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Adherence of pregnant women to Nordic dietary guidelines in relation to postpartum weight retention: results from the Norwegian Mother and Child Cohort Study.

https://arctichealth.org/en/permalink/ahliterature256846
Source
BMC Public Health. 2014;14:75
Publication Type
Article
Date
2014
Author
Anne von Ruesten
Anne Lise Brantsæter
Margaretha Haugen
Helle Margrete Meltzer
Kirsten Mehlig
Anna Winkvist
Lauren Lissner
Author Affiliation
Division of Environmental Medicine, Norwegian Institute of Public Health, Oslo, Norway. Anne.Lise.Brantsaeter@fhi.no.
Source
BMC Public Health. 2014;14:75
Date
2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Body Weight
Diet Surveys
Diet, Reducing - psychology
Female
Humans
Norway - epidemiology
Nutrition Policy
Patient Compliance - statistics & numerical data
Postpartum Period - psychology
Pregnancy
Weight Gain
Young Adult
Abstract
Pregnancy is a major life event for women and often connected with changes in diet and lifestyle and natural gestational weight gain. However, excessive weight gain during pregnancy may lead to postpartum weight retention and add to the burden of increasing obesity prevalence. Therefore, it is of interest to examine whether adherence to nutrient recommendations or food-based guidelines is associated with postpartum weight retention 6 months after birth.
This analysis is based on data from the Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health. Diet during the first 4-5 months of pregnancy was assessed by a food-frequency questionnaire and maternal weight before pregnancy as well as in the postpartum period was assessed by questionnaires. Two Healthy Eating Index (HEI) scores were applied to measure compliance with either the official Norwegian food-based guidelines (HEI-NFG) or the Nordic Nutrition Recommendations (HEI-NNR) during pregnancy. The considered outcome, i.e. weight retention 6 months after birth, was modelled in two ways: continuously (in kg) and categorically (risk of substantial postpartum weight retention, i.e. =?5% gain to pre-pregnancy weight). Associations between the HEI-NFG and HEI-NNR score with postpartum weight retention on the continuous scale were estimated by linear regression models. Relationships of both HEI scores with the categorical outcome variable were evaluated using logistic regression.
In the continuous model without adjustment for gestational weight gain (GWG), the HEI-NFG score but not the HEI-NNR score was inversely related to postpartum weight retention. However, after additional adjustment for GWG as potential intermediate the HEI-NFG score was marginally inversely and the HEI-NNR score was inversely associated with postpartum weight retention. In the categorical model, both HEI scores were inversely related with risk of substantial postpartum weight retention, independent of adjustment for GWG.
Higher adherence to either the official Norwegian food guidelines or possibly also to Nordic Nutrition Recommendations during pregnancy appears to be associated with lower postpartum weight retention.
Notes
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PubMed ID
24456804 View in PubMed
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An incident case-referent study on plasma enterolactone and breast cancer risk.

https://arctichealth.org/en/permalink/ahliterature18873
Source
Eur J Nutr. 2002 Aug;41(4):168-76
Publication Type
Article
Date
Aug-2002
Author
Kerstin Hultén
Anna Winkvist
Per Lenner
Robert Johansson
Herman Adlercreutz
Göran Hallmans
Author Affiliation
Epidemiology Department of Public Health and Clinical Medicine, Umeå University, Sweden. kerstin.hulten@epiph.umu.se
Source
Eur J Nutr. 2002 Aug;41(4):168-76
Date
Aug-2002
Language
English
Publication Type
Article
Keywords
4-Butyrolactone - analogs & derivatives - blood
Aging
Breast Neoplasms - epidemiology - prevention & control
Cohort Studies
Dietary Fiber - administration & dosage
Female
Humans
Lignans - blood
Questionnaires
Reference Values
Research Support, Non-U.S. Gov't
Risk factors
Abstract
OBJECTIVE: Using a nested case-referent design, we evaluated the relationship between plasma levels of the lignan enterolactone and the risk of developing breast cancer. METHODS: 248 cases and 492 referents were selected from three population-based cohorts in northern Sweden. Blood samples were donated at enrollment. All blood samples were stored at -80 degrees C. Cases and referents were matched for age, date of blood sample and sampling centre. Breast cancer cases were identified through the regional and national cancer registries. RESULTS: Plasma enterolactone was lower among smokers in all cohorts and in subjects with BMI 28 in one of the cohorts. Low plasma concentrations of enterolactone, below the 12.5(th) percentile (mean plasma enterolactone 2.9 nmol/l), were associated with an increased risk of breast cancer. Also, high values of plasma enterolactone, above the 87.5(th) percentile (mean plasma enterolactone 58.2 nmol/l) were significantly associated with an increased breast cancer risk among women from two cohorts with only incident cases and a higher number of pre-menopausal women. High plasma enterolactone concentrations among older women from a mammary screening project with mostly prevalent cases were associated with a non-significant slightly reduced breast cancer risk. CONCLUSION: Very low plasma concentrations of enterolactone were associated with an increased breast cancer risk in all three cohorts. In two of the cohorts, with only incident cases, very high plasma concentrations were also associated with an increased breast cancer risk. In the third cohort with mainly screen-detected cases from a mammary screening program, high plasma enterolactone concentrations were associated with a weak decreased breast cancer risk.
PubMed ID
12242585 View in PubMed
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Associations among 25-year trends in diet, cholesterol and BMI from 140,000 observations in men and women in Northern Sweden.

https://arctichealth.org/en/permalink/ahliterature123566
Source
Nutr J. 2012;11:40
Publication Type
Article
Date
2012
Author
Ingegerd Johansson
Lena Maria Nilsson
Birgitta Stegmayr
Kurt Boman
Göran Hallmans
Anna Winkvist
Author Affiliation
Department of Odontology, Umeå University, 901 87, Umeå, Sweden. ingegerd.johansson@odont.umu.se
Source
Nutr J. 2012;11:40
Date
2012
Language
English
Publication Type
Article
Keywords
Adult
Alcohol Drinking - adverse effects - trends
Body mass index
Cholesterol - blood
Cohort Studies
Cross-Sectional Studies
Diet Surveys
Diet, Carbohydrate-Restricted - adverse effects
Diet, High-Fat - adverse effects
Diet, Reducing - adverse effects - trends
Female
Follow-Up Studies
Health promotion
Humans
Male
Mass Media - trends
Middle Aged
Patient Compliance - ethnology
Sex Characteristics
Sweden
Weight Gain
Abstract
In the 1970s, men in northern Sweden had among the highest prevalences of cardiovascular diseases (CVD) worldwide. An intervention program combining population- and individual-oriented activities was initiated in 1985. Concurrently, collection of information on medical risk factors, lifestyle and anthropometry started. Today, these data make up one of the largest databases in the world on diet intake in a population-based sample, both in terms of sample size and follow-up period. The study examines trends in food and nutrient intake, serum cholesterol and body mass index (BMI) from 1986 to 2010 in northern Sweden.
Cross-sectional information on self-reported food and nutrient intake and measured body weight, height, and serum cholesterol were compiled for over 140,000 observations. Trends and trend breaks over the 25-year period were evaluated for energy-providing nutrients, foods contributing to fat intake, serum cholesterol and BMI.
Reported intake of fat exhibited two significant trend breaks in both sexes: a decrease between 1986 and 1992 and an increase from 2002 (women) or 2004 (men). A reverse trend was noted for carbohydrates, whereas protein intake remained unchanged during the 25-year period. Significant trend breaks in intake of foods contributing to total fat intake were seen. Reported intake of wine increased sharply for both sexes (more so for women) and export beer increased for men. BMI increased continuously for both sexes, whereas serum cholesterol levels decreased during 1986 - 2004, remained unchanged until 2007 and then began to rise. The increase in serum cholesterol coincided with the increase in fat intake, especially with intake of saturated fat and fats for spreading on bread and cooking.
Men and women in northern Sweden decreased their reported fat intake in the first 7 years (1986-1992) of an intervention program. After 2004 fat intake increased sharply for both genders, which coincided with introduction of a positive media support for low carbohydrate-high-fat (LCHF) diet. The decrease and following increase in cholesterol levels occurred simultaneously with the time trends in food selection, whereas a constant increase in BMI remained unaltered. These changes in risk factors may have important effects on primary and secondary prevention of cardiovascular disease (CVD).
Notes
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PubMed ID
22686621 View in PubMed
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Associations of pre-pregnancy body mass index and gestational weight gain with pregnancy outcome and postpartum weight retention: a prospective observational cohort study.

https://arctichealth.org/en/permalink/ahliterature260815
Source
BMC Pregnancy Childbirth. 2014;14:201
Publication Type
Article
Date
2014
Author
Margaretha Haugen
Anne Lise Brantsæter
Anna Winkvist
Lauren Lissner
Jan Alexander
Bente Oftedal
Per Magnus
Helle Margrete Meltzer
Source
BMC Pregnancy Childbirth. 2014;14:201
Date
2014
Language
English
Publication Type
Article
Keywords
Adult
Birth weight
Body mass index
Cesarean Section - statistics & numerical data
Emergencies
Female
Guidelines as Topic
Humans
Infant, Low Birth Weight
Infant, Newborn
Infant, Small for Gestational Age
Institute of Medicine (U.S.)
Live Birth - epidemiology
Norway - epidemiology
Obesity - epidemiology
Parity
Pre-Eclampsia - epidemiology
Pregnancy
Prospective Studies
Thinness - epidemiology
United States
Weight Gain
Young Adult
Abstract
Excessive gestational weight gain (GWG) is associated with pregnancy complications, and Norwegian Health Authorities have adopted the GWG recommendations of the US Institute of Medicine and National Research Council (IOM). The aim of this study was to evaluate if a GWG outside the IOM recommendation in a Norwegian population is associated with increased risk of pregnancy complications like hypertension, low and high birth weight, preeclampsia, emergency caesarean delivery, and maternal post-partum weight retention (PPWR) at 6 and 18 months.
This study was performed in 56 101 pregnant women included in the prospective national Norwegian Mother and Child Cohort Study (MoBa) in the years 1999 to 2008. Women who delivered a singleton live born child during gestational week 37 to 42 were included. Maternal prepregnant and postpartum weight was collected from questionnaires at 17th week of gestation and 6 and 18 months postpartum.
A weight gain less than the IOM recommendations (GWG??IOM rec.) significantly increased the risk of pregnancy hypertension, a high birth weight baby, preeclampsia and emergency cesarean delivery in both nulliparous and parous normal weight women. Similar results were found for overweight women except for no increased risk for gestational hypertension in parous women with GWG?>?IOM rec. Seventy-four percent of the overweight nulliparous women and 66% of the obese women had a GWG?>?IOM rec. A GWG?>?IOM rec. resulted in increased risk of PPWR?>?2 kg in all weight classes, but most women attained their prepregnant weight class by 18 months post-partum.
For prepregnant normal weight and overweight women a GWG?>?IOM rec. increased the risk for unfavorable birth outcomes in both nulliparous and parous women. A GWG?>?IOM rec. increased the risk of a PPWR?>?2 kg at 18 months in all weight classes. This large study supports the Norwegian Health authorities' recommendations for normal weight and overweight women to comply with the IOM rec.
Notes
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PubMed ID
24917037 View in PubMed
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Breast-feeding in relation to weight retention up to 36 months postpartum in the Norwegian Mother and Child Cohort Study: modification by socio-economic status?

https://arctichealth.org/en/permalink/ahliterature259545
Source
Public Health Nutr. 2014 Jul;17(7):1514-23
Publication Type
Article
Date
Jul-2014
Author
Martin Brandhagen
Lauren Lissner
Anne Lise Brantsaeter
Helle Margrete Meltzer
Anna-Pia Häggkvist
Margaretha Haugen
Anna Winkvist
Source
Public Health Nutr. 2014 Jul;17(7):1514-23
Date
Jul-2014
Language
English
Publication Type
Article
Keywords
Adult
Body mass index
Breast Feeding
Child, Preschool
Cohort Studies
Female
Humans
Income
Infant
Infant, Newborn
Mothers
Norway
Obesity - prevention & control
Postpartum Period
Poverty
Pregnancy
Social Class
Weight Gain
Abstract
We investigated the association between full breast-feeding up to 6 months as well as partial breast-feeding after 6 months and maternal weight retention at 6, 18 and 36 months after delivery in the Norwegian Mother and Child Cohort Study (MoBa), conducted by the Norwegian Institute of Public Health.
Cohort study. Information on exposure and outcome was collected by questionnaire.
Norway.
Women at 6 months (n 49 676), 18 months (n 27 187) and 36 months (n 17 343) postpartum.
Longer duration of full breast-feeding as well as partial breast-feeding was significantly related to lower weight retention at 6 months. At 18 months full breast-feeding (0-6 months) and partial breast-feeding for 12-18 months were significantly related to lower weight retention. At 36 months only full breast-feeding (0-6 months) was significantly related to lower weight retention. For each additional month of full breast-feeding, maternal weight was lowered by 0·50 kg/month at 6 months, 0·10 kg/month at 18 months and 0·14 kg/month at 36 months (adjusted for pre-pregnant BMI, pregnancy weight gain, age and parity). Partial breast-feeding resulted in 0·25 kg/month lower maternal weight at 6 months. Interactions were found between household income and full breast-feeding in relation to weight retention at 6, 18 and 36 months, indicating most benefit among women with low income.
The present study supports the hypothesis that full breast-feeding contributes to lower postpartum weight retention and shows that the effect is maintained for as long as 3 years postpartum.
PubMed ID
23915637 View in PubMed
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Changes in Dietary Fat Intake and Projections for Coronary Heart Disease Mortality in Sweden: A Simulation Study.

https://arctichealth.org/en/permalink/ahliterature285263
Source
PLoS One. 2016;11(8):e0160474
Publication Type
Article
Date
2016
Author
Lena Björck
Annika Rosengren
Anna Winkvist
Simon Capewell
Martin Adiels
Piotr Bandosz
Julia Critchley
Kurt Boman
Maria Guzman-Castillo
Martin O'Flaherty
Ingegerd Johansson
Source
PLoS One. 2016;11(8):e0160474
Date
2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cholesterol - blood
Coronary Disease - epidemiology - mortality - prevention & control
Dietary Fats - metabolism
Fatty Acids - metabolism
Feeding Behavior
Female
Humans
Life Style
Male
Middle Aged
Models, Theoretical
Mortality - trends
Risk factors
Smoking
Sodium Chloride, Dietary - metabolism
Sweden - epidemiology
Abstract
In Sweden, previous favourable trends in blood cholesterol levels have recently levelled off or even increased in some age groups since 2003, potentially reflecting changing fashions and attitudes towards dietary saturated fatty acids (SFA). We aimed to examine the potential effect of different SFA intake on future coronary heart disease (CHD) mortality in 2025.
We compared the effect on future CHD mortality of two different scenarios for fat intake a) daily SFA intake decreasing to 10 energy percent (E%), and b) daily SFA intake rising to 20 E%. We assumed that there would be moderate improvements in smoking (5%), salt intake (1g/day) and physical inactivity (5% decrease) to continue recent, positive trends.
In the baseline scenario which assumed that recent mortality declines continue, approximately 5,975 CHD deaths might occur in year 2025. Anticipated improvements in smoking, dietary salt intake and physical activity, would result in some 380 (-6.4%) fewer deaths (235 in men and 145 in women). In combination with a mean SFA daily intake of 10 E%, a total of 810 (-14%) fewer deaths would occur in 2025 (535 in men and 275 in women). If the overall consumption of SFA rose to 20 E%, the expected mortality decline would be wiped out and approximately 20 (0.3%) additional deaths might occur.
CHD mortality may increase as a result of unfavourable trends in diets rich in saturated fats resulting in increases in blood cholesterol levels. These could cancel out the favourable trends in salt intake, smoking and physical activity.
Notes
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PubMed ID
27490257 View in PubMed
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Changes in food choice during a successful weight loss trial in overweight and obese postpartum women.

https://arctichealth.org/en/permalink/ahliterature264667
Source
Obesity (Silver Spring). 2014 Dec;22(12):2517-23
Publication Type
Article
Date
Dec-2014
Author
Ena Huseinovic
Anna Winkvist
Fredrik Bertz
Hilde Kristin Brekke
Source
Obesity (Silver Spring). 2014 Dec;22(12):2517-23
Date
Dec-2014
Language
English
Publication Type
Article
Keywords
Adult
Diet Records
Diet Therapy
Exercise - physiology - psychology
Female
Follow-Up Studies
Food Habits
Food Preferences - physiology - psychology
Humans
Lactation - physiology - psychology
Linear Models
Obesity - physiopathology - psychology - therapy
Overweight - physiopathology - psychology - therapy
Postpartum Period - physiology - psychology
Sweden
Treatment Outcome
Weight Loss - physiology
Weight Reduction Programs
Abstract
To examine changes in intake across food groups during a weight loss trial that produced significant and sustainable weight loss in lactating women receiving dietary treatment.
At 10-14 wk postpartum, 61 overweight and obese lactating Swedish women were randomized to a 12-wk dietary (D), exercise (E), combined (DE), or control (C) treatment. Food intake was assessed by 4-d weighed diet records which were used to examine changes in intake across seven food groups from baseline to 12 wk and 1 y after randomization. Differences in changes in food choice between women receiving dietary treatment (D+DE) and no dietary treatment (E+C) were examined using multivariate linear regression.
At baseline, sweets and salty snacks contributed to 21±10 percent of total energy intake (E%). During the intervention period, women receiving dietary treatment reduced their E% from sweets and salty snacks and caloric drinks and increased their E% from vegetables more than did women not receiving dietary treatment (all P?
PubMed ID
25234605 View in PubMed
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Cost-effectiveness and quality of life of a diet intervention postpartum: 2-year results from a randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature298420
Source
BMC Public Health. 2019 Jan 08; 19(1):38
Publication Type
Journal Article
Randomized Controlled Trial
Date
Jan-08-2019
Author
Lars Hagberg
Anna Winkvist
Hilde K Brekke
Fredrik Bertz
Else Hellebö Johansson
Ena Huseinovic
Author Affiliation
Centre for Health Care Science, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Source
BMC Public Health. 2019 Jan 08; 19(1):38
Date
Jan-08-2019
Language
English
Publication Type
Journal Article
Randomized Controlled Trial
Keywords
Adult
Cost-Benefit Analysis
Female
Follow-Up Studies
Humans
Obesity - diet therapy
Postpartum Period
Primary Health Care
Program Evaluation
Quality of Life
Quality-Adjusted Life Years
Sweden
Treatment Outcome
Weight Reduction Programs - economics
Abstract
Pregnancy has been identified as a contributor to obesity. We have shown that a diet intervention postpartum produced a 2-y weight loss of 8%. Here, we present the impact of the diet intervention on cost-effectiveness and explore changes in quality of life (QOL).
A total of 110 postpartum women with overweight/obesity were randomly assigned to diet (D-group) or control (C-group). D-group received a 12-wk diet intervention within primary health care followed by monthly emails up to the 1-y follow-up. C-group received a brochure. Changes in QOL were measured using the 36-item Short Form Health Survey and EQ-5D. The analysis of cost-effectiveness was a cost-utility analysis with a health care perspective and included costs of intervention for stakeholder, quality-adjusted life-years (QALYs) gained and savings in health care. The likelihood of cost-effectiveness was examined using the net monetary benefit method.
The D-group increased their QOL more than the C-group at 12 wk. and 1 y, with pronounced differences for the dimensions general health and mental health, and the mental component summary score (all p?
PubMed ID
30621673 View in PubMed
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Cost-utility analysis of a randomized controlled weight loss trial among lactating overweight/obese women.

https://arctichealth.org/en/permalink/ahliterature265831
Source
BMC Public Health. 2014;14:38
Publication Type
Article
Date
2014
Author
Lars A Hagberg
Hilde K Brekke
Fredrik Bertz
Anna Winkvist
Source
BMC Public Health. 2014;14:38
Date
2014
Language
English
Publication Type
Article
Keywords
Adult
Cost-Benefit Analysis
Female
Humans
Lactation - physiology
Obesity - diet therapy
Postpartum Period
Quality of Life
Quality-Adjusted Life Years
Sweden
Weight Reduction Programs - economics - methods
Abstract
Overweight and obesity among young, adult women are increasing problems in Sweden as in many other countries. The postpartum period may be a good opportunity to improve eating habits and lose weight in a sustainable manner. The aim was to make a cost-utility analysis of a dietary behavior modification treatment alongside usual care, compared to usual care alone, among lactating overweight and obese women.
This study was a cost-utility analysis based on a randomized controlled and longitudinal clinical diet intervention. Between 2007-2010, 68 women living in Sweden were, after baseline measurement at 8-12 weeks postpartum, randomly assigned to a 12-week dietary behavior modification treatment or control group. Inclusion criteria were: self-reported pre-pregnancy body mass index (BMI) 25-35 kg/m2, non-smoker, singleton term delivery, birth weight?>?2500 g, intention to breastfeed for 6 mo and no diseases (mother and child). The women in the intervention group received 1.5 hour of individual counseling at study start and 1 hour at follow-up home visits after 6 weeks of intervention, with support through cell phone text messages every two wk. Dietary intervention aimed to reduce dietary intake by 500 kcal/day. The control group received usual care. Weight results have previously been reported. Here we report on analyses carried out during 2012-2013 of cost per quality adjusted life years (QALY), based on the changes in quality of life measured by EQ-5D-3 L and SF-6D. Likelihood of cost-effectiveness was calculated using Net Monetary Benefit method.
Based on conservative assumptions of no remaining effect after 1 year follow-up, the diet intervention was cost-effective. Costs per gained QALY were 8 643 - 9 758 USD. The likelihood for cost-effectiveness, considering a willingness to pay 50 000 USD for a QALY, was 87-93%.
The diet intervention is cost-effective.
ClinicalTrials.gov Identifier: NCT01343238 Registered April 27, 2011.The regional ethics committee in Gothenburg, Sweden, approved the study on November 15, 2006.
Notes
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PubMed ID
24428802 View in PubMed
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Dairy Product Intake and Cardiometabolic Diseases in Northern Sweden: A 33-Year Prospective Cohort Study.

https://arctichealth.org/en/permalink/ahliterature299093
Source
Nutrients. 2019 Jan 28; 11(2):
Publication Type
Journal Article
Date
Jan-28-2019
Author
Ingegerd Johansson
Anders Esberg
Lena M Nilsson
Jan-Håkan Jansson
Patrik Wennberg
Anna Winkvist
Author Affiliation
Department of Odontology, Umeå University, 90187 Umeå, Sweden. ingegerd.johansson@umu.se.
Source
Nutrients. 2019 Jan 28; 11(2):
Date
Jan-28-2019
Language
English
Publication Type
Journal Article
Keywords
Adult
Aged
Cohort Studies
Dairy Products
Diabetes Mellitus, Type 2 - epidemiology - etiology
Diet
Female
Humans
Male
Middle Aged
Myocardial Infarction - epidemiology - etiology
Prospective Studies
Stroke - epidemiology - etiology
Sweden - epidemiology
Abstract
Dairy products are important constituents of most diets, and their association with adverse health outcomes remains a focus. We characterized dairy food intake and examined associations with the incidence of type 2 diabetes (T2D), myocardial infarction (MI) or stroke among 108,065 Swedish men and women. Hazard ratios (HRs) and 95% CIs were estimated using the multivariable Cox proportional hazards models in a population characterized by high milk tolerance. During a mean follow-up of 14.2 years, 11,641 first-time events occurred. Non-fermented milk intake decreased, whereas butter intake increased over the period. For high intake of non-fermented milk, the HR (95% CI) for developing T2D and MI was 1.17 (1.03, 1.34) and 1.23 (1.10, 1.37), respectively, in men. A greater intake of butter, fermented milk, and cheese tended to be associated with a reduced risk of T2D and/or MI. Non-consumers and those who chose low-fat variants of the targeted dairy products had increased risk for T2D, MI, or stroke compared to those in the non-case group. Generally, effect-sizes were small. This prospective study found that non-fermented milk was associated with an increased risk for developing T2D and MI and that subjects abstaining from dairy products or choosing low-fat variants were at greater risk. However, the overall cardiometabolic risk of non-fermented milk intake was judged as low, since the effect sizes were small.
PubMed ID
30696081 View in PubMed
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