from rapeseed feeding of cows decreases milk iodine content, probably by competitive inhibition of NIS in the mammary gland. Alterations in feeding of dairy cows may alter the iodine content of consumer milk, and this may influence the risk of thyroid diseases in the population. Thiocyanate inhibition of iodine transport into milk may also be operative in humans with a high thiocyanate intake. This could further impair iodine status in breastfed children in low-iodine intake areas of the world. It can be speculated that a low-iodine content of mother's milk because of inhibition of NIS in the mammary gland may be one factor of importance for development of myxedematous cretinism.

Animal Feed↗
PubMed2002

Relations between various measures of iodine intake and thyroid volume, thyroid nodularity, and serum thyroglobulin.

BACKGROUND: Iodine intake can be measured in various ways, and each method may have advantages and disadvantages. OBJECTIVE: We sought to investigate the potential associations of various measures of iodine intake with thyroid volume, prevalence of thyroid nodules, and serum thyroglobulin. We also sought to identify, if possible, groups at risk of thyroid disease because of their food choices. DESIGN: This cohort study included 4649 randomly selected subjects with mild-to-moderate iodine deficiency; the subjects lived in 2 cities in Denmark. Iodine intake was estimated by using a food-frequency questionnaire and by measuring iodine excretion in spot urine samples. Thyroid volume and nodularity were measured with ultrasonography. RESULTS: In multiple linear regression models, significant inverse relations were found between thyroid volume and estimated 24-h iodine excretion, iodine intake from diet plus supplements, iodine intake from diet/kg body wt, and milk intake (P = 0.001 for all), but not urinary iodine excretion measured as a concentration (P = 0.40). All measures of iodine intake were significantly related to serum thyroglobulin concentration (P <or= 0.002), but only some measures of iodine intake were significantly related to the prevalence of thyroid nodules. CONCLUSIONS: Even in a geographic area where mild iodine deficiency is common, a significant relation between iodine intake and thyroid volume was found. All measures of iodine intake, except iodine excretion measured as a urinary concentration, predicted thyroid volume. Serum thyroglobulin concentration appears to be a good marker of iodine status. Subgroups with low intakes of milk and milk products had an increased risk of thyroid disease.

Adult↗
PubMed2002

Smelly science.

Explore the source record for details and available documents.

Adult↗
PubMed2002

Large differences in incidences of overt hyper- and hypothyroidism associated with a small difference in iodine intake: a prospective comparative register-based population survey.

Around 3-4 billion people in the world are covered by iodine supplementation programs to prevent developmental brain damage and other iodine deficiency (ID) disorders. Mild ID is associated with more hyperthyroidism and less hypothyroidism in the population than a high iodine intake. Knowledge of the iodine intake levels where the shifts in incidences occur is important for planning of iodine supplementation programs. A computer-based register linked to thyroid diagnostic laboratories was used to continuously identify all new cases of overt hyper- and hypothyroidism in two population cohorts with moderate and mild ID, respectively (Aalborg, n = 310,124; urinary iodine, 45 micro g/liter; and Copenhagen, n = 225,707; urinary iodine, 61 micro g/liter). The investigation was initiated before iodization of salt in Denmark and was part of the monitoring program. In 1997-1998, the incidence rate of overt hyperthyroidism was high in the area with the lowest iodine intake (92.9/100,000 per year) compared with the area with only mild ID (65.4/100,000 per year). Standardized rate ratio was 1.49, and 95% confidence interval was 1.22-1.81. The opposite relationship was present for overt hypothyroidism (moderate ID, 26.5/100,000 per year; mild ID, 40.1/100,000 per year; standardized rate ratio, 0.73; 95% confidence interval, 0.55-0.97). The different incidence rates were confirmed during each of the two following years. The results of this prospective investigation of the incidence of overt hyper- and hypothyroidism suggest that iodine supplementation of a population may increase the incidence of overt hypothyroidism, even if the population is moderately iodine-deficient. In such a population, the increase in risk of hypothyroidism should be weighed against the risk of ID disorders such as hyperthyroidism due to multinodular toxic goiter. The optimal level of iodine intake to prevent thyroid disease may be a relatively narrow range around the recommended daily iodine intake of 150 micro g.

Adolescent↗
PubMed2002

Parity is associated with increased thyroid volume solely among smokers in an area with moderate to mild iodine deficiency.

OBJECTIVE: Pregnancy has been suggested as part of the explanation of the gender difference in the prevalence of goitre, but opposing results have been reported on the association between pregnancy and goitre. We investigated the association between parity and thyroid volume and a possible impact of iodine deficiency and tobacco smoking on this association. DESIGN: A comparative, cross-sectional study of 3712 women randomly sampled from the general population in two geographical areas with moderate and mild iodine deficiency. METHODS: The participants answered questionnaires with an obstetric anamnesis, and ultrasonography of the thyroid was performed. Data were analysed in linear models and logistic regression analysis to adjust for age, iodine status, use of oral contraceptives and smoking habits. Women with present or recent pregnancies were excluded from the analyses. RESULTS: A higher thyroid volume was found among parous than among nulliparous women (P=0.007). The association between parity and thyroid volume was strongest in the youngest age groups, in the region with the most severe iodine deficiency, and among smokers. No association was found between parity and the prevalence of solitary or multiple thyroid nodules. Number of births, age at menarche or menopause, the number of fertile years, and age at first childbirth were not associated with thyroid volume. CONCLUSION: Pregnancy increases thyroid volume, particularly when combined with tobacco smoking and iodine deficiency. The effect is probably reversible seen over a spectrum of several years.

Adolescent↗