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Toft U, Buch-Andersen T, Bloch P, Reinbach HC, Jensen BB, Mikkelsen BE, Aagaard-Hansen J, Glümer C. A Community-Based, Participatory, Multi-Component Intervention Increased Sales of Healthy Foods in Local Supermarkets-The Health and Local Community Project (SoL). Int J Environ Res Public Health 2023; 20:2478. [PMID: 36767845 PMCID: PMC9915330 DOI: 10.3390/ijerph20032478] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 01/14/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
Project SoL was a 19-month (September 2012 to April 2014) community-based multi-component intervention based on the supersetting approach that was designed to promote healthier eating and physical activity among children and their families. The aim of this study was to examine the effects of a multi-component intervention (level 1) and a mass media intervention alone (level 2) compared to a control area (level 3) on food sales. The design was quasi-experimental. Weekly sales data for all Coop supermarkets in the intervention and control areas were analysed via longitudinal linear mixed-effects analyses. Significant increases in the sales of fish (total) (29%; p = 0.003), canned fish (31%; p = 0.025) and oatmeal (31%; p = 0.003) were found for the level 1 intervention area compared to the control area. In the level 2 intervention area, significant increases in the sales of vegetables (total) (17%; p = 0.038), fresh vegetables (20%; p = 0.01), dried fruit (51%; p = 0.022), oatmeal (19%; p = 0.008) and wholegrain pasta (58%; p = 0.0007) were found compared to the control area. The sales of canned fish increased by 30% in the level 1 area compared to the level 2 area (p = 0.025). This study demonstrated significant increases in the sales of healthy foods, both in the areas with multi-component and mass media interventions alone compared to the control area.
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Affiliation(s)
- Ulla Toft
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Øster Farimagsgade 5, 1353 Copenhagen, Denmark
| | - Tine Buch-Andersen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark
| | - Paul Bloch
- Health Promotion Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark
| | - Helene Christine Reinbach
- Department of Food Science, Section for Food Design and Consumer Behaviour, University of Copenhagen, Rolighedsvej 30, Building 2-74, 5th Floor, Room C505, 1958 Frederiksberg C, Denmark
| | - Bjarne Bruun Jensen
- Health Promotion Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark
| | - Bent Egberg Mikkelsen
- Department of Geosciences and Natural Resource Management, University of Copenhagen, Rolighedsvej 23, 1958 Frederiksberg C, Denmark
| | - Jens Aagaard-Hansen
- Health Promotion Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark
- SA MRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa
| | - Charlotte Glümer
- Center for Diabetes, Copenhagen Municipality, Vesterbrogade 121, 1620 Copenhagen, Denmark
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Brandão MP, Romani AQ, Sudzina F, Bo IG, Mikkelsen BE. Is health behavior among university students determined by actual body shape or by body image? A European study. Work 2021; 70:937-944. [PMID: 34744040 DOI: 10.3233/wor-213613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Appropriate body image self-perceptions provide a good help to increase the feeling of personal well-being, thus having an important impact on health. Universities, having an important role in shaping of the future workers, represent an important setting to approach health issues. OBJECTIVE This study determined to what extent different types of students in higher education (four categories of students were created: "self-secure", "perfect", "destructive" and "apologetic") are likely to adopt different health risk behaviors. METHODS A cross-sectional study in a sample of students from five European Universities in the 2016/2017 academic year was conducted. Based on the combination of body image perception and body mass index, four types of students were identified: "self-secure" (overweight students with a good self-esteem); "perfect" (underweight students with a good self-esteem); "destructive" (overweight students with a poor self-esteem); "apologetic" (underweight students with a poor self-esteem). RESULTS The study reveals that the defined types of students differed in terms of risk behavior. When the control was included, the "self-secure" student type had a reduced likelihood of being on a diet (22.3%) and physically active (17.8%) than other students (p < 0.001). CONCLUSIONS The results of this paper raise concerns about the future because the body dissatisfaction of the college student could be a big impact in long term whether at collective, personally or even professionally.
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Affiliation(s)
- Maria Piedade Brandão
- School of Health Sciences, University of Aveiro, Portugal.,Centre for Health Technology andServices Research, University of Porto, Porto, Portugal
| | | | - Frantitsek Sudzina
- Department ofBusiness and Management, Aalborg University, Aalborg, Denmark
| | - Inger Glavind Bo
- Department of Sociology and Social Work, AalborgUniversity, Aalborg, Denmark
| | - Bent Egberg Mikkelsen
- Department of Geosciences and Natural Resource, University of Copenhagen, Copenhagen, Denmark
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Mikkelsen BE, Sudzina F, Ørnbo LE, Tvedebrink TDO. Does visibility matter? – A simple nudge reduces the purchase of sugar sweetened beverages in canteen drink coolers. Food Qual Prefer 2021. [DOI: 10.1016/j.foodqual.2021.104190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Buch-Andersen T, Eriksson F, Bloch P, Glümer C, Mikkelsen BE, Toft U. The Danish SoL Project: Effects of a Multi-Component Community-Based Health Promotion Intervention on Prevention of Overweight among 3-8-Year-Old Children. Int J Environ Res Public Health 2021; 18:ijerph18168419. [PMID: 34444168 PMCID: PMC8392184 DOI: 10.3390/ijerph18168419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/14/2021] [Accepted: 07/30/2021] [Indexed: 01/24/2023]
Abstract
The aim of the study was to determine the effects of a multi-component community-based health promotion intervention on body mass index (BMI) z-scores and waist circumference (WC) in three- to eight-year-old children. A quasi-experimental design was adopted to evaluate the effects of the SoL intervention involving three intervention and three control communities. The 19-month intervention was based on the supersetting approach and was designed to promote healthier eating and physical activity among children and their families. BMI z-scores and WC were measured at baseline and follow-up. At baseline, 238 (54%) and 214 (51%) of all eligible children were measured from intervention and control, respectively. The change over time in the BMI z-scores of children from the intervention group was significantly different from that of the control group (p = 0.001). BMI z-scores increased over time in the intervention group in contrast to the control group, whose BMI z-scores decreased (difference in change between groups 0.19 z-scores 95% CI 0.08, 0.30). No significant differences were observed for WC. The results showed no favourable effects of the intervention of Project SoL on BMI z-scores and WC in children. Further studies based on a larger sample size and a longer intervention duration are needed.
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Affiliation(s)
- Tine Buch-Andersen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark;
- Correspondence: ; Tel.: +45-3816-3113
| | - Frank Eriksson
- Section of Biostatistics, Department of Public Health, Copenhagen University, Øster Farimagsgade 5, 1014 Copenhagen, Denmark;
| | - Paul Bloch
- Health Promotion Research, Steno Diabetes Center Copenhagen, Niels Steensens Vej 2, 2820 Gentofte, Denmark;
| | - Charlotte Glümer
- Center for Diabetes, Copenhagen Municipality, Vesterbrogade 121, 1620 Copenhagen, Denmark;
| | - Bent Egberg Mikkelsen
- Department of Geosciences and Natural Resource Management, Copenhagen University, Rolighedsvej 23, 1958 Frederiksberg, Denmark;
| | - Ulla Toft
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark;
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Chaudhary A, Sudzina F, Mikkelsen BE. Promoting Healthy Eating among Young People-A Review of the Evidence of the Impact of School-Based Interventions. Nutrients 2020; 12:nu12092894. [PMID: 32971883 PMCID: PMC7551272 DOI: 10.3390/nu12092894] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/24/2020] [Accepted: 09/03/2020] [Indexed: 01/09/2023] Open
Abstract
Intro: Globally, the prevalence of overweight and obesity is increasing among children and younger adults and is associated with unhealthy dietary habits and lack of physical activity. School food is increasingly brought forward as a policy to address the unhealthy eating patterns among young people. Aim: This study investigated the evidence for the effectiveness of school-based food and nutrition interventions on health outcomes by reviewing scientific evidence-based intervention studies amongst children at the international level. Methods: This study was based on a systematic review using the PRISMA guidelines. Three electronic databases were systematically searched, reference lists were screened for studies evaluating school-based food and nutrition interventions that promoted children’s dietary behaviour and health aiming changes in the body composition among children. Articles dating from 2014 to 2019 were selected and reported effects on anthropometry, dietary behaviour, nutritional knowledge, and attitude. Results: The review showed that school-based interventions in general were able to affect attitudes, knowledge, behaviour and anthropometry, but that the design of the intervention affects the size of the effect. In general, food focused interventions taking an environmental approach seemed to be most effective. Conclusions: School-based interventions (including multicomponent interventions) can be an effective and promising means for promoting healthy eating, improving dietary behaviour, attitude and anthropometry among young children. Thus, schools as a system have the potential to make lasting improvements, ensuring healthy school environment around the globe for the betterment of children’s short- and long-term health.
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Affiliation(s)
- Abina Chaudhary
- Independent Researcher, Kastrupvej 79, 2300 Copenhagen, Denmark;
| | - František Sudzina
- Department of Materials and Production, Faculty of Engineering and Science, Aalborg University, A. C. Meyers Vænge 15, 2450 Copenhagen, Denmark
- Department of Systems Analysis, Faculty of Informatics and Statistics, University of Economics, nám. W. Churchilla 1938/4, 130 67 Prague, Czech Republic
- Correspondence: or
| | - Bent Egberg Mikkelsen
- Department of Geosciences and Natural Resource Management, Faculty of Science, University of Copenhagen, Rolighedsvej 23, 1958 Frederiksberg C, Denmark;
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Christensen CB, Mikkelsen BE, Toft U. The effect of introducing a free breakfast club on eating habits among students at vocational schools. BMC Public Health 2019; 19:369. [PMID: 30943941 PMCID: PMC6446271 DOI: 10.1186/s12889-019-6701-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 03/25/2019] [Indexed: 02/06/2023] Open
Abstract
Background Unhealthy eating habits are a major problem among adolescents. The objective of the study was to assess the effect of a free breakfast club intervention on dietary habits among students at vocational schools. Methods The study included students (n = 318) from four vocational schools in Denmark. Food frequency questionnaires were used to measure eating habits at baseline, first, and second follow-up, after 7 and 14 weeks respectively, in a clustered randomized controlled intervention of four months. The effect of the intervention was evaluated through self-reported frequencies of breakfast intake, intake of whole grain products for breakfast and intake of unhealthy snacking in the morning. The outcome measures were daily breakfast intake (yes/no), daily intake of whole grain for breakfast (yes/no), and unhealthy snacking on school day mornings (yes/no). Results The proportion of students who had breakfast every school day increased significantly in the intervention schools from baseline to the first follow-up compared to the control group (OR: 3.77; P = 0.0149). The effect was attenuated at the second follow-up. The intake of whole grain products for breakfast increased significantly more among students in intervention schools compared to students in control schools both at first (OR: 4.13; P = 0.0079) and second follow-up (OR: 3.27; P = 0.0317). No significant change in unhealthy snacking was found. Conclusion Provision of free breakfast at vocational schools can improve the dietary quality of breakfast and decrease breakfast skipping. However, the sustainability of the intervention is a critical issue that needs to be further studied and addressed. Trial registration ISRCTN11265280. Registered 20 November 2018 (retrospectively registered). Electronic supplementary material The online version of this article (10.1186/s12889-019-6701-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Camilla Berg Christensen
- Department for Development and Planning, Aalborg University Copenhagen, A. C. Meyers Vænge 15, DK-2450, Copenhagen, SV, Denmark.
| | - Bent Egberg Mikkelsen
- Department for Development and Planning, Aalborg University Copenhagen, A. C. Meyers Vænge 15, DK-2450, Copenhagen, SV, Denmark.,Department of Education, Learning and Philosophy, Aalborg University, A. C. Meyers Vænge 15, DK-2450, Copenhagen, SV, Denmark
| | - Ulla Toft
- Centre for Clinical Research and Prevention Bispebjerg and Frederiksberg Hospital, Hovedvejen, Entrance 5, Nordre Fasanvej 57, DK-2000, Frederiksberg, Denmark
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Mortensen MN, Larsen AK, Skadhauge LB, Høgsted RH, Beermann T, Cook ME, Rasmussen HH, Mikkelsen BE, Holst M. Protein and energy intake improved by in-between meals: An intervention study in hospitalized patients. Clin Nutr ESPEN 2019; 30:113-118. [PMID: 30904210 DOI: 10.1016/j.clnesp.2019.01.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 01/15/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND/AIM Disease related malnutrition is a major problem in hospitals. Malnutrition in hospitalized patients is caused by many factors. Among these factors are decreased appetite and early satiety, and reaching nutritional requirements in nutritional risk patients is a challenge when using ordinary energy and protein dense food. The aim of this study was to examine if total protein and energy intake in medical and surgical patients at nutritional risk could be improved by protein fortified and energy rich in-between meals. METHODS An assortment of fortified in-between meals including 10 g of protein was developed based on patient preferences and served in the Departments of Lung Medicine and Abdominal Surgery for a period of three months. Nutrition intake was recorded before and after intervention. RESULTS Food intake records were collected from a total of 92 patients, (46 before and 46 after intervention). The total amount of protein intake per in-between meal was increased from 2,6 g to 10,3 g. Total daily protein intake increased from 49% to 88% (p < 0.00) and total energy intake from 74% to 109% (p < 0.00) of requirements. CONCLUSION Protein and energy intake for surgical and medical patients at in-between meals as well as total daily intake increased significantly. Recommended average level for individually measured requirements was reached.
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Affiliation(s)
- M N Mortensen
- Kulinarium, Patient Kitchen, Aalborg University Hospital, Aalborg, Denmark.
| | - A K Larsen
- Kulinarium, Patient Kitchen, Aalborg University Hospital, Aalborg, Denmark
| | - L B Skadhauge
- Center for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital Denmark
| | - R H Høgsted
- Kulinarium, Patient Kitchen, Aalborg University Hospital, Aalborg, Denmark
| | - T Beermann
- Center for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital Denmark
| | - M E Cook
- Center for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital Denmark
| | - H H Rasmussen
- Center for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital Denmark; Department of Clinical Medicine, Aalborg University, Denmark
| | - B E Mikkelsen
- Department of Learning & Philosophy, Aalborg University, Copenhagen, Denmark
| | - M Holst
- Center for Nutrition and Bowel Disease, Department of Gastroenterology, Aalborg University Hospital Denmark; Department of Clinical Medicine, Aalborg University, Denmark
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Gittelsohn J, Novotny R, Trude ACB, Butel J, Mikkelsen BE. Challenges and Lessons Learned from Multi-Level Multi-Component Interventions to Prevent and Reduce Childhood Obesity. Int J Environ Res Public Health 2018; 16:ijerph16010030. [PMID: 30586845 PMCID: PMC6339209 DOI: 10.3390/ijerph16010030] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/10/2018] [Accepted: 12/20/2018] [Indexed: 12/12/2022]
Abstract
Multi-level multi-component (MLMC) strategies have been recommended to prevent and reduce childhood obesity, but results of such trials have been mixed. The present work discusses lessons learned from three recently completed MLMC interventions to inform future research and policy addressing childhood obesity. B’more Healthy Communities for Kids (BHCK), Children’s Healthy Living (CHL), and Health and Local Community (SoL) trials had distinct cultural contexts, global regions, and study designs, but intervened at multiple levels of the socioecological model with strategies that address multiple components of complex food and physical activity environments to prevent childhood obesity. We discuss four common themes: (i) How to engage with community partners and involve them in development of intervention and study design; (ii) build and maintain intervention intensity by creating mutual promotion and reinforcement of the intervention activities across the multiple levels and components; (iii) conduct process evaluation for monitoring, midcourse corrections, and to engage stakeholder groups; and (iv) sustaining MLMC interventions and its effect by developing enduring and systems focused collaborations. The paper expands on each of these themes with specific lessons learned and presents future directions for MLMC trials.
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Affiliation(s)
- Joel Gittelsohn
- Center for Human Nutrition, International Health Department, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA.
| | - Rachel Novotny
- Children's Healthy Living Center of Excellence, College of Tropical Agriculture and Human Resources ⁻ University of Hawai'i at Mānoa, Honolulu, HI 96822, USA.
| | - Angela Cristina Bizzotto Trude
- Center for Human Nutrition, International Health Department, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA.
| | - Jean Butel
- Children's Healthy Living Center of Excellence, College of Tropical Agriculture and Human Resources ⁻ University of Hawai'i at Mānoa, Honolulu, HI 96822, USA.
| | - Bent Egberg Mikkelsen
- Department of Learning & Philosophy, Aalborg University, A.C. Meyers Vænge 15, DK-2450 Copenhagen SV, Denmark.
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Mikkelsen BE, Bloch P, Reinbach HC, Buch-Andersen T, Lawaetz Winkler L, Toft U, Glümer C, Jensen BB, Aagaard-Hansen J. Project SoL-A Community-Based, Multi-Component Health Promotion Intervention to Improve Healthy Eating and Physical Activity Practices among Danish Families with Young Children Part 2: Evaluation. Int J Environ Res Public Health 2018; 15:E1513. [PMID: 30021938 PMCID: PMC6069463 DOI: 10.3390/ijerph15071513] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 06/30/2018] [Accepted: 07/03/2018] [Indexed: 12/15/2022]
Abstract
Project SoL is implemented over a period of four years with the aim to promote healthy eating and physical activity among children aged 3⁻8 years by targeting the families in a Danish municipality based on the multi-component, supersetting strategy. Interventions are implemented in childcare centres, schools and supermarkets in three local communities as well as in local mass media and social media during a 19 months period in the Municipality of Bornholm. The matching Municipality of Odsherred serves as a control site based on its similarity to Bornholm regarding several socio-demographic and health indicators. The present paper gives an account of the design used for the summative and formative evaluation based on a realistic evaluation and a mixed methods approach combining qualitative and quantitative methods. Summative studies are conducted on changes of health behaviours among the involved families and within the municipalities in general, changes in community awareness of the project, changes in purchase patterns, changes in overweight and obesity among the targeted children and changes in knowledge and preferences among children due to sensory education workshops. The formative research comprises studies on children's perceptions of health, perceptions of staff at supermarkets and media professionals on their roles in supporting the health promotion agenda, and motivations and barriers of community stakeholders to engage in health promotion at community level. The paper discusses operational issues and lessons learnt related to studying complex community interventions, cross-disciplinarily, interfaces between practice and research and research capacity strengthening; and suggests areas for future research. The development and implementation of the intervention and its theoretical foundation is described in a separate paper.
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Affiliation(s)
- Bent Egberg Mikkelsen
- Department of Learning and Philosophy, Aalborg University, Copenhagen DK-2450, Denmark.
| | - Paul Bloch
- Steno Diabetes Center Copenhagen, Health Promotion, Niels Steensens Vej 6, DK-2820 Gentofte, Denmark.
| | | | - Tine Buch-Andersen
- Department of Development and Planning, Aalborg University, Copenhagen DK-2450, Denmark.
| | - Lise Lawaetz Winkler
- Research Centre for Prevention and Health, Capital Region, Glostrup DK-2600, Denmark.
| | - Ulla Toft
- Research Centre for Prevention and Health, Capital Region, Glostrup DK-2600, Denmark.
| | - Charlotte Glümer
- Research Centre for Prevention and Health, Capital Region, Glostrup DK-2600, Denmark.
| | - Bjarne Bruun Jensen
- Steno Diabetes Center Copenhagen, Health Promotion, Niels Steensens Vej 6, DK-2820 Gentofte, Denmark.
| | - Jens Aagaard-Hansen
- Steno Diabetes Center Copenhagen, Health Promotion, Niels Steensens Vej 6, DK-2820 Gentofte, Denmark.
- MRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg ZA-2000, South Africa.
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Toft U, Winkler LL, Mikkelsen BE, Bloch P, Glümer C. Discounts on fruit and vegetables combined with a space management intervention increased sales in supermarkets. Eur J Clin Nutr 2017; 71:476-480. [PMID: 28145417 DOI: 10.1038/ejcn.2016.272] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 12/08/2016] [Accepted: 12/13/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES To examine the effects of two interventions on consumer purchases of fruits and vegetables (F&V) on the Danish island of Bornholm: a 20% discount on F&V combined with improved shelf-space allocation, and improved shelf-space allocation alone. SUBJECTS/METHODS A space management intervention to promote F&V sales was performed in two large discount supermarkets on Bornholm in Denmark for 3 months (September-November 2012). In addition, a 20% discount on F&V was introduced for 3 months in one of the supermarkets ('space + price'). The effect was evaluated using sales data from the two intervention supermarkets and three control supermarkets from the same supermarket chain but in Odsherred, Denmark (control area). Both the effect on sales of fresh F&V and potential unhealthy substitution effects were evaluated using multi-level regression analyses. RESULTS During the price intervention period, the index number for sales of fresh vegetables increased by 22.2% (P=0.001) in the 'space + price' intervention supermarket compared with the control supermarkets. Furthermore, the index number for the sale of organic fresh fruit and vegetables increased by 12.1% (P=0.04) and the sale of the total amount of fruit and vegetables (fresh, frozen, dried and canned) increased by 15.3% (P=0.01) compared with the control supermarkets. In the 'space only' intervention supermarket no significant increase in the sale of fruit and vegetables was found. No unhealthy substitution effects were found. CONCLUSIONS In conclusion, a 20% price reduction on F&V significantly increased sales of F&V. The effect was most pronounced on vegetables and no negative/unhealthy substitution effects were found.
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Affiliation(s)
- U Toft
- Research Centre for Prevention and Health, The Capital Region Denmark, Glostrup University Hospital, Glostrup, Denmark
| | - L L Winkler
- Research Centre for Prevention and Health, The Capital Region Denmark, Glostrup University Hospital, Glostrup, Denmark
| | - B E Mikkelsen
- Department of Development and Planning, Aalborg University, Copenhagen, Denmark
| | - P Bloch
- Health Promotion Research, Steno Diabetes Center, Gentofte, Denmark
| | - C Glümer
- Research Centre for Prevention and Health, The Capital Region Denmark, Glostrup University Hospital, Glostrup, Denmark.,Department of Development and Planning, Aalborg University, Copenhagen, Denmark
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Mikkelsen BE, Trolle E. Partnerships for better nutrition – an analysis of how Danish authorities, researchers, non-governmental organizations and practitioners are networking to promote healthy eating. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/11026480410033467] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Bent Egberg Mikkelsen
- Department of Nutrition, Danish Institute for Food and Veterinary Research, Søborg, Denmark
| | - Ellen Trolle
- Department of Nutrition, Danish Institute for Food and Veterinary Research, Søborg, Denmark
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Freil M, Nielsen MA, Biltz C, Gut R, Mikkelsen BE, Almdal T. Reorganization of a hospital catering system increases food intake in patients with inadequate intake. Scandinavian Journal of Food and Nutrition 2016. [DOI: 10.1080/17482970600743186] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Morten Freil
- County of CopenhagenUnit of Patient EvaluationDenmark
| | | | | | - Rikke Gut
- County of CopenhagenUnit of Patient EvaluationDenmark
| | | | - Thomas Almdal
- Department of Endocrinology JHerlev University HospitalDenmark
- Department of EndocrinologyHvidovre University HospitalDenmark
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Bloch P, Toft U, Reinbach HC, Clausen LT, Mikkelsen BE, Poulsen K, Jensen BB. Revitalizing the setting approach - supersettings for sustainable impact in community health promotion. Int J Behav Nutr Phys Act 2014; 11:118. [PMID: 25218420 PMCID: PMC4172849 DOI: 10.1186/s12966-014-0118-8] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 09/08/2014] [Indexed: 11/10/2022] Open
Abstract
Background The concept of health promotion rests on aspirations aiming at enabling people to increase control over and improve their health. Health promotion action is facilitated in settings such as schools, homes and work places. As a contribution to the promotion of healthy lifestyles, we have further developed the setting approach in an effort to harmonise it with contemporary realities (and complexities) of health promotion and public health action. The paper introduces a modified concept, the supersetting approach, which builds on the optimised use of diverse and valuable resources embedded in local community settings and on the strengths of social interaction and local ownership as drivers of change processes. Interventions based on a supersetting approach are first and foremost characterised by being integrated, but also participatory, empowering, context-sensitive and knowledge-based. Based on a presentation of “Health and Local Community”, a supersetting initiative addressing the prevention of lifestyle diseases in a Danish municipality, the paper discusses the potentials and challenges of supporting local community interventions using the supersetting approach. Discussion The supersetting approach is a further development of the setting approach in which the significance of integrated and coordinated actions together with a participatory approach are emphasised and important principles are specified, all of which contribute to the attainment of synergistic effects and sustainable impact of supersetting initiatives. The supersetting approach is an ecological approach, which places the individual in a social, environmental and cultural context, and calls for a holistic perspective to change potentials and developmental processes with a starting point in the circumstances of people’s everyday life. The supersetting approach argues for optimised effectiveness of health promotion action through integrated efforts and long-lasting partnerships involving a diverse range of actors in public institutions, private enterprises, non-governmental organisations and civil society. Summary The supersetting approach is a relevant and useful conceptual framework for developing intervention-based initiatives for sustainable impact in community health promotion. It strives to attain synergistic effects from activities that are carried out in multiple settings in a coordinated manner. The supersetting approach is based on ecological and whole-systems thinking, and stipulates important principles and values of integration, participation, empowerment, context and knowledge-based development.
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Affiliation(s)
- Paul Bloch
- Steno Health Promotion Center, Steno Diabetes Center, Niels Steensens Vej 8, Gentofte, DK-2820, Denmark.
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Skov LR, Lourenço S, Hansen GL, Mikkelsen BE, Schofield C. Choice architecture as a means to change eating behaviour in self-service settings: a systematic review. Obes Rev 2013; 14:187-96. [PMID: 23164089 DOI: 10.1111/j.1467-789x.2012.01054.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Revised: 09/14/2012] [Accepted: 09/14/2012] [Indexed: 11/27/2022]
Abstract
The primary objective of this review was to investigate the current evidence base for the use of choice architecture as a means to change eating behaviour in self-service eating settings, hence potentially reduce calorie intake. Twelve databases were searched systematically for experimental studies with predefined choice architecture interventions in the period of June 2011-March 2012. The 12 included studies were grouped according to type of interventions and underwent a narrative synthesis. The evidence indicates that (i) health labelling at point of purchase is associated with healthier food choice, while (ii) manipulating the plate and cutlery size has an inconclusive effect on consumption volume. Finally, (iii) assortment manipulation and (iv) payment option manipulation was associated with healthier food choices. The majority of studies were of very weak quality and future research should emphasize a real-life setting and compare their results with the effect of other more well-established interventions on food behaviour in self-service eating settings.
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Affiliation(s)
- L R Skov
- MENU Research Group, Aalborg University, Copenhagen, Denmark.
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Mikkelsen BE. Associations between pedagogues attitudes, praxis and policy in relation to physical activity of children in kindergarten--results from a cross sectional study of health behaviour amongst Danish pre-school children. ACTA ACUST UNITED AC 2012; 6 Suppl 2:12-5. [PMID: 21923289 DOI: 10.3109/17477166.2011.613655] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This paper reports on associations between physical activity, pedagogue's attitudes towards promoting physical activity and the physical activity policies (PAP) in kindergarten. The paper deals with data on physical activity of 3-6 year olds in kindergarten which originates from a cross-sectional study conducted in 2006 among all Danish kindergartens. A questionnaire of 48 questions based on pedagogues assessment regarding the health related polcies and praxis in kindergarten and the attitudes of pedagogues was mailed (n = 4200) to all institutions in the country. In total, 1149 kindergartens and 693 integrated institutions returned the survey. The results show a relation between pedagogue's attitudes towards promoting children's physical activity and the number of children having moderately intense physical activity for at least one hour a day. The study also shows a positive association between policies and pedagogue's attitudes towards promoting children's physical activity and the number of days that pedagogues initiated games that made the children physically active. The study suggests that the social and organizational environment in the kindergarten is an important determinant for the level of physical activity among children. This means that the individual norms and attitudes of pedagogues along with the collective intentions and values expressed in written and adopted organizational policies (a Physical Activity Policy--PAP) are important aspects to be worked upon if kindergarten should play an active role in the promotion of healthy lifestyle among kindergarten aged children. Strong municipal and institutional leadership as well as educational interventions in the curricula of pedagogues could be important ways to bring about such change.
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Affiliation(s)
- Bent Egberg Mikkelsen
- Research Group for Meal Science & Public Health Nutrition, Department of Development and Planning, Aalborg University, Lautrupvang 1A, DK-2750 Ballerup, Denmark
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Sansolios S, Mikkelsen BE. Views of parents, teachers and children on health promotion in kindergarten--first results from formative focus groups and observations. ACTA ACUST UNITED AC 2012; 6 Suppl 2:28-32. [PMID: 21923292 DOI: 10.3109/17477166.2011.613659] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of the study was to capture the views of children, parents and teachers on the topic of physical activity in kindergarten through observation and focus group interviews. The study was conducted in the kindergartens from the sampling group in the Danish part of PERISCOPE. 1(st) methodology: Children interviewed inside by the researcher on preferable movements and settings and then observed outside during their playtime. 2(nd) methodology: Children asked to draw themselves playing their most preferred physical activity. Parents and kindergarten teachers interviewed in two different groups, using an identical guide. Children are skilled in taking advantage of the space and facilities available for physical activity; girls need more support than boys to initiate physical activity; children are happy with the facilities and the toys available in the kindergarten. Teachers feel an increasing pressure to take more responsibility and initiatives for the children's health habits. Parents state that if more physical activity is initiated in the kindergarten, it could make children request domestic activity. Physical activity and movement concept are too abstract for children of this age to talk about: they quickly lose their focus and concentration. The new methodology of videotaping gives the researcher the chance to interpret facial expressions to capture movement, talk and actions, and to make a distinction among children, as they tend to interrupt each other. However, this method contains a weakness, if used alone, by the fact that the shooting is only a reflection of what the video camera has recorded.
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Affiliation(s)
- Sanne Sansolios
- Research Group for Meal Science & Public Health Nutrition, Department of Development and Planning, Aalborg University, Lautrupvang 1A, DK-2750 Ballerup, Denmark.
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Mikkelsen BE. Images of foodscapes: introduction to foodscape studies and their application in the study of healthy eating out-of-home environments. Perspect Public Health 2011; 131:209-16. [PMID: 21999025 DOI: 10.1177/1757913911415150] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The notion of foodscape is increasingly being used within health promotion, public health nutrition and food studies as a tool to describe our food environments and to assess the potential impact on food choice and food behaviour. This paper takes a closer look at the growing number of foodscape studies (FSS) and traces the origin of the idea of foodscapes. It reflects on the different contributions and discusses the applicability within food research. In particular it discusses how the notion can be applied in the growing number of studies that investigate the role that captive eating out-of-home environments (CEOE) in public welfare systems has on the health of the individual and on the sustainability of the environment. The paper concludes that the idea of foodscapes is a convenient tool that has many applications in food research. The foodscape framework offers obvious advantages in that it enables scholars to analyse how food, places and people are interconnected and how they interact. In particular the paper concludes that the foodscape notion is well suited to the study of foodscapes in CEOEs such as schools, kindergartens and institutions. I finally suggest that such foodscapes can be defined as physical, organizational and sociocultural spaces in which clients/guests encounter meals, food and food-related issues including health messages.
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Affiliation(s)
- Bent Egberg Mikkelsen
- Meal Science & Public Health Nutrition (MENU), Aalborg University, Lautrupvang 2, DK-2750 Ballerup, Denmark.
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Mikkelsen BE. Foodscape studies--a powerful tool to improve our understanding of the impact of food environments on behaviour. Perspect Public Health 2011; 131:206. [PMID: 21999023 DOI: 10.1177/1757913911419151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Caroli M, Malecka-Tendera E, Mikkelsen BE, Longo A. PERISCOPE Project: Workshop on physical activity and indoor/outdoor environment in kindergartens. ACTA ACUST UNITED AC 2011; 6 Suppl 2:1. [DOI: 10.3109/17477166.2011.613650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Mikkelsen BE. Policies to promote on physical activity and healthy eating in kindergartens from theory to practice. ACTA ACUST UNITED AC 2011; 6 Suppl 2:8-11. [DOI: 10.3109/17477166.2011.613653] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Søgaard Jørgensen M, Helene Arsky G, Brandhøj M, Nyberg M, Roos E, Egberg Mikkelsen B. Eating at worksites in Nordic countries: national experiences and policy initiatives. Intl J of Workplace Health Mgt 2010. [DOI: 10.1108/17538351011078938] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Egberg Mikkelsen B. Worksite foodscapes: an opportunity for better and healthier eating experiences. International Journal of Workplace Health Management 2010. [DOI: 10.1108/ijwhm.2010.35403caa.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Mikkelsen BE, Beck AM, Lassen A. Do recommendations for institutional food service result in better food service? A study of compliance in Danish hospitals and nursing homes from 1995 to 2002-2003. Eur J Clin Nutr 2006; 61:129-34. [PMID: 16835596 DOI: 10.1038/sj.ejcn.1602488] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Since 1995, significant efforts by authorities and researchers have been directed towards addressing the nutritional problems in Danish hospitals and nursing homes. AIM The purpose of this study was to investigate whether the increased focus on nutritional problems in patients and nursing home residents has resulted in measurable progress. DESIGN A questionnaire-based study was carried out among foodservice managers in Danish hospitals (n=96) and nursing homes (n=898) in 1995 and 2002/3 (n=90) and (n=682), respectively. The study used compliance with selected issues in the official Danish recommendations for institutional food service as an indicator for progress. The issues included: using nutrient calculated recipes/menus, offering menu choice options, using feedback routines on acceptability of menus, maintaining nutritional steering committees, employing food and nutrition contact persons, employing official recommendations and offering choice between three different menu energy levels. RESULTS Hospitals had a higher compliance compared to nursing homes. In 1995, this was the case for all questions asked and differences were statistically significant. Also in 2002/3, hospitals had a higher compliance, except in the case of established feedback routines. Differences were statistically significant. The results indicate that nutritional care is higher on the agenda in hospital, than in nursing homes. However, very little progress can be seen in compliance when results are analysed over the 8-year period. The only progress for nursing homes was that more homes had implemented feedback routines on acceptability of food service in 2002/3 than in 1995. The difference was statistically significant. For hospitals, however, no progress was found between 1995 and 2002/3. CONCLUSION The attempts to improve the nutritional status of hospital patients and nursing home residents seem to have failed. Still, the initiatives taken to improve the situation seem relevant. Especially the nursing homes might benefit from advantage of these experiences.
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Affiliation(s)
- B E Mikkelsen
- Department of Nutrition, Danish Institute for Food and Veterinary Research, Soeborg, Denmark.
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Mikkelsen BE, Rasmussen VB, Young I. The role of school food service in promoting healthy eating at school - a perspective from an ad hoc group on nutrition in schools, Council of Europe. ACTA ACUST UNITED AC 2005. [DOI: 10.1111/j.1471-5740.2005.00110.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Beck AM, Balknäs UN, Camilo ME, Fürst P, Gentile MG, Hasunen K, Jones L, Jonkers-Schuitema C, Keller U, Melchior JC, Mikkelsen BE, Pavcic M, Schauder P, Sivonen L, Zinck O, Øien H, Ovesen L. Practices in relation to nutritional care and support--report from the Council of Europe. Clin Nutr 2002; 21:351-4. [PMID: 12211176 DOI: 10.1054/clnu.2002.0555] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Disease-related undernutrition is significant in European hospitals but is seldom treated. In 1999, the Council of Europe decided to collect information regarding Nutrition programmes in hospitals and for this purpose a network consisting of national experts from 12 of the Partial Agreement member states was established. The aim was to review the current practice in Europe regarding hospital food provision, to highlight deficiencies and to issue recommendations in improve the nutritional care and support of hospitalised patients. The data collection regarding the nutritional care providers and their practices of nutritional care and support showed that the use of nutritional risk screening and assessment, and of nutritional support and counselling was sparse and inconsistent, and that the responsibilities in these contexts were unclear. Besides, the educational level with regard to nutritional care and support was limited at all levels. All patients have the right to expect that their nutritional needs will be fulfilled during a hospitalisation. Optimal supply of food is a prerequisite for an optimal effect of the specific treatment offered to patients. Hence, the responsibilities of staff categories and the hospital management with respect to procuring nutritional care and support should be clearly assigned. Also, a general improvement in the educational level of all staff groups is needed.
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Beck AM, Balknäs UN, Fürst P, Hasunen K, Jones L, Keller U, Melchior JC, Mikkelsen BE, Schauder P, Sivonen L, Zinck O, Øien H, Ovesen L. Food and nutritional care in hospitals: how to prevent undernutrition--report and guidelines from the Council of Europe. Clin Nutr 2001; 20:455-60. [PMID: 11534942 DOI: 10.1054/clnu.2001.0494] [Citation(s) in RCA: 124] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
In 1999 the Council of Europe decided to collect information regarding Nutrition programmes in hospitals and for this purpose a network consisting of national experts from eight of the Partial Agreement member states was established. The aim was to review the current practice in Europe regarding hospital food provision, to highlight deficiencies and to issue guidelines to improve the nutritional care and support of hospitalized patients. Five major problems seemed to be common in this context: 1) lack of clearly defined responsibilities; 2) lack of sufficient education; 3) lack of influence of the patients; 4) lack of co-operation among all staff groups; and 5) lack of involvement from the hospital management. To solve the problems highlighted, a combined 'team-effort' is needed from national authorities and all staff involved in the nutritional care and support, including hospital managers.
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Affiliation(s)
- A M Beck
- Danish Veterinary and Food Administration, Soeborg, Denmark
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