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Totland TH, Øvrebø B, Brantsæter AL, Holvik K, Bere ET, Torheim LE, Abel MH. Development and evaluation of an index assessing adherence to the Norwegian food-based dietary guidelines: the Norwegian Dietary Guideline Index (NDGI). BMC Nutr 2024; 10:94. [PMID: 38956729 PMCID: PMC11218056 DOI: 10.1186/s40795-024-00900-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 06/24/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Monitoring adherence to the Norwegian food-based dietary guidelines (FBDGs) could provide valuable insight into current and future diet-related health risks. This study aimed to develop and evaluate an index measuring adherence to the Norwegian FBDGs to be used as a compact tool in nutrition surveillance suitable for inclusion in large public health surveys. METHODS The Norwegian Dietary Guideline Index (NDGI) was designed to reflect adherence to the Norwegian FBDGs on a scale from 0-100, with a higher score indicating better adherence. Dietary intakes were assessed through 19 questions, reflecting 15 dietary components covered by the Norwegian FBDGs. The NDGI was applied and evaluated using nationally representative dietary data from the cross-sectional web-based Norwegian Public Health Survey which included 8,558 adults. RESULTS: The population-weighted NDGI score followed a nearly normal distribution with a mean of 65 (SD 11) and range 21-99. Mean scores varied with background factors known to be associated with adherence to a healthy diet; women scored higher than men (67 vs. 64) and the score increased with age, with higher educational attainment (high 69 vs. low 64) and with better self-perceived household economy (good 67 vs. restricted 62). The NDGI captured a variety of dietary patterns that contributed to a healthy diet consistent with the FBDGs. CONCLUSION The NDGI serve as a compact tool to assess and monitor adherence to the Norwegian FBDGs, to identify target groups for interventions, and to inform priorities in public health policies. The tool is flexible to adjustments and may be adaptable to use in other countries or settings with similar dietary guidelines.
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Affiliation(s)
- T H Totland
- Department of Physical Health and Ageing, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Centre for Sustainable Diets, Norwegian Institute of Public Health, Oslo, Norway
| | - B Øvrebø
- Centre for Sustainable Diets, Norwegian Institute of Public Health, Oslo, Norway
- Department of Food Safety, Division of Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - A L Brantsæter
- Centre for Sustainable Diets, Norwegian Institute of Public Health, Oslo, Norway
- Department of Food Safety, Division of Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - K Holvik
- Department of Physical Health and Ageing, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - E T Bere
- Department of Physical Health and Ageing, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - L E Torheim
- Department of Physical Health and Ageing, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Centre for Sustainable Diets, Norwegian Institute of Public Health, Oslo, Norway
| | - M H Abel
- Department of Physical Health and Ageing, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.
- Centre for Sustainable Diets, Norwegian Institute of Public Health, Oslo, Norway.
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway.
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Development and Validity Testing of an Assessment Tool for Oncofertility Barriers in Multidisciplinary Healthcare Providers on the Breast Cancer Team. THE JOURNAL OF NURSING RESEARCH : JNR 2022; 30:e195. [PMID: 35234209 DOI: 10.1097/jnr.0000000000000479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Multidisciplinary healthcare providers, especially clinical nurses, lack a valid tool to assess the comprehensive barriers affecting oncofertility care in breast cancer treatment. PURPOSE The aims of the research were to develop a self-assessment scale on oncofertility barriers and test its validity and reliability. METHODS This was a methodological study. The initial 36 items of the developed Oncofertility Barrier Scale (OBS) were generated through qualitative study and a review of the literature. This scale was further refined using expert validity (n = 10), face validity (n = 10), and item analysis (n = 184). Exploratory factor analysis with principal axis factoring and direct oblimin rotation was used to determine the construct validity. The reliability of the OBS was evaluated using internal consistency and test-retest analyses. RESULTS The mean item-level and scale-level content validity indices of the initial OBS were higher than .96. The data were shown to be feasible for the factor analysis, and a six-factor solution was chosen that accounted for approximately 57.6% of the total variance. These factors included (a) lack of information and education, (b) rigid thinking toward oncofertility care, (c) cancer patient stereotypes, (d) fertility risk, (e) insufficient support, and (f) interrupted oncofertility care. The Cronbach's alpha of the 27-item OBS was .91, and the test-retest reliability coefficient was .55. CONCLUSIONS/IMPLICATIONS FOR PRACTICE The final version of the developed OBS has acceptable reliability, content validity, and construct validity. This scale is appropriate for use in research and clinical practice settings to identify the barriers to fertility cancer care that should be resolved by the breast cancer care team.
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Teixeira B, Afonso C, Rodrigues S, Oliveira A. Healthy and Sustainable Dietary Patterns in Children and Adolescents: A Systematic Review. Adv Nutr 2021; 13:1144-1185. [PMID: 34850824 PMCID: PMC9340991 DOI: 10.1093/advances/nmab148] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/18/2021] [Accepted: 11/24/2021] [Indexed: 01/02/2023] Open
Abstract
The need for adherence to a healthy and sustainable dietary pattern in the pediatric stage is discussed worldwide, being linked to a progressive incidence of noncommunicable diseases in adulthood. The aims of this systematic review were to summarize the healthy and/or sustainable dietary patterns, defined a priori, described in the literature for use during the pediatric stage; to evaluate the adherence to these dietary patterns; and identify the health-related benefits associated with adherence to these patterns. A literature search was carried out on Medline, Scopus, and Web of Science from 2010 up to 2021, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 128 articles were included according to the following criteria: participants 2-17 y old, healthy and/or sustainable dietary patterns defined by an a priori methodology; articles written in English or Portuguese; and published since 2010. Fifty instruments with 14 adaptations that measure adherence to healthy and/or sustainable dietary patterns in children and adolescents were found. The Mediterranean Diet was the most studied dietary pattern. Adherence to healthy and/or sustainable dietary patterns has wide variations worldwide. Most of the instruments described have been little studied at pediatric ages, reducing the ability to extrapolate results. Higher adherence to these dietary patterns was associated with lower body fat, waist circumference, blood pressure, and metabolic risk. There is no consensus regarding the association with BMI. No studies have proofs of the sustainability characteristics of these instruments, it being necessary to produce a new sustainable instrument or test the association of the previous ones with, for example, the ecological footprint. Further validations of these instruments in each country and more prospective studies are needed to establish temporal relations with health-related outcomes. This systematic review was registered at www.crd.york.ac.uk/prospero/ as CRD42020221788.
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Affiliation(s)
| | - Cláudia Afonso
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal,EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Porto, Portugal,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), [Laboratory for Integrative and Translational Research in Population Health (ITR)], Porto, Portugal
| | - Sara Rodrigues
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal,EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Porto, Portugal,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), [Laboratory for Integrative and Translational Research in Population Health (ITR)], Porto, Portugal
| | - Andreia Oliveira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Porto, Portugal,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), [Laboratory for Integrative and Translational Research in Population Health (ITR)], Porto, Portugal,Faculty of Medicine, University of Porto, Porto, Portugal
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Wadolowska L, Kostecka M, Kowalkowska J, Jeruszka-Bielak M, Tomaszewska M, Danielewicz A, Hamulka J. Sustainability of a Multi-Component Education Program (ABC of Healthy Eating) after Three Months and Nine Months: The Socioeconomic Context in Improving Nutrition Knowledge in Polish Teenagers. Nutrients 2021; 13:nu13051661. [PMID: 34068863 PMCID: PMC8153617 DOI: 10.3390/nu13051661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/07/2021] [Accepted: 05/11/2021] [Indexed: 11/24/2022] Open
Abstract
The study aimed to evaluate the sustainability of a multi-component education (ABC-HEat) program related to healthy nutrition and lifestyle after three months and nine months and to assess the socioeconomic context in improving teenage nutrition knowledge. The study was designed as a clustered, controlled, education-based intervention. A sample was chosen and allocated into either an educated group (under intervention) or a control group (outside of intervention). The study covered 464 11–12-year-old students (educated/control 319/145). In the educated group, data were collected three times: before education, after three months and after nine months to measure the short- and the long-term effects of education, respectively. In the control group, data were collected in parallel. Changes in nutrition knowledge score (NKS, points) by sex, residence, family affluence scale (FAS) were the main outcome measures. The increase in the NKS was significantly higher in the educated group than in the control group—three months after education on average by 1.4 to 2.7 points (all p < 0.001) in the total sample and all subgroups, and nine months after education in rural residents by 2.2 points (p < 0.001) and in the total sample by 0.4 (p < 0.05). In the educated group, the chance of no increase in the NKS was higher in urban than rural residents after three months and nine months (adjusted odds ratios [OR] and 95% Confidence Intervals [95% CI]: 3.63, 1.80–7.31 and 2.99, 1.60–5.59, respectively, both p < 0.001) using the increase in the NKS by ≥4 points as a reference. The multi-component education program improved the nutrition knowledge of teenagers in the short term regardless of socioeconomic variables, but in the long term this effect was visible only in rural residents. It suggests that a special path of nutrition education addressed to urban teens may be required.
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Affiliation(s)
- Lidia Wadolowska
- Department of Human Nutrition, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Pl. Cieszynski 1, 10-718 Olsztyn, Poland; (L.W.); (J.K.); (A.D.)
| | - Malgorzata Kostecka
- Department of Chemistry, Faculty of Food Science and Biotechnology, University of Life Sciences, 15 Akademicka Street, 20-950 Lublin, Poland
- Correspondence: ; Tel.: +48-814-456-846
| | - Joanna Kowalkowska
- Department of Human Nutrition, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Pl. Cieszynski 1, 10-718 Olsztyn, Poland; (L.W.); (J.K.); (A.D.)
| | - Marta Jeruszka-Bielak
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Science (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland; (M.J.-B.); (J.H.)
| | - Marzena Tomaszewska
- Department of Food Gastronomy and Food Hygiene, Institute of Human Nutrition Sciences, Warsaw University of Life Science (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland;
| | - Anna Danielewicz
- Department of Human Nutrition, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Pl. Cieszynski 1, 10-718 Olsztyn, Poland; (L.W.); (J.K.); (A.D.)
| | - Jadwiga Hamulka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Science (SGGW-WULS), 159C Nowoursynowska Street, 02-787 Warsaw, Poland; (M.J.-B.); (J.H.)
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De Bortoli MM, Oellingrath IM, Fell AKM, Burdorf A, Robroek SJW. Influence of lifestyle risk factors on work ability and sick leave in a general working population in Norway: a 5-year longitudinal study. BMJ Open 2021; 11:e045678. [PMID: 33550269 PMCID: PMC7925900 DOI: 10.1136/bmjopen-2020-045678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES The aim of this study is to assess (1) whether lifestyle risk factors are related to work ability and sick leave in a general working population over time, and (2) these associations within specific disease groups (ie, respiratory diseases, cardiovascular disease and diabetes, and mental illness). SETTING Telemark county, in the south-eastern part of Norway. DESIGN Longitudinal study with 5 years follow-up. PARTICIPANTS The Telemark study is a longitudinal study of the general working population in Telemark county, Norway, aged 16 to 50 years at baseline in 2013 (n=7952) and after 5-year follow-up. OUTCOME MEASURE Self-reported information on work ability (moderate and poor) and sick leave (short-term and long-term) was assessed at baseline, and during a 5-year follow-up. RESULTS Obesity (OR=1.64, 95% CI: 1.32 to 2.05) and smoking (OR=1.62, 95% CI: 1.35 to 1.96) were associated with long-term sick leave and, less strongly, with short-term sick leave. An unhealthy diet (OR=1.57, 95% CI: 1.01 to 2.43), and smoking (OR=1.67, 95% CI: 1.24 to 2.25) were associated with poor work ability and, to a smaller extent, with moderate work ability. A higher lifestyle risk score was associated with both sick leave and reduced work ability. Only few associations were found between unhealthy lifestyle factors and sick leave or reduced work ability within disease groups. CONCLUSION Lifestyle risk factors were associated with sick leave and reduced work ability. To evaluate these associations further, studies assessing the effect of lifestyle interventions on sick leave and work ability are needed.
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Affiliation(s)
- Marit Müller De Bortoli
- Department of Nursing and Health Sciences, University of South-Eastern Norway - Campus Porsgrunn, Porsgrunn, Norway
- Occupational and Environmental Medicine, Sykehuset Telemark HF, Skien, Norway
| | - Inger M Oellingrath
- Department of Nursing and Health Sciences, University of South-Eastern Norway - Campus Porsgrunn, Porsgrunn, Norway
| | | | - Alex Burdorf
- Department of Public Health, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
| | - Suzan J W Robroek
- Department of Public Health, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
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Bottolfs M, Støa EM, Reinboth MS, Svendsen MV, Schmidt SK, Oellingrath IM, Bratland-Sanda S. Resilience and lifestyle-related factors as predictors for health-related quality of life among early adolescents: a cross-sectional study. J Int Med Res 2020; 48:300060520903656. [PMID: 32070172 PMCID: PMC7111039 DOI: 10.1177/0300060520903656] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective To examine whether lifestyle-related factors and resilience predict health-related quality of life (HRQoL) in a sample of early adolescents. Methods A total of 611 eighth grade pupils (response rate: 79%) participated in this cross-sectional study. The variables measured were physical activity (accelerometer), cardiorespiratory fitness (Andersen test) and a questionnaire assessing dietary habits, sleep disturbance, resilience (Resilience Scale for Adolescents) and HRQoL (KIDSCREEN-27). Results A total of 36% of the sample met the official recommendations of 60 minutes of daily physical activity. Univariate analysis identified physical activity, dietary habits, sleep disturbances, body mass index (BMI), cardiorespiratory fitness and resilience, but not sedentary time, as predictors of HRQoL. Multivariate regression analysis identified resilience as a positive predictor (β 0.18 to 0.27) of all HRQoL domains and sleep disturbance as a negative predictor (β −0.65 to −0.24) of four HRQoL domains. BMI (β = −0.27) and cardiorespiratory fitness (β = 0.021) were predictors of the HRQoL domain physical well-being. Adherence to dietary recommendations was both a positive and a negative predictor of HRQoL (β −0.45 to 0.59). Conclusion Resilience and sleep disturbances were the main predictors of HRQoL.
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Kowalkowska J, Wadolowska L, Czarnocinska J, Galinski G, Dlugosz A, Loboda D, Czlapka-Matyasik M. Data-Driven Dietary Patterns and Diet Quality Scores: Reproducibility and Consistency in Sex and Age Subgroups of Poles Aged 15-65 Years. Nutrients 2020; 12:nu12123598. [PMID: 33255188 PMCID: PMC7759929 DOI: 10.3390/nu12123598] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 11/20/2020] [Indexed: 12/12/2022] Open
Abstract
This study aimed to assess: (i) the test–retest reproducibility of identification of data-driven dietary patterns (DPs) derived using a Principal Component Analysis (PCA) and hypothesis-driven DPs (diet quality scores); (ii) the consistency of data-driven DPs with diet quality scores in sex and age subgroups of Poles aged 15–65 years. The study involved 504 subjects (55.6% of females). Data on food consumption frequency (33 food items) were collected twice with a two-week interval using the Dietary Habits and Nutrition Beliefs Questionnaire (KomPAN®) in a self-administered version (test and retest). Two major data-driven DPs (‘Prudent’ and ‘Western’) were identified in the total sample, sex groups and four age groups separately from test and retest data. Two diet quality scores were analysed: Pro-Healthy-Diet-Index-10 (pHDI-10) and Non-Healthy-Diet-Index-14 (nHDI-14). Tucker’s congruence coefficient indicated fair-to-good similarity of data-driven DPs between test and retest for all study subgroups, except for males. Across study subgroups, the intraclass correlation coefficient (ICC) between the test and retest ranged from 0.56 to 0.86 for ‘Prudent’ DP and 0.57 to 0.82 for ‘Western’ DP, with the lowest values in males. The ICC (test vs. retest) ranged from 0.84 to 0.88 for pHDI-10 and 0.75 to 0.88 for nHDI-14. Comparing the data-driven DPs and diet quality scores, the Spearman’s correlations ranged from 0.63 to 0.93 between ‘Prudent’ DP and pHDI-10, and from 0.60 to 0.81 between ‘Western’ DP and nHDI-14. The test–retest reproducibility of data-driven DPs and diet quality scores and their consistency were acceptable in most of the study subgroups, with a tendency to be higher for pro-health than unhealthy DPs. Data-driven DPs were more reproducible in females than males. The reproducibility of diet quality scores tended to be better in males than females and was the highest in 25–44-year-olds. The KomPAN® questionnaire can be recommended to use data-driven DPs and diet quality scores to describe the habitual diet in people aged 15–65 years.
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Affiliation(s)
- Joanna Kowalkowska
- Department of Human Nutrition, University of Warmia and Mazury in Olsztyn, Słoneczna 45F, 10-718 Olsztyn, Poland;
- Correspondence: ; Tel.: +48-89-524-5517
| | - Lidia Wadolowska
- Department of Human Nutrition, University of Warmia and Mazury in Olsztyn, Słoneczna 45F, 10-718 Olsztyn, Poland;
| | - Jolanta Czarnocinska
- Department of Human Nutrition and Dietetics, Poznan University of Life Sciences, Wojska Polskiego 28, 60-637 Poznan, Poland; (J.C.); (G.G.); (M.C.-M.)
| | - Grzegorz Galinski
- Department of Human Nutrition and Dietetics, Poznan University of Life Sciences, Wojska Polskiego 28, 60-637 Poznan, Poland; (J.C.); (G.G.); (M.C.-M.)
| | - Anna Dlugosz
- Faculty of Chemical Technology and Engineering, University of Technology and Life Sciences in Bydgoszcz, Seminaryjna 3, 85-326 Bydgoszcz, Poland;
| | - Dorota Loboda
- Institute of Health, University of Economy in Bydgoszcz, Garbary 2, 85-229 Bydgoszcz, Poland;
| | - Magdalena Czlapka-Matyasik
- Department of Human Nutrition and Dietetics, Poznan University of Life Sciences, Wojska Polskiego 28, 60-637 Poznan, Poland; (J.C.); (G.G.); (M.C.-M.)
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Dalwood P, Marshall S, Burrows TL, McIntosh A, Collins CE. Diet quality indices and their associations with health-related outcomes in children and adolescents: an updated systematic review. Nutr J 2020; 19:118. [PMID: 33099309 PMCID: PMC7585689 DOI: 10.1186/s12937-020-00632-x] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/30/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND To describe a-priori diet quality indices used in children and adolescents, appraise the validity and reliability of these indices, and synthesise evidence on the relationship between diet quality and physical and mental health, and growth-related outcomes. METHODS Five electronic databases were searched until January 2019. An a-priori diet quality index was included if it applied a scoring structure to rate child or adolescent (aged 0-18-years) dietary intakes relative to dietary or nutrient guidelines. Diagnostic accuracy studies and prospective cohort studies reporting health outcomes were appraised using the Academy of Nutrition and Dietetics Quality Criteria Checklist. RESULTS From 15,577 records screened, 128 unique paediatric diet quality indices were identified from 33 countries. Half of the indices' scores rated both food and nutrient intakes (n = 65 indices). Some indices were age specific: infant (< 24-months; n = 8 indices), child (2-12-years; n = 16), adolescent (13-18 years; n = 8), and child/adolescent (n = 14). Thirty-seven indices evaluated for validity and/or reliability. Eleven of the 15 indices which investigated associations with prospective health outcomes reported significant results, such as improved IQ, quality of life, blood pressure, body composition, and prevalence of metabolic syndrome. CONCLUSIONS Research utilising diet quality indices in paediatric populations is rapidly expanding internationally. However, few indices have been evaluated for validity, reliability, or association with health outcomes. Further research is needed to determine the validity, reliability, and association with health of frequently utilised diet quality indices to ensure data generated by an index is useful, applicable, and relevant. REGISTRATION PROSPERO number: CRD42018107630 .
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Affiliation(s)
- Phoebe Dalwood
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences & Medicine, Bond Universtiy, Robina, Queensland, 4226, Australia
| | - Skye Marshall
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences & Medicine, Bond Universtiy, Robina, Queensland, 4226, Australia.
- Nutrition Research Australia, Sydney, New South Wales, Australia.
| | - Tracy L Burrows
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, 2308, Australia
- Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Ashleigh McIntosh
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences & Medicine, Bond Universtiy, Robina, Queensland, 4226, Australia
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, 2308, Australia
- Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, 2308, Australia
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Test-Retest Reliability of a Food Frequency Questionnaire to Assess Seafood Intake Dynamics for High-End Consumers in Coastal Gulf of Mexico Communities. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2020; 2020:2704074. [PMID: 32322281 PMCID: PMC7168735 DOI: 10.1155/2020/2704074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 12/29/2019] [Accepted: 01/13/2020] [Indexed: 11/30/2022]
Abstract
Background Estimates for fish and shellfish intake are used to inform communities and healthcare systems about potential health risks and benefits for individuals, communities, and vulnerable populations. A dietary assessment instrument was designed for use in populations of high-end consumers of seafood to examine intake of finfish, shrimp, oysters, and blue crab in coastal communities across the Gulf of Mexico. Objective To validate the reliability of a novel food frequency questionnaire (FFQ) for seafood intake. Design Test-retest reliability of the FFQ, which included a species-specific photographic portion guide, was evaluated by the inperson administration and readministration of the instrument with each participant by the same interviewer. Responses from coastal and noncoastal participants were compared to discern FFQ reliability in heterogeneous samples. Participants/setting. A convenience sample of 27 coastal participants from Cedar Key, Steinhatchee, and Apalachicola, Florida, reported data for 101 household members; and 15 noncoastal participants from Gainesville, Florida, reported for 42 household members. Analysis. Repeated measures from the FFQ were evaluated using correlation concordance for continuous variables (age, weight, and height) and kappa coefficient for categorical variables (type, amount, and frequency of seafood consumed). Results Concordance correlation coefficient (1.00) and kappa coefficient (r = 0.73 to 1.00) for yearly and seasonal seafood consumption indicated substantial to almost perfect reproducibility, i.e., participants provided responses that were reproducible. Test-retest agreement was highest for coastal participants who consumed more seafood, as compared to occasional, noncoastal consumers, based on the intergroup comparison of kappa coefficients for yearly and seasonal seafood consumption (r = 0.69 to 0.99). Conclusions The seafood FFQ instrument evaluated in this study, included as a supplement to this report, used in tandem with a photographic portion guide, provides a utilitarian tool for assessing fish, shrimp, oyster, and blue crab intake dynamics in adult and youth populations drawn from coastal communities.
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De Bortoli MM, Fell AKM, Svendsen MV, Henneberger PK, Kongerud J, Oellingrath IM. Lifestyle, sick leave and work ability among Norwegian employees with asthma-A population-based cross-sectional survey conducted in Telemark County, Norway. PLoS One 2020; 15:e0231710. [PMID: 32302337 PMCID: PMC7164599 DOI: 10.1371/journal.pone.0231710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 03/30/2020] [Indexed: 11/18/2022] Open
Abstract
Objective To investigate whether physician-diagnosed asthma modifies the associations between multiple lifestyle factors, sick leave and work ability in a general working population. Methods A cross-sectional study was conducted in Telemark County, Norway, in 2013. A sample of 16 099 respondents completed a self-administered questionnaire. We obtained complete data on lifestyle, work ability and sick leave for 10 355 employed persons aged 18–50 years. We modelled sick leave and work ability using multiple logistic regression, and introduced interaction terms to investigate whether associations with lifestyle factors were modified by asthma status. Results Several lifestyle risk factors and a multiple lifestyle risk index were associated with sick leave and reduced work ability score among persons both with and without physician-diagnosed asthma. A stronger association between lifestyle and sick leave among persons with asthma was confirmed by including interaction terms in the analysis: moderate lifestyle risk score * asthma OR = 1.4 (95% CI 1.02–2.1); high lifestyle risk score * asthma OR = 1.6 (95% CI 1.1–2.3); very high lifestyle risk score * asthma OR = 1.6 (95% CI 0.97–2.7); obesity * asthma OR = 1.5 (95% CI 1.02–2.1); past smoking * asthma OR = 1.4 (95% CI 1.01–1.9); and current smoking * asthma OR = 1.4 (95% CI 1.03–2.0). There was no significant difference in the association between lifestyle and work ability score among respondents with and without asthma. Conclusions In the present study, we found that physician-diagnosed asthma modified the association between lifestyle risk factors and sick leave. Asthma status did not significantly modify these associations with reduced work ability score. The results indicate that lifestyle changes could be of particular importance for employees with asthma.
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Affiliation(s)
- Marit Müller De Bortoli
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern, Porsgrunn, Vestfold and Telemark, Norway
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Vestfold and Telemark, Norway
- * E-mail:
| | - Anne Kristin Møller Fell
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Vestfold and Telemark, Norway
| | - Martin Veel Svendsen
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Vestfold and Telemark, Norway
| | - Paul K. Henneberger
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, United States of America
| | - Johny Kongerud
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Respiratory Medicine, Oslo University Hospital, Oslo, Norway
| | - Inger M. Oellingrath
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern, Porsgrunn, Vestfold and Telemark, Norway
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11
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Birketvedt K, Mikkelsen A, Klingen LL, Henriksen C, Helland IB, Emblem R. Nutritional Status in Adolescents with Esophageal Atresia. J Pediatr 2020; 218:130-137. [PMID: 31982089 DOI: 10.1016/j.jpeds.2019.11.034] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 10/30/2019] [Accepted: 11/21/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To examine factors that may affect nutritional status in adolescents with esophageal atresia. STUDY DESIGN Anthropometric measurements, blood samples, pH measuring, mapping of dysphagia with a modified Easting Assessment Test questionnaire, 4-day dietary record, and a semistructured interview about eating habits and nutrition counseling were performed in a cross-sectional cohort of adolescents with esophageal atresia. RESULTS Out of 102 eligible patients, 68 (67%) participated. The median height-for-age Z score was -0.6 (-4.6 to 1.8). Ten (15%) were classified as stunted (height-for-age Z score <-2). Fourteen (21%) were overweight. More than two-thirds reported symptoms of dysphagia (Easting Assessment Test score ≥3) and avoided specific foods. Forty-eight (71%) completed the 4-day dietary record, which showed daily intake of energy below age-appropriate recommendations. One-third reported an energy intake below their estimated basal metabolic rate. Only 24% had received counselling from a dietitian. CONCLUSIONS Adolescents with a history of esophageal atresia have growth below reference values and energy intake below recommendations. Energy intake and its relation to stunting needs to be further studied in patients with esophageal atresia.
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Affiliation(s)
- Kjersti Birketvedt
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.
| | - Audun Mikkelsen
- Faculty of Medicine, University of Oslo, Oslo, Norway; Division of Surgery, Inflammation and Transplantation, Oslo University Hospital, Oslo, Norway
| | | | | | - Ingrid B Helland
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Ragnhild Emblem
- Faculty of Medicine, University of Oslo, Oslo, Norway; Division of Surgery, Inflammation and Transplantation, Oslo University Hospital, Oslo, Norway
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12
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Kowalkowska J, Wadolowska L, Hamulka J, Wojtas N, Czlapka-Matyasik M, Kozirok W, Bronkowska M, Sadowska J, Naliwajko S, Dziaduch I, Koronowicz A, Piasna-Slupecka E, Czeczelewska E, Czeczelewski J, Kostecka M, Dlugosz A, Loboda D, Jeruszka-Bielak M. Reproducibility of a Short-Form, Multicomponent Dietary Questionnaire to Assess Food Frequency Consumption, Nutrition Knowledge, and Lifestyle (SF-FFQ4PolishChildren) in Polish Children and Adolescents. Nutrients 2019; 11:nu11122929. [PMID: 31816859 PMCID: PMC6950380 DOI: 10.3390/nu11122929] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 11/20/2019] [Indexed: 02/08/2023] Open
Abstract
The aim of the study was to assess the reproducibility of a short-form, multicomponent dietary questionnaire (SF-FFQ4PolishChildren) in Polish children and adolescents. The study involved 437 children (6–10 years old) and 630 adolescents (11–15 years old) from rural and urban areas of Poland. The self-administered questionnaire was related to nutrition knowledge, dietary habits, active/sedentary lifestyle, self-reported weight and height, and socioeconomic data. The questionnaire was completed with a two-week interval—twice by parents for their children (test and retest for children), twice by adolescents themselves (adolescent’s test and retest) and once by adolescents’ parents (parent’s test). The strength of agreement measured using the kappa statistic was interpreted as follows: 0–0.20 slight, 0.21–0.40 fair, 0.41–0.60 moderate, 0.61–0.80 good, and 0.81–1.00 excellent. Regarding the frequency of consumption of food items and meals, kappa statistics were 0.46–0.81 (the lowest: fruit/mixed fruit and vegetable juices; the highest: Energy drinks) in test–retest for children, 0.30–0.54 (fruit/mixed fruit and vegetable juices; breakfast, respectively) in adolescent’s test–retest, 0.27–0.56 (the lowest: Sweets, fruit, dairy products; the highest: Breakfast) in adolescent’s test and parent’s test. Lower kappa statistics were found for more frequently consumed foods (juices, fruit, vegetables), higher kappa statistics were found for rarely consumed foods (energy drinks, fast food). Across study groups, kappa statistics for diet quality scores were 0.31–0.55 (pro-healthy diet index, pHDI) and 0.26–0.45 (non-healthy diet index, nHDI), for active/sedentary lifestyle items they were 0.31–0.72, for components of the Family Affluence Scale (FAS) they were 0.55–0.93, for BMI categories (based on self-reported weight and height) they were 0.64–0.67, for the nutrition knowledge (NK) of adolescents the kappa was 0.36, for the nutrition knowledge of children’s parents it was 0.62. The Spearman’s correlations for diet quality scores were 0.52–0.76 (pHDI) and 0.53–0.83 (nHDI), for screen time score they were 0.45–0.78, for physical activity score they were 0.51–0.77, for the FAS score they were 0.90–0.93, and for the NK score they were 0.68–0.80. The questionnaire can be recommended to evaluate dietary and lifestyle behaviors among children and adolescents.
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Affiliation(s)
- Joanna Kowalkowska
- Department of Human Nutrition, Faculty of Food Sciences, University of Warmia and Mazury in Olsztyn, Sloneczna 45F, 10-718 Olsztyn, Poland; (L.W.); (N.W.)
- Correspondence: ; Tel.: +48-89-524-5517
| | - Lidia Wadolowska
- Department of Human Nutrition, Faculty of Food Sciences, University of Warmia and Mazury in Olsztyn, Sloneczna 45F, 10-718 Olsztyn, Poland; (L.W.); (N.W.)
| | - Jadwiga Hamulka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Science—SGGW, Nowoursynowska 159C, 02-776 Warsaw, Poland; (J.H.); (M.J.-B.)
| | - Natalia Wojtas
- Department of Human Nutrition, Faculty of Food Sciences, University of Warmia and Mazury in Olsztyn, Sloneczna 45F, 10-718 Olsztyn, Poland; (L.W.); (N.W.)
| | - Magdalena Czlapka-Matyasik
- Institute of Human Nutrition and Dietetics, Poznań University of Life Sciences, 31 Wojska Polskiego St., 60-624 Poznań, Poland;
| | - Witold Kozirok
- Department of Commodity and Quality Management, Faculty of Entrepreneurship and Quality Science, Gdynia Maritime University, 81-87 Morska Street, 81-225 Gdynia, Poland;
| | - Monika Bronkowska
- Department of Human Nutrition, Faculty of Biotechnology and Food Science, Wrocław University of Environmental and Life Sciences, Chełmońskiego 37, 51-630 Wroclaw, Poland;
| | - Joanna Sadowska
- Department of Human Nutrition Physiology, Faculty of Food Sciences and Fisheries, West Pomeranian University of Technology in Szczecin, Papieża Pawła VI 3, 71-459 Szczecin, Poland; (J.S.); (I.D.)
| | - Sylwia Naliwajko
- Department of Bromatology, Faculty of Pharmacy with the Division of Laboratory Medicine, Medical University of Bialystok, Mickiewicza 2D, 15-222 Bialystok, Poland;
| | - Izabela Dziaduch
- Department of Human Nutrition Physiology, Faculty of Food Sciences and Fisheries, West Pomeranian University of Technology in Szczecin, Papieża Pawła VI 3, 71-459 Szczecin, Poland; (J.S.); (I.D.)
| | - Aneta Koronowicz
- Department of Human Nutrition, Faculty of Food Technology, University of Agriculture in Krakow, Balicka 122, 30-149 Krakow, Poland; (A.K.); (E.P.-S.)
| | - Ewelina Piasna-Slupecka
- Department of Human Nutrition, Faculty of Food Technology, University of Agriculture in Krakow, Balicka 122, 30-149 Krakow, Poland; (A.K.); (E.P.-S.)
| | - Ewa Czeczelewska
- Department of Nursing, Faculty of Health Sciences, Collegium Mazovia Innovative Higher School in Siedlce, Sokolowska 161, 08-110 Siedlce, Poland;
| | - Jan Czeczelewski
- Human Nutrition Laboratory, Faculty of Physical Education and Sport in Biala Podlaska, Jozef Pilsudski University of Physical Education, Warsaw, Akademicka 2, 21-500 Biala Podlaska, Poland;
| | - Malgorzata Kostecka
- Department of Chemistry, Faculty of Food Science and Biotechnology, University of Life Sciences, 15 Akademicka Street, 20-950 Lublin, Poland;
| | - Anna Dlugosz
- Faculty of Chemical Technology and Engineering, University of Technology and Life Sciences in Bydgoszcz, Seminaryjna 3, 85-326 Bydgoszcz, Poland;
| | - Dorota Loboda
- Institute of Health, University of Economy in Bydgoszcz, Garbary 2, 85-229 Bydgoszcz, Poland;
| | - Marta Jeruszka-Bielak
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Science—SGGW, Nowoursynowska 159C, 02-776 Warsaw, Poland; (J.H.); (M.J.-B.)
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13
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Bjertnaes AA, Grundt JH, Juliusson PB, Markestad TJ, Strand TA, Holten-Andersen MN. Sex-related change in BMI of 15- to 16-year-old Norwegian girls in cross-sectional studies in 2002 and 2017. BMC Pediatr 2019; 19:431. [PMID: 31718598 PMCID: PMC6849237 DOI: 10.1186/s12887-019-1790-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 10/16/2019] [Indexed: 01/22/2023] Open
Abstract
Background The prevalence of overweight and obesity (OWOB) has stabilized in some countries, but a portion of children with high body mass index (BMI) may have become heavier. This study aimed to describe the distributions of BMI and the point prevalence of OWOB in Norwegian adolescents in 2002 and 2017. Methods A cross-sectional study involving 15- to 16-year-old adolescents in Oppland, Norway, was undertaken in 2002 and 2017. We calculated their BMI, BMI z-scores (BMIz), and the prevalence of OWOB. Results The mean BMI increased from 20.7 to 21.4 (p < 0.001) for girls but remained unchanged at 21.5 vs 21.4 (p = 0.80) for boys. The prevalence of OWOB increased from 9 to 14% among girls (difference 5, 95% CI: 2, 8) and from 17 to 20% among boys (difference 3, 95% CI: − 1, 6%). The BMI density plots revealed similar shapes at both time points for both sexes, but the distribution for girls shifted to the right from 2002 to 2017. Conclusion Contrary to previous knowledge, we found that the increase in OWOB presented a uniform shift in the entire BMI distribution for 15–16-year-old Norwegian girls and was not due to a larger shift in a specific subpopulation in the upper percentiles.
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Affiliation(s)
- Asborg A Bjertnaes
- Department of Paediatric and Adolescent Medicine, Innlandet Hospital Trust, Anders Sandvigs gate 17, 2609, Lillehammer, Norway. .,Department of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Jacob H Grundt
- Department of Paediatrics, Oslo University Hospital, Oslo, Norway
| | - Petur B Juliusson
- Department of Health Registries, Norwegian Institute of Public Health, Oslo, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Paediatrics, Haukeland University Hospital, Bergen, Norway
| | - Trond J Markestad
- Department of Research, Innlandet Hospital Trust, Brumunddal, Norway
| | - Tor A Strand
- Department of Research, Innlandet Hospital Trust, Brumunddal, Norway
| | - Mads N Holten-Andersen
- Department of Paediatric and Adolescent Medicine, Innlandet Hospital Trust, Anders Sandvigs gate 17, 2609, Lillehammer, Norway.,Department of Clinical Medicine, University of Oslo, Oslo, Norway
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14
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Hestetun I, Svendsen MV, Oellingrath IM. Lifestyle, appearance satisfaction and depressive symptoms in 13-16 years old Norwegian adolescents - A cross-sectional study. Nord J Psychiatry 2019; 73:482-489. [PMID: 31419392 DOI: 10.1080/08039488.2019.1653964] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Purpose: To examine gender-specific associations between multiple lifestyle-related risk factors, appearance satisfaction and depressive symptoms in a sample of Norwegian adolescents (13-16 years of age), and to study the role of appearance satisfaction as a possible confounder in the associations between lifestyle and depressive symptoms. Materials and methods: Data were obtained from Ungdata, a cross-sectional national survey of adolescents in Norway. In total 4379 subjects were included in the study. We constructed a lifestyle risk index and used multiple logistic regressions to examine the associations between lifestyle-related risk factors, appearance satisfaction, and depressive symptoms. Results: High screen time and use of alcohol were significantly associated with depressive symptoms among girls, while high screen time, tobacco and cannabis use were significantly associated with depressive symptoms among boys. An additive relationship was observed between the lifestyle risk index scores and the likelihood of depressive symptoms for both genders, the relationship being strongest among boys. Low appearance satisfaction was strongly associated with depressive symptoms, especially among boys, and identified as an important confounder in the associations between lifestyle and depressive symptoms, particularly among girls. Conclusions: High screen time was the most prevalent lifestyle risk behavior independently associated with depressive symptoms. Multiple lifestyle changes and improvement of appearance satisfaction should be included in measures targeting adolescents for the prevention and treatment of depressive symptoms. Future studies should elaborate on the gender differences in other adolescent age groups. Appearance satisfaction should be acknowledged as an important confounder in future studies of lifestyle and depressive symptoms.
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Affiliation(s)
- Ingebjørg Hestetun
- Department of Child and Adolescent Psychiatry, Telemark Hospital , Skien , Norway
| | - Martin V Svendsen
- Department of Occupational and Environmental Medicine, Telemark Hospital , Skien , Norway
| | - Inger M Oellingrath
- Department of Nursing and Health Sciences, Faculty of Health- and Social Sciences, University of South-Eastern Norway , Porsgrunn , Norway
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15
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Midtbø LK, Nygaard LB, Markhus MW, Kjellevold M, Lie Ø, Dahl L, Kvestad I, Frøyland L, Graff IE, Øyen J. Vitamin D status in preschool children and its relations to vitamin D sources and body mass index-Fish Intervention Studies-KIDS (FINS-KIDS). Nutrition 2019; 70:110595. [PMID: 31739173 DOI: 10.1016/j.nut.2019.110595] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 08/21/2019] [Accepted: 08/30/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVES The aims of this study were to determine vitamin D status (serum 25-hydroxyvitamin D3 [s-25(OH)D3]) and examine possible associations between vitamin D status and vitamin D-rich dietary sources, sun exposure, and body mass index in preschool children ages 4 to 6 y. METHODS This is a cross-sectional study based on baseline data (collected in January-February 2015) from the two-armed randomized controlled trial Fish Intervention Studies-KIDS (FINS-KIDS) conducted in Bergen, Norway. S-25(OH)D3 concentration was determined by liquid chromatography-tandem mass spectrometry. Information regarding habitual dietary intake, recent sun vacations, and body mass index were assessed with questionnaires answered by the children's caregivers. RESULTS The children (n = 212) had a mean (standard deviation) s-25(OH)D3 of 60.7 (13.8) nmol/L; 18.9% had s-25(OH)D3 ≤50 nmol/L. In logistic regression models, non-overweight versus overweight status was inversely associated with s-25(OH)D3 ≤50 nmol/L (odds ratio: 0.41; 95% confidence interval, 0.18-0.95; P = 0.037). Non-sun versus sun vacations were associated with s-25(OH)D3 ≤75 nmol/L (odds ratio: 5.33; 95% confidence interval, 1.93-14.77; P = 0.001). CONCLUSIONS The majority of the preschool children (81%) had s-25(OH)D3 >50 nmol/L. Children with overweight status had an increased risk of s-25(OH)D3 ≤50 nmol/L, and children who had not been on sun vacations were at a greater risk of s-25(OH)D3 ≤75 nmol/L.
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Affiliation(s)
| | | | | | | | - Øyvind Lie
- Institute of Marine Research, Bergen, Norway; Directorate of Fisheries, Bergen, Norway
| | | | - Ingrid Kvestad
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
| | | | - Ingvild Eide Graff
- Institute of Marine Research, Bergen, Norway; NORCE Norwegian Research Centre, Bergen, Norway
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16
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Ahrendt Bjerregaard A, Halldorsson TI, Tetens I, Frodi Olsen S. Mother's dietary quality during pregnancy and offspring's dietary quality in adolescence: Follow-up from a national birth cohort study of 19,582 mother-offspring pairs. PLoS Med 2019; 16:e1002911. [PMID: 31513597 PMCID: PMC6742222 DOI: 10.1371/journal.pmed.1002911] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 08/02/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The Developmental Origins of Health and Disease (DOHaD) hypothesis postulates that exposures during early life, such as maternal dietary intake during pregnancy, may have a lifelong impact on the individual's susceptibility to diseases. The individual's own lifestyle habits are obviously an additional factor, but we have only limited knowledge regarding how it may interact with prenatal exposures in determining later disease. To gain further insight into these potentially complex relationships, we examined the longitudinal association between maternal diet quality during pregnancy and diet quality in early adolescence in a contemporary cohort. METHODS AND FINDINGS From 1996 to 2003, the Danish National Birth Cohort (DNBC) was established. Women from across the country were enrolled, and dietary intake in midpregnancy was assessed concurrently with a 360-item food frequency questionnaire (FFQ) (https://www.dnbc.dk/-/media/arkiv/projekt-sites/dnbc/kodeboeger/dnbc-food-frequency-questionnaire/dnbc-food-frequency-questionnaire-pdf.pdf?la=en). During 2013-2018, dietary intake was assessed at age 14 years with a 150-item FFQ (https://www.dnbc.dk/-/media/arkiv/projekt-sites/dnbc/kodeboeger/ffq-14/dnbc-ffq-14-english-translation.pdf?la=en) in the DNBC children. Among the 19,582 mother-offspring pairs included in the analyses, the mean age (±standard deviation [SD]) was 30.7 (±4.1) years and 14.0 (±0.0) years for mothers and offspring, respectively. The majority of both mothers (67%) and offspring (76%) were classified as normal weight. For both questionnaires, a Healthy Eating Index (HEI) was developed as an indicator for diet quality based on current Danish Food-Based Dietary Guidelines (FBDG) including eight components: fruits and vegetables, fish, dietary fibres, red meat, saturated fatty acids (SFAs), sodium, sugar-sweetened beverages (SSBs), and added sugar. The HEI score was divided into quartiles; individuals in the highest quartile represented those with the most optimal diet. The maternal HEI score was correlated positively with offspring HEI score (Pearson r = 0.22, p < 0.001). A log-linear binomial model was used to estimate the relative risk of the offspring being in the highest quartile of HEI at age 14 years if the mother was ranked in quartile 4 during pregnancy. Results showed that offspring born to mothers who were in the highest HEI quartile during pregnancy were more likely themselves to be located in the highest HEI quartile at age 14 years (risk ratio [RR]: 2.1, 95% confidence interval [CI]: 2.0, 2.3, p < 0.001). Adjusting for maternal prepregnancy body mass index (BMI), parity, education, alcohol intake, physical activity, smoking, and breastfeeding, as well as offspring total energy intake and sex, did not influence the effect estimates. The limitations of our study include that some attrition bias towards more healthy participants was observed when comparing participants with nonparticipants. Bias in the FFQ method may also have resulted in underrepresentation of adolescents with poorer diet quality. CONCLUSIONS In this study using data from a large national birth cohort, we observed that maternal diet quality during pregnancy was associated with diet quality of the offspring at age 14 years. These findings indicate the importance of separating early dietary exposures from later dietary exposures when studying dietary aetiologies of diseases postulated to have developmental origins such as, for instance, obesity or asthma in observational settings.
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Affiliation(s)
- Anne Ahrendt Bjerregaard
- Center for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- * E-mail:
| | - Thorhallur Ingi Halldorsson
- Center for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- The Unit for Nutrition Research, Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Inge Tetens
- Vitality—Centre for Good Older Lives, Department of Nutrition, Exercise, and Sports, University of Copenhagen, Denmark
| | - Sjurdur Frodi Olsen
- Center for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
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17
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Socio-economic and cultural disparities in diet among adolescents and young adults: a systematic review. Public Health Nutr 2019; 23:843-860. [PMID: 31466544 DOI: 10.1017/s1368980019002362] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To explore dietary differences according to socio-economic and sociocultural characteristics of adolescents and young adults. DESIGN A systematic review was conducted. SETTING The main search source was MEDLINE, consulted between January 2012 and March 2017. Quality of selected studies was assessed based on dietary measurement method, sample selection, socio-economic indicator choice and statistical modelling. PARTICIPANTS Cross-sectional and longitudinal studies, assessing relationships between socio-economic status and dietary intake (patterns, scores and food groups) in the 10- to 40-year-old general population of high-income countries, were selected. RESULTS Among the 7250 reports identified, forty were selected, seventeen of which were of high quality; their conclusions, related only to adolescents, were combined and presented. The most favourable dietary patterns, higher dietary scores, greater consumption of fruits, vegetables and dairy products, and lower consumption of sugary sweetened beverages and energy-dense foods, were associated with better parental socio-economic status, particularly in terms of higher education. Migrant status was associated with plant-based patterns, greater consumption of fruits and vegetables and of sugary sweetened beverages and energy-dense foods. For the other food groups, and for young adults, very few high-quality studies were found. CONCLUSIONS The socio-economic gradient in adolescent diets requires confirmation by higher-grade studies of a wider set of food groups and must be extended to young adult populations. Future nutritional interventions should involve the most vulnerable adolescent populations, taking account of socio-economic status and migration.
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18
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Saha S, Nordström J, Mattisson I, Nilsson PM, Gerdtham UG. Modelling the Effect of Compliance with Nordic Nutrition Recommendations on Cardiovascular Disease and Cancer Mortality in the Nordic Countries. Nutrients 2019; 11:nu11061434. [PMID: 31242671 PMCID: PMC6627195 DOI: 10.3390/nu11061434] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 06/19/2019] [Accepted: 06/21/2019] [Indexed: 12/13/2022] Open
Abstract
The objective of this study is to estimate the number of deaths attributable to cardiovascular diseases and diet-related cancers that could be prevented or delayed in the Nordic countries, i.e., Sweden, Denmark, Finland, Norway, and Iceland, if adults adhere to the Nordic Nutrition Recommendations (NNR). A sex- and age-group specific epidemiological macro-simulation model was used to estimate the preventable deaths due to the differences between country specific actual intake and recommended intake of changes in food components. Data included in the model are a baseline scenario (actual dietary intake), a counterfactual scenario (recommended intake), and age-and sex-specific mortality for cardiovascular and diet-related cancer diseases, together with the total population risk of a specific year. Monte Carlo analyses with 5000 iterations were performed to produce the 95% uncertainty intervals. The model predicts that Iceland would benefit the most by adhering to the NNR, followed by Finland. In all the Nordic countries, the highest benefit would be achieved by adhering to the fruits and vegetable intakes, except Denmark, where a lower recommended intake of salt would provide the highest benefit. For men, fruits and vegetables could have saved more lives compared to other dietary components for all the Nordic countries, while for women, dietary fiber was the most prominent factor, except in Iceland. The Nordic Council should consider policies for promoting healthy eating according to the needs of each country.
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Affiliation(s)
- Sanjib Saha
- Health Economics Unit, Department of Clinical Science (Malmö), Lund University, SE-22381 Lund, Sweden.
| | - Jonas Nordström
- School of Economics and Management, Agrifood Economics Centre, Lund University, SE-22007 Lund, Sweden.
- Department of Food and Resource Economics, University of Copenhagen, DK-1958 Frederiksberg C, Denmark.
| | | | - Peter M Nilsson
- Department of Internal Medicine, Skane University Hospital, SE-20502 Malmo, Sweden.
- Department of Clinical Sciences (Malmo), Lund University, SE-20502 Malmo, Sweden.
| | - Ulf-G Gerdtham
- Health Economics Unit, Department of Clinical Science (Malmö), Lund University, SE-22381 Lund, Sweden.
- Department of Economics, Lund University, SE-22363 Lund, Sweden.
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Oellingrath IM, De Bortoli MM, Svendsen MV, Fell AKM. Lifestyle and work ability in a general working population in Norway: a cross-sectional study. BMJ Open 2019; 9:e026215. [PMID: 30948597 PMCID: PMC6500250 DOI: 10.1136/bmjopen-2018-026215] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 01/18/2019] [Accepted: 01/28/2019] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate the association between multiple lifestyle-related risk factors (unhealthy diet, low leisure-time physical activity, overweight/obesity and smoking) and self-rated work ability in a general working population. SETTING Population-based cross-sectional study, in Telemark County, Norway, 2013. PARTICIPANTS A random sample of 50 000 subjects was invited to answer a self-administered questionnaire and 16 099 responded. Complete data on lifestyle and work ability were obtained for 10 355 participants aged 18-50 years all engaged in paid work during the preceding 12 months. OUTCOME MEASURE Work ability was assessed using the Work Ability Score (WAS)-the first question in the Work Ability Index. To study the association between multiple lifestyle risk factors and work ability, a lifestyle risk index was constructed and relationships examined using multiple logistic regression analysis. RESULTS Low work ability was more likely among subjects with an unhealthy diet (ORadj 1.3, 95% CI 1.02 to 1.5), inactive persons (ORadj 1.4, 95% CI 1.2 to 1.6), obese respondents (ORadj 1.5, 95% CI 1.3 to 1.7) and former and current smokers (ORadj 1.2, 95% CI 1.1 to 1.4 and 1.3, 95% CI 1.2 to 1.5, respectively). An additive relationship was observed between the lifestyle risk index and the likelihood of decreased work ability (moderate-risk score: ORadj 1.3; 95% CI 1.1 to 1.6; high-risk score: ORadj 1.9; 95% CI 1.6 to 2.2; very high risk score: ORadj 2.4; 95% CI 1.9 to 3.0). The overall population attributable fraction (PAF) of low work ability based on the overall risk index was 38%, while the PAFs of physical activity, smoking, body mass index and diet were 16%, 11%, 11% and 6%, respectively. CONCLUSIONS Lifestyle risk factors were associated with low work ability. An additive relationship was observed. The findings are considered relevant to occupational intervention programmes aimed at prevention and improvement of decreased work ability.
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Affiliation(s)
- Inger M Oellingrath
- Department of Nursing and Health Sciences, University of South-Eastern Norway, Porsgrunn, Norway
| | - Marit Müller De Bortoli
- Department of Nursing and Health Sciences, University of South-Eastern Norway, Porsgrunn, Norway
| | - Martin Veel Svendsen
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway
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Kvestad I, Vabø S, Kjellevold M, Nøstbakken OJ, Midtbø LK, Hysing M, Markhus MW, Madsen L, Handeland K, Graff IE, Lie Ø, Frøyland L, Stormark KM, Dahl L, Øyen J. Fatty fish, hair mercury and cognitive function in Norwegian preschool children: Results from the randomized controlled trial FINS-KIDS. ENVIRONMENT INTERNATIONAL 2018; 121:1098-1105. [PMID: 30360881 DOI: 10.1016/j.envint.2018.10.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 10/11/2018] [Accepted: 10/11/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND The toxic effects of prenatal methylmercury (MeHg) include neurological abnormalities and developmental delay of which infants and children are particular susceptible. Studies on the effects of low and moderate exposure show conflicting results. Seafood is the main dietary source of MeHg, but also contributes with nutrients regarded as beneficial for development. OBJECTIVES To measure the change in total hair mercury concentration (THHg) after an intervention of lunch meals with fatty fish or meat in Norwegian preschool children, and to examine the associations between THHg and cognitive function. METHODS Children (n = 232) 4-6 years old were randomized to lunch meals with fatty fish (n = 114) or meat (n = 118) three times a week for 16 weeks. THHg was determined using a Direct Mercury Analyzer, and cognitive function was assessed by the Wechsler Preschool and Primary Intelligence Scale-III (WPPSI-III) pre- and post-intervention. Linear mixed effect models were used to analyze changes in THHg and WPPSI-III scores. RESULTS The mean (SD) THHg pre-intervention was 0.373 (0.204) mg kg-1. Children in the fish group had an increase in THHg (change 0.162, 95% CI 0.111, 0.213 mg kg-1), whereas children in the meat group had decreased THHg (-0.053, 95% CI -0.103, -0.002 mg kg-1). There were no notable associations between THHg and the WPPSI-III raw scores at baseline or after 16 weeks of the fish/meat intervention. CONCLUSIONS Lunch meals including fatty fish led to a significant increase in THHg, but the values remain below the point of departures used for risk assessment by the EFSA, WHO and US-EPA. We observed no associations between THHg and cognitive function.
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Affiliation(s)
- Ingrid Kvestad
- Regional Center for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Center, Bergen, Norway
| | - Silje Vabø
- Institute of Marine Research, Bergen, Norway
| | | | | | | | - Mari Hysing
- Regional Center for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Center, Bergen, Norway
| | | | - Lise Madsen
- Institute of Marine Research, Bergen, Norway
| | | | | | - Øyvind Lie
- Institute of Marine Research, Bergen, Norway
| | | | - Kjell Morten Stormark
- Regional Center for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Center, Bergen, Norway
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21
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Kowalkowska J, Wadolowska L, Czarnocinska J, Czlapka-Matyasik M, Galinski G, Jezewska-Zychowicz M, Bronkowska M, Dlugosz A, Loboda D, Wyka J. Reproducibility of a Questionnaire for Dietary Habits, Lifestyle and Nutrition Knowledge Assessment (KomPAN) in Polish Adolescents and Adults. Nutrients 2018; 10:nu10121845. [PMID: 30513711 PMCID: PMC6315932 DOI: 10.3390/nu10121845] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 11/17/2018] [Accepted: 11/21/2018] [Indexed: 12/15/2022] Open
Abstract
The aim of the study was to evaluate the reproducibility of the Dietary Habits and Nutrition Beliefs Questionnaire (KomPAN) in Polish adolescents and adults, including the assessment of indexes developed based on the questionnaire. In total, the study involved 954 subjects aged 15–65 (53.9% females). Interviews using the interviewer-administered questionnaire (IA-Q) in healthy subjects (n 299) and the self-administered questionnaire (SA-Q) in healthy subjects (n 517) and outpatients (n 138) were conducted and repeated after two weeks. Considering the consumption frequency of 33 food items, the cross-classification (test-retest) agreement of classification into the same category obtained for IA-Q in healthy subjects ranged from 72.2% (fruit juices) to 91.6% (energy drinks); the kappa statistic was >0.60 for all food items. For SA-Q conducted in healthy subjects the cross-classification agreement ranged from 63.8% (vegetable oils, margarines, mixes of butter and margarines) to 84.7% (lard); the kappa statistic was >0.50 for all food items. For SA-Q in outpatients, the cross-classification agreement ranged from 42.0% (both fruit juices and white rice, white pasta, fine-ground groats) to 92.0% (energy drinks); the kappa statistic was ≥0.40 for 20/33 food items. The kappa statistic for lifestyle items ranged 0.42–0.96, and for the nutrition knowledge level it ranged 0.46–0.73. The questionnaire showed moderate to very good reproducibility and can be recommended to assess dietary habits, lifestyle and nutrition knowledge of healthy adolescents and adults and those suffering from chronic diseases, after validation and/or calibration study is carried out. The reproducibility of the interviewer-administered questionnaire was better than its self-administered version. The reproducibility of the self-administered questionnaire was better in healthy subjects than in outpatients.
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Affiliation(s)
- Joanna Kowalkowska
- Department of Human Nutrition, University of Warmia and Mazury in Olsztyn, Słoneczna 45F, 10-718 Olsztyn, Poland.
| | - Lidia Wadolowska
- Department of Human Nutrition, University of Warmia and Mazury in Olsztyn, Słoneczna 45F, 10-718 Olsztyn, Poland.
- Behavioral Conditions of Nutrition Team, Committee of Human Nutrition Science, Polish Academy of Sciences, 00-901 Warsaw, Poland.
| | - Jolanta Czarnocinska
- Behavioral Conditions of Nutrition Team, Committee of Human Nutrition Science, Polish Academy of Sciences, 00-901 Warsaw, Poland.
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, Wojska Polskiego 28, 60-637 Poznan, Poland.
| | - Magdalena Czlapka-Matyasik
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, Wojska Polskiego 28, 60-637 Poznan, Poland.
| | - Grzegorz Galinski
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, Wojska Polskiego 28, 60-637 Poznan, Poland.
| | - Marzena Jezewska-Zychowicz
- Behavioral Conditions of Nutrition Team, Committee of Human Nutrition Science, Polish Academy of Sciences, 00-901 Warsaw, Poland.
- Department of Organization and Consumption Economics, Warsaw University of Life Sciences-SGGW, Nowoursynowska 159 C, 02-776 Warsaw, Poland.
| | - Monika Bronkowska
- Department of Human Nutrition, Wrocław University of Environmental and Life Sciences, Chełmońskiego 37, 51-630 Wroclaw, Poland.
| | - Anna Dlugosz
- Faculty of Chemical Technology and Engineering, University of Technology and Life Sciences in Bydgoszcz, Seminaryjna 3, 85-326 Bydgoszcz, Poland.
| | - Dorota Loboda
- Institute of Health, University of Economy in Bydgoszcz, Garbary 2, 85-229 Bydgoszcz, Poland.
| | - Joanna Wyka
- Department of Human Nutrition, Wrocław University of Environmental and Life Sciences, Chełmońskiego 37, 51-630 Wroclaw, Poland.
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Fatty Fish Intake and the Effect on Mental Health and Sleep in Preschool Children in FINS-KIDS, a Randomized Controlled Trial. Nutrients 2018; 10:nu10101478. [PMID: 30314281 PMCID: PMC6213752 DOI: 10.3390/nu10101478] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 09/28/2018] [Accepted: 10/08/2018] [Indexed: 12/11/2022] Open
Abstract
Mental health and sleep problems are prevalent in children during preschool years. The aim of the current study was to investigate if increased intake of fatty fish compared with meat improves mental health and sleep in four- to six-year-old children. The children (n = 232) in the two-armed randomized controlled trial, Fish Intervention Studies-KIDS (FINS-KIDS), were randomly assigned to lunch meals with fatty fish (herring/mackerel) or meat (chicken/lamb/beef) three times a week for 16 weeks. The fish and meat were weighed before and after the meals to record the exact consumption in grams (dietary compliance). Mental health problems were assessed by the strengths and difficulties questionnaire (SDQ) and sleep by parent report pre- and post-intervention. There was no significant statistical difference between changes in mental health and sleep for the fish eating group compared with the meat eating group, neither in the crude analysis nor after adjusting for intake of fish or meat (dietary compliance).
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Bilici S, Mortaş H, Kocaadam B, Köksal E. Assessment of the Contribution of Dietary and Beverage Intake Quality to Obesity Development. J Am Coll Nutr 2018; 37:515-521. [DOI: 10.1080/07315724.2018.1445048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Saniye Bilici
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Gazi University, Ankara, Turkey
| | - Hande Mortaş
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Gazi University, Ankara, Turkey
| | - Betül Kocaadam
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Gazi University, Ankara, Turkey
| | - Eda Köksal
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Gazi University, Ankara, Turkey
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Nerhus I, Odland M, Kjellevold M, Midtbø LK, Markhus MW, Graff IE, Lie Ø, Kvestad I, Frøyland L, Dahl L, Øyen J. Iodine status in Norwegian preschool children and associations with dietary iodine sources: the FINS-KIDS study. Eur J Nutr 2018; 58:2219-2227. [PMID: 29974227 PMCID: PMC6689280 DOI: 10.1007/s00394-018-1768-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 06/29/2018] [Indexed: 11/24/2022]
Abstract
Purpose Iodine is an essential trace element necessary for thyroid hormone synthesis. Iodine deficiency is a continuing public health problem despite international efforts to eliminate it. Studies on iodine status in preschoolers are scarce. Thus, the aims of the current study were to determine the iodine status and to investigate possible associations between urinary iodine concentration (UIC) and estimated 24 h iodine extraction (UIE) and iodine-rich foods. Methods Data are cross-sectional baseline data, obtained from the two-armed randomized controlled dietary trial “Fish Intervention Studies-KIDS” (FINS-KIDS) conducted in Bergen, Norway. UIC was determined by inductively coupled plasma-mass spectrometry in spot urine samples. Inadequate UIC was defined as median < 100 µg/L, and low estimated 24 h UIE as < 65 µg/day. Habitual dietary intake was assessed by a short food frequency questionnaire. Logistic regression models were used to investigate possible associations between UIC and estimated 24 h UIE and iodine-rich dietary sources including seafood, dairy products and eggs. Iodine/creatinine ratio (I/Cr) was also estimated. Results Urinary spot samples were obtained from 220 children. The median (interquartile range) UIC and estimated 24 h UIE was 132 (96) µg/L, and 65 (55) µg/day, respectively. The majority of children had an estimated I/Cr ratio within 100–199 µg/g. Intake of sweet milk < 2 times/day versus ≥ 2 times/day was associated with UIC < 100 µg/L (OR 2.17, 95% CI 1.07–4.38, p = 0.031). Intake of dairy products (OR 3.59, 95% CI 1.13–11.43, p = 0.031) and sweet milk (OR 2.77, 95% CI 1.37–5.61, p = 0.005) < 2 times/day versus ≥ 2 times day was associated with estimated 24 h UIE < 65 µg/day. Conclusions The preschoolers had adequate iodine status. Low intake of sweet milk and dairy products were associated with low iodine status.
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Affiliation(s)
- Ive Nerhus
- Institute of Marine Research (IMR), Nordnes, P.O. Box 1870, 5817, Bergen, Norway
| | - Mathilde Odland
- Institute of Marine Research (IMR), Nordnes, P.O. Box 1870, 5817, Bergen, Norway
- Clinical Institute 1, University of Bergen, Bergen, Norway
| | - Marian Kjellevold
- Institute of Marine Research (IMR), Nordnes, P.O. Box 1870, 5817, Bergen, Norway
| | - Lisa Kolden Midtbø
- Institute of Marine Research (IMR), Nordnes, P.O. Box 1870, 5817, Bergen, Norway
| | - Maria Wik Markhus
- Institute of Marine Research (IMR), Nordnes, P.O. Box 1870, 5817, Bergen, Norway
| | - Ingvild Eide Graff
- Institute of Marine Research (IMR), Nordnes, P.O. Box 1870, 5817, Bergen, Norway
- Uni Research Health, Bergen, Norway
| | - Øyvind Lie
- Institute of Marine Research (IMR), Nordnes, P.O. Box 1870, 5817, Bergen, Norway
- Directorate of Fisheries, Bergen, Norway
| | - Ingrid Kvestad
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway
| | - Livar Frøyland
- Institute of Marine Research (IMR), Nordnes, P.O. Box 1870, 5817, Bergen, Norway
| | - Lisbeth Dahl
- Institute of Marine Research (IMR), Nordnes, P.O. Box 1870, 5817, Bergen, Norway
| | - Jannike Øyen
- Institute of Marine Research (IMR), Nordnes, P.O. Box 1870, 5817, Bergen, Norway.
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Øyen J, Kvestad I, Midtbø LK, Graff IE, Hysing M, Stormark KM, Markhus MW, Baste V, Frøyland L, Koletzko B, Demmelmair H, Dahl L, Lie Ø, Kjellevold M. Fatty fish intake and cognitive function: FINS-KIDS, a randomized controlled trial in preschool children. BMC Med 2018; 16:41. [PMID: 29530020 PMCID: PMC5848440 DOI: 10.1186/s12916-018-1020-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Marine resources including fatty fish are important sources of n-3 long chain polyunsaturated fatty acids (n-3 LC-PUFAs), which are important for brain development. To our knowledge, this is the first randomized controlled trial (RCT) investigating the impact of fatty fish on cognition in preschool children. The purpose of the trial was to investigate whether an increased intake of fatty fish compared to meat improves cognitive function in children 4-6 years old. METHODS The children (n = 232) in this two-armed RCT, Fish Intervention Studies-KIDS (FINS-KIDS) were recruited from 13 kindergartens in Bergen, Norway. They were randomly assigned to lunch meals with fatty fish (herring/mackerel) or meat (chicken/lamb/beef) three times a week for 16 weeks. The fish and meat were weighed before and after the meals to record the exact consumption (dietary compliance). The primary outcome was cognitive function measured by the Wechsler Preschool and Primary Scale of Intelligence, 3rd edition (WPPSI-III) and fine-motor coordination measured by the 9-Hole Peg Test (9-HPT) at pre- and post-intervention. Biological samples (blood, urine, hair), and questionnaires to the caregivers were included at both time points. Linear mixed effect models with a random intercept for kindergarten were used to analyze changes from pre- to post-intervention in the primary outcome variables. RESULTS There were 218 children included in the trial (105 in the fish, and 113 in the meat group). The children consumed a mean (standard deviation) of 2070 (978) g fish or 2675 (850) g meat from the study meals (p < 0.0001). The fish group had a significant increase of red blood cell n-3 LC-PUFAs. The intervention had no effect on the WPPSI-III scores (mean change total raw score; fish group 17.7, 95% confidence interval (CI) 14.8-20.7 vs meat group 17.8, 95% CI 15.0-20.6, p = 0.97) in the main analyses. In the sub-analyses, adjusting for dietary compliance, the fish group showed a higher improvement on total raw score (20.4, 95% CI 17.5-23.3) compared to the meat group (15.2, 95% CI 12.4-18.0, p = 0.0060); docosahexaenoic acid mediated this effect. CONCLUSIONS There was no beneficial effect of fatty fish compared to meat on cognitive functioning in the preschool children. When considering dietary compliance, we found a beneficial effect of fatty fish on cognitive scores. TRIAL REGISTRATION ClinicalTrials.gov, NCT02331667 December 17, 2014.
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Affiliation(s)
- Jannike Øyen
- Institute of Marine Research (IMR), P.O Box 1870 Nordnes, NO-5817, Bergen, Norway.
| | - Ingrid Kvestad
- Regional Centre for Child and Youth Mental Health, Uni Research Health, Bergen, Norway
| | - Lisa Kolden Midtbø
- Institute of Marine Research (IMR), P.O Box 1870 Nordnes, NO-5817, Bergen, Norway
| | - Ingvild Eide Graff
- Institute of Marine Research (IMR), P.O Box 1870 Nordnes, NO-5817, Bergen, Norway
| | - Mari Hysing
- Regional Centre for Child and Youth Mental Health, Uni Research Health, Bergen, Norway
| | - Kjell Morten Stormark
- Regional Centre for Child and Youth Mental Health, Uni Research Health, Bergen, Norway.,Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | - Maria Wik Markhus
- Institute of Marine Research (IMR), P.O Box 1870 Nordnes, NO-5817, Bergen, Norway
| | | | - Livar Frøyland
- Institute of Marine Research (IMR), P.O Box 1870 Nordnes, NO-5817, Bergen, Norway
| | - Berthold Koletzko
- Ludwig-Maximilians-Universität München, Dr. von Hauner Children's Hospital, Div. Metabolic & Nutritional Medicine, University of Munich Medical Center, Munich, Germany
| | - Hans Demmelmair
- Ludwig-Maximilians-Universität München, Dr. von Hauner Children's Hospital, Div. Metabolic & Nutritional Medicine, University of Munich Medical Center, Munich, Germany
| | - Lisbeth Dahl
- Institute of Marine Research (IMR), P.O Box 1870 Nordnes, NO-5817, Bergen, Norway
| | - Øyvind Lie
- Institute of Marine Research (IMR), P.O Box 1870 Nordnes, NO-5817, Bergen, Norway
| | - Marian Kjellevold
- Institute of Marine Research (IMR), P.O Box 1870 Nordnes, NO-5817, Bergen, Norway
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26
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Handeland K, Skotheim S, Baste V, Graff IE, Frøyland L, Lie Ø, Kjellevold M, Markhus MW, Stormark KM, Øyen J, Dahl L. The effects of fatty fish intake on adolescents' nutritional status and associations with attention performance: results from the FINS-TEENS randomized controlled trial. Nutr J 2018; 17:30. [PMID: 29475446 PMCID: PMC5824444 DOI: 10.1186/s12937-018-0328-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 01/19/2018] [Indexed: 02/08/2023] Open
Abstract
Background Adolescence involves changes in dietary habits that may induce imbalances in the intake of different nutrients. Fish is an important dietary source of omega-3 (n-3) long-chain polyunsaturated fatty acids (LCPUFAs), vitamin D, several minerals and high-quality protein. By using secondary outcomes and exploratory analyses, the aims of this paper were to evaluate if nutritional biomarkers (red blood cell fatty acids, serum (s)-25(OH)D, s-ferritin and urinary iodine concentration (UIC)) were altered during a dietary intervention, and if they mediated previously reported changes in attention performance. In addition, to examine the status of the biomarkers and explore associations between dietary pattern, biomarkers and attention performance cross-sectionally at baseline. Methods The Fish Intervention Studies-TEENS (FINS-TEENS) was a three-armed intervention trial, including adolescents from eight secondary schools (n = 415; age: 14–15y) in Bergen, Norway. Participants were individually randomized to receive either fish meals, meat meals or n-3 LCPUFA supplements, three times a week for a total of 12 weeks. Blood and urine samples were collected pre and post intervention and attention performance was assessed with the d2 test of attention. Analyses of covariance (ANCOVA) assessed differences between groups in changes of biomarkers and linear mixed models were applied in analyses of attention performance and biomarkers. The trial is registered in ClinicalTrials.gov (NCT02350322). Results At baseline, the mean omega-3 index was 5.8 ± 1.3% and deficient status were identified for s-25(OH)D (54%), s-ferritin (10%) and UIC (40%). The intervention resulted in an increase in DHA and the omega-3 index which was larger in the supplement group compared to the fish and meat group (P < 0.01), and in the fish group compared to the meat group (P < 0.01). No differences between the groups were observed for changes in 25(OH)D, s-ferritin or UIC. None of the biomarkers mediated performance in the d2 test. The intake of fatty fish and a healthy dietary pattern was associated with scores in processing speed at baseline. Conclusions These results show that Norwegian adolescents have insufficient status of important nutrients, which may be improved with fatty fish consumption or n-3 LCPUFA supplements. However, nutritional status was not associated with scores in the d2 test of attention.
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Affiliation(s)
- Katina Handeland
- Institute of Marine Research (IMR), P.O. Box 1870 Nordnes, 5817, Bergen, Norway. .,Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, P.O. Box 7800, 5020, Bergen, Norway.
| | - Siv Skotheim
- Regional Centre for Child and Youth Mental Health, Uni Research Health, P.O. Box 7810, 5020, Bergen, Norway
| | - Valborg Baste
- Present Address: Uni Research Health, P.O. Box 7810, 5020, Bergen, Norway
| | - Ingvild E Graff
- Institute of Marine Research (IMR), P.O. Box 1870 Nordnes, 5817, Bergen, Norway.,Present Address: Uni Research Health, P.O. Box 7810, 5020, Bergen, Norway
| | - Livar Frøyland
- Institute of Marine Research (IMR), P.O. Box 1870 Nordnes, 5817, Bergen, Norway
| | - Øyvind Lie
- Institute of Marine Research (IMR), P.O. Box 1870 Nordnes, 5817, Bergen, Norway.,Present Address: Directorate of Fisheries, P.O. Box 185 Sentrum, 5804, Bergen, Norway
| | - Marian Kjellevold
- Institute of Marine Research (IMR), P.O. Box 1870 Nordnes, 5817, Bergen, Norway
| | - Maria W Markhus
- Institute of Marine Research (IMR), P.O. Box 1870 Nordnes, 5817, Bergen, Norway
| | - Kjell M Stormark
- Regional Centre for Child and Youth Mental Health, Uni Research Health, P.O. Box 7810, 5020, Bergen, Norway.,Department of Health Promotion and Development, University of Bergen, P.O. Box 7807, N-5020, Bergen, Norway
| | - Jannike Øyen
- Institute of Marine Research (IMR), P.O. Box 1870 Nordnes, 5817, Bergen, Norway
| | - Lisbeth Dahl
- Institute of Marine Research (IMR), P.O. Box 1870 Nordnes, 5817, Bergen, Norway
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Skotheim S, Handeland K, Kjellevold M, Øyen J, Frøyland L, Lie Ø, Eide Graff I, Baste V, Stormark KM, Dahl L. The effect of school meals with fatty fish on adolescents' self-reported symptoms for mental health: FINS-TEENS - a randomized controlled intervention trial. Food Nutr Res 2017; 61:1383818. [PMID: 29056893 PMCID: PMC5642191 DOI: 10.1080/16546628.2017.1383818] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 09/18/2017] [Indexed: 12/11/2022] Open
Abstract
There is a growing body of evidence linking fish consumption and n-3 LCPUFAs to mental health. Still, the results from randomized trials with n-3 LCPUFAs show conflicting results, and it is possible that the combined effect of several nutrients in fish may explain the observed associations. To aim of the present study was to investigate if school meals with fatty fish three times per week for 12 weeks could alter mental health in a sample of typically developing adolescents. In the Fish Intervention Studies-TEENS (FINS-TEENS), adolescents from eight secondary schools (n=425) in Norway, were randomized to receive school meals with fatty fish, meat or n-3 LCPUFA supplements. Mental health was assessed with the Strengths and Difficulties Questionnaire (SDQ) and the differences between the groups were assessed with linear mixed effect models, unadjusted and adjusted for baseline and dietary compliance. The results showed no effects of school meals with fatty fish compared to similar meals with meat or n-3 LCPUFAs on the adolescents' self-reported symptom scores for mental health. Among adolescents scoring above the SDQ cut-offs (high-scorers), the fish- improved less than the meat group in the self-reported symptom scores for total difficulties- and emotional problems. However, the findings should be regarded as preliminary, as the analyses for the high-scorer group were underpowered. In conclusion, serving school meals with fatty fish did not alter mental health in a typically developing sample of adolescents. It is possible that serving healthy school meals with meat is more beneficial than similar meals with fatty fish in adolescents scoring high on mental health problems. However, the results should be seen as preliminary, as the dietary compliance in the fish group was low and the analyses in the high score group underpowered. Thus, further studies should investigate the associations between fish consumption and adolescents' mental health.
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Affiliation(s)
- Siv Skotheim
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway
| | - Katina Handeland
- National Institute of Nutrition and Seafood Research (NIFES), Bergen, Norway
- Department of Clinical medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Marian Kjellevold
- National Institute of Nutrition and Seafood Research (NIFES), Bergen, Norway
| | - Jannike Øyen
- National Institute of Nutrition and Seafood Research (NIFES), Bergen, Norway
| | - Livar Frøyland
- National Institute of Nutrition and Seafood Research (NIFES), Bergen, Norway
| | - Øyvind Lie
- National Institute of Nutrition and Seafood Research (NIFES), Bergen, Norway
| | - Ingvild Eide Graff
- National Institute of Nutrition and Seafood Research (NIFES), Bergen, Norway
| | | | - Kjell Morten Stormark
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | - Lisbeth Dahl
- National Institute of Nutrition and Seafood Research (NIFES), Bergen, Norway
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Handeland K, Øyen J, Skotheim S, Graff IE, Baste V, Kjellevold M, Frøyland L, Lie Ø, Dahl L, Stormark KM. Fatty fish intake and attention performance in 14-15 year old adolescents: FINS-TEENS - a randomized controlled trial. Nutr J 2017; 16:64. [PMID: 28969711 PMCID: PMC5625698 DOI: 10.1186/s12937-017-0287-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 09/21/2017] [Indexed: 12/30/2022] Open
Abstract
Background Fatty fish is the dominant dietary source of n-3 LCPUFAs but it also contains other micronutrients considered important for brain development and function. To our knowledge, the effect of fatty fish intake on cognitive function in adolescents has not been investigated in randomized controlled trials (RCTs) previously. The aim of the present trial was to investigate whether consumption of fatty fish meals three times per week for 12 weeks could alter attention performance in adolescents compared to similar meals with meat or n-3 LCPUFA supplements. Methods In the Fish Intervention Studies-TEENS (FINS-TEENS), adolescents from eight secondary schools (n = 426; age: 14-15y) were individually randomized. Attention performance was assessed with the d2 test of attention. Differences between groups from pre to post intervention were assessed with linear mixed effect models and general estimates equation. The fish group was set as reference. Dietary compliance was recorded for each meal throughout the trial and controlled for in the adjusted analyses. Results The improvement in processing speed was significantly lower in the meat (−11.8; 95% CI: -23.3, −0.4) and supplement (−13.4; 95% CI: -24.9, −1.8) group compared to the fish group (reference). The supplement group also showed inferior improvement in total performance (−10.4; 95% CI: -20.0, −0.7) compared to the fish group (reference). The results were slightly affected when controlling for dietary compliance. Omission errors decreased in the meat group compared to the fish group (Incidence rate ratio = 0.85; 95% CI: 0.74, 0.98), but the difference disappeared when controlling for dietary compliance. Conclusions We observed a small beneficial effect of fatty fish, compared to meat meals and supplements on processing speed. However, these results are difficult to interpret due to low dietary compliance. This study shows that different taste preferences among participants is challenging in intervention trials with food. A prospective cohort design may be a better alternative when studying diet in the future. Trial registration number ClinicalTrials.gov registration number: NCT02350322. Electronic supplementary material The online version of this article (10.1186/s12937-017-0287-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Katina Handeland
- National Institute of Nutrition and Seafood Research (NIFES), P.O.Box 2029 Nordnes, 5817, Bergen, Norway. .,Department of Clinical Medicine, Faculty of Medicine, University of Bergen, P.O. Box 7800, 5020, Bergen, Norway.
| | - Jannike Øyen
- National Institute of Nutrition and Seafood Research (NIFES), P.O.Box 2029 Nordnes, 5817, Bergen, Norway
| | - Siv Skotheim
- Regional Centre for Child and Youth Mental Health, Uni Research Health, P.O.Box 7810, 5020, Bergen, Norway
| | - Ingvild E Graff
- National Institute of Nutrition and Seafood Research (NIFES), P.O.Box 2029 Nordnes, 5817, Bergen, Norway
| | - Valborg Baste
- Uni Research Health, P.O.Box 7810, 5020, Bergen, Norway
| | - Marian Kjellevold
- National Institute of Nutrition and Seafood Research (NIFES), P.O.Box 2029 Nordnes, 5817, Bergen, Norway
| | - Livar Frøyland
- National Institute of Nutrition and Seafood Research (NIFES), P.O.Box 2029 Nordnes, 5817, Bergen, Norway
| | - Øyvind Lie
- National Institute of Nutrition and Seafood Research (NIFES), P.O.Box 2029 Nordnes, 5817, Bergen, Norway
| | - Lisbeth Dahl
- National Institute of Nutrition and Seafood Research (NIFES), P.O.Box 2029 Nordnes, 5817, Bergen, Norway
| | - Kjell M Stormark
- Regional Centre for Child and Youth Mental Health, Uni Research Health, P.O.Box 7810, 5020, Bergen, Norway.,Department of Health Promotion and Development, University of Bergen, P.O.Box 7807, N-5020, Bergen, Norway
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The Influence of Sweet Taste Perception on Dietary Intake in Relation to Dental Caries and BMI in Saudi Arabian Schoolchildren. Int J Dent 2017; 2017:4262053. [PMID: 28912812 PMCID: PMC5585662 DOI: 10.1155/2017/4262053] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 07/04/2017] [Indexed: 12/22/2022] Open
Abstract
Objectives The aim of the study was to evaluate the influence of sweet taste perception on dietary habits in Saudi schoolchildren. In addition, the relationship between dietary habits and both caries and BMI was studied. Methods A cross-sectional observational study comprising 225 schoolchildren aged 13–15 years from Jeddah, Saudi Arabia, was conducted. The consumption frequency of certain food items was analysed from a beverage and snack questionnaire and a three-day estimated dietary record was obtained. The sweet taste perception level was determined as sweet taste threshold (TT) and sweet taste preference (TP). Children were grouped into low, medium, and high, according to their sweet taste perception level. ICDAS and DMFS indices were used for caries registration and anthropometric measurements using BMI were collected. Results Sweet taste perception was found to be negatively correlated to the number of main meals and positively correlated to both snack and sweet intake occasions. Statistically significant differences were found between the TT and TP groups with regard to the number of main meals and sweet intake (p ≤ 0.01). No significant correlation between the dietary variables and caries or BMI was found. Conclusions The dietary habits and sweet intake were found to be influenced by the sweet taste perception level, while the relation between the dietary habits and the caries and BMI was found insignificant.
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Skotheim S, Dahl L, Handeland K, Frøyland L, Lie Ø, Øyen J, Kjellevold M, Stormark KM, Graff IE. Design of the FINS-TEENS study: A randomized controlled trial assessing the impact of fatty fish on cognitive performance in adolescents. Scand J Public Health 2017; 45:621-629. [PMID: 28691640 DOI: 10.1177/1403494817717408] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
AIMS To describe the rationale, study design, population and dietary compliance in a randomized controlled trial (RCT) investigating the effect of fatty fish on cognitive performance and mental health in adolescents. METHOD In the Fish Intervention Studies-TEENS (FINS-TEENS) study we individually randomized 478 adolescents (14-15-year-olds) from eight secondary schools in Norway to receive school meal lunches with fatty fish or meat or n-3 supplements three times a week for 12 weeks. Demographic factors, psychological tests and biological measures were collected pre-and post-intervention. Duplicate portions of lunch meals were collected and individual intake recorded throughout the study. RESULTS In total, 481 out of 785 adolescents (61%) agreed to participate and 34 (7%) dropped out. Breakfast consumption was the only group difference in background characteristics. Analyses of selected nutrients in the lunch meals showed higher levels of n-3 fatty acids, vitamin D and n-6 fatty acids in the fish compared to the meat meals. Dietary compliance (score 0-144) revealed that the intake in the Fish group (mean = 59, standard deviation (SD) = 35) were lower than in the Meat group (mean = 83, SD = 31, p < 0.01) and Supplement group (mean = 105, SD = 25, p < 0.01). CONCLUSIONS The results show that it is possible to conduct a RCT with fatty fish in a school-based setting. The results also emphasize the importance of collecting detailed records of dietary compliance, as this information is important when interpreting and analysing the outcome of dietary interventions.
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Affiliation(s)
- Siv Skotheim
- 1 Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway
| | - Lisbeth Dahl
- 2 National Institute of Nutrition and Seafood Research (NIFES), Bergen, Norway
| | - Katina Handeland
- 2 National Institute of Nutrition and Seafood Research (NIFES), Bergen, Norway.,3 Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Livar Frøyland
- 2 National Institute of Nutrition and Seafood Research (NIFES), Bergen, Norway
| | - Øyvind Lie
- 2 National Institute of Nutrition and Seafood Research (NIFES), Bergen, Norway
| | - Jannike Øyen
- 2 National Institute of Nutrition and Seafood Research (NIFES), Bergen, Norway
| | - Marian Kjellevold
- 2 National Institute of Nutrition and Seafood Research (NIFES), Bergen, Norway
| | - Kjell Morten Stormark
- 1 Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Bergen, Norway.,4 Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | - Ingvild Eide Graff
- 2 National Institute of Nutrition and Seafood Research (NIFES), Bergen, Norway
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Krusinska B, Kowalkowska J, Wadolowska L, Wuenstel JW, Slowinska MA, Niedzwiedzka E. Fibre-Related Dietary Patterns: Socioeconomic Barriers to Adequate Fibre Intake in Polish Adolescents. A Short Report. Nutrients 2017; 9:nu9060590. [PMID: 28604589 PMCID: PMC5490569 DOI: 10.3390/nu9060590] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 06/06/2017] [Accepted: 06/07/2017] [Indexed: 11/21/2022] Open
Abstract
There is no complete explanation for the association between socioeconomic status (SES), fibre, and whole diet described by dietary patterns. The aim of this short report was to increase the understanding of adolescent dietary patterns related to fibre in their social context. A cross-sectional study was conducted involving 1176 adolescents aged 13–18 years from central and north-eastern Poland. The overall SES was composed of five single factors: place of residence, self-declared economic situation of family, self-declared economic situation of household, paternal and maternal education. The consumption frequency of nine dietary fibre sources was collected using Block’s questionnaire and was expressed in points. Fibre dietary patterns (DPs) were drawn by cluster analysis and odds ratios (ORs) adjusted for age, sex, and BMI were calculated. Three fibre-related DPs were identified: “High-fibre” (mean frequency of total fibre intake 22.7 points; range: 0–36), “Average-fibre” (17.7 points), “Low-fibre” (14.6 points). The “High-fibre” DP was characterized by a relatively higher frequency consumption of white bread, fruit, fruit or vegetable juices, potatoes, green salad and prepared vegetables, and a moderate frequency consumption of high-fibre or bran cereals and wholegrain bread compared to the “Low-fibre” DP. The “Average-fibre” DP was characterized by a relatively higher frequency consumption of wholegrain bread and high-fibre or bran cereals and a moderate frequency consumption of fruit, fruit or vegetable juices, green salad and prepared vegetables compared to the “Low-fibre” DP. Less likely to adhere to the “High-fibre” DP were adolescents with low SES (OR: 0.55, 95% CI: 0.39–0.77) or average SES (0.58, 95% CI: 0.41–0.81) in comparison with high SES (reference) as a result of elementary or secondary paternal or maternal education, rural residence, and lower household economic situation. Similar associations were found for the “Average-fibre” DP. Low and average socioeconomic status resulting from lower parents’ education, rural residence, and lower economic situation were inversely associated with achieving a relatively high fibre intake in Polish adolescents. Consuming single high-fibre foods was not sufficient to achieve a high-fibre diet in Polish adolescents. These data suggest that the consumption of a wide variety of dietary fibre sources—both relatively high-fibre and low-fibre foods—may help Polish adolescents in achieving a relatively high-fibre diet.
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Affiliation(s)
- Beata Krusinska
- Department of Human Nutrition, University of Warmia and Mazury in Olsztyn, Sloneczna 45F, 10-718 Olsztyn, Poland.
| | - Joanna Kowalkowska
- Department of Human Nutrition, University of Warmia and Mazury in Olsztyn, Sloneczna 45F, 10-718 Olsztyn, Poland.
| | - Lidia Wadolowska
- Department of Human Nutrition, University of Warmia and Mazury in Olsztyn, Sloneczna 45F, 10-718 Olsztyn, Poland.
| | - Justyna Weronika Wuenstel
- Department of Human Nutrition, University of Warmia and Mazury in Olsztyn, Sloneczna 45F, 10-718 Olsztyn, Poland.
| | - Malgorzata Anna Slowinska
- Department of Human Nutrition, University of Warmia and Mazury in Olsztyn, Sloneczna 45F, 10-718 Olsztyn, Poland.
| | - Ewa Niedzwiedzka
- Department of Human Nutrition, University of Warmia and Mazury in Olsztyn, Sloneczna 45F, 10-718 Olsztyn, Poland.
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