Staff Publications

Staff Publications

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    'Staff publications' is the digital repository of Wageningen University & Research

    'Staff publications' contains references to publications authored by Wageningen University staff from 1976 onward.

    Publications authored by the staff of the Research Institutes are available from 1995 onwards.

    Full text documents are added when available. The database is updated daily and currently holds about 240,000 items, of which 72,000 in open access.

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Body-fat indicators and kidney function decline in older post-myocardial infarction patients : The Alpha Omega Cohort Study
Esmeijer, Kevin ; Geleijnse, Johanna M. ; Giltay, Erik J. ; Stijnen, Theo ; Dekker, Friedo W. ; Fijter, Johan W. de; Kromhout, Daan ; Hoogeveen, Ellen K. - \ 2018
European Journal of Preventive Cardiology 25 (2018)1. - ISSN 2047-4873 - p. 90 - 99.
Cardiovascular disease - Kidney function - Obesity - Risk factors

Background: Obesity increases risk of hypertension and diabetes, the leading causes of end-stage renal disease. The effect of obesity on kidney function decline in stable post-myocardial infarction patients is poorly documented. This relation was investigated in a large cohort of older post-myocardial infarction patients. Design: Data were analysed from 2410 post-myocardial infarction patients in the Alpha Omega Trial, aged 60–80 years receiving optimal pharmacotherapy treatment (79% men, 18% diabetes). Methods: Cystatin C based estimated glomerular filtration rate (eGFRcysC) was calculated at baseline and after 41 months, using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Obesity was defined as body mass index ≥ 30 kg/m2 and high waist circumference as ≥102 and ≥88 cm for men and women. The relation between body mass index, waist circumference and annual eGFRcysC decline was evaluated by linear regression. Results: At baseline, mean (standard deviation) eGFRcysC was 81.5 (19.6) ml/min/1.73 m2, 23% of all patients were obese. After multivariable adjustment, the annual mean (95% confidence interval) eGFRcysC decline in men and women was –1.45 (–1.59 to –1.31) and –0.92 (–1.20 to –0.63) ml/min/1.73 m2, respectively (p = 0.001). Obese versus non-obese patients and patients with high versus normal waist circumference experienced greater annual eGFRcysC decline. Men and women showed an additional annual eGFRcysC decline of –0.35 (–0.56 to –0.14) and –0.21 (–0.55 to 0.14) ml/min/1.73 m2 per 5 kg/m2 body mass index increment (p for interaction 0.3). Conclusions: High compared to normal body mass index or waist circumference were associated with more rapid kidney function decline in older stable post-myocardial infarction patients receiving optimal drug therapy.

Cardiovascular Risk Factors Accelerate Kidney Function Decline in Post−Myocardial Infarction Patients : The Alpha Omega Cohort Study
Esmeijer, Kevin ; Geleijnse, Johanna M. ; Fijter, Johan W. de; Giltay, Erik J. ; Kromhout, Daan ; Hoogeveen, Ellen K. - \ 2018
Kidney International Reports 3 (2018)4. - ISSN 2468-0249 - p. 879 - 888.
cardiovascular risk factors - kidney function decline - lifestyle

Introduction: Impaired kidney function is a robust risk factor for cardiovascular mortality. Age-related annual kidney function decline of 1.0 ml/min per 1.73 m2 after age 40 years is doubled in post−myocardial infarction (MI) patients. Methods: We investigated the impact of the number of cardiovascular risk factors (including unhealthy lifestyle) on annual kidney function decline, in 2426 post-MI patients (60−80 years) of the prospective Alpha Omega Cohort study. Glomerular filtration rate was estimated by serum cystatin C (eGFRcysC) and combined creatinine−cystatin C (eGFRcr-cysC), using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations from 2012. Data were analyzed by multivariable linear and logistic regression. Results: At baseline, mean (SD) eGFRcysC and eGFRcr-cysC were 81.5 (19.6) and 78.5 (18.7) ml/min per 1.73 m2, respectively. Of all patients, 79% were men, 19% had diabetes, 56% had high blood pressure (≥140/90 mm Hg), 16% were current smokers, 56% had high serum low-density lipoprotein (LDL of ≥2.5 mmol/l), and 23% were obese (body mass index of ≥30.0 kg/m2). After multivariable adjustment, the additional annual eGFRcysC decline (95% confidence interval) was as follows: in patients with versus without diabetes, −0.90 (−1.23 to −0.57) ml/min per 1.73 m2; in patients with high versus normal blood pressure, −0.50 (−0.76 to −0.24) ml/min per 1.73 m2; in obese versus nonobese patients, −0.31 (−0.61 to 0.01) ml/min per 1.73 m2; and in current smokers versus nonsmokers, −0.19 (−0.54 to 0.16) ml/min per 1.73 m2. High LDL was not associated with accelerated eGFRcysC decline. Similar results were obtained with eGFRcr-cysC. Conclusion: In older, stable post-MI patients without cardiovascular risk factors, the annual kidney function decline was −0.90 (−1.16 to −0.65) ml/min per 1.73 m2. In contrast, in post-MI patients with ≥3 cardiovascular risk factors, the annual kidney function decline was 2.5-fold faster, at −2.37 (−2.85 to −1.89) ml/min per 1.73 m2.

Smaaklessen op 9 scholen
Willemsen-Regelink, Marlies - \ 2017

sLeerlingen uit groep 3, 4 en de schakelgroep van Apollo hebben in november deelgenomen aan Smaaklessen. De lessen worden gegeven door gastdocenten Baukje Hoogeveen en Jolanda Kats.

Modelinstrumentarium Landelijk Meetnet Mestbeleid : beschrijving indicatoren landbouwpraktijk
Oudendag, Diti ; Blokland, Pieter Willem ; Greijdanus, Auke ; Leeuwen, Ton van; Hoogeveen, Marga ; Veen, Hennie van der - \ 2017
Wageningen : Wageningen Economic Research (Wageningen Economic Research nota 2017-047) - 69
Sectorrapportage Duurzame Zuivelketen : prestaties 2016 in perspectief
Doornewaard, G.J. ; Reijs, J.W. ; Beldman, A.C.G. ; Jager, J.H. ; Hoogeveen, M.W. - \ 2017
Wageningen : Wageningen Economic Research (Wageningen Economic Research rapport 2017-087) - ISBN 9789463438223 - 199
Effect of omega-3 fatty acid supplementation on plasma fibroblast growth factor 23 levels in post-myocardial infarction patients with chronic kidney disease : The alpha omega trial
Borst, Martin H. de; Baia, Leandro C. ; Hoogeveen, Ellen K. ; Giltay, Erik J. ; Navis, Gerjan ; Bakker, Stephan J.L. ; Geleijnse, Johanna M. ; Kromhout, Daan ; Soedamah-Muthu, Sabita S. - \ 2017
Nutrients 9 (2017)11. - ISSN 2072-6643
Cardiovascular - Chronic kidney disease - Fibroblast growth factor 23 - Myocardial infarction - N-3 polyunsaturated fatty acids
Fibroblast growth factor 23 (FGF23) is an independent risk factor for cardiovascular mortality in chronic kidney disease. Omega-3 (n-3) fatty acid consumption has been inversely associated with FGF23 levels and with cardiovascular risk. We examined the effect of marine n-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and plant-derived alpha-linolenic acid (ALA) on plasma FGF23 levels in post-myocardial infarction patients with chronic kidney disease. In the randomized double-blind Alpha Omega Trial, 4837 patients with a history of myocardial infarction aged 60–80 years (81% men) were randomized to one of four trial margarines supplemented with a targeted additional intake of 400 mg/day EPA and DHA, 2 g/day ALA, EPA-DHA plus ALA, or placebo for 41 months. In a subcohort of 336 patients with an eGFR < 60 mL/min/1.73 m2 (creatinine-cystatin C-based CKD-EPI formula), plasma C-terminal FGF23 was measured by ELISA at baseline and end of follow-up. We used analysis of covariance to examine treatment effects on FGF23 levels adjusted for baseline FGF23. Patients consumed 19.8 g margarine/day on average, providing an additional amount of 236 mg/day EPA with 158 mg/day DHA, 1.99 g/day ALA or both, in the active intervention groups. Over 79% of patients were treated with antihypertensive and antithrombotic medication and statins. At baseline, plasma FGF23 was 150 (128 to 172) RU/mL (mean (95% CI)). After 41 months, overall FGF23 levels had increased significantly (p < 0.0001) to 212 (183 to 241) RU/mL. Relative to the placebo, the treatment effect of EPA-DHA was indifferent, with a mean change in FGF23 (95% CI) of −17 (−97, 62) RU/mL (p = 0.7). Results were similar for ALA (36 (−42, 115) RU/mL) and combined EPA-DHA and ALA (34 (−44, 113) RU/mL). Multivariable adjustment, pooled analyses, and subgroup analyses yielded similar non-significant results. Long-term supplementation with modest quantities of EPA-DHA or ALA does not reduce plasma FGF23 levels when added to cardiovascular medication in post-myocardial patients with chronic kidney disease.
Integrale aanpak scoort! Verbinding Zorg, Sport en Bewegen
Leenaars, Karlijn - \ 2017

Vier jaar geleden startten de Wageningen Universiteit en het Radboudumc – in samenwerking met Kenniscentrum Sport, VSG, ROS en KNGF – het onderzoeksproject Verbinding Zorg, Sport en Bewegen. Karlijn Leenaars, promovenda aan de WUR, en Eva Smit – PhD-student aan het Radboudumc – volgden dertien buurtsportcoaches uit negen verschillende gemeenten (Den Haag, Den Bosch, Heusden, Nijmegen, Zwolle, Hoogeveen, Emmen, Utrecht en Franeker). De opdracht die de buurtsportcoaches kregen was eerstelijnszorg met de sport- en beweegsector te verbinden en zo volwassenen te stimuleren meer te gaan bewegen. Het onderzoek is inmiddels afgerond. Karlijn Leenaars verdedigt in september haar proefschrift over buurtsportcoaches die werkzaam zijn op het snijvlak van sport en zorg.

Hogere stikstofefficiëntie niet ten koste van economisch resultaat
Doornewaard, G.J. ; Hoogeveen, M.W. - \ 2017
V-focus 14 (2017)4. - ISSN 1574-1575 - p. 20 - 23.
Kidney dysfunction, systemic inflammation and mental well-being in elderly post-myocardial infarction patients
Heeres, Rick H.M. ; Hoogeveen, Ellen K. ; Geleijnse, Marianne ; Goede, Janette De; Kromhout, Daan ; Giltay, Erik J. - \ 2017
BMC Psychology 5 (2017). - ISSN 2050-7283
Background The aim was to investigate whether mild kidney dysfunction and low-grade inflammation in post-myocardial infarction patients are independently associated with markers of mental well-being (i.e. depressive and apathy symptoms, and dispositional optimism). Methods In post-myocardial infarction patients, kidney function was assessed by estimated glomerular filtration rate (eGFR) calculated from the combined CKD-EPI formula based on serum levels of both creatinine and cystatine C. Systemic inflammation was assessed using high sensitivity C-reactive protein (hs-CRP) levels. The 15-item Geriatric Depression Scale (GDS-15), the 3-item apathy subscale and the 4-item optimism questionnaire (4Q) were used to measure mental well-being and were analyzed using linear multivariable regression analysis. Results Of the 2355 patients, mean age was 72.3 (range 63–84) years and 80.1% were men. After multivariable adjustment, a poorer kidney function was associated with more depressive symptoms (β = -0.084, p < 0.001), more apathy symptoms (β = -0.101, p < 0.001), and less dispositional optimism (β = 0.072, p = 0.002). Moreover, higher levels of hs-CRP were associated with more depressive symptoms (β = 0.051, p = 0.013), more apathy symptoms (β = 0.083, p < 0.001) and less dispositional optimism (β = -0.047 p = 0.024). Apathy showed the strongest independent relation with both low eGFR and high hs-CRP. Conclusions In post-myocardial infarction patients, impaired kidney function and systemic inflammation showed a stronger association with apathy than with depressive symptoms and dispositional optimism.
Sectorrapportage Duurzame Zuivelketen : prestaties 2015 in perspectief
Reijs, J.W. ; Doornewaard, G.J. ; Jager, J.H. ; Hoogeveen, M.W. ; Beldman, A.C.G. - \ 2016
Wageningen : Wageningen Economic Research (Wageningen Economic Research rapport 2016-094) - ISBN 9789463430418 - 175
Mineralenmanagement onder de loep : Koeien & Kansen-bedrijven vergeleken met andere melkveebedrijve
Doornewaard, G.J. ; Hoogeveen, M.W. ; Ham, A. van den; Reijs, J.W. ; Oenema, J. ; Hooijboer, A.E.J. - \ 2016
Wageningen : Wageningen Economic Research (Rapport / Wageningen Economic Research 2016-042) - ISBN 9789462579392 - 77
Monitoringsprotocol Energie Duurzame Zuivelketen
Hoogeveen, M.W. ; Helmes, R.J.K. ; Doornewaard, G.J. ; Smit, P.X. ; Reijs, J.W. - \ 2016
Wageningen : LEI Wageningen UR (Rapport / LEI Wageningen UR 2016-043) - ISBN 9789462578166 - 45
melkveehouderij - duurzaamheid (sustainability) - landbouw en milieu - duurzame energie - monitoring - emissiereductie - agro-industriële ketens - melkveebedrijven - nederland - dairy farming - sustainability - agriculture and environment - sustainable energy - emission reduction - agro-industrial chains - dairy farms - netherlands
With the Sustainable Dairy Chain initiative, dairy businesses and dairy farmers are pursuing a futureproof and responsible dairy sector. A monitoring protocol has been developed for the theme ‘Climateneutral development’. This protocol describes the calculation methods and data sources in a systematic manner. The protocol was created following a request by the Sustainable Dairy Chain steering group and developed by LEI Wageningen UR in collaboration with the ‘Climate-neutral development’ programme team and various other stakeholders. This project was also used to make improvements to the monitor thus providing more insight into sector developments in terms of the energy objectives.
Financial burden of allergen free food preparation in the catering business
Hoogeveen, A.R. ; Fels, Ine van der; Bonanno, A. ; Bremer, M.G.E.G. - \ 2016
Quality Assurance and Safety of Crops & Foods 8 (2016)2. - ISSN 1757-8361 - p. 301 - 308.
Food allergens - Partial budgeting analysis - Willingness to pay

This study aimed to quantify costs and benefits of allergen free food (food not containing ingredients that fall under the European labelling regime) production at a catering business under two scenarios. In scenario 1 the caterer provides information to the consumer regarding the presence of allergens in the meals served, uses allergen free ingredients in preparation of allergen free meals, but does not avoid cross contamination during food preparation. Scenario 2 expands upon scenario 1 as to also include the prevention of cross contamination during preparation of allergen free foods. A stochastic partial budgeting analysis was performed to simulate the costs and benefits in both scenarios, relative to the current situation of providing neither information regarding the presence of allergens nor serving allergen free meals. Costs values were based upon the adaptations necessary to comply with the two scenarios for an on premise catering location. Fixed and variable cost items were identified via literature review, critical inspection of the catering establishment, and expert opinion. Benefit items were identified and quantified via a questionnaire about willingness to pay and willingness to buy at a catering location, according to each scenario. Given the price increase of meals in accordance to the estimated willingness to pay, and using mean values of the distributions of the costs and benefit items, an investment payback time of 8.1 and 7.7 months was estimated for scenarios 1 and 2, respectively. However, with median values of the distributions, both scenarios were not profitable, since monthly net profits were estimated at € -413 and € -636 for scenarios 1 and 2, respectively. If additional costs are not passed on to the consumer, no scenario is profitable. Catering companies can use the methodology and results in their decision making process on serving allergen free foods.

Toelichting van resultaten DuRPh-onderzoek en gesprek over vervolgmogelijkheden
Lotz, Bert - \ 2015
Toelichting van resultaten DuRPh-onderzoek en gesprek over vervolgmogelijkheden met Staatsecretaris Sharon Dijksma, DG Hans Hoogeveen, Louise Veerbeek & Tanja van Oers EZ-PAV), Caspar Itz (EZ-woordvoering) en Bram Wits (EZ Bureau bestuursraad), Ministerie van EZ, Den Haag
No effect on n-3 fatty acids supplementation on NT-proBNP after myocardial infaction: THe Alpha Omega Trial
Hoogeveen, E.K. ; Geleijnse, J.M. ; Kromhout, D. ; Sant, P. van 't; Gemen, E.F. ; Giltay, E.J. - \ 2015
European Journal of Preventive Cardiology 22 (2015)5. - ISSN 2047-4873 - p. 648 - 655.
brain natriuretic peptide - chronic heart-failure - glomerular-filtration-rate - serum creatinine - cystatin c - stability - risk - omega-3-fatty-acids - metaanalysis - mortality
BACKGROUND: heart failure is a major risk factor for cardiovascular mortality, for which n-3 fatty acids may have beneficial effects. We examined the effect of marine eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and plant-derived alpha-linolenic acid (ALA) on N-Terminal-pro Brain Natriuretic Peptide (NT-proBNP), a biomarker of heart failure. METHODS: we randomly assigned 4837 post-myocardial infarction patients, aged 60-80 years (82% men), to margarines supplemented with a targeted additional intake of 400¿mg/day EPA and DHA, 2¿g/day ALA, EPA-DHA plus ALA, or placebo for 40 months. In a random selection of 639 patients, NT-proBNP was determined both at baseline and at the end of follow-up. NT-proBNP was loge-transformed and analysed by type of treatment using analysis of covariance adjusting for baseline NT-proNBP. RESULTS: patients consumed on average 19.8¿g margarine/day, providing an additional amount of 238¿mg/day EPA with 158¿mg/day DHA, 1.98¿g/day ALA, or both, in the active-treatment groups. In the placebo group, the geometric mean level NT-proBNP increased from 245¿ng/l (95%-confidence interval [CI]: 207-290) to 294¿ng/l (95%-CI: 244-352) after 40 months (p¿=¿0.001). NT-proBNP levels were not affected by ALA (+8% versus placebo; 95%-CI: -8% to +25%; p¿=¿0.34), EPA-DHA (+2% versus placebo; 95%-CI: -14% to +18%; p¿=¿0.78), nor EPA-DHA plus ALA (+9% versus placebo; 95%-CI: -8% to +25%; p¿=¿0.31) treatment. CONCLUSIONS: supplementation with modest amounts of EPA-DHA, with or without ALA, did not have a significant effect on NT-proBNP levels in patients with a history of myocardial infarction.
Poster: Impaired Kidney Function is a Risk Factor for 40 Months All-cause Mortality in post-myocardial infarction patients
Hoogeveen, E.K. ; Geleijnse, J.M. ; Soedamah-Muthu, S.S. ; Goede, J. de; Kromhout, D. ; Giltay, E.J. - \ 2014
Ruimtelijke spreiding ammoniakemissies 2013
Koeijer, T.J. de; Luesink, H.H. ; Kuhlman, J.W. ; Puister-Jansen, L.F. ; Hoogeveen, M.W. - \ 2014
Den Haag : LEI Wageningen UR (Factsheet / LEI Wageningen UR 14-118b2) - 2
ammoniakemissie - ruimtelijke verdeling - landbouw en milieu - bemesting - begrazing - ammonia emission - spatial distribution - agriculture and environment - fertilizer application - grazing
Voor de NEC-richtlijn (National Emission Ceiling), GCN/GDN (Grootschalige concentratie- en depositiekaarten) en de PAS (Programmatische aanpak stikstof) monitort de Emissieregistratie de emissies van diverse stoffen. De landbouw levert met 85% de belangrijkste bijdrage aan de emissie van ammoniak. LEI Wageningen UR levert elke drie jaar de regionale emissie van ammoniak uit bemesting en beweiding. De ammoniakemissies worden met MAMBO berekend per gemeente.
Regionale bodembelasting door stikstof en fosfaat, en ammoniakemissie 2013
Koeijer, T.J. de; Luesink, H.H. ; Kuhlman, J.W. ; Puister-Jansen, L.F. ; Hoogeveen, M.W. - \ 2014
Den Haag : LEI Wageningen UR (Factsheet / LEI Wageningen UR 14-118b1) - 4
stikstof - fosfaat - emissie - ammoniak - gronddruk - belasting (loads) - mest - landbouwschuren - broeikasgassen - ammoniakemissie - nitrogen - phosphate - emission - ammonia - ground pressure - loads - manures - barns - greenhouse gases - ammonia emission
In de Emissieregistratie (ER) monitort het RIVM jaarlijks de emissies van diverse stoffen en emissiebronnen van verschillende bedrijven en sectoren. LEI Wageningen UR levert gegevens aan de ER over de regionale ammoniakemissies uit de landbouw en de bodembelasting met stikstof en fosfaat van landbouwbodems. Deze gegevens worden berekend met behulp van het Mest- en Ammoniakmodel voor Beleidsondersteuning (MAMBO) van het LEI.
Effect of omega-3 fatty acids on kidney function after myocardial infarction: The Alpha Omega Trial
Hoogeveen, E.K. ; Geleijnse, J.M. ; Kromhout, D. ; Stijnen, T. ; Gemen, E.F. ; Kusters, R. ; Giltay, E.J. - \ 2014
Clinical Journal of the American Society of Nephrology 9 (2014)10. - ISSN 1555-9041 - p. 1676 - 1683.
patients receiving hemodialysis - dialysis - ownership - mortality
Background and objectives Kidney function gradually decreases with age, and myocardial infarction accelerates this deterioration. Omega-3 (n-3) fatty acids may slow down the decline of kidney function. The effect of marine and plant-derived n-3 fatty acids on kidney function in patients after myocardial infarction was examined. Design, setting, participants, & measurements In the Alpha Omega Trial, 2344 patients with history of myocardial infarction ages 60–80 years old (81% men) were randomized to one of four trial margarines. The patients received an additional targeted amount of 400 mg/d eicosapentaenoic acid and docosahexaenoic acid, 2 g/d a-linolenic acid, eicosapentaenoic acid–docosahexaenoic acid plus a-linolenic acid, or placebo for 40 months. Serum cystatin C and serum creatinine were assessed at baseline and after 40 months. Creatinine–cystatin C-based GFR was estimated with the Chronic Kidney Disease Epidemiology Collaboration equation. Results Patients consumed 19.9 g margarine/d, providing an additional 239 mg/d eicosapentaenoic acid with 159 mg/d docosahexaenoic acid, 1.99 g/d a-linolenic acid, or both in the active treatment groups. After 40 months, compared with baseline, mean (±SD) creatinine–cystatin C-based GFR was -6.9 (±12.6), -4.8 (±13.4), -6.2 (±12.8), and -6.0 (±13.0) ml/min per 1.73 m2 in the placebo, eicosapentaenoic acid–docosahexaenoic acid, a-linolenic acid, and eicosapentaenoic acid–docosahexaenoic acid plus a-linolenic acid groups, respectively. After 40 months, in patients receiving eicosapentaenoic acid–docosahexaenoic acid compared with placebo, the decline in creatinine–cystatin C-based GFR was 2.1 less (95% confidence interval, 0.6 to 3.6; P
No effect of n-3 fatty acids on high-sensitivity C-reactive protein after myocardial infarction: The Alpha Omega Trial
Hoogeveen, E.K. ; Geleijnse, J.M. ; Kromhout, D. ; Giltay, E.J. - \ 2014
European Journal of Preventive Cardiology 21 (2014)11. - ISSN 2047-4873 - p. 1429 - 1436.
soluble adhesion molecules - coronary-heart-disease - necrosis-factor-alpha - cardiovascular risk - fish-oil - docosahexaenoic acid - inflammatory markers - serum concentrations - supplementation - men
Background Persistent inflammation plays a role in the pathogenesis of atherosclerosis. n-3 Fatty acids may have anti-inflammatory effects. This study examined the effect of plant-derived alpha-linolenic acid (ALA) and marine n-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on high-sensitivity C-reactive protein (hsCRP), a systemic marker of (low-grade) inflammation. Design/Methods A supplementary study in the Alpha Omega Trial: a multicenter, double-blind, randomized, placebo-controlled trial of low-dose n-3 fatty acids. Patients were enrolled from 2002 to 2006 and followed for 40 months. A total of 2425 patients, aged 60–80 years (79% men), with a history of myocardial infarction, were randomly assigned to margarines supplemented with a targeted additional intake of 400¿mg/day EPA and DHA, 2¿g/day ALA, EPA-DHA plus ALA, or placebo for 40 months. Results Patients consumed on average 19.8¿g margarine/day, providing an additional amount of 238¿mg/day EPA with 158¿mg/day DHA, 1.98¿g/day ALA, or both, in the active treatment groups. In the placebo group, the geometric mean hsCRP (95% confidence interval (CI)) was 1.84¿mg/l (95% CI: +1.70 to +2.00) at baseline and 1.98¿mg/l (95% CI: 1.82 to 2.15) after 40 months (p¿
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