Syfte: Syftet med uppsatsen var att göra en analys av vilka resultat som deltagarna uppnått efter 2 års dagvårdsbehandling på Överviktsenheten, Karolinska Universitetssjukhuset. Följande frågor står i fokus för denna studie:? Svarar män och kvinnor olika på behandlingen i fråga om relativ och absolut viktminskning?? Finns det skillnader mellan ursprungs-BMI (kg/m2) och viktminskningen, i relativa och absoluta termer?? Skiljer sig olika åldersgrupper åt i fråga om relativ och absolut viktminskning?? Hur ändras sjukdomsprevalensen för IGT/diabetes typ II, höga triglyceridnivåer, hypertoni och metabolt syndrom under behandlingens gång?Metod: Behandlingen innefattar beteendemodifikation i form av förändrade kostvanor och ökad fysisk aktivitet. Uträkningarna baseras på tre mätningar; före behandlingsstart, samt efter 1 och 2 år. Dessa består av blodprover samt längd, vikt och blodtryck.

Sahlgrenska Academy at University of GothenburgDepartment of Clinical NutritionAbstractTitle: The effect of nutritional treatment on functional recovery after stroke, a systematic reviewAuthor: Ingrid Blankenau and Amanda LindbladSupervisor: AnneMarie GrönbergExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTS Type of paper: Examination paper, 15 hpDate: April 13, 2011Background: Every year 30 000 people in Sweden suffer from stroke. This costs society about twelve billion SEK. Many stroke survivors experience functional impairment which may lead to difficulties for them to meet their nutritional needs. Nutritional treatment is important in the recovery process after stroke as malnutrition increases the risk of complications.Objective: To investigate the possible effect of nutritional treatment on functional recovery after stroke.Search strategy: The search was conducted in the databases PubMed, Scopus and Cochrane by using the English keywords stroke, nutrition, rehabilitation, functional outcome, recovery, acute stroke, ischemic stroke, ischemic acute stroke, nutrition therapy, brain hemorrhage, functional recovery and nutritional rehabilitation.Selection criteria: Studies published before 2001 conducted on human subjects who suffer from stroke where they measured functional capacity and did a nutritional intervention, written in English, Swedish or Norwegian, and did not have to be requested from the library.Data collection and analysis: A systematic search was performed in PubMed. Studies which had an interesting heading were examined and abstract read.

Sahlgrenska Academy at University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Does the number of chews affect satiation and satiety?Author: Madeleine Johansson och Helena AnderssonSupervisor: Heléne Bertéus ForslundExaminer: Frode SlindeProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 27, 2014Background: Overweight and obesity is a growing problem worldwide. In 2008, 35% of theworld's population were overweight and 11% obese , which is almost doubling since 1980,according to WHO. Recommendations on overweight and obesity is not just about what weeat but how we eat. A generally accepted recommendation is to eat slowly and chew yourfood properly in order to increase fullness and reduce energy intake.

Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Coconut water and recovery/water-electrolyte balance after physicalexcercise ? A systematic overviewAuthor: Irene Eriksson and Alexandra ÖquistSupervisor: Henriette PhilipsonExaminer: Frode SlindeProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: April 09, 2014Background: During physical exercise, it is common with dehydration, which affectsperformance negatively. To restore the fluid balance it is optimal to drink fluids containingsalt and carbohydrates. In theory, coconut water should be a good recovery drink because oftheir nutrient content.Objective: To evaluate the scientific evidence available, to investigate whether coconut wateris better than water or sports drinks for rehydration after physical exercise.Search strategy: PubMed, Scopus and Cochrane Library have been used in the literarysearch. Keywords used were recovery, fluid balance, fluid therapy, water-electrolyte balance,rehydration, dehydration, hydration, exercise, physical activity, resistance training, activity,sports, training, coconut water in varying combinations, in order to cover as wide area aspossible.

Sahlgrenska Academy at University of GothenburgDepartment of Department of Internal Medicine and Clinical NutritionAbstractTitle: Does coffee consumption affect the risk of stroke?Author: Jenny KällSupervisor: Heléne Bertéus ForslundExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 22, 2012___________________________________________________________________________Background: The widespread consumption of coffee worldwide makes this drink interesting to study from a public health perspective. Even minor health effects may be important for the whole population. Stroke patients require the largest number of days spent in hospitals and nursing homes than any other medical condition group. Risk factors for stroke include smoking, high alcohol intake, physical inactivity, hypertension, hypercholesterolemia, high waist-hip ratio and diabetes.

Missbruk av alkohol och droger förekommer på alla arbetsplatser. I samband med rehabiliteringsutredningar gällande missbruk- och beroendeproblem framkom det i flera fall att arbetskamrater och även chefer under flera års tid hade känt till eller misstänkt att medarbetaren haft missbruksproblem. Företagshälsovården Previa i Malmö sammanställde en utbildning som riktades till chefer samt fackliga företrädare på Universitetssjukhuset i Malmö, UMAS. Syfte: Avsikten med denna rapport var att följa upp vad de som deltagit i utbildningen ansåg om upplägget med att arbetsgivaren och företagshälsovården höll utbildningen tillsammans och vad man ansåg om att utbildningen var obligatorisk. Det var även intressant att få veta om man kände till att det fanns en alkohol- och drogpolicy på arbetsplatsen och om man upplevde att utbildningen haft ett värde för egen del.

Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Does low fat dairy products reduce blood pressure?Author: Emma Bergman and Naman LimaniSupervisor: Lena HulthénExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 26, 2014Background: It is estimated that at least a third of the population in Sweden have a high blood pressure with genetics, unhealthy diet and physical inactivity as the main contributing causes. High blood pressure is one of the greatest risk factors to develop cardiovascular diseases, which is the leading cause of death worldwide. Milk is a nutritional food product and previous research suggests that low fat dairy products may have blood pressure lowering effect.Objective: The aim was to examine the scientific basis of how low fat dairy products affect blood pressure.Search strategy: Twelve searches were conducted on PubMed and Scopus, where the chosen search terms were combined to produce a broad search as possible in the particular area. The search terms used were dairy, dairy products, milk, blood pressure and hypertension.Selection criteria: Studies on normotensive or hypertensive individuals who received low fat dairy products were included.

Syfte: Syftet med denna systematiska ?versiktsartikel var att unders?ka det vetenskapliga underlaget avseende effekten av vitamin D-supplement p? ickeallergisk astma hos vuxna. Metod: Litteraturs?kningen genomf?rdes i tv? databaser, PubMed och Scopus. S?kningen genomf?rdes med hj?lp av tre s?kblock. Blocken specificerades efter inneh?ll; astma, vitamin D och randomiserade kontrollerade studier (RCT). Studierna som inkluderades i denna systematiska ?versiktsartikel var gjorda p? vuxna personer med icke-allergisk astma och utan samsjuklighet. Interventionen var vitamin D-supplement och kontrollen var placebo.

Sahlgrenska AcademyAt University of GothenburgDepartment of internal medicine and clinical nutritionAbstractTitle: D for depression: Does vitamin D supplementation have apalliative effect on depressive symptoms? ? A systematic reviewAuthor: Emelie Nacksten and Lua Ferreira RangelSupervisor: Fredrik BertzExaminer: Ingrid LarssonProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 22th, 2013BackgroundDepression is one of the major diseases in the world and is ranked by the WHO as the leading causeof disability. Several studies suggest that there is a correlation between low s-25(OH)D levels and theoccurrence of depression. Current research has found enzymes required for synthesis of the active formof vitamin D and its receptors (VDR) in the brain. The potential role of the vitaminas a neuroactive steroid has resulted in an increased interest in investigating the role of vitamin D in thetreatment of depression.ObjectiveStudy the scientific evidence to determine if vitamin D supplementation can relieve depressive symptomsin adults.Search strategyThe literature search was conducted in the databases Scopus, Pubmed, Cochrane and PsychInfo.

Sahlgrenska Academy at University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Coconut water as a rehydration fluid. - Can coconut water be recommended as a better choice than water or sports drink after moderately intense training?Author: My Green, Joakim LundSupervisor: Henriette PhilipsonExaminer: Frode SlindeProgram: Dietician study program, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 26th, 2014Background: Already in the 1960s an alternative to water as a rehydration fluid occurred, the so-called sports drink. Coconut water has in recent years been claimed as the "natural sports drink" in media. Coconut water is sold in shops and fitness centers around the world and has established itself as an alternative to water and sports drink in terms of rehydration after a workout.Objective: To investigate whether there is scientific evidence to recommend coconut water as a rehydration drink after moderately intense exercise ahead of water or sports drink.Search strategy: The search for articles in this systematic review was performed in the databases PubMed, Scopus, Cochrane and GUPEA.

Denna uppsats handlar om kuratorers känslomässiga upplevelser i mötet med cancerpatienter i livets slutskede. Fyra kuratorer på Karolinska universitetssjukhuset i Solna och två från Södersjukhuset intervjuades utifrån en semistrukturerad intervjuguide. Uppsatsen har en kvalitativ induktiv ansats. Frågeställningar handlar om vilka känslor som uppkommer i möten med döende cancerpatienter och hur kuratorer hanterar dessa känslor. Intervjuguiden berör två områden; svårigheter och möjligheter och hanterbarhet av känslor.

Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Alcohol consumption after training and its effects on muscle gain and recovery adult menAuthor: Frida Carlstedt, Puck JanssonSupervisor: Frode SlindeExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: April 09, 2014Background: Today, the Swedish population exceeds the recommendations for alcohol intake while advised to move at least thirty minutes a day. It is well established what happens if you drink alcohol before a workout or if you workout the day after an alcohol intake, but it is less well established how muscle gain and recovery are affected by an intake of alcohol in the phase of recovery.Objective: The objective of this review is to investigate if there is a relation between alcohol intake after a workout and effected recovery and muscle gain. This was performed by measuring the outcomes cortisol, testosterone, creatine kinase as well as different measures of muscle strength. The issue was ?Does an intake of alcohol after training affect recovery and muscle gain??Search strategy: A systematic review in the databases PubMed and Scopus with the MeSH-terms: exercise, muscles, recovery of function, training, athletic performance, performance, sport, alcohol drinking, alcohols, alcohol and ethanol.Selection criteria: Criteria for articles to be included in this review were that they would be RCT- and human studies in healthy subjects as well as containing an ethanol intake after a physical activity that consisted of weight training in the form of resistance training or other forms of activity that promotes strength.Data collection and analysis: A systematic search for literature as mentioned above (search strategy) was performed as well as an analysis with the SBU quality review template for randomized studies, and a quality review for each measure of outcome according to Gothenburg University summarized evidence template for measures of outcome.4Main results: Many studies are authored by the same group of researchers and/or are of a lower quality.

Sahlgrenska Academyat University of GothenburgDepartment of internal medicine and clinical nutritionAbstractTitle: Does omega-3 mitigate skin symptoms in psoriatic patients? ? A systematic review about the effects of supplementationAuthor: Anita Borgmästars and Sara LinderSupervisor: Mette AxelsenExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 22, 2012Background: Psoriasis is an inflammatory skin disease with high prevalency. Its treatment is time-consuming and associated with many side effects. Therefore alternative forms of treatment, among them omega-3 supplementation, have been investigated. Omega-3 is a family of polyunsaturated fatty acids whose metabolites participate in the regulation of inflammatory reactions in tissues and may therefore have a positive effect on skin symptoms in patients with psoriasis.Objective: To determine if omega-3 supplementation has a beneficial effect on skin symptoms in psoriasis compared to omega-6 supplementation by rating the evidence quality in available studies.Search strategy: The literature search was conducted in the databases PubMed, Scopus and Amed.

Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Can an increased intake of omega-3 fatty acids have an effect on testosteronelevels in women with PCOS?Author: Ylva Dernbrant och Helene HagenborgSupervisor: Lena HulthénExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 23, 2012BackgroundPolycystic ovary syndrome affects women of fertile age and consists of elevated testosterone levels and increased insulin resistance along with effects on ovulation and fertility. The elevated level of testosterone often leads to problem with acne and hirsutism, and it is also common with overweight and metabolic syndrome. The nutrition treatment has mainly consisted of energy restriction, together with exercise and drugs to reduce insulin resistance and consequently reduce androgen levels. However, an in-depth knowledge about how the components of our diet can affect further, is lacking.Omega-3-fatty acids can affect insulin resistance and testosterone levels within other groups but today knowledge is lacking if these findings can be transferred to women with PCOS.

Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Vitamin D supplementation and its effect on body composition in the overweightand obese ? a systematic reviewAuthor: Johanna Blum and Emma Sellin FrimodigSupervisor: Sofia KlingbergExaminer: Ingrid LarssonProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: April 10, 2013Background: There is an increasing burden of overweight and obesity worldwide. Theconditions lead to morbidity and lowered quality of life. Since there is research showing aconnection between obesity and low levels of serum 25(OH)D, this raises the question ifsupplementation of vitamin D may have positive effects on body weight, waist circumference andbody composition in the overweight and obese.Objective: To investigate if there is enough scientific evidence to recommend vitamin Dsupplementation combined with nutrition therapy to overweight and obese patients.Search strategy: The systematic collection of data was performed in the databases PubMed andScopus. Search terms included were ?vitamin D supplementation?, ?obesity? ?cohort?, ?vitamin D?,?vitamin D3 supplementation? and ?overweight?.Selection criteria: Human studies with RCT, CCT or cohort design written in English orSwedish were included.