B. Heitmann
University of Southern Denmark, National Institute of Public Health, Department Member
Introduction Few studies have examined the role of maternal diet in relation to development of autoimmune diseases such as coeliac disease (CD). In Denmark, cancellation of mandatory vitamin D fortification of margarine in June 1985... more
Introduction Few studies have examined the role of maternal diet in relation to development of autoimmune diseases such as coeliac disease (CD). In Denmark, cancellation of mandatory vitamin D fortification of margarine in June 1985 provides this opportunity. This study examined if prenatal exposure to extra vitamin D from food fortification or season of birth were associated with a decreased risk of developing CD later in life. If low prenatal vitamin D levels are a risk factor, there are immediate, cheap and easy public health implications. Methods This register based study has a partially ecologic design. The two entire cohorts were created using information available from the Danish birth registry and development of CD (ICD-8 269 ICD-10 K90) over 30 years was retrieved from the Danish National Patient Register. Logistic regression analysis was used to generate odds ratios and 95% confidence intervals. Results There was a lower odds ratio of developing CD (OR: 0.811 95% CI 0.655;...
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The aim of this article was to examine the relationship between childhood caries, body mass index (BMI) and subsequent changes in BMI over 6 years, and to investigate whether these associations were modified by social class. Data were... more
The aim of this article was to examine the relationship between childhood caries, body mass index (BMI) and subsequent changes in BMI over 6 years, and to investigate whether these associations were modified by social class. Data were from the European Youth Heart Study (EYHS) merged with data on caries experience from the Danish National Board of Health, (SCOR register). At baseline, 26.2% of the children/adolescents were caries free and 39% at follow-up. A larger percentage of normal weight children/adolescents were caries free, compared with the overweight/obese group of children/adolescents. The linear regression analysis showed that childhood caries was generally not associated with either BMI or subsequent changes in BMI. However, among children whose mothers were well educated, there was an inverse association between caries at baseline and subsequent changes in BMI over a period of 6 years, for example, a high caries experience was associated with a smaller increment in BMI, compared with the group of children with a low caries experience. No association was found for those with lower SES. An inverse association between caries and subsequent changes in BMI was found, but only among children with well-educated mothers, suggesting that high caries experience may be a marker for low future risk of overweight among the more advantaged. Associations did not appear to be significant among the less advantaged; however, numbers in this group were low, and an association may have been overlooked. Hence, more studies are needed to confirm these findings.
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Background— Light to moderate alcohol consumption is associated with a reduced risk of coronary heart disease. This protective effect of alcohol, however, may be confined to middle-aged or older individuals. Coronary heart disease... more
Background— Light to moderate alcohol consumption is associated with a reduced risk of coronary heart disease. This protective effect of alcohol, however, may be confined to middle-aged or older individuals. Coronary heart disease incidence is low in men <40 years of age and in women <50 years of age; for this reason, study cohorts rarely have the power to investigate the effects of alcohol on coronary heart disease risk in younger adults. This study examined whether the beneficial effect of alcohol on coronary heart disease depends on age. Methods and Results— In this pooled analysis of 8 prospective studies from North America and Europe including 192 067 women and 74 919 men free of cardiovascular diseases, diabetes, and cancers at baseline, average daily alcohol intake was assessed at baseline with a food frequency or diet history questionnaire. An inverse association between alcohol and risk of coronary heart disease was observed in all age groups; hazard ratios among mode...
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Research Interests: Engineering, Obesity, Denmark, Humans, Weight Loss, and 14 moreFemale, Male, Genetic Association Studies, Follow-up studies, Body Mass Index, Waist Circumference, Waist to Hip Ratio, Adult, Single Nucleotide Polymorphism, Weight Gain, Cohort Studies, Waist Hip Ratio, Medical and Health Sciences, and diet reducing
Women diagnosed with gestational diabetes mellitus (GDM) are more likely to later develop diabetes. Evidence from some previous reviews suggests that low vitamin D status during pregnancy increases the risk of developing GDM, but whether... more
Women diagnosed with gestational diabetes mellitus (GDM) are more likely to later develop diabetes. Evidence from some previous reviews suggests that low vitamin D status during pregnancy increases the risk of developing GDM, but whether vitamin D during pregnancy also influences the risk of diabetes post GDM is less well studied. Thus, the aim of this systematic literature review was to summarize the current available literature on that topic. This review considered observational studies and randomized controlled trials (RCTs). Five databases were searched. The risk of bias of the included studies was assessed. A total of six studies were included: three observational studies and three RCTs. Findings were inconsistent across the six included studies. However, when considering RCTs only, the findings more strongly suggested that vitamin D supplementation during and after pregnancy did not have an influence on markers of diabetes development or diabetes development post GDM. This sys...
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Based on a large volume of observational scientific studies and many summary papers, a high consumption of meat and processed meat products has been suggested to have a harmful effect on human health. These results have led guideline... more
Based on a large volume of observational scientific studies and many summary papers, a high consumption of meat and processed meat products has been suggested to have a harmful effect on human health. These results have led guideline panels worldwide to recommend to the general population a reduced consumption of processed meat and meat products, with the overarching aim of lowering disease risk, especially of cancer. We revisited and updated the evidence base, evaluating the methodological quality and the certainty of estimates in the published systematic reviews and meta-analyses that examined the association between processed meat consumption and the risk of cancer at different sites across the body, as well as the overall risk of cancer mortality. We further explored if discrepancies in study designs and risks of bias could explain the heterogeneity observed in meta-analyses. In summary, there are severe methodological limitations to the majority of the previously published syst...
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BACKGROUND Many weight loss programs show short-term effectiveness, but subsequent weight loss maintenance is difficult to achieve. Digital technologies offer promising means to delivering behaviour change approaches at low cost and on a... more
BACKGROUND Many weight loss programs show short-term effectiveness, but subsequent weight loss maintenance is difficult to achieve. Digital technologies offer promising means to delivering behaviour change approaches at low cost and on a wide scale. The NoHoW project was a European Commission H2020-funded project aimed to develop, test, and evaluate a digital Toolkit designed to promote successful long-term weight management. The Toolkit was tested in an 18-month large-scale international 2 x 2 factorial (motivation and self-regulation versus emotion regulation) randomised controlled trial, conducted in overweight/obese adults who lost ≥5% of their body weight in the preceding twelve months before enrolment into the intervention. OBJECTIVE This paper describes the development of the NoHoW Toolkit focusing on the logic models, content and specifications, and results from user testing. METHODS The Toolkit was developed using a systematic approach including (1) development of the theory-based logic models, (2) selection of behaviour change techniques, (3) translation of these techniques into a digital web-based app (NoHoW Toolkit components), (4) technical development, (5) user evaluation and refinement of the Toolkit. RESULTS The Toolkit included a set of web-based tools and inputs from digital tracking devices (smart scales and activity trackers), with modules targeting weight, physical activity, and dietary behaviours. The final Toolkit was comprised of 34 sessions, distributed through 15 modules, providing active content over a 4-month period. The motivation and self-regulation arm consisted of 8 modules (17 sessions), the emotion regulation arm was presented with 7 modules (17 sessions), and the combined arm received the full Toolkit (15 modules, 34 sessions). The sessions included a range of implementations, such as videos, testimonies, and questionnaires. Further, the Toolkit contained 5 specific data tiles for monitoring weight, steps, healthy eating, mood and sleep. CONCLUSIONS A systematic approach to the development of digital solutions based on theory, evidence, and user testing, may significantly contribute to the advancement of the science of behaviour change and improve current solutions for sustained weight management. Testing the Toolkit using a 2x2 design provided a unique opportunity to examine the effect of motivation and self-regulation and emotion regulation separately, as well as the effect of their interaction in weight loss maintenance. CLINICALTRIAL ISRCTN88405328
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Few studies have examined the role of maternal diet in relation to development of coeliac disease (CD). In Denmark, cancellation of mandatory vitamin D fortification of margarine in June 1985 provided this opportunity. This study examined... more
Few studies have examined the role of maternal diet in relation to development of coeliac disease (CD). In Denmark, cancellation of mandatory vitamin D fortification of margarine in June 1985 provided this opportunity. This study examined if season of birth or prenatal exposure to extra vitamin D from food fortification were associated with developing CD later in life. A strength of this study is the distinctly longer follow-up of patients (30 years). This register-based study has a semi-ecological design. Logistic regression analysis was used to estimate odds ratios and to calculate 95% confidence intervals. The odds ratio for developing CD was 0.81 (95% CI 0.66; 1.00 p = 0.054), comparing those with fetal exposure to mandatory vitamin D fortification policy of margarine to those without after adjusting for gender and season of birth. There was a statistically significant season effect particularly for children born in autumn (OR 1.6 95% CI 1.16; 2.21) and born in summer (OR 1.5 95...
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Background: low vitamin D status in pregnancy can influence the offspring’s lung function and contribute to childhood asthma development. The objective of this study was to examine the influence of neonatal vitamin D status on the... more
Background: low vitamin D status in pregnancy can influence the offspring’s lung function and contribute to childhood asthma development. The objective of this study was to examine the influence of neonatal vitamin D status on the development of asthma among children age 3–9 years in a large population sample. Method: in a case-cohort study utilizing a Danish biobank and register data we examined the association between neonatal 25-hydroxyvitamin D3 (25(OH)D3) concentrations and incidence of asthma among children aged 3–9 years. Cases of asthma (n = 911) were randomly selected among all cases of asthma in the Danish National Patient Register from children born between 1992 and 2002. The sub-cohort (n = 1423) was randomly selected among all children born in the same period. We used a weighted Cox proportional hazard model assessing the hazard of first asthma diagnoses by quintiles of 25(OH)D3. Results: the median 25(OH)D3 (interquartile range) for asthma cases was 23 nmol/L (14–35) a...
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Background Several studies have suggested a link between the type of alcoholic beverage consumption and body weight. However, results from longitudinal studies have been inconsistent, and the association between adolescent alcohol... more
Background Several studies have suggested a link between the type of alcoholic beverage consumption and body weight. However, results from longitudinal studies have been inconsistent, and the association between adolescent alcohol consumption long-term weight gain has generally not been examined. Methods The study was based on data from 720 Danish adolescents aged between 15 to 19 years at baseline from the Danish Youth and Sports Study (YSS). Self-reported alcohol use, height, weight, smoking, social economic status (SES) and physical activity levels were assessed in baseline surveys conducted in 1983 and 1985, and in the follow up survey which was conducted in 2005. Multiple linear regression analyses were used to examine the association between alcohol consumption in adolescence and subsequent weight gain later in midlife. Results There was no significant association between total alcohol consumption during adolescence and change in BMI into midlife (P = 0.079) (β − 0.14; 95% CI ...
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Studies have suggested that vitamin D status at birth may be associated with a range of neonatal outcomes. The aim of this study was to assess the association between neonatal 25-hydroxyvitamin D3 (25(OH)D3) concentration and gestational... more
Studies have suggested that vitamin D status at birth may be associated with a range of neonatal outcomes. The aim of this study was to assess the association between neonatal 25-hydroxyvitamin D3 (25(OH)D3) concentration and gestational age, birth weight, Ponderal Index and size for gestational age. Neonatal capillary blood stored as dried blood spots was used to assess 25(OH)D3 concentrations among 2686 subjects selected from a random population sub-sample of individuals, born in Denmark from 1 May 1981 to 31 December 2002. There was an inverse association between 25(OH)D3 concentration and gestational age at birth of -0·006 (95 % CI -0·009, -0·003, P<0·001) weeks of gestation per 1 nmol/l increase in 25(OH)D3 concentration. An inverted U-shaped association between 25(OH)D3 and birth weight and Ponderal Index (P=0·04) was found, but no association with size for gestational age was shown. This study suggests that neonatal 25(OH)D3 concentration is associated with anthropometric ...
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Recent studies have shown an association between weight change and the makeup of the intestinal microbiota in humans. Specifically, Lactobacillus, a part of the entire gastrointestinal tract's microbiota, has been shown to contribute... more
Recent studies have shown an association between weight change and the makeup of the intestinal microbiota in humans. Specifically, Lactobacillus, a part of the entire gastrointestinal tract's microbiota, has been shown to contribute to weight regulation. We examined the association between the level of oral Lactobacillus and the subsequent 6-year weight change in a healthy population of 322 Danish adults aged 35-65 years at baseline. Prospective observational study. In unadjusted analysis the level of oral Lactobacillus was inversely associated with subsequent 6-year change in BMI. A statistically significant interaction between the baseline level of oral Lactobacillus and the consumption of complex carbohydrates was found, e.g. high oral Lactobacillus count predicted weight loss for those with a low intake of complex carbohydrates, while a medium intake of complex carbohydrates predicted diminished weight gain. A closer examination of these relations showed that BMI change and...
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Chronic inflammatory diseases (CIDs) are frequently treated with biological medications, specifically tumour necrosis factor inhibitors (TNFi)). These medications inhibit the pro-inflammatory molecule TNF alpha, which has been strongly... more
Chronic inflammatory diseases (CIDs) are frequently treated with biological medications, specifically tumour necrosis factor inhibitors (TNFi)). These medications inhibit the pro-inflammatory molecule TNF alpha, which has been strongly implicated in the aetiology of these diseases. Up to one-third of patients do not, however, respond to biologics, and lifestyle factors are assumed to affect treatment outcomes. Little is known about the effects of dietary lifestyle as a prognostic factor that may enable personalised medicine. The primary outcome of this multidisciplinary collaborative study will be to identify dietary lifestyle factors that support optimal treatment outcomes. This prospective cohort study will enrol 320 patients with CID who are prescribed a TNFi between June 2017 and March 2019. Included among the patients with CID will be patients with inflammatory bowel disease (Crohn's disease and ulcerative colitis), rheumatic disorders (rheumatoid arthritis, axial spondyloa...
Research Interests: Research Design, Quality of life, Life Style, Inflammation, Diet, and 14 morePatient reported outcome measures, Prospective studies, Humans, Chronic Disease, Skin Diseases, Uveitis, Dietary fiber, Tumor necrosis factor-alpha, Prognosis, Meat products, Rheumatic diseases, Red meat, Precision Medicine, and Inflammatory Bowel Diseases
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Prenatal low vitamin D may have consequences for bone health. By means of a nationwide mandatory vitamin D fortification programme, we examined the risk of fractures among 10–18-year-old children from proximate birth cohorts born around... more
Prenatal low vitamin D may have consequences for bone health. By means of a nationwide mandatory vitamin D fortification programme, we examined the risk of fractures among 10–18-year-old children from proximate birth cohorts born around the date of the termination of the programme. For all subjects born in Denmark during 1983–1988, civil registration numbers were linked to the Danish National Patient Registry for incident and recurrent fractures occurring at ages 10–18 years. Multiplicative Poisson models were used to examine the association between birth cohort and fracture rates. The variation in fracture rates across birth cohorts was analysed by fitting an age-cohort model to the data. We addressed the potential modification of the effect of vitamin D availability by season of birth. The risk of fractures was increased among both girls and boys who were born before the vitamin D fortification terminated in 1985 (rate ratio (RR) exposed v. non-exposed girls: 1·15 (95 % CI 1·11, 1...
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Objective The study aimed to evaluate the impact of a 15-month intervention on dietary intake conducted among obesity-prone normal-weight pre-school children. Design Information on dietary intake was obtained using a 4 d diet record. A... more
Objective The study aimed to evaluate the impact of a 15-month intervention on dietary intake conducted among obesity-prone normal-weight pre-school children. Design Information on dietary intake was obtained using a 4 d diet record. A diet quality index was adapted to assess how well children’s diet complied with the Danish national guidelines. Linear regression per protocol and intention-to-treat analyses of differences in intakes of energy, macronutrients, fruit, vegetables, fish, sugar-sweetened beverages and diet quality index between the two groups were conducted. Setting The Healthy Start study was conducted during 2009–2011, focusing on changing diet, physical activity, sleep and stress management to prevent excessive weight gain among Danish children. Subjects From a population of 635 Danish pre-school children, who had a high birth weight (≥4000 g), high maternal pre-pregnancy BMI (≥28·0 kg/m2) or low maternal educational level (<10 years of schooling), 285 children com...
Research Interests: Public Health Nutrition, Denmark, Child Behavior, Overweight, Humans, and 14 moreSleep, Patient Compliance, Exercise, Follow-up studies, Body Mass Index, Risk factors, Pediatric Obesity, Healthy Diet, Risk Factors, Psychological Stress, Healthy Lifestyle, Energy Intake, Child preschool, and Medical and Health Sciences
Hair cortisol concentration (HCC) has been suggested as a promising marker for chronic stress. However, studies investigating the influence of hair dyeing and hair washing frequency on HCC have shown inconsistent results. To examine... more
Hair cortisol concentration (HCC) has been suggested as a promising marker for chronic stress. However, studies investigating the influence of hair dyeing and hair washing frequency on HCC have shown inconsistent results. To examine associations between HCC and hair dyeing status or weekly hair washing frequency among women. This cross-sectional study was based on data from 266 mothers participating in the Healthy Start intervention study. HCC was measured in the proximal end of the hair (1-2cm closest to the scalp) while hair dyeing status, frequency of hair washing and covariates were reported by the women. Linear regression analyses were applied to assess the associations between HCC and hair dyeing or weekly frequency of hair washing. No statistically significant difference (p=0.91) in HCC was found between women who dyed hair (adjusted mean: 137pg/mg [95% CI: 122,153]) and women with natural hair color (adjusted mean: 139pg/mg [95% CI: 123,155]). Frequency of hair washing was n...
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To investigate associations between mothers' and children's food intake. Cross-sectional study. Background variables collected through self-reports and from the register of the total population. Mothers recorded their own and... more
To investigate associations between mothers' and children's food intake. Cross-sectional study. Background variables collected through self-reports and from the register of the total population. Mothers recorded their own and their children's food intake in a diary during 2 4-day periods. Eight counties in mid Sweden. Three- and 5-year-old children and their mothers were randomly selected from the register of the total population. A total of 2,045 families were invited, 355 of whom accepted. Mothers who accepted were older and to a larger extent born in Sweden. The final sample of mother-child pairs with complete food records was 189. Mothers' and children's food intake (16 food items). Spearman rank-order correlation with 95% confidence intervals (2-sided). Moderation was investigated using generalized estimation equations with robust variance. The strongest correlations between mothers' and children's food intake were found for pizza and oily fish (r = ...
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The epidemiological evidence that a high-fat diet promotes the development of obesity is considered suggestive but not definitive. The purpose of this paper is to provide a review of various epidemiological methods that have been used to... more
The epidemiological evidence that a high-fat diet promotes the development of obesity is considered suggestive but not definitive. The purpose of this paper is to provide a review of various epidemiological methods that have been used to address this issue as well as an updated summary of the existing evidence. Ecological studies describing dietary fat intake and obesity at the population level provide mixed results and are likely to be biased by both confounding and unknown data quality factors that differ systematically across the populations studied. Cross-sectional studies are generally in agreement that the concentration of fat in the diet is positively associated with relative weight. Prospective studies of diet in relation to subsequent weight change give inconsistent results. This may be due to behavioural factors such as dieting in response to weight gain; in addition, this type of study rarely takes into account the possible interaction between genetic predisposition and dietary fat in promoting weight gain. Finally, intervention studies in free-living subjects are considered, providing evidence of a consistent but short-lived period of active weight loss on low-fat diets. The experimental evidence on this relationship is more conclusive than the epidemiological evidence, although biological mechanisms remain controversial. Some areas for future epidemiological research involve: longitudinal studies of dietary fat intake as a predictor of growth in children; observational studies relating total dietary fat and specific types of fat to overall as well as regional adiposity; and randomized intervention studies of the effect of low-fat diets with particular emphasis on and familial predisposition to obesity and other possible modifying factors.
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ABSTRACT
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Research Interests: Pediatrics, Motivational Interviewing, Overweight, Humans, Female, and 15 moreMale, Infant, Exercise, Mothers, Body Mass Index, Feeding Behavior, Prevalence, Adult, Pediatric Obesity, Primary Prevention, Child Health Services, Socioeconomic Factors, Child preschool, Psychology and Cognitive Sciences, and Medical and Health Sciences
Obesity is increasing globally. Lifestyle and genetic factors alone cannot explain this increase. This review study describes possible associations between environmental chemicals and the growing prevalence of obesity. The review mainly... more
Obesity is increasing globally. Lifestyle and genetic factors alone cannot explain this increase. This review study describes possible associations between environmental chemicals and the growing prevalence of obesity. The review mainly focuses on halogenated organic compounds and their possible effect on obesity development. The literature is, however, limited and knowledge of the mechanisms insufficient. Consequently, it is difficult to describe the risks from these chemicals on obesity development.
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The Danish Fitness and Nutrition Council has proposed a model to monitor the prevalence of overweight and obesity in Denmark. The model should make it possible to assess whether different initiatives reduce the prevalence of obesity and... more
The Danish Fitness and Nutrition Council has proposed a model to monitor the prevalence of overweight and obesity in Denmark. The model should make it possible to assess whether different initiatives reduce the prevalence of obesity and to gain knowledge on how to prevent obesity. The prevalence of obesity should be estimated in a non-biased randomly selected sample of the population once yearly, using all available data from routine measurements and encouraging new measurements conducted in professional settings where routine data are not available.
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We aimed to assess the association between exposure to sunshine during gestation and the risk of type 1 diabetes (T1D) in Danish children. The study population included 331,623 individuals born in Denmark from 1983 to 1988; 886 (0.26%)... more
We aimed to assess the association between exposure to sunshine during gestation and the risk of type 1 diabetes (T1D) in Danish children. The study population included 331,623 individuals born in Denmark from 1983 to 1988; 886 (0.26%) developed T1D by the age of 15 years. The values of sunshine hours were obtained from the Danish Meteorological Institute. Gestational exposure to sunshine was calculated by summing recorded monthly sunshine hours during the full 9 months prior to the month of birth. The linear variable then was split into two categories separated by the median value. Cox regression models showed that more sunshine during the third gestational trimester was associated with lower hazards (HR) of T1D at age 5-9 years in males: HR (95% CI): 0.60 (0.43-0.84), p=0.003. Our results should be considered in the context of evidence-based recommendations to the public about skin protection from the sun.
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Despite solid evidence of an association between centralized body fatness and subsequent disease risk, little is known about the consequences of changes in body fat distribution. Recently it was shown that large hip circumference (HC),... more
Despite solid evidence of an association between centralized body fatness and subsequent disease risk, little is known about the consequences of changes in body fat distribution. Recently it was shown that large hip circumference (HC), measured once, was protective against total and cardiovascular disease (CVD) mortality in women but that gain or loss in HC was unrelated to these outcomes. This study examines whether a 6-year change in waist circumference (WC) predicts mortality and CVD in the same study sample. Baseline WC and 6-year change in WC as predictors of mortality and CVD were analyzed in 2,492 women from the Danish MONICA study and the Prospective Population Study of Women in Gothenburg, Sweden. Increase in WC was significantly associated with increased subsequent mortality and CVD adjusting for BMI and other covariates, with some evidence of a J-shaped association. Associations between increase in WC and outcomes were restricted to women with normal weight at baseline an...
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Studies have suggested that total intake of trans-fatty acids (TFA) is positively associated with changes in body weight and waist circumference, whereas intake of TFA from ruminant dairy and meat products (R-TFA) has not been associated... more
Studies have suggested that total intake of trans-fatty acids (TFA) is positively associated with changes in body weight and waist circumference, whereas intake of TFA from ruminant dairy and meat products (R-TFA) has not been associated with weight gain. However, these previous studies are limited by self-reported measures of body weight and waist circumference or by a cross-sectional design. The objective of the present study was to investigate if R-TFA intake was associated with subsequent changes in anthropometry (body weight, waist and hip circumference) measured by technicians and body composition (body fat percentage). A 6-year follow-up study. Information on dietary intake was collected through diet history interviews, and anthropometric and bioelectrical impedance measurements were obtained by trained technicians at baseline (1987-1988) and at follow-up (1993-1994). Multiple regression with cubic spline modelling was used to analyse the data. Copenhagen County, Denmark. Two...
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The season of birth might influence prenatal circumstances, which may influence the risk of developing type 2 diabetes. The aim of this study was to determine whether the diagnosis of type 2 diabetes in Denmark changed with the season of... more
The season of birth might influence prenatal circumstances, which may influence the risk of developing type 2 diabetes. The aim of this study was to determine whether the diagnosis of type 2 diabetes in Denmark changed with the season of birth. This study used data from the population-based Copenhagen School Health Records Register (CSHRR) that includes schoolchildren born between 1930 and 1989. Via a personal identification number, the CSHRR was linked to the National Patient Register containing hospital discharge diagnoses since 1977. The effect of seasonal variation in birth on the risk of type 2 diabetes was assessed using Cox regression, with month or season of birth as the predictor. The underlying time variable was age, and follow-up started in 1977 or at age 30 years. The study population consisted of 223,099 people, of whom 12,486 developed adult type 2 diabetes. Using January as the reference month, the risk of type 2 diabetes by month of birth was not statistically differ...
Research Interests: Vitamin D, Adolescent, Birth Weight, Denmark, Humans, and 15 moreChild, Female, Male, Young Adult, Risk factors, Registries, Clinical Sciences, Adult, Public health systems and services research, Risk Factors, Seasons, Proportional Hazards Models, Cohort Studies, Child preschool, and Paediatrics and reproductive medicine
The objective of the study was to assess whether gestational and early infancy exposure to low dose vitamin D from a mandatory margarine fortification programme in Denmark influenced the risk of developing type 1 diabetes (T1D) before age... more
The objective of the study was to assess whether gestational and early infancy exposure to low dose vitamin D from a mandatory margarine fortification programme in Denmark influenced the risk of developing type 1 diabetes (T1D) before age of 15 years. The study population included all individuals born in Denmark from 1983 to 1988 and consisted of 331,623 individuals. The 1st of June 1985, which was the date of issue of the new ministerial order cancelling mandatory fortification of margarine with vitamin D in Denmark, served as a reference point separating the studied population into various exposure groups. We further modelled birth cohort effects in children developing T1D as a linear spline, and compared the slopes between the birth cohorts with various prenatal and infancy exposures to vitamin D fortification. In total, 886 (0.26%) individuals developed T1D before the age of 15 years. The beta coefficients (95% CI), or slopes, for linear birth cohort effect in log Hazard Ratio (...
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Research Interests: Health and Birth Weight
The association between recent and more distant weight changes before and after the diagnosis of type 2 diabetes has been little researched. The aim of this study is to determine the influence of patients' weight history before... more
The association between recent and more distant weight changes before and after the diagnosis of type 2 diabetes has been little researched. The aim of this study is to determine the influence of patients' weight history before diabetes diagnosis on the observed 6-year weight changes after diagnosis. A clinical cohort study combined with self-reported past weight history. In total 885 patients aged ≥40 years and newly diagnosed with clinical type 2 diabetes were included. Body weight was measured immediately after diabetes diagnosis and again at the 6-year follow up examination (median, 5.7 years). At diagnosis patients reported their weight 1 year and 10 years previously, and also at the age of 20. Multivariate linear regression analyses controlled for 20 baseline patient characteristics. The median (interquartile range) age at diagnosis was 63.2 (53.9; 71.4) years. Median body weight was 80.0 (72.0; 90.0) kg 10 years before diagnosis, 85.0 (75.0; 95.0) kg 1 year before diagnos...
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In the last 25-30 years, there has been a marked increase in the prevalence of obesity within almost all age groups of the Danish population. The largest increase has been documented in studies based on objective data from total... more
In the last 25-30 years, there has been a marked increase in the prevalence of obesity within almost all age groups of the Danish population. The largest increase has been documented in studies based on objective data from total populations, and the latest data show the increase as continuing. The Danish studies show heterogeneity in the development of the obesity epidemic within various birth cohorts over time. This indicates a need for further etiological research, not only into behavioural factors but also into early life factors that may explain some of this pattern.
Research Interests: Obesity, Adolescent, Denmark, Disease Outbreaks, Humans, and 7 moreChild, Female, Male, Clinical Sciences, Prevalence, Adult, and Cohort Studies
Excessive consumption of sugar-sweetened beverages (SSBs) has become an intractable public health concern worldwide, making investigation of healthy beverage alternatives for SSBs imperative. To summarize the available evidence on the... more
Excessive consumption of sugar-sweetened beverages (SSBs) has become an intractable public health concern worldwide, making investigation of healthy beverage alternatives for SSBs imperative. To summarize the available evidence on the effects of replacing SSBs with beverage alternatives on long-term health outcomes. We systematically retrieved studies from six electronic databases from inception to November 2013. Prospective cohort studies and randomized controlled trials (RCTs) examining the effects of substituting beverage alternatives for SSBs on long-term health outcomes in both children and adults were included. The quality of included studies was assessed using the Scottish Intercollegiate Guidelines Network 50 methodology checklists. Six cohort studies and four RCTs were included in the systematic review with the quality rating ranging from acceptable to high. Evidence from both cohort studies and RCTs showed substitution of SSBs by various beverage alternatives was associate...
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A high intake of sugar-sweetened beverages (SSB) has been linked to weight gain, obesity and type 2 diabetes; however, the influence on CVD risk remains unclear. Therefore, our objective was to summarize current evidence for an... more
A high intake of sugar-sweetened beverages (SSB) has been linked to weight gain, obesity and type 2 diabetes; however, the influence on CVD risk remains unclear. Therefore, our objective was to summarize current evidence for an association between SSB consumption and cardiovascular risk factors and events. The article search was performed in August 2013. Two independent researchers performed the article search and selection, data extraction and quality assessment. Eligible studies reported the intake of SSB and one of the following outcomes: change in blood pressure, blood lipid or blood sugar, or CVD events such as stroke or myocardial infarction. Only intervention and longitudinal studies were included. Only studies in adults (aged 18+ years old) were considered. Two of four prospective studies found clear direct associations between SSB consumption and CHD, while two of three studies, including both men and women, found direct associations between SSB consumption and stroke; howe...
Research Interests: Public Health Nutrition, Evidence Based Medicine, Stroke, Humans, Hyperglycemia, and 14 moreHypertension, Female, Male, Incidence, Risk factors, High-Fructose Corn Syrup, Beverages, Adult, Coronary heart disease, Sex Factors, Risk Factors, Vascular Diseases, Medical and Health Sciences, and Hyperlipidemias
To determine whether habitual dietary intake was associated with body fat mass and body fat distribution, independently of possible confounding by the genetic and shared environmental background. We examined correlations between intrapair... more
To determine whether habitual dietary intake was associated with body fat mass and body fat distribution, independently of possible confounding by the genetic and shared environmental background. We examined correlations between intrapair differences in specific dietary composition and intake of foods and macronutrients in relation to differences in anthropometric phenotypes in a population-based sample of monozygotic twins. Data originated from a cross-sectional study, conducted in 1997-2000, of healthy twin pairs with measured anthropometry and information from food frequency questionnaire supplemented by self-reported weight from 1994 to 2002 and self-reported waist circumference from 2002. For this study, 153 men and 158 women identical twin pairs were included. Intrapair differences in dietary factors and anthropometry were studied using correlation analyses. Only few statistically significant correlations between intrapair differences in dietary intake and anthropometry were f...