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Background: Chronic obstructive pulmonary disease (COPD) is a progressive disabling condition, for which tobacco smoking, environmental pollution, inherited α-antitrypsin deficiency and their interactions are predisposing factors. We carried out a family study on COPD in order to address the role of heritable and environmental risk factors at a population level. Methods: In a nationwide study on familial risks for COPD the Multigeneration Register on 0-72-year-old subjects was linked to the Hospital Discharge Register from years 1987 to 2004. Standardised incidence ratios (SIRs) were calculated for affected singleton siblings, twins and spouses by comparing them with those whose siblings or spouses had no hospitalisation for COPD. Results: More than 14 300 hospitalised cases and 604 affected siblings were identified. The familial SIR for obstructive chronic bronchitis was 4.65, which was higher for those diagnosed at young age but independent of sex or the age differences between the siblings. When both siblings were diagnosed with obstructive chronic bronchitis or emphysema the SIRs were 4.45 and 14.22, respectively. The SIR for obstructive chronic bronchitis in 24 twin pairs was 11.87. The SIR for spouses was about 1.6. Conclusions: The much higher risk for siblings of patients with COPD than the risk for spouses suggests that heritable effects underlie familial susceptibility to this disease. For the rare familial emphysema, α-antitrypsin deficiency may be an important cause. To what extent it also contributes to familial obstructive chronic bronchitis remains to be established. The anticipated gene-environment interactions with sufficient sample size need to be accommodated in future aetiological studies on COPD. [ABSTRACT FROM AUTHOR]

• Nutritional and antinutritional profiles of fava bean varieties were examined. • Results indicate substantial nutritional differences between cultivars. • Nutritional gain from fava beans is significantly affected by the cultivar. • Bioavailability of iron is a concern when selecting fava bean varieties. A dietary shift from resource-demanding animal protein to sustainable food sources, such as protein-rich beans, lowers the climate footprint of food production. In this study, we examined the nutrients and antinutrients in 15 fava bean varieties cultivated in Sweden to select varieties with high nutritional value. On a dry weight basis, the fava beans were analyzed for their content of protein (range 26–33%), amino acids (leucine range: 50.8–72.1 mg/g protein, lysine range: 44.8–74.8 mg/g protein), dietary fiber (soluble fraction range: 0.55–1.06%, insoluble fraction range: 10.7–16.0%), and iron (1.8–21.3 mg/100 g) and zinc contents (0.9–5.2 mg/100 g), as well as for the following antinutrients: lectin (0.8–3.2 HU/mg); trypsin inhibitor (1.2–23.1 TIU/mg) and saponin (18–109 µg/g); phytate (112–1,281 mg/100 g); total phenolic content (1.4–5 mg GAE/g); and vicine(403 µg/g − 7,014 µg/g), convicine (35.5 µg/g − 3,121 µg/g) and the oligosaccharides raffinose (1.1–3.9 g/kg), stachyose (4.4–13.7 g/kg) and verbascose (8–15 g/kg). The results indicate substantial differences between cultivars in relation to their contents of nutrients and antinutrients. Only one of the cultivars studied (Sunrise) have adequate estimated bioavailability of iron, which is of major concern for a diet in which legumes and grains serve as important sources of iron. The nutritional gain from consuming fava beans is significantly affected by the cultivar chosen as the food source. [ABSTRACT FROM AUTHOR]

A WHO expert group recommends neonatal screening for α[sub 1]-antitrypsin deficiency (α[sub 1]ATD). Homozygous α[sub 1]ATD PiZZ occurs in 1 in 5000 of the U.S. Caucasian population and up to 1 in 500 individuals of the European population, with a large regional variation. It is a risk factor that predisposes mainly to liver disease in early infancy and emphysema in early adulthood. Most importantly, smoking decreases the duration of the asymptomatic phase and life expectancy by 10-20 y. The Swedish α[sub 1]AT screening programme and subsequent information and advice prevented the majority of adolescents from starting to smoke. The involved parents and α[sub 1]ATD adolescents retrospectively recommended neonatal screening. Potential advantages of neonatal α[sub 1]AT screening are: early diagnosis and treatment of neonatal liver disease, optimal treatment of fever and bacterial infections theoretically preventing liver cell damage, genetic advice and information about the consequences of passive and active smoking. Potential advantages of postponing screening until age 11-12 y are: identification of α[sub 1]ATD close to the age when smoking may start, and possibility for the child to take part in the screening decision. Disadvantages of α[sub 1]AT screening are: psychosocial reactions-the mother probably being most vulnerable in the neonatal period-and discrimination by insurance companies and employers. Important uncertainties are: lack of knowledge concerning participation in a voluntary α[sub 1]AT screening, psychosocial reactions and the efficacy of anti-smoking advice if the information is given to school-age children and families. Thus the question whether and when to screen for α[sub 1]ATD is still the topic of lively debate. [ABSTRACT FROM AUTHOR]

Examines the genetics of alpha-antitrypsin deficiency and liver disease in Sweden. Role of alpha-antitrypsin as a serum protease inhibitor; Identification on the autosomal codominant pattern of alleles; Association between alpha-antitrypsin and childhood cirrhosis.