Bakgrund: Ett lämpligt näringsintag är viktigt för främjandet och bevarandet av både den allmänna och orala hälsan. Karies är en multifaktoriell sjukdom där kosten har en betydelsefull roll. Kosten kan bidra till både kariesförekomst och kariesprevention. Functional food definieras som ”livsmedel som ger hälsovinster utöver basnutritionen” och ”livsmedel som har en eller flera tillsatser som modifierats för att bidra till en hälsosam kosthållning”. Syfte: Syftet med studien var att kartlägga kunskapsnivån och tillämpningen av information till patienterna om Functional food i det kariesförebyggande arbetet inom Folktandvården, Landstinget Kronoberg. Metod: Enkätstudiens urval bestod av tandläkare, tandhygienister och tandsköterskor, totalt 106 deltagare, från 17 olika Folktandvårdskliniker tillhörande allmäntandvården i Landstinget Kronoberg. Enkäten bestod av 24 frågor som bedömdes enligt ett graderat poängsättningssystem. Resultatet redovisades deskriptivt med hjälp av tabeller och diagram. Statistiska analyser utfördes med hjälp chitvåtest. Resultat: Majoriteten av deltagarna kategoriserades i grupperna: låg kunskapsnivå samt låg till medelhög tillämpningsnivå av Functional food i det kariesförebyggande arbetet. Merparten av deltagarna hade ett stort intresse av att få ytterligare kunskap. Slutsats: Tandvårdspersonalen önskade mer kunskap om Functional food för en ökad tillämpning i patientarbetet, givet att vetenskaplig evidens uppnås. / Background: An adequate nutrition is essential for the promotion and maintenance of the general and oral health. Dental caries is a multifactorial disease in which diet is a important factor. Functional foods are defined as "foods that provide health benefits beyond basic nutrition" and "foods that has one or more additives, modified to contribute to a healthy diet". Aim: The aim of the study was to identify the level of knowledge and application regarding information to patients about Functional food in caries prevention work in Public dental services, County Council of Kronoberg. Method: The survey included 106 participants consisted of dentists, dental hygienists and dental nurses from 17 different Public dental services. The survey consisted of 24 questions. The results were presented descriptive, with tables and charts, as well as statistically analyzes using chi-square tests. Results: The majority of participants were categorized into the groups: low level of knowledge and medium or low application level of Functional food in the caries prevention work. Most of the participants had a great interest in obtaining additional knowledge. Conclusion: Dental professionals would like to get more knowledge about Functional food for an increased application in patient care, provided that scientific evidence is obtained.

The aim of the thesis: The aim of this observational study of non-interventional nature, was to map the representation of macronutrients and selected micronutrients in the menus served to patients suffering of gastritis as well as other nutrition diets. Additionally, to research and review the dietary systems in healthcare facilities of the Czech Republic, in order to compare the obtained data with recommended nutritional intakes, as recommended/stated in the issue "Reference Values for Nutrition Intake". The purpose is to evaluate, whether both types of the diets follow the recommended values. Methodology: The source of the data for this thesis were the menus distributed to patients following the recommendations of norms related to gastritis and rational nutrition diets for the period of one week. By applying the "Nutriservis PROFESIONAL software" the content of studied macronutrients and selected micronutrients in the daily menus was determined in the collected data. Results: Ten selected healthcare facilities from six regions in the Czech Republic participated in the research. It was determined from the obtained data, that insufficient presence of fiber, wrong balance, as well as the amount of unsaturated and saturated fatty acids along with high amount of sodium were the key malpractices,...

Multiple sclerosis (MS) is among the most common neuroinflammatory diseases across the globe and is autoimmune mediated in nature. This progressive, highly debilitating disease often leaves individuals wheelchair bound within 15-25 years of onset. MS is characterized by inflammatory lesions that appear in unpredictable locations around the central nervous system. Lesions can be visualized using magnetic resonance imaging (MRI) technology. As neuroinflammation continues and lesions accumulate, patients can experience a wide array of progressively worsening symptoms including but not limited to motor impairments, sensory disturbances, loss of control of bodily functions, and/or neuropathic pain, depending on the location of lesion formations. There are different types of MS, the most common being relapsing-remitting MS (RRMS) seen in about 85% of cases and characterized by periods of symptom remission followed by flare-ups. A large majority of these patients go on to develop secondary progressive MS (SPMS) where neurological damage and patient decline is progressive and continuous. Primary progressive MS (PPMS) is seen in about 10% of cases and is characterized by progressive and continuous patient decline from the outset of disease. Other rarer forms of MS do exist but will not be discussed further. Research aimed at MS is at an all-time high and the timing could not be better: its global incidence and prevalence is climbing. For decades MS has been thought of as a disease caused by dysfunctional CD4+ T-helper 1 (Th1) cells. It is now known that many different cell types contribute to MS pathophysiology. These other cell types include macrophages and dendritic cells of the innate immune system due to their expression of MHC class II molecules that function to activate CD4+ Th1 cells. More recent research has implicated CD8+ T-cells and B-cells in contributing to disease through direct destruction of neural cells that express MHC class I molecules and through the generation of autoantibodies, respectively. While these discoveries are important and provide hope for future breakthrough treatments, there are still enormous gaps in the medical community’s knowledge of what causes MS. The epidemiologic pattern of MS prevalence has for many decades interested scientists and hinted at a potential cause of this disease. MS tends to affect white individuals with genetic ties to northern Europe, but this relationship may not still hold true, as MS incidence and prevalence may be rising faster in black populations compared to other races/ethnicities, at least in the United States. MS occurs nearly 3 times as often in females than in males, and is strongly associated with Epstein-Barr virus (EBV) infection—especially in those that go on to develop infectious mononucleosis (IM). MS prevalence increases markedly in regions north of 40 degrees North latitude or south of 40 degrees South latitude. MS risk also changes depending on body mass index (BMI) considerations, migration history, and in families with a genetic history of the disease. It is well-accepted that MS has a genetic component, the most important of which is the presence of the HLA-DRB1*1501 allele that codes for certain proteins in MHC class II molecules. However, genetics alone are unable to sufficiently account for MS risk as the concordance rate for identical twins with MS is only 25-30%. These well-established findings imply that some unknown environmental factor(s) must be contributing to MS initiation and progression. All of the environmental factors listed above have a common connecting thread that is logically and empirically verifiable: vitamin D. This fat-soluble vitamin can either be endogenously synthesized in the skin after exposure to ultraviolet B (UVB) light or consumed through the diet, the former being of more importance to humans. Epidemiologic patterns suggest a protective role for vitamin D in MS, where low or deficient levels of vitamin D may be a contributor to increased risk for MS. Populations living at greater latitudes, north or south, have significantly greater prevalence of MS which coincides with the reduction of endogenously produced vitamin D in these regions due to a lesser amount of UVB light (and of lower intensity) experienced year-round. Increases in BMI, especially increased adiposity, correlate with increased risk for MS and with prevalence of vitamin D deficiency. Women tend to naturally have greater adiposity than men, thus increasing their risk for MS. Estrogens and vitamin D have been shown to act synergistically to protect against MS, therefore vitamin D deficiency may increase risk for MS in women. Vitamin D is a known immunomodulatory agent that promotes tolerogenic immune states. Vitamin D also offsets many of the harmful effects caused by EBV, among these including repression of B-cell differentiation into plasma cells, reduced MHC II expression, and promotion of B cell apoptosis. This serves to repress deleterious immunoglobulin secretion by B-cells. Vitamin D is also immunologically beneficial as it promotes regulatory T cell function and their expression of protective cytokines, and through its inhibition of inflammatory Th1 and Th17 cell functions. In total, the immunomodulatory mechanisms of vitamin D are important as the immunological states produced by vitamin D are exactly the opposite of those observed in MS patients and MS animal models. Research in vitamin D is gaining attention as the scientific community is quickly discovering that its true physiologic role extends far beyond its classical function as a calcium regulator. Indeed, rapidly evolving research is revealing roles for vitamin D in cardiovascular function and blood pressure regulation, brain development and neurological function, and even in the prevention of certain cancers. However, this thesis will focus on its most well-known function secondary to calcium regulation: immunomodulation and its anti-inflammatory capabilities. The last portion of this thesis will present information advocating for the increase in minimum dietary intake of vitamin D from its current value of 800 IU/day to 5,000 IU/day. While a more than 5-fold increase may seem drastic, the tolerable upper limit is at least 10,000 IU/day even by the most conservative of estimates—the true upper limit is probably around 20,000 IU/day and may even be 50,000 IU/day. The global prevalence of vitamin D deficiency is so extensive that some authors have even considered it a global pandemic: upwards of 50% of the entire world population may be deficient in this crucial vitamin. Increasing vitamin D supplementation is an extremely low risk way to reduce risk for MS and other diseases.

We eat foods not nutrients. What is more, we eat them in combinations. Consequently, capturing our complex food habits is likely an advantage in nutrition research. The overall aim of this doctoral thesis was therefore to investigate dietary patterns in the Swedish population –nutrient intakes, nutritional biomarkers and health aspects. Prostate cancer is the most common cancer among men in the developed world. However, the impact of dietary factors on disease risk is largely unknown. In Study I we investigated the association between a Mediterranean- and a Low-carbohydrate-high-protein dietary pattern and prostate cancer risk, in a cohort of elderly Swedish men. The latter (but not the former) was associated, inversely, with prostate cancer risk when taking validity in food records into account. Diet is one of our main exposure routes to environmental contaminants. Hence, such exposure could act as a mediating factor in the relation between diet and health. In Study II we investigated the association between; a Mediterranean- and a Low-carbohydrate-high-protein dietary pattern, as well as the official dietary recommendations, and circulating levels of environmental contaminants, in an elderly Swedish population. The first two patterns were positively related to levels of both persistent organic pollutants and heavy metals, whilst the dietary recommendations were inversely associated to dioxin and lead. Finally, although dietary patterns are likely to influence health, little is known about current dietary patterns in Sweden. In Study III we used a data-reduction method to identify dietary patterns in a nationwide sample of the Swedish population. Two major patterns were derived; a Healthy pattern of foods generally considered healthy (e.g. vegetables, fruits, fish and vegetable-oils) and a Swedish traditional pattern (with e.g. meats, potatoes, sauces, non-Keyhole milk-products, sweet-bakery products and margarine). Derived patterns were associated to population characteristics and the Healthy dietary pattern was inversely associated to anthropometric variables in Study IV. Dietary characteristics of the patterns were well reflected in correlations to nutrient intake and (to a lesser extent) in nutritional biomarkers. In conclusion dietary patterns for overall health should be considered, as well as other lifestyle-factors, when interpreting results in nutrition epidemiology and establishing dietary recommendations.