Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Is pricing a way to affect share of fruits and vegetables in a diet?Author: Maria PopovSupervisor: Heléne Bertéus ForslundExaminer: Ingrid LarssonProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 23, 2013Background: Fruits and vegetables (FV) are important for health, including occurrence of diabetes, obesity and cardiovascular diseases. Said diseases cause most cases of illness and death in high-income countries. Only a small part of the population achieves the FV-intake goal, so a higher FV-intake is desirable. Besides general information campaigns there is another method of influencing what people might buy.Objective: To examine whether different pricing is connected to FV-intake or ?purchase.Search strategy: Databases PubMed, Scopus and Summon were searched with ?vegetable consumption", "price/pricing policy" and "food choice? in different combinations.Selection criteria: Studies performed after year 2000 on at least 18 years old persons from North America, Europe or Australia, examining changes in FV-price and -purchase.

Bakgrund Sveriges ökande befolkning i kombination med minskande resurser till sjukvården leder till allt fler överbeläggningar. Detta inverkar negativt på arbetsmiljö och patientsäkerhet vid vårdinrättningarna. Samtidigt är effektivitets- och kvalitetsarbete lagstadgat för Sveriges vårdinrättningar sedan 2005.Problemdiskussion På Sahlgrenska sjukhuset jobbar man med förbättringsarbete enligt den egenutvecklade FOKUS-modellen. För att kunna veta om imple-menterade förbättringsåtgärder har gett önskat resultat behöver man genomföra utvärderingar och ta fram nyckeltal som mäter effekterna av åtgärderna. Dessa nyckeltal ska samtidigt kunna relateras till Sahl-grenskas balanserade styrkort.

Sahlgrenska Academy at University of Gothenburg Department of Internal Medicine and Clinical NutritionAbstractTitle: Can probiotics prevent atopic dermatitis in children with high risk?Author: Laura Pienihäkkinen and Max OlinSupervisor: Heléne Bertéus ForslundExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 22, 2012Background Allergic disease is today common, this including atopic dermatitis, which is the most common inflammatory skin disease in the world. Heredity has been shown to play a major role in the development of this disease. It is therefore of high interest for both the individual and society to find effective methods for preventing atopic dermatitis in individuals with high risk profile. Probiotics are beneficial for the bacterial profile in the intestine and it is therefore of interest to study if they through their anti-inflammatory effect could prevent atopic dermatitis.Objective The aim was to study whether administration of probiotics to the mother and the child (directly or via breast milk) could prevent atopic dermatitis in children with high risk profile (at least one first degree relative with a diagnosed allergic disease).Search strategy A systematic literature search was done in databases PubMed and Scopus with search terms maternal, prenatal, probiotics, allergy, atopic dermatitis, prevention, and children.Selection criteria Randomized, controlled human studies and original articles in English were included.

Introduktion: Läkemedelsverkets generella rekommendation är att naturläkemedel ska sättasut inför anestesi. Litteratur tyder på att läkare sällan frågar om naturläkemedelsanvändning iden preoperativa bedömningen, samtidigt som patienten sällan uppger sådant användande. Attha väsentlig information om patienten inför anestesi är en förutsättning förhandlingsberedskap för anestesisjuksköterskan, vilket gör säker och tydlig kommunikation tillen viktig del i patientsäkerheten.Syfte: Syftet med denna studie var att kartlägga huruvida anestesiologer beaktar patientersanvändning av naturläkemedel inom anestesi.Metod: För denna kartläggning genomfördes en kvantitativ enkätundersökning riktad motanestesiologer inom Sahlgrenska Universitetssjukhuset. Enkäten bestod av nio slutna och tvåöppna frågor. Kvantitativ data analyserades i SPSS och redovisades med frekvenstabeller,medan samtliga kvalitativa data redovisades med citat.Resultat: Inom ramen för denna pilotstudie delades tretton enkäter ut, varav elva besvarades.Könsfördelningen av respondenterna var 64 % (n=7) män och 36 % (n=4) kvinnor ochrespondenternas läkartjänster inom anestesi var ST-läkare 36 % (n=4), överläkare 36 % (n=4)samt specialistläkare 27 % (n=3).

Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionTitle: The effect of the glycemic index of breakfasts in energy intake inchildren and adolescentsAuthor: Charlotte Olofsson, Cornelia Johansson and Maria NordbeckSupervisor: Fredrik BertzExaminer: Ingrid LarssonProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 16, 2013Background: The glycemic index (GI) and it´s effect on energy intake is a debated subject.Research has been done whether food with lower GI decreases hunger and lowers energyintake, which could be an effective tool to prevent overweight in children and adolescents.Breakfast eating is successful for maintaining a healthy weight and it´s therefore interesting tosee if the quality of the carbohydrates matters.Objective: To evaluate the scientific evidence regarding the effect of GI of breakfasts inchildren?s and adolescents energy intake.Search strategy: To find relevant articles, a systematic literature search was made in thedatabases PubMed, Scopus and Cochrane. Search terms that were used were: breakfast,breakfast quality, children, glycemic index, energy intake, obesity.Selection criteria: Randomized controlled trials and cohort trials, breakfast eatingindividuals, children and adolescents under 18 years old, reported glycemic index. Outcomemeasurements: Energy intake.Data collection and analysis: Six original articles met the inclusion criteria and werereviewed by the SBU audit template for randomized and controlled studies. There after onearticle was excluded because of very low quality of the study.

Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Effects of isoflavone supplementation from soybeans on LDL-cholesterol levels in adultAuthors: Malin Blomgren Alegria and Ruut ReivaaraSupervisor: Lena HulthénExaminer: Frode SlindeProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: 2013-04-08Background: One of the most common causes of death in Sweden is due to cardiovascular diseases such as heart attack and stroke. Hypercholesterolemia is one of the risk factors for cardiovascular disease. In Asia, hypercholesterolemia is less common than in the Western countries. In Asian countries, soy products are consumed in larger quantities than in the Western world, which has led to implemented research with the intention of examining soy's potential effect on cholesterol levels.Objective: To investigate whether there is scientific evidence that isoflavone supplementation from soy bean may have a lowering effect on LDL-cholesterol.Search strategy: The databases used for the systematic literature search were PubMed, Scopus and Cochrane. Keywords used were cholesterol and 9 versions of this, and isoflavones and 11 versions of that.Selection criteria: RCT articles, on humans, written in English, published from 2011 onwards, that focused on interventions with isoflavones from soybeans and its effect on blood cholesterol, the participants were over 18 years old and the study time was at least 24 weeks.

Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Whole fat versus low-fat dairy products for primary prevention of cardiovascular disease. A systematic review.Author: Josefine Lindqvist, Robin Järnmark, Mathilde OhlinSupervisor: Mette AxelsenExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: 2014-04-09BackgroundResearch indicates that dairy products seems to have a protective impact on the incidence of cardiovascular disease regardless fat content. Paradoxically the Nordic nutrition recommendations recommend an exchange of full fat dairy product to low-fat dairy products.ObjectiveThe aim of this review is to investigate whether the variation in fat content of dairy products have any bearing on the onset of cardiovascular disease. With regard to common risk markers for cardiovascular disease the outcome measures hypertension, hyperlipidemia and weight gain is examined.Search strategyThe searches were made in the databases Medline (23/1-14) and Scopus (6/2-14).Selection criteriaRestrictions: Human Studies, Adults, Randomized Controlled Trials, English.Data collection and analysisTwo RCTs were included. Validation of the separate studies was performed with SBU's review template for individual studies and GRADE was used for summarizing the evidence of outcome measuresMain resultsThe two included studies examined the outcome measures blood pressure, weight and blood lipids.

Sahlgrenska Academy at University of GothenburgDepartment of Internal Medicine and Clinical NutritionABSTRACTTitle: The connection between IBS and FODMAPsAuthor: Helena Hautamäki and Rebecka BertilssonSupervisor: Sofia KlingbergExaminer: Frode SlindeProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: 2013-04-10Background: IBS (Irritable Bowel Syndrome) is a functional gastrointestinal disorder, and is acommon disorder in the western population. The predominant symptoms are diarrhoea,abdominal pain, bloating, constipation, and excessive flatus. Today there are no evidence basedrecommendations concerning dietary factors for patients diagnosed with IBS, but recently certainfactors in the diet that seems to trigger the symptoms have been identified. These factors areshort-chain carbohydrates, Fermentable Oligosaccharides, Disaccharides, Monosaccharides, andPolyols (FODMAPS), which are not completely absorbed in the lumen.Objective: The purpose of this systematic review article is to examine whether there are anyevidence that a diet low in FODMAPs may induce improvement of symptoms in patientsdiagnosed with IBS.Search strategy: The literature search was performed in the databases PubMed, Scopus,Summon and Google Scholar. The keywords were ?Irritable bowel syndrome + FODMAPs?,?Irritable bowel syndrome + diet? and ?FODMAP and diet?.Selection criteria: The inclusion criteria were patients diagnosed with IBS between the ages 18and 69.

Bakgrund: Sepsis, svår sepsis och septisk chock är ett accelererande tillstånd där tid till antibiotika och vätskebehandling har stor betydelse för denna utsatta patientgrupp. Trots att nästan hälften av sepsispatienterna anländer till sjukhus med ambulans, så gör diffusa symtom att enbart en liten del identifierats eller mottagit någon form av behandling. Syfte: Att belysa svaga länkar i den tidiga vårdkedjan för patienter som i efterhand diagnostiserats med positiv blododling/sepsis. Metod: Kvantitativ registerstudie. Samtliga patienter (n=696) i Sahlgrenska Universitets sjukhus upptagningsområde som testades med positiv blododling (Sepsis) under perioden: 1 februari till 30 april 2012 analyserades.

Sahlgrenska Academy at University of GothenburgDepartment of Internal medicine and Clinical nutritionAbstractTitel: Can omega-3 prevent the emergence of allergy?? A systematic reviewAuthor: Karin Andersson and Cecilia BjörertzSupervisor: Henriette PhilipsonExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 hpType of paper: Examination paper, 15 hpDate: 2012-05-23Background Today allergy is a major public health issue and one of our most common chronic diseases. It would be most profitable if there was a way to prevent the emergence of allergies, both regarding the community and the individual. The antiinflammatory property of omega-3 influences the immune system and is thought to have a preventive effect on allergic symptoms. To investigate whether the mothers intake of omega-3 during pregnancy and lactation affects the child?s future development of allergy is therefore of high interest.Objective To examine if omega-3 supplement given to mothers during pregnancy, or pregnancy and lactation, is shown to be beneficial in children with heredity to develop allergy.Search strategy Articles were collected from the data bases PubMed, Cochrane and Scopus.

Sahlgrenska Academy at University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Changes in blood pressure by replacing regular coffee with decaffeinated coffee,in healthy, normotensive subjectsAuthor: Linnéa Adolfsson and Hillevi Pilgren SautterSupervisor: Lena HulthénExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 ECTSDate: April 12, 2012Background Hypertension is a risk factor for developing cardiovascular disease, which is themost common cause of premature death. Contributing factors to hypertension are genetics,lifestyle and nutrition. Earlier studies have shown that coffee may increase blood pressure.Objective To investigate the scientific basis whether replacing regular coffee with decaffeinatedcoffee would affect blood pressure in healthy, normotensive subjects.Search strategy Searches have been done in databases; PubMed and Scopus in February 2012.Keywords used were: ?coffee blood pressure?, ?coffee cardiovascular disease?, ? kaffeblodtryck?, ?kaffe hjärtkärlsjukdom?, ?coffee and decaffeinated coffee?, ?decaffeinated coffeeand blood pressure?, ?decaffeinated coffee and cardiovascular disease? and ?exchangedecaffeinated coffee?.Selection criteria Studies with healthy, normotesive subjects, >15 years old, BMI < 30, morethan one week of intervention, randomized controlled trails and human trials were included.Only trials using caffeine from coffee versus decaffeinated coffee and studies in English andSwedish were accepted. Exclusion criteria were other interventions such as weight loss, changesin diet, medications or stress tests.Data collection and analysis Studies were selected after inclusion and exclusion criteria.

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.