Árin av at eta sjómat á vandan fyri postpartum depressión og hjartasjúku hjá kvinnum.
Sjúrður Fróði Olsen professor dr.med., Ph.D., Aarhus Universitet
Erik Lykke Mortensen cand.psych., lektor, institutleder på Institut for Folkesundhedsvidenskab ved Københavns Universitet
Inga Thórsdóttir professor, Ph.D. Nutrition Unit Landsspitali, University of Iceland
Final: 1.8.2005 – 28.1.2010
Stuðul úr Granskingargrunninum:
Original project description:
Verkætlanin miðjar ímóti at kanna møgulig heilsufremjandi árin fyri kvinnur av at eta sjómat, við serligum atliti at hjartaæðrasjúku og eftirføðingar tunglyndi, sonevnd postpartum depressión. Gagnligu árinini av fiski og fiskaolju við atliti at fyribyrging og viðgerð av hjartasjúku hjá monnum eru rættuliga væl skjalprógvað. Eitt nú vísti ein stór italsk kanning, at fiskur og fiskaolja í matinum kundi minka um vandan hjá monnum við blóðtøppi í hjartanum at doyggja árini aftaná. Tó at hjartasjúkur hjá kvinnum er eitt vaksandi vandamál um okkara leiðir er merkisvert litið av slíkum tilfari grundað á kvinnur.
Eitt danskt tilfar, ið umfatar uml. 8000 barnakonur í Århus, ið áttu barn millum 1993-97, býður serligar møguleikar at kanna hetta nærri. Tær vórðu ma. bidnar at lýsa, hvussu ofta tær ótu fisk. Úr donsku landssjúklingaskránni ber til at fáa upplýst hvørjar kvinnur, ið síðani eru raktar av hjartasjúkum, nú næstan 10 ár aftaná, at tær áttu.
Sannlíkt er, at serligu, longu n-3 fitisýrurnar, sum ma. eru í fiskaolju, hava týdning fyri sjálva heilafunktiónina. N-3 fitisýrur eru í stórum nøgdum í heilavevnaði, og nýggjar kanningar benda á, at tvørrandi nøgd av hesum fitisýrum í matinum kann elva til tunglyndi. Eftirføðingar tunglyndi (PPD) kann ávirka kensluliga sambandið millum móður og barn, og tískil hava óbøtiligar fylgjur fyri barnið, mammuna og familjuna.
Eitt annað danskt tilfar, grundað á uml. 100.000 barnakonur, ið áttu barn í tíðarskeiðnum 1997-2003, býður serstakar møguleikar at kanna, hvørt tað at eta sjómat hjá barnakonum minkar um vandan fyri PPD. Barnakonurnar vórðu spurdar gjølla um matvanar. Verða dáta úr kanningini samanborin við almennar heilsuskráir sæst, hvørjar ið vórðu innlagdar við eftirføðingar tunglyndi.
Bæði tilfar eru serstøk í heiminum í stødd og góðsku, so at úrslit og niðurstøður kunnu rættast fyri skeivleikar (confounding), elvdir av øðrum viðurskiftum, ið hava týdning fyri hjartasjúku ella PPD.
The objective of this phd-project was to investigate how some specific nutritional exposures during pregnancy influence the risks of postpartum depression (PPD) and of contracting cardiovascular diseases (CVD) during the years after pregnancy within the frame of two prospective pregnancy cohorts: the Danish National Birth Cohort (DNBC) and a smaller cohort of pregnant women from Aarhus (Århus cohort).
Fish is rich on the essential long-chain n-3 polyunsaturated fatty acids (LCn3FAs), which have been shown to be beneficial to health. Likewise, several studies have shown negative associations between physical activity and a wide range of chronic diseases including depression. Although findings with respect to the effects of these aspects of nutrition have not been consistent, there seems to be a broad consensus that physical activity as well as fish intake is advantageous to health.
In the first study we examined the relation between intake of fish and LCn3FAs and the risk of PPD among 54,202 women from the DNBC. Intake of fish and LCn3FAs was assessed by a food frequency questionnaire in mid-pregnancy and quantified based on assumptions of portion sizes and food tables. Women with PPD were identified based on data from the Danish patient and prescription registries up to 1 year postpartum; hospitalization due to depression (PPD-admission) and prescription of an antidepressant (PPD-prescription) were treated as separate outcomes. We observed no association between fish intake and PPD-admission, whereas a 40% higher risk of PPD-prescription was found for the lowest compared with the highest fish intake group. No association was observed with respect to LCn3FA intake.
In the second study we investigated the association between leisure time physical activity during pregnancy and the risk of PPD, defined as described above, among 70,866 women from the DNBC. Information on physical activity was collected by a telephone interview in week 12 of gestation. Women engaging in vigorous activity had a 20% lower risk of PPD-prescription compared to women who were not physically active during pregnancy; whereas no association was observed for PPD-admission.
In the third and the fourth study the association between intakes of fish and LCn3FAs and the risk of CVD was explored in two cohorts of relatively young women (mean ages at follow-up: 38 years (DNBC) and 41 years (Århus cohort)). In the Århus cohort (N=7305) fish intake was assessed by questionnaires in gestation weeks 16 and 30; in the DNBC (N=48,627) intake was assessed as described above. Data on CVD was obtained from the Danish National Patients Registry, and diagnoses of hypertensive, ischaemic and cerebrovascular diseases were used to define the outcome. Analyses based on the Århus cohort showed no increased risk for women with a low intake of fish. In the DNBC we found that low intake of fish and LCn3FAs were associated with a 50 and 90% higher risk of CVD, respectively, compared to women with a high fish intake. In a subset of women consistently reporting the same fish intake on 3 different assessment occasions the effect was strengthened to an almost 3-fold higher risk of CVD for women with a low vs high fish intake in the DNBC. Although we saw no association based on the Århus cohort, the differences in study size among other points, render our findings based on the DNBC: that no, or very low intake of fish and n-3 PUFA is associated with an increased risk of cardiovascular disease, probable.
These 4 studies exploit some of the unique resources available in Denmark for epidemiologic research: the large prospective pregnancy cohorts containing information on a wide range of exposures and characteristics of the participants linked with high-quality national registries.
Strøm M, Mortensen EL, Halldorsson ThI, Thorsdottir I, and Olsen SF Fish and long-chain n-3 polyunsaturated fatty acid intakes during pregnancy and risk of postpartum depression: a prospective study based on a large national birth cohort Am J Clin Nutr 2009;90:149-55
Strøm M, Mortensen EL, Halldorsson ThI, Østerdal ML, and Olsen SF Leisure-Time Physical Activity in Pregnancy and Risk of Postpartum Depression: A Prospective Study in a Large National Birth Cohort J Clin Psychiatry 2009;70(12):1707-14
Strøm M, Mortensen EL, Henriksen TB, and Olsen SF Fish intake during pregnancy and risk of cardiovascular disease later in life (in manuscript)
Strøm M, Halldorsson ThI, Mortensen EL, Torp-Pedersen C, and Olsen SF Fish and long-chain n-3 polyunsaturated fatty acid intakes and risk of cardiovascular disease in women: findings from a prospective study based on a large national birth cohort (in manuscript)
Presentations at conferences:
Total energy intake and physical activity in pregnancy: Lower energy intake among physically active women. Oral presentation at the 6th International Conference on Dietary Assessment Methods (ICDAM), Copenhagen, April 2006.
Covariate structure of fish intake in the Danish National Birth Cohort (DNBC). Poster presentation at the International Conference on Foetal Programming and Developmental Toxicity (PPTOX), Tórshavn, Faroe Islands May 2007.
Does leisure time physical activity affect the risk of postpartum depression? Prospective study in a large national birth cohort. Oral presentation at the 9th Nordic Nutrition Conference, Copenhagen, June 2008.