At the Dept Clinical Nutrition about 30 people are employed, working with education, research, laboratory work and administration. The dept is responsible for the Program in Dietetics at the university. Clinical nutrition may be defined as the science of the relationship between diet and health. In research, clinical nutrition is the link between clinical disciplines and parts of physiology, biochemistry, molecular biology, immunology, microbiology, epidemiology and food science. The topic is characterized by its methodology and development of methodology for the assessment of nutritional status, body composition, energy metabolism, needs and intake of nutrients, and the professional dialogue as a tool. The dept has close collaboration with the Section for Clinical Nutrition, Medicine, Sahlgrenska University Hospital. The Section hosts dieticians, physicians and a laboratory.
The Dept Clinical Nutrition has always been strong in research on body composition, energy metabolism, cholesterol metabolism, phytosterol metabolism, and minerals and trace minerals thanks to the methodological development of the laboratory. Lately, also nutritional epidemiology has been added to the tool box.
Research at the dept of relevance to EpiLife includes the validation of simple methods for the assessment of energy intake and physical activity, and nutritional epidemiology. In large nutritional epidemiology studies, tools are needed for the assessment of dietary intake and physical activity that are cheap and user friendly in large groups of individuals. To interpret the results, these tools must be validated against methods that are objective but often also more labor intensive and expensive. The Dept Clinical Nutrition is one of four laboratories in Europe that house the equipment to measure energy metabolism with a method called doubly labelled water, which is regarded as “the Gold Standard” for the assessment of energy metabolism. The dept also has the equipment to assess body composition, e.g., dual energy x-ray absorptiometry (DXA) and multifrequency bioelectrical impedance spectroscopy (BIS ). These allow for the identification of fat and fat free mass as well as cell mass and extracellular water. With respect to physical activity, the dept works with the development and validation of objective methods for the assessment of more complex patterns of movement than what heart rate monitors offer. Here, the dept collaborates with the manufacturers of the tools ActiReg and SenseWear.
The research in nutritional epidemiology has its focus in studies based on the Vasterbotten Intervention Project (VIP). VIP is a population-based study in Västerbotten County, northern Sweden, where blood samples and life style information has been gathered on around 110 000 individuals since 1985. We utilize this data base in collaboration with researchers at Dept Nutrition Research, Umeå University, and evaluate associations between serum levels of folic acid and homocysteine and dietary intake of folic acid, vitamin B6 and vitamin B12 and risk of later development of myocardial infarction and stroke. In VIP, all newly diagnosed cases in myocardial infarction and stroke are registered according to strict WHO criteria. We have shown that low serum levels of folic acid and high serum levels of homocysteine are significantly associated with increased risk of later development of stroke. Low dietary intake of folic acid exhibits the same association but this was not significant. Also, we found that polymorphism in the gene MTHFR, which is involved in the homocysteine metabolism, was significantly related to increased risk of stroke.
In collaboration with researchers at the Dept Nutrition Research, Umeå University, we are evaluating the relationship between dietary intake of phytosterols, serum cholesterol levels and later risk of developing a myocardial infarction. This is also done within the VIP cohort database. The study is possible because the Dept Clinical Nutrition previously has developed a database with phytosterol content of more than 300 Swedish foods.
Further, dietary information in VIP is being used to develop dietary patterns among inhabitants in Västerbotten. Using cluster analysis, we identify groups of women and men with different dietary patterns and assess whether these patterns are associated with self perceived health and later risk of developing different illnesses.
Finally, in collaboration with the Dept Obstetrics and Gynecology, Umeå University, we are evaluating gestational diabetes mellitus (GDM) with a combination of epidemiological and qualitative methods. The am is to highlight the experiences of women of developing GDM and how this affects the women’s senses of health and wellbeing, and the effect on family life and work life during as well as after delivery.