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1.
Nutrients ; 12(9)2020 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-32927800

RESUMO

Milk and fermented milk consumption has been linked to health and mortality but the association with Parkinson's disease (PD) is uncertain. We conducted a study to investigate whether milk and fermented milk intakes are associated with incident PD. This cohort study included 81,915 Swedish adults (with a mean age of 62 years) who completed a questionnaire, including questions about milk and fermented milk (soured milk and yogurt) intake, in 1997. PD cases were identified through linkage with the Swedish National Patient and Cause of Death Registers. Multivariable-adjusted hazard ratios were obtained from Cox proportional hazards regression models. During a mean follow-up of 14.9 years, 1251 PD cases were identified in the cohort. Compared with no or low milk consumption (<40 mL/day), the hazard ratios of PD across quintiles of milk intake were 1.29 (95% CI 1.07, 1.56) for 40-159 mL/day, 1.19 (95% CI 0.99, 1.42) for 160-200 mL/day, 1.29 (95% CI 1.08, 1.53) for 201-400 mL/day, and 1.14 (95% CI 0.93, 1.40) for >400 mL/day. Fermented milk intake was not associated with PD. We found a weak association between milk intake and increased risk of PD but no dose-response relationship. Fermented milk intake was not associated with increased risk of PD.

2.
Pharm. pract. (Granada, Internet) ; 16(4): 0-0, oct.-dic. 2018. tab
Artigo em Inglês | IBECS | ID: ibc-180986

RESUMO

Background: Generic substitution (GS), is a cost-containment strategy meant to contain pharmaceutical expenditure without compromising health objectives. In order to shape GS into a policy that is both efficient and safe it is crucial to understand which factors are most important for patients' trust in GS. Objective: To assess Swedish patients' level of trust in the bioequivalence of cheap and expensive generic medicines, and the association between trust and various factors. Methods: A cross-sectional study was conducted. Questionnaires were handed out at 12 community pharmacies in Sweden, selected through stratified sampling, between March and April 2015. The questionnaire included seven socio-demographic questions in addition to 18 items divided into three sections: the 'views on generic medicine'-scale, information on and prior experiences of GS, financial aspects and change of color/name. Odds Ratios (ORs) were estimated applying adjusted logistic regression analyses with trust in the bioequivalence of generic medicines used as outcome variable and various factors as predictors. Results: A total of 719 patients participated (response rate 85.7%). The results show that 70.7% of the respondents' trust that cheap and expensive interchangeable generic medicines are equal. Of the respondents 36.0% considered the change in appearance and 40.8% the change in names to complicate adherence. Lower trust in the bioequivalence of generic medicines were associated with being female (aOR=1.82, 95%CI 1.20:2.75, p<0.01), patients perceiving that changes in product name and appearance make adherence more complicated (aOR=2.18, 95%CI 1.48:3.19, p<0.001), disagreeing in that GS saves money for me (the customer) (aOR=2.68, 95%CI 1.58:4.55, p<0.001) or that GS saves money for society (aOR=3.21, 95%CI 1.46:7.08, p<0.01). Conclusions: Seven out of ten respondents had trust in the bioequivalence of generic medicines, and one in three considered GS to complicate adherence. Four factors were associated with lower trust in GS, i.e. female gender, agreeing that changes in product name and appearance complicates adherence, disagreeing in that GS saves money for me or disagreeing in that GS saves money for the society. Low trust in GS needs to be addressed, not least in the communication between health professionals and patients


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Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Medicamentos Bioequivalentes , Medicamentos Genéricos/uso terapêutico , Adesão à Medicação/estatística & dados numéricos , Confiança , Suécia/epidemiologia , Substituição de Medicamentos/estatística & dados numéricos , Estudos Transversais , Inquéritos e Questionários/estatística & dados numéricos , Preferência do Paciente/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde
3.
Am J Pharm Educ ; 82(2): 6208, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29606708

RESUMO

Objective. To describe Nordic pharmacy students' opinions of their patient communication skills training (PCST), and the association between course leaders' reports of PCST qualities and students' perceptions of their training. Secondary objective was to determine what factors influence these associations. Methods. A cross-sectional questionnaire-based study was performed. The various curricula were categorized into three types (basic, intermediate and innovative training) and students were divided into three groups according to the type of training they had received. Multivariable logistic regression models were fitted with different opinions as outcomes and three types of training as exposure, using generalized estimation equations. Results. There were 370 students who responded (response rate: 77%). Students within the innovative group were significantly more likely to agree that they had received sufficient training, and to agree with the assertion that the pharmacy school had contributed to their level of skills compared to students in the basic group. Conclusion. There appears to be an association between larger and varied programs of training in patient communication skills and positive attitudes toward this training on the part of the students, with students reporting that they received sufficient training, which likely enhanced their skills.


Assuntos
Competência Clínica , Comunicação , Educação em Farmácia/métodos , Estudantes de Farmácia/psicologia , Adulto , Estudos Transversais , Currículo , Avaliação Educacional , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Países Escandinavos e Nórdicos , Inquéritos e Questionários , Adulto Jovem
4.
Eur J Clin Pharmacol ; 74(5): 627-636, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29290074

RESUMO

PURPOSE: Despite FDA and EMA warnings of long-term use, little is known regarding the time to onset (TTO) of neurological adverse drug reactions (ADR) for metoclopramide. The aims of this study were, first, to evaluate whether neurological ADRs are more commonly reported for metoclopramide than for other medications, and second, to describe how time to onset of neurological ADRs differs by age and gender. METHODS: All ADR reports with metoclopramide as the suspected/interacting drug were extracted from the WHOs Global ADR database Vigibase® between 1967 and May 2016. Cox proportional hazards models were fit using TTO of neurological ADRs as the outcome and age, gender, and type of ADR as predictors. Proportional Reporting Ratios (PRRs) for neurological ADRs were compared across age and gender. Lawyer reports were excluded in the analysis. RESULTS: Over 47,000 ADR reports with metoclopramide were identified. Over one third (35.6%) of the reports came from lawyers. The majority of ADRs in general and neurological ADRs in specific occurred within the first 5 days of metoclopramide use (median 1 day). TTO increased with age. Neurological ADRs were reported two to four times as frequently for metoclopramide than for other drugs, with the highest PRRs observed in children (PRR = 4.24 for girls and 4.60 for boys). CONCLUSIONS: Most adverse drug reactions occur within the first 5 days of treatment with metoclopramide. Patients requiring use of metoclopramide should be carefully monitored for neurological ADRs during the first days of treatment.


Assuntos
Antieméticos/efeitos adversos , Antagonistas dos Receptores de Dopamina D2/efeitos adversos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Metoclopramida/efeitos adversos , Síndromes Neurotóxicas/epidemiologia , Adolescente , Adulto , Sistemas de Notificação de Reações Adversas a Medicamentos/estatística & dados numéricos , Criança , Pré-Escolar , Bases de Dados Factuais/estatística & dados numéricos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Farmacovigilância , Organização Mundial da Saúde , Adulto Jovem
5.
Pharm Pract (Granada) ; 16(4): 1298, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30637031

RESUMO

Background: Generic substitution (GS), is a cost-containment strategy meant to contain pharmaceutical expenditure without compromising health objectives. In order to shape GS into a policy that is both efficient and safe it is crucial to understand which factors are most important for patients' trust in GS. Objective: To assess Swedish patients' level of trust in the bioequivalence of cheap and expensive generic medicines, and the association between trust and various factors. Methods: A cross-sectional study was conducted. Questionnaires were handed out at 12 community pharmacies in Sweden, selected through stratified sampling, between March and April 2015. The questionnaire included seven socio-demographic questions in addition to 18 items divided into three sections: the 'views on generic medicine'-scale, information on and prior experiences of GS, financial aspects and change of color/name. Odds Ratios (ORs) were estimated applying adjusted logistic regression analyses with trust in the bioequivalence of generic medicines used as outcome variable and various factors as predictors. Results: A total of 719 patients participated (response rate 85.7%). The results show that 70.7% of the respondents' trust that cheap and expensive interchangeable generic medicines are equal. Of the respondents 36.0% considered the change in appearance and 40.8% the change in names to complicate adherence. Lower trust in the bioequivalence of generic medicines were associated with being female (aOR=1.82, 95%CI 1.20:2.75, p<0.01), patients perceiving that changes in product name and appearance make adherence more complicated (aOR=2.18, 95%CI 1.48:3.19, p<0.001), disagreeing in that GS saves money for me (the customer) (aOR=2.68, 95%CI 1.58:4.55, p<0.001) or that GS saves money for society (aOR=3.21, 95%CI 1.46:7.08, p<0.01). Conclusions: Seven out of ten respondents had trust in the bioequivalence of generic medicines, and one in three considered GS to complicate adherence. Four factors were associated with lower trust in GS, i.e. female gender, agreeing that changes in product name and appearance complicates adherence, disagreeing in that GS saves money for me or disagreeing in that GS saves money for the society. Low trust in GS needs to be addressed, not least in the communication between health professionals and patients.

8.
Exp Gerontol ; 92: 52-55, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28323025

RESUMO

The accuracy of predictive equations for calculating resting energy expenditure (REE) in elderly people has been questioned. Aging is associated with progressive declines in REE, which partly is explained by loss of fat free mass (FFM). Against this background we aimed to identify the most accurate predictive equation for REE in octogenarian men, taking body composition into account and using indirect calorimetry as reference value. REE was measured in 22 men (mean age 82.6±0.3years) and compared with six predictive equations: two based on FFM and four based on body weight, height and/or age. FFM was derived from Dual-energy X-ray absorptiometry analyses. Spearman's rank correlations showed a moderate to high positive monotonic correlation (r=0.62 to 0.79) between measured and calculated REE (all p<0.005).The mean calculated REE was significantly different from measured REE for all equations except Mifflin-St Jeor. A calculated REE within 10% of measured REE was considered acceptable and the equations of Mifflin-St Jeor, WHO and Harris-Benedict captured 64%, 50% and 45% of the participant, respectively. The Mifflin-St Jeor equation had the lowest root mean square error (138kcal), followed by the equation by Harris-Benedict (189kcal) and WHO (220kcal). The equations from Luhrmann, Henry and Cunningham predicted REE rather poorly in our study subjects, with e.g. <40% of the individuals within 10% of measured REE. Our results indicate that the Mifflin-St Jeor equation (using FFM) is the most accurate equation estimating REE in these octogenarian men. Harris-Benedict or WHO equations are potential alternatives if information on FFM is unavailable, although their accuracy on an individual level is limited.


Assuntos
Envelhecimento/fisiologia , Metabolismo Basal , Composição Corporal , Absorciometria de Fóton , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Peso Corporal , Calorimetria Indireta , Humanos , Masculino , Valor Preditivo dos Testes , Suécia
9.
Am J Clin Nutr ; 105(4): 936-943, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28202477

RESUMO

Background: Vitamin D has been implicated as being important for maintaining cognitive function in old age. Results from longitudinal studies examining the association of vitamin D with incident dementia and cognitive impairment have been inconsistent.Objective: We investigated the relation between vitamin D, assessed in 3 different ways, and the risk of dementia.Design: We measured plasma 25-hydroxyvitamin D [25(OH)D] with the use of high-performance liquid chromatography-mass spectrometry, assessed dietary vitamin D intake with the use of 7-d dietary records, and created a vitamin D-synthesis genetic risk score (GRS) at baseline (1991-1995) in a cohort of 1182 Swedish men (mean age: 71 y). In a maximum of 18 y (median: 12 y) of follow-up, 116 men developed Alzheimer disease, 64 men developed vascular dementia, and 250 men developed all-cause dementia. An additional 80 men declined in cognitive function as assessed with the use of the Mini-Mental State Examination. Adjusted HRs and ORs were calculated with the use of Cox and logistic regressions.Results: The mean ± SD plasma 25(OH)D concentration was 68.7 ± 19.1 nmol/L. Plasma 25(OH)D, dietary vitamin D intake, and vitamin D-synthesis GRS were not associated with any cognitive outcomes (crude and adjusted HRs and ORs were ∼1.0 for all continuous exposures). The adjusted HR for all-cause dementia was 0.88 (95% CI: 0.59, 1.31) in men with plasma 25(OH)D concentrations ≤50 compared with >75 nmol/L. The adjusted HR for all-cause dementia was 0.92 (95% CI: 0.63, 1.32) for the lowest compared with highest tertiles of vitamin D intake. The adjusted HR for the continuous GRS for all-cause dementia was 1.04 (95% CI: 0.91, 1.19).Conclusion: In this cohort study, we show that there is no association between baseline vitamin D status and long-term risk of dementia or cognitive impairment over an 18-y period of time.


Assuntos
Disfunção Cognitiva/sangue , Demência/sangue , Deficiência de Vitamina D/sangue , Vitamina D/análogos & derivados , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/sangue , Doença de Alzheimer/epidemiologia , Doença de Alzheimer/etiologia , Cognição , Disfunção Cognitiva/etiologia , Estudos de Coortes , Demência/epidemiologia , Demência/etiologia , Demência/genética , Registros de Dieta , Seguimentos , Predisposição Genética para Doença , Humanos , Incidência , Modelos Logísticos , Masculino , Razão de Chances , Modelos de Riscos Proporcionais , Suécia/epidemiologia , Vitamina D/administração & dosagem , Vitamina D/sangue , Deficiência de Vitamina D/complicações
10.
Int J Pharm Pract ; 25(4): 274-281, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27531756

RESUMO

OBJECTIVES: The objective was to study the relationship between the length and content of patient-pharmacist communication in community pharmacies, and generic substitution. METHODS: The study was conducted in six community pharmacies in Sweden. Non-participant observations with audio recordings and short structured interviews were conducted. Out of 32 pharmacists 29 agreed to participate (90.6%), as did 282 out of 407 patients (69.3%). Logistic regression analysis was applied to calculate odds ratio for occurrence of generic substitution. Linear regression (ß-coefficients) was applied to test for differences in time spent on different categories. KEY FINDINGS: In encounters where generic substitution occurred more time (19.2 s) was spent on non-medical (for instance administrative or economical) issues (P = 0.01, 95% confidence interval 4.8-33.6). However, the total time of the encounter was not significantly longer. The amount of time spent on non-medical issues increased with age of patient (age 60+: ß, 33 s, P < 0.001). The results indicate that more time was spent on medical issues with patients who have a higher education (high school: ß, 10.8 s, P = 0.07, university: ß, 10.2 s, P = 0.11) relative to those with only elementary school education. CONCLUSIONS: Occurrence of generic substitution was correlated with more time spent on communicating on non-medical, but not on medical, issues. No extra time was spent on medical information for the groups normally overrepresented among those with low health literacy. This study suggests that pharmacists need to further embrace their role in promoting rational use of medicines, not least when generic substitution occurs.


Assuntos
Comunicação , Serviços Comunitários de Farmácia/organização & administração , Substituição de Medicamentos/estatística & dados numéricos , Farmacêuticos/psicologia , Relações Profissional-Paciente , Adulto , Fatores Etários , Serviços Comunitários de Farmácia/economia , Substituição de Medicamentos/economia , Escolaridade , Letramento em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Papel Profissional , Suécia , Fatores de Tempo
11.
J Alzheimers Dis ; 43(1): 109-19, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25062901

RESUMO

BACKGROUND: Adherence to dietary patterns has been associated with cognitive decline and dementia, but studies are inconsistent. OBJECTIVE: Dietary patterns, i.e., WHO recommendations (Healthy Diet Indicator), a Mediterranean-like diet (modified Mediterranean Diet Score, mMDS), and a low carbohydrate high protein diet (LCHP), were related to incident cognitive dysfunction, as indicated by Alzheimer's disease (AD), all-type dementia, and all-type cognitive impairment, in a cohort of 1,138 elderly Swedish men. METHODS: Dietary patterns were derived from 7-day records. Risk relations were calculated by Cox and logistic regression analyses, adjusted for potential confounders. Sensitivity analysis was performed in a subpopulation (n = 564) with energy intake according to the Goldberg cut-off. RESULTS: During a mean follow-up of 12 years, 84, 143, and 198 men developed AD, all-type dementia, and all-type cognitive impairment, respectively. There was no association between Healthy Diet Indicator and any of the outcomes. Hazard ratios associated with 1 standard deviation (SD) increment in the LCHP score were 1.16 (95% confidence interval [CI]: 0.95, 1.43) for AD and 1.16 (95% CI: 0.99, 1.37) for all-type dementia. mMDS was not associated with dementia diagnosis. Odds ratio (OR)/1 SD increase for mMDS and all-type cognitive impairment was 0.82 (95% CI: 0.65, 1.05). In the subpopulation OR for mMDS and all-type cognitive impairment was 0.32 (95% CI: 0.11, 0.89). CONCLUSION: We found no strong associations with development of cognitive dysfunction for any of the dietary patterns investigated. However, there was a potentially beneficial association for a Mediterranean-like diet on the development of cognitive dysfunction in the subpopulation.


Assuntos
Transtornos Cognitivos/epidemiologia , Demência/epidemiologia , Dieta com Restrição de Carboidratos , Dieta Mediterrânea , Comportamento Alimentar , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtornos Cognitivos/sangue , Demência/sangue , Ingestão de Energia , Seguimentos , Humanos , Modelos Logísticos , Estudos Longitudinais , Masculino , Modelos de Riscos Proporcionais , Sensibilidade e Especificidade , Suécia/epidemiologia
12.
J Comp Eff Res ; 3(1): 41-51, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24345256

RESUMO

BACKGROUND: Generic losartan provides an opportunity to enhance angiotensin receptor blocker (ARB) prescribing efficiency, with all ARBs essentially being similar. Initially, there was limited activity in NHS Bury (UK). This changed in March 2011 with therapeutic switching and other measures encouraging the prescribing of losartan following generics to enhance its utilization versus patented ARBs. AIM: This study aims to assess the impact of multiple measures on losartan utilization, its price and total ARB expenditure. METHODS: An interrupted time series analysis was performed. Utilization was measured as prescription items dispensed, typically 28 days. RESULTS: No immediate change in losartan utilization was observed following generics. This changed after the multiple initiatives with losartan accounting for 65% of all single ARB items dispensed by the study end. ARB expenditure was 59% below prestudy levels by the study end, which was helped by a 92% reduction in expenditure per item for losartan. Annual net savings from the program were estimated at just under GB£290,000, which is over eight-times the cost of implementation. CONCLUSION: Multiple measures can enhance prescribing efficiency. Health authorities cannot rely on a 'spillover' effect from other classes in order to affect changes in physician prescribing habits.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/administração & dosagem , Uso de Medicamentos/economia , Medicamentos Genéricos/administração & dosagem , Hipertensão/tratamento farmacológico , Losartan/administração & dosagem , Padrões de Prática Médica/economia , Bloqueadores do Receptor Tipo 1 de Angiotensina II/economia , Bloqueadores do Receptor Tipo 1 de Angiotensina II/uso terapêutico , Redução de Custos , Custos e Análise de Custo , Medicamentos Genéricos/economia , Humanos , Capacitação em Serviço , Losartan/economia , Losartan/uso terapêutico , Medicina Estatal/organização & administração , Reino Unido
13.
Res Social Adm Pharm ; 10(1): 149-55, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-23591412

RESUMO

BACKGROUND: It is important that pharmacists counsel patients about their prescribed medicines, as it leads to improved therapeutic outcome, increases compliance, and decreases confusion and insecurity. Studies have shown that the number of patients getting any pharmaceutical counseling varies greatly. Swedish pharmacists claim that the focus of the dialog with the patient has switched from pharmaceutical counseling to economy and regulations. OBJECTIVE: The aim of this study was to determine the content and time disposition of the patient-pharmacist communication during dispensing of prescribed medicines at Swedish community pharmacies. METHOD: Non-participant observations and audio recordings were used as data-collecting methods. The content of the dialog was categorized into 2 deductively decided main categories-medicinal and non-medicinal issues-and 12 inductively decided subcategories. RESULTS: A total of 282 pharmacy encounters were observed and recorded, of which 259 fully coincided with the inclusion criteria. After categorizing the content of each encounter the results showed that there was little or no dialog regarding medicinal issues during the pharmacy encounter in Swedish community pharmacies. Forty percent of the dialog concerns non-medical issues and almost half of the encounter was silent. CONCLUSION: Medicines are an essential treatment method in healthcare, and pharmaceutical expertise is available to patients who enter a community pharmacy. The results of this study show that today's pharmacy encounter is not focused on improving the use of medication, possibly resulting in the patient not gaining the most benefit from his or her treatment.


Assuntos
Comunicação , Serviços Comunitários de Farmácia/organização & administração , Farmacêuticos/organização & administração , Relações Profissional-Paciente , Serviços Comunitários de Farmácia/estatística & dados numéricos , Aconselhamento/estatística & dados numéricos , Coleta de Dados , Feminino , Humanos , Masculino , Farmacêuticos/estatística & dados numéricos , Papel Profissional , Suécia , Fatores de Tempo
14.
Int J Pharm Pract ; 20(6): 377-83, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23134096

RESUMO

OBJECTIVE: Generic drug substitution reduces costs for medicines, but the downsides include unintentional double medication, confusion and anxiety among patients. Information from pharmacists affects patients' experiences of substitution with generic drugs. The aim of this study was to explore experiences and attitudes to generic substitution among Swedish community pharmacists. METHODS: An interview guide was developed. Semi-structured interviews with community pharmacists were conducted and transcribed verbatim. Analysis was inductive; extracts from the transcripts were compared and combined to form themes and subcategories. Pharmacists from a heterogeneous convenience sample of pharmacies were interviewed until data saturation had been achieved. KEY FINDINGS: Sixteen pharmacists were interviewed. Three main themes and twelve subcategories were identified, with the main themes being the role of the pharmacist, pharmacists' concerns regarding patients, and the generic drug. Pharmacists found it positive that generic substitution decreases the costs for pharmaceuticals but also emphasized that the switch can confuse and worry patients, which could result in less benefit from treatment. Respondents claimed that generic substitution has changed the focus in the pharmacist-patient meeting towards economics and regulations. CONCLUSION: According to the interviewed pharmacists generic substitution is not primarily an issue of generic versus brand-name products, but concerns above all the challenges that the switch implies for patients and pharmacists. To prevent known confusion and concerns among patients it is important that community pharmacists acquire the necessary tools and knowledge to manage this situation; pharmacists themselves as well as pharmacy owners and authorities share responsibility for this.


Assuntos
Atitude do Pessoal de Saúde , Substituição de Medicamentos/métodos , Medicamentos Genéricos/uso terapêutico , Farmacêuticos/psicologia , Adulto , Serviços Comunitários de Farmácia/organização & administração , Coleta de Dados , Substituição de Medicamentos/economia , Medicamentos Genéricos/economia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Farmacêuticos/organização & administração , Papel Profissional , Suécia
15.
Am J Clin Nutr ; 92(4): 967-74, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20826627

RESUMO

BACKGROUND: Comparative studies on dietary patterns and long-term mortality are sparse. OBJECTIVE: The objective was to examine the relations between 10-y mortality and adherence to the World Health Organization dietary guidelines [Healthy Diet Indicator (HDI)], a Mediterranean-like diet, and a carbohydrate-restricted (CR) diet in elderly Swedish men. DESIGN: Dietary habits were determined by 7-d dietary records in a population-based longitudinal study of 924 Swedish men (age: 71 ± 1 y). The HDI score (-1 to 8 points), the Mediterranean Diet Score (MDS; 0-8 points), and the CR score (2-20 points) were calculated for each participant. Nonadequate reporters of energy intake were identified (n = 413). Mortality was registered during a median follow-up of 10.2 y. Cox proportional hazards regression, with multivariable adjustments, was used to determine the effects of adherence to each dietary pattern. RESULTS: Two hundred fifteen and 88 subjects died of all-cause and cardiovascular disease, respectively. In all individuals, risk relations to mortality for each SD increment in the scores were observed for only MDS, with an adjusted hazard ratio (HR) of 0.83 (95% CI: 0.70, 0.99). Among adequate dietary reporters (n = 511), adjusted HRs for each SD increment in scores were enhanced for MDS (ie, 0.71; 95% CI: 0.55, 0.92) for all-cause mortality and 0.63 (95% CI: 0.42, 0.96) for cardiovascular mortality. Corresponding HRs for CR diet score were 1.19 (95% CI: 0.97, 1.45) for all-cause mortality and 1.44 (95% CI: 1.03, 2.02) for cardiovascular mortality. CONCLUSION: Adherence to a Mediterranean-like dietary pattern reduced mortality, whereas adherence to a CR dietary pattern appeared to increase mortality in elderly Swedish men, especially when only adequate dietary reporters were considered.


Assuntos
Dieta com Restrição de Carboidratos/mortalidade , Dieta Mediterrânea , Carboidratos da Dieta/efeitos adversos , Idoso , Animais , Pressão Sanguínea , Doenças Cardiovasculares/mortalidade , Estudos de Coortes , Diabetes Mellitus Tipo 2/epidemiologia , Dieta/normas , Proteínas na Dieta , Ingestão de Energia , Peixes , Frutas , Humanos , Estudos Longitudinais , Masculino , Seleção de Pacientes , Modelos de Riscos Proporcionais , Análise de Sobrevida , Suécia/epidemiologia , Verduras
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