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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
Less detail

Adipocyte size predicts incidence of type 2 diabetes in women.

https://arctichealth.org/en/permalink/ahliterature148637
Source
FASEB J. 2010 Jan;24(1):326-31
Publication Type
Article
Date
Jan-2010
Author
Malin Lönn
Kirsten Mehlig
Calle Bengtsson
Lauren Lissner
Author Affiliation
Department of Clinical Chemistry, Sahlgrenska University Hospital, Bruna stråket 16, Gothenburg, Sweden. malin.lonn@medic.gu.se
Source
FASEB J. 2010 Jan;24(1):326-31
Date
Jan-2010
Language
English
Publication Type
Article
Keywords
Abdominal Fat - pathology - physiopathology
Adipocytes - pathology - physiology
Adult
Aged
Aged, 80 and over
Body Composition
Cell Count
Cell Size
Cohort Studies
Diabetes Mellitus, Type 2 - epidemiology - etiology - pathology - physiopathology
Female
Humans
Insulin Resistance
Middle Aged
Predictive value of tests
Prospective Studies
Risk factors
Sweden - epidemiology
Abstract
Enlarged subcutaneous abdominal adipocytes have been shown to predict incidence of type 2 diabetes (T2D) in the Pima population of Arizona (USA). We investigated the role of subcutaneous abdominal adipocyte size (AAS), as well as femoral adipocyte size (FAS), as predictors of T2D in a population-based Swedish cohort. In 1974-1975, a sample of 1302 middle-aged women underwent a health examination, including anthropometry and evaluation of parental medical history. In addition, body composition (total body potassium and total body water), AAS and FAS (adipose tissue needle biopsy) were assessed in a subsample of 245 women. Incidence of T2D was followed until 2001, with 36 cases eligible for inclusion in this analysis. Women developing T2D had larger AAS at baseline vs. women remaining healthy (age/heredity-adjusted hazard ratio for increase of AAS by 1 sd [AAS-HR] 1.91; P
PubMed ID
19741173 View in PubMed
Less detail

Age and time effects on children's lifestyle and overweight in Sweden.

https://arctichealth.org/en/permalink/ahliterature267916
Source
BMC Public Health. 2015;15:355
Publication Type
Article
Date
2015
Author
Lotta Moraeus
Lauren Lissner
Linda Olsson
Agneta Sjöberg
Source
BMC Public Health. 2015;15:355
Date
2015
Language
English
Publication Type
Article
Keywords
Age Factors
Beverages
Body mass index
Body Weight
Child
Cross-Sectional Studies
Diet
Exercise
Female
Health Behavior
Humans
Life Style
Male
Obesity - epidemiology
Overweight - epidemiology
Prevalence
Questionnaires
Sedentary lifestyle
Socioeconomic Factors
Sweden - epidemiology
Abstract
High physical activity, low sedentary behavior and low consumption of sugar-sweetened beverages can be markers of a healthy lifestyle. We aim to observe longitudinal changes and secular trends in these lifestyle variables as well as in the prevalence of overweight and obesity in 7-to-9-year-old schoolchildren related to gender and socioeconomic position.
Three cross-sectional surveys were carried out on schoolchildren in grades 1 and 2 (7-to-9-year-olds) in 2008 (n = 833), 2010 (n = 1085), and 2013 (n = 1135). Information on children's level of physical activity, sedentary behavior, diet, and parent's education level was collected through parental questionnaires. Children's height and weight were also measured. Longitudinal measurements were carried out on a subsample (n = 678) which was included both in 2008 (7-to-9-year-olds) and 2010 (9-to-11-year-olds). BMI was used to classify children into overweight (including obese) and obese based on the International Obesity Task Force reference. Questionnaire reported maternal education level was used as a proxy for socioeconomic position (SEP).
Longitudinally, consumption of sugar-sweetened beverages = 4 days/week increased from 7% to 16% in children with low SEP. Overall, sedentary behavior > 4 hours/day doubled from 14% to 31% (p
Notes
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PubMed ID
25884997 View in PubMed
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Alcohol intake among women and its relationship to diabetes incidence and all-cause mortality: the 32-year follow-up of a population study of women in Gothenburg, Sweden.

https://arctichealth.org/en/permalink/ahliterature9133
Source
Diabetes Care. 2005 Sep;28(9):2230-5
Publication Type
Article
Date
Sep-2005
Author
Leif Lapidus
Calle Bengtsson
Elisabet Bergfors
Cecilia Björkelund
Fredrik Spak
Lauren Lissner
Author Affiliation
Department of Primary Health Care, Sahlgrenska Uni, Göteborg University, Box 454 S-405 30 Göteborg, Sweden. leif.lapidus@swipnet.se
Source
Diabetes Care. 2005 Sep;28(9):2230-5
Date
Sep-2005
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Alcohol Drinking
Body mass index
Cause of Death
Diabetes Mellitus - epidemiology - mortality
Female
Humans
Incidence
Longitudinal Studies
Physical Fitness
Research Support, Non-U.S. Gov't
Risk factors
Smoking
Sweden
Abstract
OBJECTIVE: The purpose of the study was to explore the predictive value of women's alcohol habits in relation to incidence of diabetes and all-cause mortality. Special attention was paid to potential confounding factors such as age, heredity, education, socioeconomic group, physical inactivity, smoking, blood pressure, serum lipids, and, in particular, obesity. RESEARCH DESIGN AND METHODS: A longitudinal population study consisting of a representative sample of 1,462 women aged 38-60 started in Göteborg, Sweden, in 1968-1969 monitoring for diabetes and mortality over 32 years. RESULTS: Alcohol intake, expressed as intake of wine, hard liquor, or total grams of alcohol, was significantly negatively associated to 32-year diabetes incidence independent of age. However, the apparently protective effect of the alcohol variables was attenuated when BMI was included as a covariate. The inverse relationship between wine intake and diabetes did not remain after adjustment for physical activity or socioeconomic group. Beer and wine intake were significantly negatively associated to mortality. Increase of alcohol intake between the examination in 1968-1969 and 1980-1981 was significantly inversely related to the mortality between 1980-1981 and 2000-2001 and independent of all covariates. No relationship was observed between an increase in alcohol intake and diabetes incidence. However, after adjustment for age, family history, and basal alcohol consumption altogether, a significant inverse relationship was observed between increase of alcohol and diabetes incidence. CONCLUSIONS: The initially significant inverse associations observed between alcohol and diabetes as well as mortality were dependent on a number of confounding factors, of which BMI seems to be the most important.
PubMed ID
16123495 View in PubMed
Less detail

Assessment of selection bias in a health survey of children and families - the IDEFICS Sweden-study.

https://arctichealth.org/en/permalink/ahliterature264169
Source
BMC Public Health. 2013;13:418
Publication Type
Article
Date
2013
Author
Susann Regber
Masuma Novak
Gabriele Eiben
Lauren Lissner
Sabrina Hense
Tatiana Zverkova Sandström
Wolfgang Ahrens
Staffan Mårild
Source
BMC Public Health. 2013;13:418
Date
2013
Language
English
Publication Type
Article
Keywords
Adult
Child
Child Welfare
Child, Preschool
Cross-Sectional Studies
Family
Female
Health Surveys
Humans
Male
Pediatric Obesity - epidemiology - etiology - prevention & control
Pregnancy
Registries - statistics & numerical data
Selection Bias
Smoking - adverse effects
Sweden - epidemiology
Abstract
A health survey was performed in 2007-2008 in the IDEFICS/Sweden study (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) in children aged 2-9 years. We hypothesized that families with disadvantageous socioeconomic and -demographic backgrounds and children with overweight and obesity were underrepresented.
In a cross-sectional study, we compared Swedish IDEFICS participants (N=1,825) with referent children (N=1,825) using data from Statistics Sweden population registers. IDEFICS participants were matched for age and gender with a referent child living in the same municipality. Longitudinal weight and height data from birth to 8 years was collected for both populations (n=3,650) from the children's local health services. Outcome measures included the family's socioeconomic and demographic characteristics, maternal body mass index (BMI) and smoking habits before pregnancy, the children's BMI standard deviation score (SDS) at the age of inclusion in the IDEFICS study (BMISDS-index), and the children's BMI-categories during the age-span. Comparisons between groups were done and a multiple logistic regression analysis for the study of determinants of participation in the IDEFICS study was performed.
Compared with IDEFICS participants, referent families were more likely to have lower education and income, foreign backgrounds, be single parents, and have mothers who smoked before pregnancy. Maternal BMI before pregnancy and child's BMISDS-index did not differ between groups. Comparing the longitudinal data-set, the prevalence of obesity was significantly different at age 8 years n= 45 (4.5%) versus n= 31 (2.9%) in the referent and IDEFICS populations, respectively. In the multivariable adjusted model, the strongest significant association with IDEFICS study participation was parental Swedish background (odds ratio (OR) = 1.91, 95% confidence interval (CI) (1.48-2.47) followed by parents having high education OR 1.80, 95% CI (1.02-3.16) and being married or co-habiting OR 1.75 95% CI (1.38-2.23).
Families with single parenthood, foreign background, low education and income were underrepresented in the IDEFICS Sweden study. BMI at inclusion had no selection effect, but developing obesity was significantly greater among referents.
Notes
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PubMed ID
23634972 View in PubMed
Less detail

Association between periodontal disease and ischemic heart disease among Swedish women: a cross-sectional study.

https://arctichealth.org/en/permalink/ahliterature151946
Source
Acta Odontol Scand. 2009;67(4):193-9
Publication Type
Article
Date
2009
Author
Ulrika Stenman
Anette Wennström
Margareta Ahlqwist
Calle Bengtsson
Cecilia Björkelund
Lauren Lissner
Magnus Hakeberg
Author Affiliation
Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Ulrika.Stenman@vgregion.se
Source
Acta Odontol Scand. 2009;67(4):193-9
Date
2009
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Angina Pectoris - epidemiology
Body mass index
Cholesterol - blood
Chronic Periodontitis - epidemiology
Cross-Sectional Studies
Female
Gingival Pocket - epidemiology
Humans
Hypertension - epidemiology
Jaw, Edentulous, Partially - epidemiology
Middle Aged
Myocardial Infarction - epidemiology
Myocardial Ischemia - epidemiology
Personal Satisfaction
Population Surveillance
Prospective Studies
Risk factors
Sweden - epidemiology
Tooth Loss - epidemiology
Triglycerides - blood
Waist-Hip Ratio
Abstract
The aim of this cross-sectional study was to analyze the relationship between chronic periodontitis and ischemic heart disease (IHD).
A cross-section of women aged 38 to 84 years were examined in 1992-93 (analysis based on n=1056). Medical and dental examinations were included in the analysis specifically with regard to IHD and periodontitis. Other well-known risk factors for IHD were used as covariates in multivariable statistical analysis.
Among the dentate women in this study (n=847), 74 had IHD and 773 did not. There was no statistically significant difference between numbers of pathological gingival pockets between these groups (58.1% had one or more pathological pockets in the IHD group compared to 57.6% in the non-IHD group). Bivariate analysis of dentate individuals showed significant associations between IHD and number of missing teeth, age, body mass index, waist/hip ratio, life satisfaction, hypertension, and levels of cholesterol and triglycerides. However, in the final multivariable logistic regression model, with the exception of age, only number of teeth (
PubMed ID
19301159 View in PubMed
Less detail

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
Less detail

Birth weight in relation to leisure time physical activity in adolescence and adulthood: meta-analysis of results from 13 nordic cohorts.

https://arctichealth.org/en/permalink/ahliterature98582
Source
PLoS One. 2009;4(12):e8192
Publication Type
Article
Date
2009
Author
Lise Geisler Andersen
Lars Angquist
Michael Gamborg
Liisa Byberg
Calle Bengtsson
Dexter Canoy
Johan G Eriksson
Marit Eriksson
Marjo-Riitta Järvelin
Lauren Lissner
Tom I Nilsen
Merete Osler
Kim Overvad
Finn Rasmussen
Minna K Salonen
Lene Schack-Nielsen
Tuija H Tammelin
Tomi-Pekka Tuomainen
Thorkild I A Sørensen
Jennifer L Baker
Author Affiliation
Institute of Preventive Medicine, Center for Health and Society, Copenhagen University Hospital, Copenhagen, Denmark.
Source
PLoS One. 2009;4(12):e8192
Date
2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Birth Weight - physiology
Cohort Studies
Female
Humans
Leisure Activities
Logistic Models
Male
Middle Aged
Motor Activity - physiology
Scandinavia
Young Adult
Abstract
BACKGROUND: Prenatal life exposures, potentially manifested as altered birth size, may influence the later risk of major chronic diseases through direct biologic effects on disease processes, but also by modifying adult behaviors such as physical activity that may influence later disease risk. METHODS/PRINCIPAL FINDINGS: We investigated the association between birth weight and leisure time physical activity (LTPA) in 43,482 adolescents and adults from 13 Nordic cohorts. Random effects meta-analyses were performed on categorical estimates from cohort-, age-, sex- and birth weight specific analyses. Birth weight showed a reverse U-shaped association with later LTPA; within the range of normal weight the association was negligible but weights below and above this range were associated with a lower probability of undertaking LTPA. Compared with the reference category (3.26-3.75 kg), the birth weight categories of 1.26-1.75, 1.76-2.25, 2.26-2.75, and 4.76-5.25 kg, had odds ratios of 0.67 (95% confidence interval: 0.47, 0.94), 0.72 (0.59, 0.88), 0.89 (0.79, 0.99), and 0.65 (0.50, 0.86), respectively. The shape and strength of the birth weight-LTPA association was virtually independent of sex, age, gestational age, educational level, concurrent body mass index, and smoking. CONCLUSIONS/SIGNIFICANCE: The association between birth weight and undertaking LTPA is very weak within the normal birth weight range, but both low and high birth weights are associated with a lower probability of undertaking LTPA, which hence may be a mediator between prenatal influences and later disease risk.
PubMed ID
20016780 View in PubMed
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Blood pressure components and changes in relation to white matter lesions: a 32-year prospective population study.

https://arctichealth.org/en/permalink/ahliterature150631
Source
Hypertension. 2009 Jul;54(1):57-62
Publication Type
Article
Date
Jul-2009
Author
Xinxin Guo
Leonardo Pantoni
Michela Simoni
Calle Bengtsson
Cecilia Björkelund
Lauren Lissner
Deborah Gustafson
Ingmar Skoog
Author Affiliation
Institute of Neuroscience and Physiology, University of Gothenburg, Sweden. xinxin.guo@neuro.gu.se
Source
Hypertension. 2009 Jul;54(1):57-62
Date
Jul-2009
Language
English
Publication Type
Article
Keywords
Adult
Aged
Blood pressure
Brain - pathology
Female
Humans
Logistic Models
Middle Aged
Population Surveillance
Prospective Studies
Sweden
Time Factors
Tomography, X-Ray Computed
Abstract
This study aimed to examine the long-term effect of high blood pressure (systolic blood pressure, diastolic blood pressure, pulse pressure, and mean arterial pressure) on white matter lesions and to study changes in different blood pressure components in relation to white matter lesions. A representative population of women was examined in 1968 and re-examined in 1974, 1980, 1992, and 2000. The presence and severity of white matter lesions on computed tomography were rated by a visual rating scale in 1992 and 2000 in 539 women. Systolic and diastolic blood pressures were measured at all of the examinations. We found that presence and severity of white matter lesions in 1992/2000 were associated with higher diastolic blood pressure and mean arterial pressure at each examination but not with systolic blood pressure and pulse pressure. Odds ratios (95% CIs) for the presence of white matter lesions per 10-mm Hg increase in diastolic pressure were 1.4 (1.0 to 1.9) in 1968, 1.3 (1.0 to 1.8) in 1974, 1.4 (1.1 to 1.9) in 1980, and 1.3 (1.0 to 1.6) in 1992 after adjustment for confounders. The presence of white matter lesions was also associated with a 24-year increase in diastolic pressure (>10 mm Hg), systolic pressure (>40 mm Hg), pulse pressure (>24 mm Hg), and mean arterial pressure (>6 mm Hg; odds ratios [95% CIs]: 2.6 [1.3 to 5.1] for diastolic pressure; 2.0 [1.2 to 3.4] for systolic pressure; 1.8 [1.1 to 2.7] for pulse pressure; and 2.2 [1.4 to 3.4] for mean arterial pressure). Our findings suggest that lowering high diastolic blood pressure and preventing large increases in systolic and diastolic blood pressures may have a protective effect on white matter lesions.
PubMed ID
19487586 View in PubMed
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BMI, eating habits and sleep in relation to salivary counts of mutans streptococci in children - the IDEFICS Sweden study.

https://arctichealth.org/en/permalink/ahliterature279480
Source
Public Health Nutr. 2016 Apr;19(6):1088-92
Publication Type
Article
Date
Apr-2016
Author
Louise Arvidsson
Dowen Birkhed
Monica Hunsberger
Anne Lanfer
Lauren Lissner
Kirsten Mehlig
Staffan Mårild
Gabriele Eiben
Source
Public Health Nutr. 2016 Apr;19(6):1088-92
Date
Apr-2016
Language
English
Publication Type
Article
Keywords
Body mass index
Body Weight
Child
Child, Preschool
Colony Count, Microbial
Cross-Sectional Studies
Dental Caries - microbiology - prevention & control
Diet
Dietary Sucrose - administration & dosage - adverse effects
Female
Humans
Hydrogen-Ion Concentration
Logistic Models
Male
Overweight - microbiology - prevention & control
Saliva - microbiology
Sleep
Streptococcus mutans - isolation & purification
Sweden
Waist Circumference
Abstract
The objective of the present study was to investigate the association between salivary counts of mutans streptococci (MS) and children's weight status, while considering associated covariates. MS ferments carbohydrates from the diet and contributes to caries by lowering the pH in dental plaque. In adults, high counts of MS in saliva have been associated with overweight, but this has not been shown in children.
Cross-sectional study investigating salivary counts of MS, BMI Z-score, waist circumference, meal frequency, sugar propensity and sleep duration, in children.
West Sweden.
Children (n 271) aged 4-11 years.
Medium-high counts of MS were positively associated with higher BMI Z-score (OR=1·6; 95% CI 1·1, 2·3). Positive associations were also found between medium-high counts of MS and more frequent meals per day (OR=1·5; 95% CI 1·1, 2·2), greater percentage of sugar-rich foods consumed (OR=1·1; 95% CI 1·0, 1·3) and female sex (OR=2·4; 95% CI 1·1, 5·4). A negative association was found between medium-high counts of MS and longer sleep duration (OR=0·5; 95% CI 0·3, 1·0).
BMI Z-score was associated with counts of MS. Promoting adequate sleep duration and limiting the intake frequency of sugar-rich foods and beverages could provide multiple benefits in public health interventions aimed at reducing dental caries and childhood overweight.
PubMed ID
26228762 View in PubMed
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