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<p><strong>Bakgrund </strong>Livsstilsrelaterade sjukdomar är idag den största dödsorsaken i Sverige, men stora möjligheter till både primär och sekundär prevention finns. För att åstadkomma detta är förändringar av kostvanor och livsstil centrala delar. Här har dietisten en viktig roll då dessa förändringar visat sig vara mycket svåra att klara av på egen hand. Men hur upplever dietister arbetet med denna patientgrupp? Ibland kan de känna sig otillräckliga i sin yrkesroll, men de upplever ändå sitt arbete som viktigt. Vidare skulle det vara intressant att undersöka vilka andra tankar och känslor som kan uppkomma hos dietister.<strong>Syfte </strong>Syftet med studien var att undersöka hur dietister upplever och hanterar att arbeta med patienter som ordineras behandling vilken innefattar en livsstilsförändring där kostomläggning ingår som en central del.<strong>Metod</strong> Fyra kvalitativa intervjuer genomfördes med dietister som arbetade med livsstilspatienter. Som stöd vid intervjuerna användes en semistrukturerad frågeguide. Intervjuerna spelades in och transkriberades sedan ordagrant. Transkriberat material analyserades med kvalitativ innehållsanalys.<strong>Resultat</strong> Dietistens arbete med denna patientgrupp upplevdes som väldigt komplext. Det var inte bara dietisternas eget arbetssätt och egenskaper som påverkade upplevelsen av att behandla dessa patienter. Även patientens beteende och hinder samt de behandlingstekniker som behärskades av dietisten hade en betydande roll. Dietisterna upplevde också att det fanns vissa begränsningar som kunde påverka deras förmåga att ge bästa behandling. Motivation hos patienten upplevdes vara av stor betydelse för att lyckas med en livsstilsförändring.<strong>Slutsats</strong> Dietister upplever att arbetet med patienter som ska genomgå en livsstilsförändring inbegriper mer än att förmedla kunskaper om kost. Motivationsfrämjande insatser betraktas som dietistens viktigaste redskap vid behandling av denna patientgrupp. Ökad kunskap om sådana behandlingsstrategier skulle därför kunna gynna både dietister och patienter.</p> / <p><strong>Background</strong> Lifestylerelated diseases are the most common causes of death in Sweden, but there are great options for both primary and secondary prevention. To achieve this, changes in diet and lifestyle are both central elements. Here dietitians play an important role as these changes proved to be very difficult for patients to cope with on their own. How do dietitians experience the work with these patients? Although they may feel inadequate they still feel that their work is important. Furthermore it would be interesting to examine other thoughts and feelings that may arise among dietitians.<strong>Objective</strong> The objective of this study was to examine how dietitians perceive and manage to work with patients who are prescribed treatment that involves lifestyle changes where changes in diet are central parts.<strong>Method</strong> Four qualitative interviews were conducted with dietitians working with patients undergoing lifestyle change. A semi structured topic guide was used to broadly shape the interviews. All interviews were digitaly recorded and transcribed verbatim. The transcripts were analysed with qualitative content analysis.<strong>Result</strong> Dietitians experienced work with patients undergoing lifestyle changes as very complex. Not only the dietitian’s own practice and qualities influenced the experience of treating these patients. Patientbehavior and barriers along with different treatment strategies mastered by the dietitian were also important. Dietitians experienced that there were certain limitations that could affect their ability to provide best treatment. The patients motivation was thought of as very important to achieve lifestyle changes.<strong>Conclusion</strong> This study suggests that dietitians’ work experience with patients undergoing lifestyle change includes more than just thorough knowledge about food. Promoting motivation is an important tool in treatment of these patients. Increased knowledge about different behavior modification strategies could therefore favour both patients and dietitians.</p>

<p>In the Swedish elderly-care sector the institutions are of different character and the kind of care and food-supply they offer vary in scope and intensity. The aim of this study was to analyse how food and meals were handled and provided to the elderly living within those situations and in this context, how food was expressed as a substance or/and in symbols. This study focus on the social organisation that embraces the diet of the elderly and shapes the provisions of their meals, on the norms, values and behaviours of the different social identities in the organisation. The empirical work included in-depth interviews and participant observations in four different residential care homes, including various hierarchical levels, i.e. politicians and different personnel, in the organisation of food-supply to the elderly. In each care home different types of care and food-supply were studied, i.e. elderly having their meals in 24hour care, partime day care and those who ate in the restaurants. Generally, provision of meals was routine and meals were planned, prepared and served with little or no attention to what substanse and symbol it brought to the elderly. The elderly had limited possibilities to influence their own meals and those with the largest need of care, being the most fragile and sick had the least influence. The views of politicians and different personnel indicated that they considered themself powerless, which resulted in a "freedom of responsibility". It was obvious that there existed a clear discrepancy between how the informants considered the provision of food and meals should be organised and carried out, in comparison to reality. The current unsatisfactory provision of meals to the elderly is attributed to the marginalisation of specifically three areas: the symbolic value of food, the life and needs of the elderly and the traditional knowledge and experiences of women in their role as housewife and carer of the family.</p>

In the Swedish elderly-care sector the institutions are of different character and the kind of care and food-supply they offer vary in scope and intensity. The aim of this study was to analyse how food and meals were handled and provided to the elderly living within those situations and in this context, how food was expressed as a substance or/and in symbols. This study focus on the social organisation that embraces the diet of the elderly and shapes the provisions of their meals, on the norms, values and behaviours of the different social identities in the organisation. The empirical work included in-depth interviews and participant observations in four different residential care homes, including various hierarchical levels, i.e. politicians and different personnel, in the organisation of food-supply to the elderly. In each care home different types of care and food-supply were studied, i.e. elderly having their meals in 24hour care, partime day care and those who ate in the restaurants. Generally, provision of meals was routine and meals were planned, prepared and served with little or no attention to what substanse and symbol it brought to the elderly. The elderly had limited possibilities to influence their own meals and those with the largest need of care, being the most fragile and sick had the least influence. The views of politicians and different personnel indicated that they considered themself powerless, which resulted in a "freedom of responsibility". It was obvious that there existed a clear discrepancy between how the informants considered the provision of food and meals should be organised and carried out, in comparison to reality. The current unsatisfactory provision of meals to the elderly is attributed to the marginalisation of specifically three areas: the symbolic value of food, the life and needs of the elderly and the traditional knowledge and experiences of women in their role as housewife and carer of the family.

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Bakgrund Det finns ännu inga etablerade officiella gränsvärden för övervikt och fetma som är baserade på proportionen fettmassa (FM%) utan de gränsvärden som finns är utgår body mass index (BMI) eller midjemått. Syfte Att utveckla modeller för att prediktera FM, procentuellt och i kg, utifrån antropometriska mått hos unga och medelålders (20-49 år) svenska män. Vidare syftar uppsatsen till att undersöka vilka värden för FM% som motsvarar 25 kg/m2 och 30 kg/m2 i BMI och samt för 94 cm och 102 cm i midjemått. Metod Männen har rekryterats med hjälp av en mödravårdscentral, kvinnohälsan, i Linköping i samband med ett projekt om utveckling av barnfetma. Totalt 136 män undersöktes med Bod Pod, en maskin som mäter kroppssammansättning med hög validitet. Vidare mättes antropometriska mått såsom vikt, längd och midjemått vid mättillfället. Resultat Regressionsmodellerna med midjemått och BMI (r=0,94) samt midjemått (r=0,94) var de som var signifikant högst korrelerade till FM (kg). De regressionsmodellerna som förklarade mest av variansen i FM% var de med 1) M/L (midja/längd), midjemått och BMI 2) M/L och 3) midjemått som oberoende variabler (r=0,86-0,88). Ett BMI på 25 kg/m2 och 30 kg/m2 motsvaras av 23, respektive 32 FM%. Motsvarande värden för midjemått 94 och 102 cm var 25, respektive 31 FM%. Slutsats Midjemått och M/L (midjemått/längd) är bäst för att prediktera mängden fettmassa (FM), både i procent och kg. BMI 25 kg/m2 motsvarar 23±1 i FM% och BMI 30 kg/m2 korresponderas av 32±2 i FM%. / Introduction Currently, no official cut-offs regarding overweight and obesity based on proportion fat mass (FM%) are available. Existing cut-offs are instead derived from body mass index (BMI) and waist circumference. Aim To develop equations to predict FM, in percent and kg, from anthropometric measures in young and middle aged (20-49 years of age) Swedish men. Also, this paper aims to investigate which values for FM% that corresponds to firstly 25 kg/m2 and 30 kg/m2 in BMI and secondly to 94 cm and 102 cm in waist circumference. Methods The men in the study were recruited in collaboration with a maternity clinic, kvinnohälsan, in Linköping. In total, 136 men were measured by the means of Bod Pod, a device that measures body composition in a valid manner. Anthropometric measures such as weight, height and waist circumference were measured. Results The regression models with waist circumference and BMI (r=0,94) and waist circumference (r=0,94) were significantly strongest related to FM (kg). The regression models who explained most of the variability in FM% were the ones with 1) W/H (waist circumference/height), waist circumference and BMI 2) W/H and 3) waist circumference as independent variables. A BMI of 25 kg/m2 and 30 kg/m2 corresponds to a FM% of 23 and 32, respectively. Corresponding values for waist circumference (94 and 102 cm) were 25 FM% and 31 FM%, respectively. Conclusion Waist circumference and W/H were the best variables to predict fat mass, both in percent and kg. BMI 25 kg/m2 corresponds to a FM% of 23±1 while BMI 30 kg/m2 is equivalent to 32±2 in FM%.

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Background Overweight and obesity in childhood is associated with physical, psychological and social consequences. Physical inactivity is regarded as one of the main factors that have contributed to the increase in childhood obesity through out the world. Overweight and obesity as well as physical activity level are shown to track from childhood to adolescence and adulthood, thereby influencing not only the current health status but also long-term health. The general purpose of this thesis was to evaluate the effect of a 2-year family-based lifestyle intervention on physical activity and metabolic health among children with overweight and obesity. Methods Children with overweight or obesity living in northern Sweden were recruited to the study. In total 105 children, mean age 10.5 years (SD±1.09), were randomized into either an intervention or a control group. The intervention group was offered as a 2-year family-based lifestyle intervention; the 1st year consisted of 14 group sessions and during the 2nd year the intervention was web-based. The control group did not participate in any intervention sessions, but performed all measurements. Physical activity was measured in all children using SenseWear Pro2 Armband (SWA) during 4 consecutive days before, in the middle and after the intervention, data regarding anthropometrics and blood values were collected in the same periods. Twenty-two of the children wore SWA during 14 days before the intervention in order to validate energy expenditure (EE) estimated by SWA against EE measured with double labelled water. Results The SWA, together with software version 5.1, proved to be a valid device to accurately estimate EE at group level of overweight and obese children. There were no statistically significant differences between the groups neither before nor after the intervention regarding physical activity and screen-time. All children significantly decreased their time being active ≥3 METs during the study period. After the study period, significantly fewer in the control group achieved the national physical activity recommendation, and they had significantly increased their screen-time. However, these changes were not seen within the intervention group. The intervention group had a significantly lower apolipoprotein B/A1 compared to the control group at 1-year measurement; no other significant differences were found regarding metabolic markers. No statistical difference was found between the groups regarding body mass index after the 2-year study period. Conclusion Even though a comprehensive program, the 2-year family-based lifestyle intervention had limited effects on physical activity and metabolic health in overweight and obese children. SWA is a device that can be used in future studies to measure energy expenditure among free-living overweight or obese children. / SELFH

More often consumers demand instant dry soup that can be prepared with a water temperature below 100o C, which is currently not possible, because the dry soup becomes too thin when using water with a lower temperature. In this study, various kinds of starch studies were made to optimize the starch used in the existing product to make it more viscous at both high and low temperatures. The result was that one of the two starches present in the existing product was retained by change in quantity as it contributed to important flavor parameters. The second was removed and replaced with a starch that made the product more viscous at lower temperatures. To find out if the new product differed from the existing product a viscosity measurement and a sensory paired preference test were made. The viscosity measurement contributed objective data that clarified whether differences existed or not. The sensory paired preference test provided insight into which of the two product variants the consumers preferred. The new starch contributes to higher viscosity at temperatures below 100 ° C and is significantly different from the existing product and is preferred by consumers when prepared at lower temperatures. The exclusion of one of the existing starches resulted in lack of mouth feel at 100oC which consumers perceive as negative. In order for this result to be possible to use to optimize the existing product it requires further product development for the company to gain customer satisfaction. / Fler och fler konsumenter efterfrågar Varma Koppen som kan tillagas med vatten vid lägre temperaturer än kokande vatten, vilket i nuläget inte är möjligt då pulversoppan blir för tunn vid tillsats av kallare vatten. I denna studie har olika sorters stärkelse arbetats med för att optimera det stärkelseinnehåll som finns i den befintliga produkten för att göra den viskös vid både höga och låga temperaturer. Resultatet blev att en av de två stärkelser som förekom i den befintliga produkten behölls men förändrades i mängd då den bidrog till viktiga smakparametrar. Den andra plockades bort och ersattes med en stärkelse som gjorde produkten mer viskös vid lägre temperaturer. För att ta reda på om den nya produkten skiljde sig ifrån den befintliga utfördes en viskositetsmätning och ett sensoriskt parvist preferenstest. Viskositetsmätningen bidrog med objektiv data som klargjorde ifall skillnader fanns eller inte. Det sensoriskt parvisa preferenstestet gav en inblick i vilken av de två produktvarianterna som konsumenterna föredrog. Den nya stärkelsen bidrar till högre viskositet vid temperaturer under 100oC och skiljer sig signifikant från den befintliga produkten och föredras av konsumenterna vid lägre temperaturer. Uteslutandet av en av de befintliga stärkelserna har dock bidragit till en försämrad munkänsla vid 100o C som konsumenterna ser som negativ. För att detta resultat ska kunna användas för att ge en optimerad pulversoppa krävs därför vidare produktutveckling på företaget.