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  • 151.
    Wendin, Karin
    et al.
    Högskolan Kristianstad, Forskningsmiljön Food and Meals in Everyday Life (MEAL). Högskolan Kristianstad, Fakulteten för naturvetenskap, Avdelningen för mat- och måltidsvetenskap.
    Olshov, Anders
    Äter vi ihjäl oss?: mattrender på tvärs mot hälsa och hållbarhet2018Rapport (Annet vitenskapelig)
    Abstract [sv]

    Idag äter vi så mycket att fler dör av fetma och övervikt än av undernäring. Konsekvenserna av människans växande aptit är enorma, inte bara för de individer som drabbas av fetma och dess följdsjukdomar som typ 2-diabetes och hjärt-kärlsjukdomar, utan också för växter, djur och klimat. Vi får i oss för mycket energi, vilket gör oss feta, och vi äter mer kött och fisk, vilket tär på jordens resurser. I Sverige har andelen överviktiga och feta ökat från 46 till 51 procent i åldersgruppen 16-84 år under tioårsperioden 2006-2016. De direkta och indirekta samhällskostnaderna för fetma och övervikt beräknas till 70 miljarder kronor av Folkhälsomyndigheten. Fortsätter fetman att öka i samma takt som under det senaste decenniet når kostnaderna 95 miljarder kronor om tio år, enligt myndigheten. Det skulle motsvara statens utgifter för rättsväsendet, försvar och samhällets krisberedskap. De globala årliga utgifterna relaterat till fetmaepidemin ligger på 18 000 miljarder kronor, runt 2,8 procent av hela världens samlade bruttonationalprodukt. Omkring fem procent av alla dödsfall globalt kan relateras till fetma. Fetma är även den enskilt största riskfaktorn för diabetes. Görs inget kan 1,4 miljarder vuxna (22 procent av alla vuxna) leva med fetma 2045 och 736 miljoner med diabetes (12 procent). Diabetesrelaterade hälsoutgifter skulle då stiga till över 8 000 miljarder kronor och orsaka stort individuellt lidande. I Sverige har köttkonsumtionen fördubblats sedan 1990 från 27 till 53 kilo per person och år och den totala konsumtionen från 230 till 527 miljoner kilo. Det följer en internationell trend där ekonomisk tillväxt och ökade disponibelinkomster ökar efterfrågan på kött och mejeriprodukter. Som följd tas allt större landarealer i anspråk och skövlas skog på andra håll i världen, minskar biodiversiteten och ökar utsläppen i form av växthusgaser från djur. Globalt ger utsläppen från matdjuren (kor, får, getter, grisar och kyckling) 6 miljarder ton växthusgaser per år, vilket motsvarar knappt en femtedel av det totala utsläppet av växthusgaser. Nästan hälften av all skog som en gång täckte jordens yta är borta. Grundvattenkällorna minskar då jordbruken använder stora vattenmängder. Cirka en tredjedel av fiskbestånden är överfiskade. Då jordens befolkning förväntas öka från dagens 7,6 miljarder till knappt 10 miljarder invånare år 2050 och livsmedels- och köttkonsumtionen samtidigt ökar skulle livsmedelsproduktionen, enligt FAO, behöva öka med 70 procent om maten ska räcka till alla. Det är svårt eftersom de areella resurserna och vattenresurserna är begränsade. Det är inte heller hållbart mot bakgrund av den globala uppvärmningen och andra hållbarhetsmål. Åtgärder för att skapa en hållbar livsmedelskonsumtion brådskar. Sänkningarna av matmomsen 1992 och 1996, EU-medlemskapet och den globala konkurrensen inom livsmedel har gjort mat billigare relativt andra varor. I kombination med ökade inkomster gör det att konsumenter lägger en allt mindre andel av hushållsbudgeten på matinköp och att de har råd att äta skadligt mycket. Höjd matmoms samt införande av kött-, fett- och sockerskatter är ekonomiska styrmedel som kan användas för att minska matkonsumtionen och valet av mat samtidigt som skatteintäkterna kan används till riktade satsningar för bättre skolmat, bättre måltider inom äldreomsorgen och till ekonomiskt svaga grupper.För att få till stånd en strukturell beteendeförändring måste samhället även på andra sätt ge medborgare och verksamheter incitament att agera i mer hälsosamma och miljövänliga riktningar. Det kan röra sig om informations- och utbildninginsatser, allmänna folkhälsoundersökningar, mer vegetariskt och mindre kött  i skolorna, införandet av ett licenssystem för att att få bort godis och läskförsäljningen från livsmedelsbutikerna, åtgärder för att minska matsvinnet och främjande av cykling och idrott. En rimlig ambition är att Sverige verkar för att bli en internationell förebild med världens friskaste folk.  

  • 152.
    Wendin, Karin
    et al.
    Uppsala University, Department of Domestic Sciences.
    Solheim, R
    Allmere, T
    Johansson, L
    Flavour and texture in sourmilk affected by thickeners and fat content1997Inngår i: Food Quality and Preference, ISSN 0950-3293, E-ISSN 1873-6343, Vol. 8, nr 4, s. 281-291Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    When reducing fat content or replacing fat with thickener in reduced fat foods, flavour and texture may change. The objective of this study was to investigate effects of thickener and fat content on flavour and texture in low-fat foods. We used sourmilk with 0.1% or 4.2% fat where odour compounds with differing polarity, maltol or ethyl 2-methylbutyrate, were added. Sourmilk with: O.1 g 100 ml(-1) or 0.5 g 100 ml(-1) gelatine; 0.05 g 100 ml(-1) or 1.O g 100 ml(-1) pectin; or 0.65 g 100 ml(-1) or 0.9 g 100 ml(-1) xanthan added, and sourmilk without any thickener added, for each of the two odour compounds were manufactured. Sensory evaluation by descriptive profiling and viscosity measurements by Bohlin VOR were made. Perceived thickness increased with higher fat content and with increased concentration of thickener. Viscosity (measured by a Bohlin rheometer) did also increase with higher fat content and with increased concentration of thickener. Smell and flavour of maltol increased with higher fat content, while smell and flavour of ethyl 2-methylbutyrate were unaffected. Smell and flavour of the maltol were unaffected by all the thickeners, while smell and flavour of the ester were affected. Sourness was masked by all the thickeners.

  • 153.
    Wendin, Karin
    et al.
    Högskolan Kristianstad, Forskningsmiljön Food and Meals in Everyday Life (MEAL). Högskolan Kristianstad, Sektionen för lärande och miljö, Avdelningen för Humanvetenskap.
    Westergren, Albert
    Högskolan Kristianstad, Forskningsmiljön PRO-CARE. Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap I. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
    Blücher, Anna
    Linnéuniversitetet.
    Andersson, Håkan
    Linnéuniversitetet.
    Lindén, Maria
    Mälardalens högskola.
    Nyberg, Maria
    Högskolan Kristianstad, Forskningsmiljön Food and Meals in Everyday Life (MEAL). Högskolan Kristianstad, Sektionen för lärande och miljö, Avdelningen för Humanvetenskap.
    Pajalic, Zada
    Norge.
    Olsson, Viktoria
    Högskolan Kristianstad, Forskningsmiljön Food and Meals in Everyday Life (MEAL). Högskolan Kristianstad, Sektionen för lärande och miljö, Avdelningen för Humanvetenskap.
    Örtman, Gerd
    Linnéuniversitetet.
    Högberg, Ann-Marie
    Anhörigas Riksförbund.
    Borgstierna, Catharina
    Bestic AB.
    Stuhr Olsson, Gunnel
    Findus AB.
    Toll, Birgitta
    Borås stad.
    Mer krävs för att undvika svält bland äldre2015Inngår i: Svenska Dagbladet, ISSN 1101-2412, nr 23 decemberArtikkel i tidsskrift (Annet (populærvitenskap, debatt, mm))
  • 154.
    Westergren, Albert
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Nutrition and its relation to mealtime preparation, eating, fatigue and mood among stroke survivors after discharge from hospital: a pilot study2008Inngår i: The Open Nursing Journal, ISSN 1874-4346, Vol. 2, s. 15-20Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Eating difficulties and nutritional deficits are common among persons with acute stroke and during rehabilitation. Little is known about such problems after discharge from hospital. In addition the relationship between fatigue and nutritional status among stroke survivors living in the community remains to be explored. The aim of this pilot study was to describe mealtime preparation, eating, fatigue, mood and nutritional status among persons with stroke six months after discharge from hospital and to explore associations between these factors. Patients were interviewed six months poststroke. Standardised questions and methods were used. The mean age of the 89 respondents was 77.2 (SD 6.6) years, 44 were women and 45 men. Difficulties with swallowing, ingestion and energy to eat occurred among 27%, 20% and 7% respectively. Difficulties with cooking and buying food occurred among 57% and 56% respectively and 41% were at nutritional risk. Feeling full of energy less than some of the time was experienced by 61% while 15% had felt gloomy and sad at least some of the time during the previous four weeks. Considering activities of daily living (ADL), having a less favourable nutritional status was significantly predicted by difficulties with buying food, difficulties with ingestion and being a woman. Considering psychological state (mood and energy), having a less favourable nutritional status was significantly predicted by a lack of energy and high age. This study supports the occurrence of a nutritionally related fatigue by means of “lack of energy”. The associations between poor nutritional status and fatigue can work in both directions. Thus persons with fatigue are more prone to have poor nutritional status and those with poor nutritional status are at greater risk of fatigue. Besides fatigue also difficulties with buying food and ingestion are associated with nutritional risk. As nutritional deficits occur a long time after stroke onset it is important to assess aspects of mealtime preparation and the eating process and when necessary provide food delivery service and eating assistance in order to prevent a vicious circle of undernourishment and fatigue to develop.

  • 155.
    Westergren, Albert
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
    Blomqvist, Kerstin
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
    Edberg, Anna-Karin
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
    Petersson, Pia
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Sätt måltidsupplevelsen i centrum2012Inngår i: Kristianstadsbladet, ISSN 1103-9523, nr 16/6, s. B4-Artikkel i tidsskrift (Annet (populærvitenskap, debatt, mm))
    Abstract [sv]

    Måltidsupplevelsen påverkas av så mycket; ljuset i lokalen, ljud, dukning, servering, bemötande, maten, smakerna, doften och sällskapet. Men hur kan den kunskapen omsättas på sjukhus och äldreboenden? Det skriver Albert Westergren, professor i omvårdnad, Kerstin Blomqvist, biträdande professor i klinisk omvårdnad, Anna-Karin Edberg, professor i omvårdnad, och Pia Petersson, ansvarig för sjuksköterskeprogrammet, samtliga på Högskolan Kristianstad.

  • 156.
    Westergren, Albert
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
    Hagell, Peter
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
    Screening for nutritional risk among home dwelling elderly people without service from the municipality2011Inngår i: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 6, nr Suppl. 1, s. 87-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Risk factors for malnutrition were frequent mamong elderly persons and calls for preventive actions through information about how to eat healthy. This information can be provided during preventive home visits.

  • 157.
    Westergren, Albert
    et al.
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Hedin, Gita
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Do study circles and a nutritional care policy improve nutritional care in a short- and long-term perspective in special accommodations?2010Inngår i: Food & nutrition research, ISSN 1654-661X, Vol. 54, s. 5402-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Study circles give positive short-term effects and a NCP gives positive short- and long-term effects on NC. Whether a combination of study circles and the implementation of a NCP can give even better results is an area for future studies.

  • 158.
    Westergren, Albert
    et al.
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Lindholm, Christina
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Axelsson, Carolina
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Ulander, Kerstin
    Högskolan Kristianstad, Institutionen för hälsovetenskaper.
    Prevalence of eating difficulties and malnutrition among persons within hospital care and special accommodations2008Inngår i: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 12, nr 1, s. 39-43Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: The aim of this study was to explore the prevalence of eating difficulties and malnutrition among persons in hospital care and in special accommodations. DESIGN: The cross-sectional observational study was performed in Nov. 2005. SETTING: Hospitals and special accommodations. PARTICIPANTS: Out of 2,945 persons, 2,600 (88%) agreed to participate (1,726 from special accommodations and 874 from hospitals). In total all special accommodations in six municipalities and six hospitals were involved. MEASUREMENTS: Risk of undernutrition was estimated as at least two of: body mass index below recommendation, weight loss and/or eating difficulties. Overweight was graded based on body mass index (if 69 years or younger: 25 or above: if 70 years or older: 27 or above). RESULTS: The mean age of those living in hospitals was 69 years and 53% were women, while the corresponding figures for those in special accommodations were 85 years and 69% women. In hospitals and special accommodations, eating difficulties were common (49% and 56% respectively) and about one quarter had a body mass index (BMI) below the limits (20% and 30% respectively) and one-third above the limit (39% and 30% respectively) thus only about 40% had a BMI within the limits. Both in hospitals and in special accommodations 27% were considered to have a moderate or high risk of undernutrition. CONCLUSION: Only about 40% in special accommodations and hospital care have a BMI within the recommended limits. As both low and high BMI are frequent in both settings, the focus of care should not only be on undernutrition but also on overweight. Using the Swedish criteria for defining risk of undernutrition seems to give a slightly lower prevalence than has been shown in previous Swedish studies, but this can be due to an underestimation of the occurrence of eating difficulties.

  • 159.
    Westergren, Albert
    et al.
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Lindholm, Christina
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Matsson, Anna
    Stroke Unit, Central Hospital Kristianstad.
    Ulander, Kerstin
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Minimal Eating Observation Form: reliability and validity2009Inngår i: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 13, nr 1, s. 6-12Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: Eating difficulties are common for patients in hospitals (82% have one or more). Eating difficulties predict undernourishment, need for assistance when eating, length of hospital stay and level of care after hospital stay. Eating difficulties have through factor analysis (FA) been found to belong to three dimensions (ingestion, deglutition and energy). The present study investigates inter-observer reliability. Other questions at issue are if the findings from the previous FA can be confirmed, if adjustments need to be done and if the Minimal Eating Form (MEOF) can serve as an assessment model for identification of eating difficulties. Previously found associations between eating difficulties and outcomes as well as measures taken to improve oral intake were also investigated. Design: Inter-observer study and cross-sectional observational study. Settings: Hospitals and special accommodations (SAs). Participants and measurements: Inter-observer study: Observers made standardized assessments of eating, independently and at the same time, on a sample of 50 patients with stroke. Survey study: 2600 (88%) out of 2945 persons agreed to participate in a survey of eating and nutrition. All SAs within six municipalities and six hospitals were involved. Nursing students, clinical tutors and staff performed the assessments, supported by the researchers. Results: The average agreement between observers of eating difficulties was 89% (Kappa coefficient 0.70). In the survey study, the mean age of persons (n=1726) living in SAs was 85 years (SD 8) and 69% were women, while the corresponding figures for patients (n=874) in hospitals were 69 years (SD 18) and 53% women. Low Body Mass Index (BMI) was found in 27%, unintentional weight loss in 23% and need of eating assistance in 38% of the persons. Protein- and energy- (PE-) enriched food was given to 4%, adapted consistency of food to 23% and food supplements to 16% of the persons. The new FA confirmed the previous one and minor adjustments of the model were made. Having ingestion difficulties was the strongest predictor of need for eating assistance (OR 14.5). Deglutition difficulties strongly predicted serving of adapted consistency of food (OR 7.3). Poor energy levels and reduced appetite predicted weight loss (OR 6.0), BMI below limits (OR 2.5), supplements (OR 5.3) and PE-enriched food (OR 3.4). Conclusions: The MEOF has satisfying validity and reliability. The earlier model of eating difficulties was confirmed (MEOF-I), and the model was slightly adjusted to a new model, MEOF-II. Providing eating assistance seems effective in preventing malnutrition (weight loss and BMI below limits), and is mainly provided to persons with ingestion difficulties. Difficulties with energy intake and appetite are not associated with eating assistance; indicating that those persons might need support of some other kind. This support can include providing PE-enriched food and supplements, but seems however insufficiently or inadequately delivered, as low energy and appetite problems are also associated with both weight loss and low BMI. Findings from other studies are confirmed.

  • 160.
    Westergren, Albert
    et al.
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Lindholm, Christina
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Ulander, Kerstin
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Eating difficulties among elderly persons predict support and outcome2007Inngår i: 29th ESPEN Congress, 8-11 sept. 2007. Prag, 2007Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Rationale: Difficulties regarding ingestion, deglutition and/or energy predicts malnutrition, assistance when eating, length of hospital stay and level of care after in-hospital rehabilitation. In this study, previously found associations between eating difficulties and outcome as well as actions taken to improve oral intake were investigated.Methods: All special accommodations (SAs) within six municipalities and six hospitals were involved. Out of 2945 persons 2600 (88%) agreed to participate. Students, clinical tutors and staff collected the data. Logistic regression analyses explored associations between eating difficulties (independent variables), support and outcome (dependent variables).Results: Mean age of persons (n=2600) was 79.7 years (SD 14.4) and 63% were women. Low BMI (<20 if /=70 yrs) was found in 27%, unintentional weight loss 23%, eating assistance 38%, protein- and energy (PE-) enriched food 4%, adapted consistency of food 23% and food supplements 16%. Ingestion difficulties was the strongest predictor of eating assistance (OR 14.6). Deglutition difficulties predicted adapted consistency of food (OR 7.4). Energy and appetite predicted BMI below limits (OR 2.5), weight loss (OR 6.0), PE-enriched food (OR 3.4) and supplements (OR 5.3).Conclusions: Eating assistance to elderly persons seems effective in preventing malnutrition (weight loss and low BMI) and is mainly provided to those with ingestion difficulties. Difficulties with energy and appetite are not associated with eating assistance indicating that support of some other kind is needed such as providing PE-enriched food and supplements. This support seems however insufficiently or inadequately delivered as energy and appetite problems are associated with weight loss and low BMI. Findings from other studies are confirmed. Studies comparing “optimised nutritional support” to persons with energy and appetite problems versus “regular support” are needed.

  • 161.
    Westergren, Albert
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
    Nilsson, M.
    Edfors, Ellinor
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Lindskov, Susanne
    Hagell, Peter
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
    Adaptation of "Seniors in the community: risk evaluation for eating and nutrition , version ll" (SCREEN ll) for use in  Sweden: report on the translation process and field test2010Konferansepaper (Fagfellevurdert)
  • 162.
    Westergren, Albert
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
    Nilsson, Maria
    Lund University.
    Hagell, Peter
    Lund University.
    Adaptation of "Seniors in the community risk evaluation for eating and nutrition, Version II" (SCREEN II) for use in Sweden: report on the translation process2010Rapport (Annet vitenskapelig)
    Abstract [en]

    This report describes the initial stages of the Swedish adaptation of "Seniors in the community: Risk evaluation for eating and nutrition, Version II" (SCREEN II) that has been developed by Heather Keller.

  • 163.
    Westergren, Albert
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
    Norberg, Erika
    Central Hospital, Kristianstad.
    Hagell, Peter
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
    Diagnostic performance of the Minimal Eating Observation and Nutrition Form – Version II (MEONF-II) and Nutritional Risk Screening 2002 (NRS 2002) among hospital inpatients – a cross-sectional study2011Inngår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 10, s. 24-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The usefulness of the nutritional screening tool Minimal Eating Observation and Nutrition Form – Version II (MEONF-II) relative to Nutritional Risk Screening 2002 (NRS 2002) remains untested. Here we attempted to fill this gap by testing the diagnostic performance and user-friendliness of the MEONF-II and the NRS 2002 in relation to the Mini Nutritional Assessment (MNA) among hospital inpatients. Methods: Eighty seven hospital inpatients were assessed for nutritional status with the 18- item MNA (considered as the gold standard), and screened with the NRS 2002 and the MEONF-II. Results: The MEONF-II sensitivity (0.61), specificity (0.79), and accuracy (0.68) were acceptable. The corresponding figures for NRS 2002 were 0.37, 0.82 and 0.55, respectively. MEONF-II and NRS 2002 took five minutes each to complete. Assessors considered MEONF-II instructions and items to be easy to understand and complete (96- 99%), and the items to be relevant (87%). For NRS 2002, the corresponding figures were 75-93% and 79%, respectively. Conclusions: The MEONF-II is an easy to use, relatively quick and sensitive screening tool to assess risk of undernutrition among hospital inpatients. With respect to user-friendliness and sensitivity the MEONF-II seems to perform better than the NRS 2002, although larger studies are needed for firm conclusions. The different scoring systems for undernutrition appear to identify overlapping but not identical patient groups. A potential limitation with the study is that the MNA was used as gold standard among patients younger than 65 years.

  • 164.
    Westergren, Albert
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
    Norberg, Erika
    Departments of Nutrition and Health, Central Hospital, Kristianstad.
    Vallén, Christina
    Departments of Nutrition and Health, Central Hospital, Kristianstad.
    Hagell, Peter
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
    Cut-off scores for the Minimal Eating Observation and Nutrition Form – Version II (MEONF-II) among hospital inpatients2011Inngår i: Journal of Food and Nutrition Research, ISSN 1336-8672, E-ISSN 1338-4260, Vol. 55, s. 7289-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND AND OBJECTIVE:

    The newly developed Minimal Eating Observation and Nutrition Form - Version II (MEONF-II) has shown promising sensitivity and specificity in relation to the Mini Nutritional Assessment (MNA). However, the suggested MEONF-II cut-off scores for deciding low/moderate and high risk for undernutrition (UN) (>2 and >4, respectively) have not been decided based on statistical criteria but on clinical reasoning. The objective of this study was to identify the optimal cut-off scores for the MEONF-II in relation to the well-established MNA based on statistical criteria.

    DESIGN:

    Cross-sectional study.

    METHODS:

    The study included 187 patients (mean age, 77.5 years) assessed for nutritional status with the MNA (full version), and screened with the MEONF-II. The MEONF-II includes assessments of involuntary weight loss, Body Mass Index (BMI) (or calf circumference), eating difficulties, and presence of clinical signs ofUN. MEONF-II data were analysed by Receiver Operating Characteristics (ROC) curves and the area under the curve (AUC); optimal cut-offs were identified by the Youden index (J=sensitivity+specificity-1).

    RESULTS:

    According to the MEONF-II, 41% were at moderate or high UN risk and according to the MNA, 50% were at risk or already undernourished. The suggested cut-off scores were supported by the Youden indices. The lower cut-off for MEONF-II, used to identify any level of risk for UN (>2; J=0.52) gave an overall accuracy of 76% and the AUC was 80%. The higher cut-off for identifying those with high risk for UN (>4; J=0.33) had an accuracy of 63% and the AUC was 70%.

    CONCLUSIONS:

    The suggested MEONF-II cut-off scores were statistically supported. This improves the confidence of its clinical use.

  • 165.
    Westergren, Albert
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
    Norberg, Erika
    Departments of Nutrition and Health, Central Hospital, Kristianstad.
    Vallén, Christina
    Departments of Nutrition and Health, Central Hospital, Kristianstad.
    Hagell, Peter
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
    Cut-off scores for the Minimal Eating Observation and Nutrition Form - Version ll (MEONF ll) among hospital inpatients2011Konferansepaper (Fagfellevurdert)
  • 166.
    Westergren, Albert
    et al.
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Petersson, K.
    Lindholm, Christina
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Axelsson, Carolina
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Ulander, Kerstin
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    "Study circles" improves nutritional care and body mass index2008Inngår i: Clinical nutrition supplements, Volume 3, Supplement 1, 2008, page 61: 30th ESPEN Congress, 13-16 sept, 2008. Florence, Italy, 2008, s. 61-Konferansepaper (Fagfellevurdert)
    Abstract [en]

    The staffs’ knowledge, experiences and motivation are likely to be important and so is an adaptation to each unit’s context to achieve positive changes in nutritional practice. How do study circles (SCs) and policy documents (PD) affect nutritional interventions for persons with moderate or high risk for undernutrition (UN-risk) in special accommodations (SAs)?

     

    All SAs within six municipalities were involved. UN-risk was defined as the occurrence of at least two of; involuntary weight loss, Body Mass Index below limit (<20 if /=70 yrs) and/or presence of eating difficulties. In year 2005 and 2007 it was 361 (27%) out of 1337 and 322 (35%) out of 920 persons respectively that were at UN-risk and included in this study. Interventions: In 18 of the departments 39 SCs were implemented, involving 8 staff each, in total 315 persons. Each group met for 3 occasions (3 hours each time) to discuss eating and nutrition based on a manual (www.vardalinstitutet.net/scn). The SCs did not focus on the above definition of UN-risk. In four other SAs a PD was politically anchored. No intervention was implemented in the other SAs.

     

    SCs and PD increased the precision in provided nutritional actions significantly for persons at UN-risk.

     

    The precision (percent) in the provision of nutritional actions.

    Intervention

    Year 2005

    Year 2007

    P-value

    No intervention

    n=229, 86 y

    n=202, 87 y

     

      E-food

    10

    11

    .875

      Food supplement

    31

    29

    .751

      Eating assistance

    65

    67

    .611

     

     

     

     

    Study circles

    n=92, 87 y

    n=82, 87 y

     

      E-food

    16

    32

    .012 *

      Food supplement

    24

    39

    .045 *

      Eating assistance

    67

    69

    .870

     

     

     

     

    Policy document

    n=40, 86 y

    n=38, 85 y

     

      E-food

    5

    24

    .023 *

      Food supplement

    52

    53

    .999

      Eating assistance

    72

    68

    .805

    y = mean age in years, * = significant increase in provision (p<0.05), E-food = Energy Enriched

     

    Both study circles and policy documents improves the precision in the provision of correct nutritional actions for those at moderate or high risk for undernutrition. It is likely that a combination of study circles and policy documents can improve the precision of provision of nutritional actions even more.

  • 167.
    Westergren, Albert
    et al.
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Petersson, Karin
    Lindholm, Christina
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Axelsson, Carolina
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Ulander, Kerstin
    Högskolan Kristianstad, Sektionen för Hälsa och Samhälle.
    Overweight and risk for undernutrition among persons within special accommodations and hospital care – Year 2005 and 20072008Inngår i: Clinical nutrition supplements, Volume 3, Supplement 1, 2008, page 160-161.: 30th ESPEN Congress, 13-16 sept, 2008. Florence, Italy, 2008, s. 160-161Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Rationale: Both undernutrition and overweight have major impacts on morbidity and mortality and are thus important to prevent. This study explores the prevalence of undernutrition and overweight among persons in special accommodations (SAs) and hospital care in the year of 2005 and 2007. Methods: Six hospitals and all of the SAs within six municipalities were involved. In the year of 2005, 2600 (88%) out of 2945 persons agreed to participate in the study, and in 2007 there were 2255 (81%) out of 2784 persons participating. Risk for undernutrition was defined as the occurrence of at least two of the following; involuntary weight loss, Body Mass Index (BMI) below limit (<20 if /=70 yrs) and/or presence of eating difficulties. Overweight was defined based on BMI (if /=25: if >/=70 yrs: BMI >/=27)[1]. Nursing students, clinical tutors and staff collected the data. Results: The mean age and the risk for undernutrition increased significantly in SAs between the two years. The prevalence of overweight increased with three percent in hospitals as well as in SAs although this increase was not statistically significant. Table:

    Percent of persons at risk for undernutrition and with overweight

     

    SAs2005 (n=1726)

    SAs2007 (n=1526)

    P-value

    Hospitals2005 (n=874)

    Hospitals2007 (n=728)

    P-value

     

    Agemean (SD)

    85 (8)

    86 (8)

    <0.001

    69 (18)

    69 (16)

    0.987

    At risk forundernutrition

    27

    35

    <0.001

    27

    28

    0.947

    Overweight

    30

    33

    0.089

    39

    42

    0.182

     

    SAs = Special Accommodations

    Conclusion: The society in general and health care professionals in specific needs to consider not only prevention for persons at risk for undernutrition, but also the prevention for persons becoming overweight. Reference(s) Only 3 Lines maximum: 1. Westergren A, Lindholm C, Axelsson C & Ulander K. Prevalence of eating difficulties and malnutrition among persons within hospital care and special accommodations. The Journal of Nutrition Health and Aging 2008, Vol 12, Number 1, Page 39-43.

  • 168.
    Westergren, Albert
    et al.
    Högskolan Kristianstad, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna.
    Stuhr Olsson, Gunnel
    Findus Sverige AB.
    Kost och näring borde ta en större del av diskussionen om äldres livskvalitet2017Inngår i: Landskronaposten, ISSN 2001-7162, nr 12 oktober, s. A3-Artikkel i tidsskrift (Annet (populærvitenskap, debatt, mm))
    Abstract [sv]

    Fokus på motion och läkemedel är givetvis bra för att förebygga fallolyckor bland äldre. Tyvärr har kost- och näringsaspekten fallit bort ur diskussionen. Det skriver Albert Westergren, professor vid Högskolan Kristianstad och Gunnel Stuhr Olsson, Findus Sverige AB.

  • 169.
    Westergren, Albert
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap I. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
    Torfadóttir, Ólina
    Akureyri University Hospital.
    Hagell, Peter
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap I. Högskolan Kristianstad, Forskningsmiljön PRO-CARE. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
    Malnutrition and nutritional care in an Icelandic teaching hospital2014Inngår i: Research, ISSN 2334-1009, nr 1, s. 1270-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: About 30% of hospital inpatients are at undernutrition (UN) risk and it is important that sufficient nutritional treatment and care is provided in order to avoid a decline in health. Aim: To explore the prevalence of UN risk, the associations between UN-risk and other factors, and describe the nutritional treatment/care towards those at UN-risk at an Icelandic teaching hospital. An additional aim was to evaluate the user friendliness of a nutritional screening tool. Methods: Inpatients (n=56; median age 69 years; 29 women) were assessed by eight nurses using the Minimal Eating Observation and Nutrition form – version II (MEONF-II), a recently developed nursing nutritional screening tool. Results: In total 23% (n=13) were at moderate/high UN-risk. The prevalence of overweight/obesity was 57%. Among patients at UN-risk, 61% received energy dense food, oral nutritional supplements, and/or artificial nutrition; this figure was 35% among those at no/low risk. MEONF-II total scores correlated with dependency in activities of daily living (rs, 0.350), and UN-risk categories correlated with tiredness (rs, 0.426). The MEONF-II was regarded as easy to use and relevant. Conclusion: There is a need for interventions connecting the nutritional screening with individualised nutritional treatment and care in order to narrow the gap between screening and intervention. The Icelandic version of the MEONF-II is perceived as user-friendly.

  • 170.
    Westergren, Albert
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
    Torfadóttir, Ólina
    Akureyri Hospital, Iceland.
    Ulander, Kerstin
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Axelsson, Carolina
    Högskolan Kristianstad, Sektionen för lärande och miljö, Avdelningen för Naturvetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
    Lindholm, Christina
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Malnutrition prevalence and precision in nutritional care: an intervention study in one teaching hospital in Iceland2010Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, nr 13-14, s. 1830-1837Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim. The aim of this study was to explore the point prevalence of malnutrition and the targeting of nutritional interventions in relation to undernutrition risk before and after an intervention. Background. Malnutrition risk and the precision in targeting nutritional treatment are indicators of quality of care. Knowledge regarding the in-hospital prevalence of malnutrition and nutritional treatment is meagre for Iceland. Design. Pre- and postintervention study. Methods. The study was performed during one day in 2006 (March) and one day in 2007 (April). In total, 95 (89%) and 92 (88%) patients agreed to participate. Moderate/high undernutrition risk was defined as the occurrence of at least two of the following: involuntary weight loss, body mass index below limit and eating difficulties according to Minimal Eating Observation Form - Version II. Being overweight was graded based on body mass index. Specific nutritional care actions were recorded. Intervention: A five-point programme for nutrition and eating was implemented. Results. Moderate/high risk for undernutrition was found in 25 and 17% in the two years (ns, not significant). A high body mass index was found in 53 and 54% (ns). The number of patients with a documented body mass index significantly increased between the two surveys (1 and 30%, p-value < 0 center dot 0005). The use of oral supplements increased from 11-40% (p < 0 center dot 0005) and especially among those at no/low undernutrition risk, with ingestion or deglutition difficulties (p < 0 center dot 0005 in both cases) but not among those with appetite and energy problems (ns). Conclusion. Implementing a nutritional programme does not necessarily affect the number of in-patients with malnutrition, but it is likely to increase the precision of nutritional care to some extent. Relevance to clinical practice. Greater efforts need to be taken to increase the precision of nutritional care among patients at moderate/high undernutrition risk and among those with appetite and energy problems.

  • 171.
    Williams, Lauren
    et al.
    University of Newcastle, Callaghan, NSW.
    Germov, John
    University of Newcastle, Callaghan, NSW.
    Freij, Maria
    University of Newcastle, Callaghan, NSW.
    Is the Slow Food movement driven by environmental sustainability, health concerns or conviviality?2010Inngår i: Nutrition & Dietetics, ISSN 1747-0080, Vol. 67, nr Suppl. 1, s. 18-19Artikkel i tidsskrift (Fagfellevurdert)
1234 151 - 171 of 171
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