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Wills AK, Hillesund ER, Van Lippevelde W, Barker M, Vik FN, Øverby NC. Preconception diet in adolescence and its association with hypertensive disorders of pregnancy and preterm birth. Results from The HUNT study. Br J Nutr 2024:1-22. [PMID: 38634260 DOI: 10.1017/s0007114524000746] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Our aim was to estimate associations of adolescent dietary patterns and meal habits with hypertensive disorders of pregnancy (HDP) and preterm birth. We used data from a prospective cohort study (Norwegian Young-HUNT1) where dietary information was collected during adolescence and pregnancy outcomes were obtained through record linkage to the Norwegian national birth registry. The outcomes were HDP, hypertension, preeclampsia/ eclampsia, and preterm birth in the first pregnancy and in any pregnancy. Diet was self-reported from validated questionnaires and exposures were dietary indexes (healthy; unhealthy; fruit and vegetable; fibre index) and meal habits. Recruitment took place in schools. Eligible participants were females aged 13-19 years at the time of dietary assessment with a subsequent singleton pregnancy (n=3622). Women who reported a higher fibre intake in adolescence had a lower risk of pre-eclampsia in the first pregnancy (RR: 0.84; 95% CI: 0.7-1.0) although this was weaker in sensitivity analyses. Regular meal habits in mid-adolescence (aged 13-15y), particularly breakfast and lunch, were weakly associated with a lower risk of hypertension in pregnancy. Our results are the first to indicate an association between aspects of diet and dietary behavior in mid-adolescence and subsequent HDPs. More evidence is needed from larger studies to replicate the results and from alternative study-designs to disentangle causality.
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Affiliation(s)
- Andrew Keith Wills
- Centre for Lifecourse Nutrition, Department of Nutrition and Public Health, University of Agder, Postboks 422, 4604 Kristiansand, Norway
| | - Elisabet Rudjord Hillesund
- Centre for Lifecourse Nutrition, Department of Nutrition and Public Health, University of Agder, Postboks 422, 4604 Kristiansand, Norway
| | - Wendy Van Lippevelde
- Unit Consumer Behaviour; Department of Marketing, Innovation and Organisation; Faculty of Economics and Business Administration; Ghent University; Tweekerkenstraat 2, 9000 Ghent, Belgium
| | - Mary Barker
- School of Health Sciences, Faculty of Environmental and Life Sciences and MRC Lifecourse Epidemiology Centre, Faculty of Medicine, University of Southampton, UK
| | - Frøydis Nordgård Vik
- Centre for Lifecourse Nutrition, Department of Nutrition and Public Health, University of Agder, Postboks 422, 4604 Kristiansand, Norway
| | - Nina Cecilie Øverby
- Centre for Lifecourse Nutrition, Department of Nutrition and Public Health, University of Agder, Postboks 422, 4604 Kristiansand, Norway
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Medin AC, Vik FN, Helle C, Helland SH, Wills AK, Osorio NG, Lian H, Ersfjord TI, Van Daele W, Bjørkkjær T, Valen EN, Gebremariam MK, Grasaas E, Kiland C, von Thiele Schwarz U, Abel MH, Love P, Campbell K, Rutter H, Barker ME, Hillesund ER, Øverby NC. Scaling up evidence-based digital early life nutrition interventions in a county setting: an implementation trial - protocol for Phase 2 of the Nutrition Now project. Front Public Health 2024; 11:1326787. [PMID: 38264256 PMCID: PMC10803599 DOI: 10.3389/fpubh.2023.1326787] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/13/2023] [Indexed: 01/25/2024] Open
Abstract
Background Few effective health interventions transition from smaller efficacy or effectiveness studies to real-world implementation at scale, representing a gap between evidence and practice. Recognising this, we have developed Nutrition Now - a tailored digital resource building on four efficacious dietary interventions, aiming to improve nutrition in the important first 1,000 days of life. Nutrition Now targets and guides expectant parents and parents of 0-2 year olds, serves as a reliable source of evidence-based information for midwives and public health nurses at maternal and child healthcare (MCH) centres, and offers pedagogical tools for early childhood education and care (ECEC) staff. The aim of this study is to implement Nutrition Now at scale and evaluate the impact of different sets of multifaceted implementation strategies on implementation outcomes. Methods A quasi-experimental design with three study arms will be used, providing either low, medium or high implementation support, when rolled out in 50 municipalities in 2 counties in Norway. Nutrition Now will be implemented in MCH and ECEC settings and made available to expectant parents and parents of 0-2 year olds through social media and MCH. The implementation support builds on strategies described in the Expert Recommendations for Implementing Change (ERIC) implementation framework and is informed by dialogues with stakeholders. Impact of the different degree of implementation support will be assessed by examining reach, adoption, fidelity, and sustainability using usage data generated from the Nutrition Now resource, publicly available municipal data and qualitative interviews with MCH and ECEC staff. Discussion Nutrition Now Phase 2 will break new ground by scaling up successively delivered and complementary dietary interventions in the first 1,000 days of life in a real-life context. The project also seeks to identify what level of implementation support is most effective when implementing digital, scalable, evidence-based early-life nutrition interventions in community settings. The project will inform implementation research and provide knowledge about effective implementation strategies to be used in a national scale-up of Nutrition Now. Trial registration The study is registered prospectively (submitted 14/06/2022, registration date: 19/06/2022) in the International Standard Randomised Controlled Trial Number registry (ISRCTN): reg. Number: ISRCTN10694967, https://doi.org/10.1186/ISRCTN10694967.
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Affiliation(s)
- Anine Christine Medin
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Frøydis Nordgård Vik
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Christine Helle
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Sissel Heidi Helland
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Andrew Keith Wills
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Natalie Garzon Osorio
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Henrik Lian
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Torunn Iveland Ersfjord
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Wim Van Daele
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Tormod Bjørkkjær
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Erlend Nuland Valen
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Mekdes Kebede Gebremariam
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Erik Grasaas
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Charlotte Kiland
- Department of Political Science and Management, Faculty of Social Sciences, University of Agder, Kristiansand, Norway
| | - Ulrica von Thiele Schwarz
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Procome, Medical Management Centre, LIME, Karolinska Institutet, Stockholm, Sweden
| | - Marianne Hope Abel
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Penny Love
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, VIC, Australia
| | - Karen Campbell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, VIC, Australia
| | - Harry Rutter
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
- Department of Social and Policy Sciences, University of Bath, Bath, United Kingdom
| | - Mary Elizabeth Barker
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
| | - Elisabet Rudjord Hillesund
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Nina Cecilie Øverby
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
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Helle C, Hillesund ER, Øverby NC. Maternal mental health is associated with children's frequency of family meals at 12 and 24 months of age. Matern Child Nutr 2024; 20:e13552. [PMID: 37596722 PMCID: PMC10750025 DOI: 10.1111/mcn.13552] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/03/2023] [Accepted: 07/20/2023] [Indexed: 08/20/2023]
Abstract
Diet during the child's first years is important for growth and development. In toddlerhood, higher diet quality is reported among children eating meals together with family. Although previous literature has documented several associations between maternal mental health and early child feeding practices, less is known about the relationship between maternal mental health and child frequency of shared family meals. This study explores associations between maternal symptoms of anxiety and depression, measured by The Hopkins Symptoms Checklist (SCL-8), and toddler participation in family meals. We used cross-sectional data from the Norwegian study Early Food for Future Health, in which participants responded to questionnaires at child age 12 (n = 455) and 24 months (n = 295). Logistic regression was used to explore associations between maternal mental health and child having regular (≥5 per week) or irregular (<5 per week) family meals (breakfast and dinner), adjusting for relevant child and maternal confounding variables. Children of mothers with higher scores of anxiety and depression had higher odds of Irregular family meals at both timepoints; (OR: 2.067, p = 0.015) and (OR: 2.444, p = 0.023). This is one of few studies exploring associations between maternal mental health and child frequency of shared family meals in early childhood, a period where the foundation for life-long health is shaped. Given the high prevalence of mental ailments and disorders, these findings are important and may inform future public health interventions. Further exploration of this relation is needed, including longitudinal research to test predictive associations and qualitative studies to increase insight and understanding.
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Affiliation(s)
- Christine Helle
- Department of Nutrition and Public Health, Faculty of Health and Sport SciencesUniversity of AgderKristiansandNorway
| | - Elisabet R. Hillesund
- Department of Nutrition and Public Health, Faculty of Health and Sport SciencesUniversity of AgderKristiansandNorway
| | - Nina Cecilie Øverby
- Department of Nutrition and Public Health, Faculty of Health and Sport SciencesUniversity of AgderKristiansandNorway
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Valen EN, Øverby NC, Hardy‐Johnson P, Vik FN, Salvesen L, Omholt ML, Barker ME, Hillesund ER. Lessons learned from talking with adults about nutrition: A qualitative study in the PREPARED project. Matern Child Nutr 2024; 20 Suppl 2:e13540. [PMID: 37277971 PMCID: PMC10765357 DOI: 10.1111/mcn.13540] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 05/15/2023] [Accepted: 05/19/2023] [Indexed: 06/07/2023]
Abstract
Improving diet and dietary behaviour of men and women before pregnancy has the potential to benefit both their current and long-term health and the health of their children. Little is known, however, about adults' perception of diet's role in prepregnancy health. This study aimed to explore the state of knowledge and awareness of preconception nutritional health in adults within the fertile age range and what they perceived could motivate healthy eating using the self-determination theory as a theoretical framework. We analysed 33 short exploratory interviews with men (n = 18) and women (n = 15) aged 18-45 years. Participants were grab sampled from three different public locations in the southern part of Norway. Interviews were audio-recorded, transcribed verbatim in 2020 and analysed using a thematic analysis with a semantic approach in 2022. The findings suggest that adults within the fertile age range are not intrinsically motivated to eat healthily, but when they do, it is because eating healthily often aligns with other goals consistent with their values, that is, getting fit or looking good. They possess some basic knowledge of healthy behaviours during pregnancy but are generally unaware of the importance of preconception health and nutrition. There is a need to increase awareness of the impact of preconception health on the health of this and future generations. Improved nutritional education on the significance of diet before conception might facilitate optimal conditions for conceiving and for pregnancy in the adult population within fertile age range.
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Affiliation(s)
- Erlend N. Valen
- Department of Nutrition and Public HealthUniversity of AgderKristiansandVest‐AgderNorway
| | - Nina Cecilie Øverby
- Department of Nutrition and Public HealthUniversity of AgderKristiansandVest‐AgderNorway
| | - Polly Hardy‐Johnson
- Medical Research Council Lifecourse Epidemiology UnitUniversity of SouthamptonSouthamptonUK
| | - Frøydis N. Vik
- Department of Nutrition and Public HealthUniversity of AgderKristiansandVest‐AgderNorway
| | - Lorentz Salvesen
- Department of Nutrition and Public HealthUniversity of AgderKristiansandVest‐AgderNorway
| | - Mona L. Omholt
- Department of Nutrition and Public HealthUniversity of AgderKristiansandVest‐AgderNorway
| | - Mary Elizabeth Barker
- Department of Nutrition and Public HealthUniversity of AgderKristiansandVest‐AgderNorway
- Medical Research Council Lifecourse Epidemiology UnitUniversity of SouthamptonSouthamptonUK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation TrustSouthamptonUK
| | - Elisabet R. Hillesund
- Department of Nutrition and Public HealthUniversity of AgderKristiansandVest‐AgderNorway
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Helle C, Hillesund ER, Øverby NC. A qualitative study of public health nurses' perspectives and experiences on nutritional guidance for parents of infants and toddlers. Matern Child Nutr 2024; 20 Suppl 2:e13546. [PMID: 37439563 PMCID: PMC10765362 DOI: 10.1111/mcn.13546] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/26/2023] [Accepted: 06/07/2023] [Indexed: 07/14/2023]
Abstract
In Norway, public health nurses (PHNs) are responsible for giving parents nutritional knowledge, but limited research describes how they perceive this task. This study explores PHNs' perceptions and experiences on nutritional guidance for parents of infants and toddlers. Semistructured interviews with six PHNs were conducted and transcribed verbatim. Data were subjected to thematic analysis. Five main themes were identified: (1) Dietary guidance for parents is central to the work; (2) PHNs perceive they have parents' trust, and parents are in general open to nutrition counselling; (3) food and meals must be seen in light of the family context; (4) The dialogue must be adapted to the individual family; and (5) PHNs have expertise on nutrition; however, updating knowledge is difficult. Nutritional guidance was perceived by PHNs as a core activity. They felt that they had parents' trust, and that parents were particularly open to nutritional guidance during the first 2 years. Counselling was generally well received, but conversations on overweight were perceived as difficult. PHNs strove to tailor their guidance to individual needs. However, providing guidance on a wide range of issues in different families and cultures could be challenging. They acknowledged a need for updating knowledge but the offer of courses was sparse. Our findings suggest a discrepancy between how nutrition is prioritized in the education of PHNs and what they encounter in clinical practice. In the future, this should be given more attention given the PHNs' unique position to promote healthy eating and long-term health.
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Affiliation(s)
- Christine Helle
- Department of Nutrition and Public Health, Faculty of Health and Sport SciencesUniversity of AgderKristiansanNorway
| | - Elisabet R. Hillesund
- Department of Nutrition and Public Health, Faculty of Health and Sport SciencesUniversity of AgderKristiansanNorway
| | - Nina Cecilie Øverby
- Department of Nutrition and Public Health, Faculty of Health and Sport SciencesUniversity of AgderKristiansanNorway
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6
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Rai AS, Sletner L, Jenum AK, Øverby NC, Stafne SN, Qvigstad E, Pripp AH, Sagedal LR. Employing fasting plasma glucose to safely limit the use of oral glucose tolerance tests in pregnancy: a pooled analysis of four Norwegian studies. Front Endocrinol (Lausanne) 2023; 14:1278523. [PMID: 38098869 PMCID: PMC10720624 DOI: 10.3389/fendo.2023.1278523] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/10/2023] [Indexed: 12/17/2023] Open
Abstract
Background/objective There is no international consensus about the optimal approach to screening and diagnosis of gestational diabetes mellitus (GDM). Fasting plasma glucose (FPG) has been proposed as an alternative universal screening test to simplify the diagnosis of GDM. We investigate the ability of the FPG to predict a 2-hour glucose value below the cut-off for GDM, thereby "ruling out" the necessity of a full OGTT and assess the proportion of GDM-related complications associated with the identified FPG level. Materials and methods This study included secondary data from four Norwegian pregnancy cohorts (2002-2013), encompassing 2960 women universally screened with late mid-pregnancy 75g OGTT measuring FPG and 2-hour glucose. For a range of FPG thresholds, we calculated sensitivity to predict elevated 2-hour glucose, number of OGTTs needed and percentage of GDM cases missed, applying modified World Health Organization (WHO) 2013 criteria (2013WHO) and 2017 Norwegian criteria (2017Norwegian). We analyzed pregnancy outcomes for women above and below our selected threshold. Results The prevalence of GDM was 16.6% (2013WHO) and 10.1% (2017Norwegian). A FPG threshold of 4.7 mmol/L had a sensitivity of 76% (2013WHO) and 80% (2017Norwegian) for detecting elevated 2-hour glucose, with few missed GDM cases (2.0% of those ruled out and 7.5% of all GDM cases for 2013WHO, and 1.1% of those ruled out and 7% of all GDM cases for 2017Norwegian). When excluding women with FPG <4.7mmol/l and those with GDM based on FPG, only 24% (2013WHO) and 29% (2017Norwegian) would require OGTT. Women with FPG <4.7mmol/l, including missed GDM cases, had low risk of large-for-gestational-age newborns, cesarean section and operative vaginal delivery. Conclusion A FPG threshold of 4.7mmol/l as a first step when screening for GDM could potentially eliminate the need for OGTT in 70-77% of pregnancies. Women with FPG below this threshold appear to carry low risk of GDM-associated adverse pregnancy outcomes.
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Affiliation(s)
- Anam Shakil Rai
- Department of Research, Sorlandet Hospital, Kristiansand, Norway
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Line Sletner
- Department of Pediatric and Adolescents Medicine, Akershus University Hospital, Akershus, Norway
| | - Anne Karen Jenum
- General Practice Research Unit (AFE), Department of General Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Nina Cecilie Øverby
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Signe Nilssen Stafne
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Clinical Services, St.Olavs Hospital Trondheim University Hospital, Trondheim, Norway
| | - Elisabeth Qvigstad
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Are Hugo Pripp
- Oslo Centre of Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Linda Reme Sagedal
- Department of Research, Sorlandet Hospital, Kristiansand, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Obstetrics and Gynaecology, Sorlandet Hospital, Kristiansand, Norway
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Ostojic SM, Øverby NC. Editorial: Scientific integrity in nutritional research. Front Nutr 2023; 10:1323265. [PMID: 38024353 PMCID: PMC10668013 DOI: 10.3389/fnut.2023.1323265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Sergej M. Ostojic
- Department of Nutrition and Public Health, Faculty of Health and Sports Sciences, University of Agder, Kristiansand, Vest-Agder, Norway
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Salvesen L, Valen EN, Wills AK, Hillesund ER, Vik FN, Engeset D, Øverby NC, Medin AC. Developmental origins of health and disease knowledge is associated with diet quality in preconception young adult men and women. J Dev Orig Health Dis 2023; 14:631-638. [PMID: 38014542 DOI: 10.1017/s2040174423000314] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
The Developmental Origins of Health and Disease (DOHaD) approach supports that nutritional exposures in early life affect an individual's later health and risk of disease. Dietary exposure during the preconception period may also influence individual, and inter- and transgenerational health and disease risk, in both men and women. This study aimed to describe knowledge of the DOHaD approach (DOHaDKNOWLEDGE) and diet quality in preconception young adults in Norway, to assess associations between DOHaDKNOWLEDGE and a Diet Quality Score (DQS), and to assess gender differences in those above. Data from 1362 preconception young adults was obtained from the PREPARED study baseline dataset. The sample had 88% women participants, a mean age of 27 years, 36% had overweight or obesity, and 77% had higher level of education. DOHaDKNOWLEDGE was assessed by the participants' agreement to five statements using a Likert scale. Diet quality was assessed using aspects of diet quality and a DQS derived from a dietary screener. We found moderate level of both DOHaDKNOWLEDGE (12/20 points) and diet quality (DQS: 60/100 points), indicating potential for improvements. Specifically, the greatest potential for diet quality improvements were observed for sugary foods, red and processed meats, legumes, and unsalted nuts and seeds. Gender differences were observed for both DOHaDKNOWLEDGE and diet quality. DOHaDKNOWLEDGE was positively associated with DQS, adjusted for sociodemographic factors, with little evidence of an interaction effect by gender. This study indicates that knowledge of the DOHaD approach is positively associated with diet quality in preconception young men and women. Future studies should consider incorporating pregnancy intentions, relationship status, and health literacy.
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Affiliation(s)
- Lorentz Salvesen
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Erlend Nuland Valen
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Andrew Keith Wills
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Elisabet Rudjord Hillesund
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Frøydis Nordgård Vik
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Dagrun Engeset
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Nina Cecilie Øverby
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Anine Christine Medin
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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Rai AS, Sletner L, Jenum AK, Øverby NC, Stafne SN, Qvigstad E, Pripp AH, Sagedal LR. Adverse pregnancy outcomes among women in Norway with gestational diabetes using three diagnostic criteria. PLoS One 2023; 18:e0280750. [PMID: 37410781 PMCID: PMC10325062 DOI: 10.1371/journal.pone.0280750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 01/08/2023] [Indexed: 07/08/2023] Open
Abstract
INTRODUCTION The aim of this study was to examine the risk of adverse perinatal outcomes in women diagnosed with GDM by the World Health Organization (WHO) 1999 criteria, and in those retrospectively identified by the Norwegian-2017 and WHO-2013 criteria but not by WHO-1999 criteria. We also examine the effect of maternal overweight/obesity and ethnicity. MATERIAL AND METHODS We used pooled data from four Norwegian cohorts (2002-2013), encompassing 2970 mother-child pairs. Results from universally offered 75-g oral glucose tolerance tests measuring fasting plasma glucose (FPG) and 2-hour glucose (2HG) were used to assign women into three diagnostic groups: Diagnosed and treated by WHO-1999 (FPG≥7.0 or (2HG ≥7.8 mmol/L), identified by WHO-2013 (FPG ≥5.1 or 2HG ≥8.5 mmol/L), and identified by Norwegian-2017 criteria (FPG ≥5.3 or 2HG ≥9.0 mmol/L). Perinatal outcomes included large-for-gestational-age (LGA) infants, cesarean section, operative vaginal delivery, preterm birth and preeclampsia. RESULTS Compared to the non-GDM group, women diagnosed with GDM by either of the three criteria had an increased risk of large-for-gestational-age infants (adjusted odds ratios (OR) 1.7-2.2). Those identified by the WHO-2013 and Norwegian-2017 criteria but not diagnosed and treated by WHO-1999 criteria had an additional increased risk of cesarean section (OR 1.36, 95% CI 1.02,1.83 and 1.44, 95% CI 1.03,2.02, respectively) and operative vaginal delivery (OR 1.35, 95% CI 1.1,1.7 and 1.5, 95% CI 1.1,2.0, respectively). The proportions of LGA neonates and cesarean section were higher for women with GDM in both normal-weight and overweight/obese women. Asians had a lower risk of delivering large-for-gestational-age infants than Europeans applying national birthweight references, but maternal glucose values were similarly positively associated with birthweight in all ethnic groups. CONCLUSIONS Women who met the WHO-2013 and Norwegian-2017 criteria, but were not diagnosed by the WHO-1999 criteria and therefore not treated, had an increased risk of LGA, cesarean section and operative vaginal delivery compared to women without GDM.
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Affiliation(s)
- Anam Shakil Rai
- Department of Research, Sorlandet Hospital, Kristiansand, Norway
| | - Line Sletner
- Department of Pediatric and Adolescents Medicine, Akershus University Hospital, Nordbyhagen, Akershus, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anne Karen Jenum
- Department of General Medicine, General Practice Research Unit (AFE), Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Nina Cecilie Øverby
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Signe Nilssen Stafne
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Clinical Services, St.Olavs Hospital Trondheim University Hospital, Trondheim, Norway
| | - Elisabeth Qvigstad
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Are Hugo Pripp
- Oslo Centre of Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Linda Reme Sagedal
- Department of Research, Sorlandet Hospital, Kristiansand, Norway
- Department of Obstetrics and Gynaecology, Sorlandet Hospital, Kristiansand, Norway
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Vejrup K, Agnihotri N, Bere E, Schjølberg S, LeBlanc M, Hillesund ER, Øverby NC. Adherence to a healthy and potentially sustainable Nordic diet is associated with child development in The Norwegian Mother, Father and Child Cohort Study (MoBa). Nutr J 2022; 21:46. [PMID: 35843945 PMCID: PMC9290263 DOI: 10.1186/s12937-022-00799-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 10/13/2021] [Accepted: 06/19/2022] [Indexed: 11/30/2022] Open
Abstract
Background The rapid neurodevelopment that occurs during the first years of life hinges on adequate nutrition throughout fetal life and early childhood. Therefore, adhering to a dietary pattern based on healthy foods during pregnancy and the first years of life may be beneficial for future development. The aim of this paper was to investigate the relationship between adherence to a healthy and potentially sustainable Nordic diet during pregnancy and in early childhood and child development. Methods This study is based on the Norwegian Mother, Father and Child Cohort Study (MoBa) and uses data from the Medical Birth Registry of Norway (MBRN). In 83,800 mother-child pairs, maternal pregnancy diet and child diet at 6 months, 18 months and 3 years were scored according to adherence to the New Nordic Diet (NND). NND scores were calculated both as a total score and categorized into low, medium, or high adherence. Child communication and motor development skills were reported by parents at 6 months, 18 months, 3 and 5 years, using short forms of the Ages and Stages Questionnaire and the Child Development Inventory. Associations of NND adherence with child development were estimated with linear and logistic regression in crude and adjusted models. Results When examining the NND and child developmental scores as percentages of the total scores, we found positive associations between the NND scores (both maternal pregnancy diet and child diet) and higher scoring on child development (adjusted \documentclass[12pt]{minimal}
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\begin{document}$$\hat{\beta}$$\end{document}β^ s [95% confidence intervals] ranging from 0.007 [0.004, 0.009] to 0.045 [0.040, 0.050]). We further found that low and medium adherence to NND were associated with higher odds of later emerging developmental skills compared to high NND adherence at nearly all measured timepoints (odds ratios [95% CI] ranging from significant values 1.15 [1.03–1.29] to 1.79 [1.55, 2.06] in adjusted analyses). Conclusions Our findings support that adherence to a healthy and potentially sustainable diet early in life is important for child development every step of the way from pregnancy until age 5 years. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-022-00799-5.
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Affiliation(s)
- Kristine Vejrup
- Department of Nutrition and Public Health, Centre for Lifecourse Nutrition, University of Agder, Kristiansand, Norway.,Norwegian Armed Forces Medical Services, Sessvollmoen, Norway
| | - Neha Agnihotri
- Department of Nutrition and Public Health, Centre for Lifecourse Nutrition, University of Agder, Kristiansand, Norway.
| | - Elling Bere
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway.,Department of Health and Inequality, Norwegian Institute of Public Health, Oslo, Norway.,Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Synnve Schjølberg
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Marissa LeBlanc
- Department of Nutrition and Public Health, Centre for Lifecourse Nutrition, University of Agder, Kristiansand, Norway.,Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Elisabet Rudjord Hillesund
- Department of Nutrition and Public Health, Centre for Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Nina Cecilie Øverby
- Department of Nutrition and Public Health, Centre for Lifecourse Nutrition, University of Agder, Kristiansand, Norway
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11
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Hunter KE, Johnson BJ, Askie L, Golley RK, Baur LA, Marschner IC, Taylor RW, Wolfenden L, Wood CT, Mihrshahi S, Hayes AJ, Rissel C, Robledo KP, O'Connor DA, Espinoza D, Staub LP, Chadwick P, Taki S, Barba A, Libesman S, Aberoumand M, Smith WA, Sue-See M, Hesketh KD, Thomson JL, Bryant M, Paul IM, Verbestel V, Stough CO, Wen LM, Larsen JK, O'Reilly SL, Wasser HM, Savage JS, Ong KK, Salvy SJ, Messito MJ, Gross RS, Karssen LT, Rasmussen FE, Campbell K, Linares AM, Øverby NC, Palacios C, Joshipura KJ, González Acero C, Lakshman R, Thompson AL, Maffeis C, Oken E, Ghaderi A, Campos Rivera M, Pérez-Expósito AB, Banna JC, de la Haye K, Goran M, Røed M, Anzman-Frasca S, Taylor BJ, Seidler AL. Transforming Obesity Prevention for CHILDren (TOPCHILD) Collaboration: protocol for a systematic review with individual participant data meta-analysis of behavioural interventions for the prevention of early childhood obesity. BMJ Open 2022; 12:e048166. [PMID: 35058256 PMCID: PMC8783820 DOI: 10.1136/bmjopen-2020-048166] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 11/18/2021] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Behavioural interventions in early life appear to show some effect in reducing childhood overweight and obesity. However, uncertainty remains regarding their overall effectiveness, and whether effectiveness differs among key subgroups. These evidence gaps have prompted an increase in very early childhood obesity prevention trials worldwide. Combining the individual participant data (IPD) from these trials will enhance statistical power to determine overall effectiveness and enable examination of individual and trial-level subgroups. We present a protocol for a systematic review with IPD meta-analysis to evaluate the effectiveness of obesity prevention interventions commencing antenatally or in the first year after birth, and to explore whether there are differential effects among key subgroups. METHODS AND ANALYSIS Systematic searches of Medline, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo and trial registries for all ongoing and completed randomised controlled trials evaluating behavioural interventions for the prevention of early childhood obesity have been completed up to March 2021 and will be updated annually to include additional trials. Eligible trialists will be asked to share their IPD; if unavailable, aggregate data will be used where possible. An IPD meta-analysis and a nested prospective meta-analysis will be performed using methodologies recommended by the Cochrane Collaboration. The primary outcome will be body mass index z-score at age 24±6 months using WHO Growth Standards, and effect differences will be explored among prespecified individual and trial-level subgroups. Secondary outcomes include other child weight-related measures, infant feeding, dietary intake, physical activity, sedentary behaviours, sleep, parenting measures and adverse events. ETHICS AND DISSEMINATION Approved by The University of Sydney Human Research Ethics Committee (2020/273) and Flinders University Social and Behavioural Research Ethics Committee (HREC CIA2133-1). Results will be relevant to clinicians, child health services, researchers, policy-makers and families, and will be disseminated via publications, presentations and media releases. PROSPERO REGISTRATION NUMBER CRD42020177408.
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Affiliation(s)
- Kylie E Hunter
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Brittany J Johnson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Lisa Askie
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Rebecca K Golley
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Louise A Baur
- Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, New South Wales, Australia
| | - Ian C Marschner
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Rachael W Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Luke Wolfenden
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Charles T Wood
- School of Medicine, Duke University, Durham, North Carolina, USA
| | - Seema Mihrshahi
- Department of Health Systems and Populations, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Alison J Hayes
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Chris Rissel
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kristy P Robledo
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Denise A O'Connor
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- Monash Department of Clinical Epidemiology, Cabrini Institute, Malvern, Victoria, Australia
| | - David Espinoza
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Lukas P Staub
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Paul Chadwick
- Centre For Behaviour Change, University College London, London, UK
| | - Sarah Taki
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Population Health Research and Evaluation Hub, Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Angie Barba
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Sol Libesman
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Mason Aberoumand
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Wendy A Smith
- Canterbury Community Health Centre, Sydney Local Health District, Campsie, New South Wales, Australia
- Consumer Representative, Sydney, New South Wales, Australia
| | | | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | | | - Maria Bryant
- Department of Health Sciences and the Hull York Medical School, University of York, York, UK
| | - Ian M Paul
- Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Vera Verbestel
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | | | - Li Ming Wen
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Population Health Research and Evaluation Hub, Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Junilla K Larsen
- Behavioural Science Institute, Radboud Universiteit, Nijmegen, The Netherlands
| | - Sharleen L O'Reilly
- School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
| | - Heather M Wasser
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jennifer S Savage
- Department of Nutritional Sciences & Center for Childhood Obesity Research, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Ken K Ong
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Sarah-Jeanne Salvy
- Research Center for Health Equity, Cedars-Sinai Medical Center, West Hollywood, California, USA
| | - Mary Jo Messito
- Grossman School of Medicine, New York University, New York, New York, USA
| | - Rachel S Gross
- Grossman School of Medicine, New York University, New York, New York, USA
| | - Levie T Karssen
- Behavioural Science Institute, Radboud Universiteit, Nijmegen, The Netherlands
| | - Finn E Rasmussen
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Karen Campbell
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Ana Maria Linares
- College of Nursing, University of Kentucky, Lexington, Kentucky, USA
| | - Nina Cecilie Øverby
- Faculty of Health and Sport Sciences, Department of Nutrition and Public Health, University of Agder, Kristiansand, Vest-Agder, Norway
| | - Cristina Palacios
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
| | - Kaumudi J Joshipura
- Department of Epidemiology, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
- Center for Clinical Research and Health Promotion, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico, USA
| | - Carolina González Acero
- Social Protection and Health Division, Inter-American Development Bank, Santo Domingo, Distrito Nacional, Dominican Republic
| | | | - Amanda L Thompson
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Claudio Maffeis
- Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, Verona, Italy
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - Ata Ghaderi
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | | | - Ana B Pérez-Expósito
- Social Protection and Health Division, Inter-American Development Bank, Washington, District of Columbia, USA
| | - Jinan C Banna
- Department of Human Nutrition, Food and Animal Sciences, University of Hawaii, Honolulu, Hawaii, USA
| | - Kayla de la Haye
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Michael Goran
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Margrethe Røed
- Faculty of Health and Sport Sciences, Department of Nutrition and Public Health, University of Agder, Kristiansand, Vest-Agder, Norway
| | - Stephanie Anzman-Frasca
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Barry J Taylor
- Better Start National Science Challenge, University of Otago, Dunedin, New Zealand
| | - Anna Lene Seidler
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
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12
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Johnson BJ, Hunter KE, Golley RK, Chadwick P, Barba A, Aberoumand M, Libesman S, Askie L, Taylor RW, Robledo KP, Mihrshahi S, O'Connor DA, Hayes AJ, Wolfenden L, Wood CT, Baur LA, Rissel C, Staub LP, Taki S, Smith W, Sue-See M, Marschner IC, Espinoza D, Thomson JL, Larsen JK, Verbestel V, Odar Stough C, Salvy SJ, O'Reilly SL, Karssen LT, Rasmussen FE, Messito MJ, Gross RS, Bryant M, Paul IM, Wen LM, Hesketh KD, González Acero C, Campbell K, Øverby NC, Linares AM, Wasser HM, Joshipura KJ, Palacios C, Maffeis C, Thompson AL, Ghaderi A, Lakshman R, Banna JC, Oken E, Campos Rivera M, Pérez-Expósito AB, Taylor BJ, Savage JS, Røed M, Goran M, de la Haye K, Anzman-Frasca S, Seidler AL. Unpacking the behavioural components and delivery features of early childhood obesity prevention interventions in the TOPCHILD Collaboration: a systematic review and intervention coding protocol. BMJ Open 2022; 12:e048165. [PMID: 35058255 PMCID: PMC8783827 DOI: 10.1136/bmjopen-2020-048165] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 10/28/2021] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Little is known about how early (eg, commencing antenatally or in the first 12 months after birth) obesity prevention interventions seek to change behaviour and which components are or are not effective. This study aims to (1) characterise early obesity prevention interventions in terms of target behaviours, delivery features and behaviour change techniques (BCTs), (2) explore similarities and differences in BCTs used to target behaviours and (3) explore effectiveness of intervention components in preventing childhood obesity. METHODS AND ANALYSIS Annual comprehensive systematic searches will be performed in Epub Ahead of Print/MEDLINE, Embase, Cochrane (CENTRAL), CINAHL, PsycINFO, as well as clinical trial registries. Eligible randomised controlled trials of behavioural interventions to prevent childhood obesity commencing antenatally or in the first year after birth will be invited to join the Transforming Obesity in CHILDren Collaboration. Standard ontologies will be used to code target behaviours, delivery features and BCTs in both published and unpublished intervention materials provided by trialists. Narrative syntheses will be performed to summarise intervention components and compare applied BCTs by types of target behaviours. Exploratory analyses will be undertaken to assess effectiveness of intervention components. ETHICS AND DISSEMINATION The study has been approved by The University of Sydney Human Research Ethics Committee (project no. 2020/273) and Flinders University Social and Behavioural Research Ethics Committee (project no. HREC CIA2133-1). The study's findings will be disseminated through peer-reviewed publications, conference presentations and targeted communication with key stakeholders. PROSPERO REGISTRATION NUMBER CRD42020177408.
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Affiliation(s)
- Brittany J Johnson
- Caring Fututures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Kylie E Hunter
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Rebecca K Golley
- Caring Fututures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Paul Chadwick
- Centre for Behaviour Change, University College London, London, UK
| | - Angie Barba
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Mason Aberoumand
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Sol Libesman
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Lisa Askie
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Rachael W Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Kristy P Robledo
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Seema Mihrshahi
- Department of Health Systems and Populations, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Denise A O'Connor
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Monash Department of Clinical Epidemiology, Cabrini Institute, Malvern, Victoria, Australia
| | - Alison J Hayes
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Charles T Wood
- School of Medicine, Duke University, Durham, North Carolina, USA
| | - Louise A Baur
- The Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Chris Rissel
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Lukas P Staub
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Sarah Taki
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Population Health Research and Evaluation Hub, Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Wendy Smith
- Canterbury Community Health Centre, Campsie, New South Wales, Australia
- Consumer Representative, Sydney, New South Wales, Australia
| | | | - Ian C Marschner
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - David Espinoza
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Junilla K Larsen
- Behavioural Science Institute, Radboud Universiteit, Nijmegen, Gelderland, The Netherlands
| | - Vera Verbestel
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Cathleen Odar Stough
- Department of Psychology, University of Cincinnati Medical Center, Cincinnati, Ohio, USA
| | - Sarah-Jeanne Salvy
- Research Center for Health Equity, Cedars-Sinai Medical Center, West Hollywood, California, USA
| | - Sharleen L O'Reilly
- School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
| | - Levie T Karssen
- Behavioural Science Institute, Radboud Universiteit, Nijmegen, Gelderland, The Netherlands
| | - Finn E Rasmussen
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Mary Jo Messito
- Grossman School of Medicine, New York University, New York, New York, USA
| | - Rachel S Gross
- Grossman School of Medicine, New York University, New York, New York, USA
| | - Maria Bryant
- Department of Health Sciences and the Hull York Medical School, University of York, Heslington, UK
| | - Ian M Paul
- College of Medicine, Penn State, Hershey, Pennsylvania, USA
| | - Li Ming Wen
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Population Health Research and Evaluation Hub, Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Carolina González Acero
- Office of Strategic Planning and Development Effectiveness, Inter- American Development Bank, Santo Domingo, Dominican Republic
| | - Karen Campbell
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Nina Cecilie Øverby
- Faculty of Health and Sport Sciences, Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway
| | - Ana M Linares
- College of Nursing, University of Kentucky, Lexington, Kentucky, USA
| | - Heather M Wasser
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kaumudi J Joshipura
- Center for Clinical Research and Health Promotion, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Cristina Palacios
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Claudio Maffeis
- Pediatric Diabetes and Metabolic Disorders Unit, Universita degli Studi di Verona, Verona, Italy
| | - Amanda L Thompson
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, UK
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ata Ghaderi
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Rajalakshmi Lakshman
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Jinan C Banna
- Human Nutrition, Food and Animal Sciences, University of Hawaii System, Honolulu, Hawaii, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts, USA
| | | | - Ana B Pérez-Expósito
- Office of Strategic Planning and Development Effectiveness, Inter- American Development Bank, Washington DC, District of Columbia, USA
| | - Barry J Taylor
- Better Start National Science Challenge, University of Otago, Dunedin, New Zealand
| | - Jennifer S Savage
- Department of Nutritional Sciences and Center for Childhood Obesity Research, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Margrethe Røed
- Faculty of Health and Sport Sciences, Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway
| | - Michael Goran
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Kayla de la Haye
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Stephanie Anzman-Frasca
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Anna Lene Seidler
- National Health and Medical Research Council Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia
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13
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Øverby NC, Hillesund ER, Helland SH, Helle C, Wills AK, Lamu AN, Osorio NG, Lian H, Ersfjord TI, Van Daele W, Bjørkkjær T, Valen EN, Gebremariam MK, Grasaas E, Kiland C, Schwarz UVT, Abel MH, Love P, Campbell K, Rutter H, Barker ME, Vik FN, Medin AC. Evaluating the effectiveness and implementation of evidence-based early-life nutrition interventions in a community setting a hybrid type 1 non-randomized trial - the Nutrition Now project protocol. Front Endocrinol (Lausanne) 2022; 13:1071489. [PMID: 36704042 PMCID: PMC9871808 DOI: 10.3389/fendo.2022.1071489] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/15/2022] [Indexed: 01/11/2023] Open
Abstract
UNLABELLED Disappointingly few efficacious health interventions are successfully scaled up and implemented in real world settings. This represents an evidence-to-practice gap, with loss of opportunity to improve practice. Aiming to improve nutrition in the first 1000 days of life, we have combined four efficacious dietary interventions into a single adapted digital resource (Nutrition Now) for implementation in a Norwegian community setting. Nutrition Now targets pregnant women and parents of 0-2-year-olds with messages focusing on healthy dietary behaviours. Early childhood education and care (ECEC) staff are provided with pedagogical tools addressing healthy food exposure and child food acceptance. Objectives: a) evaluate the effectiveness of provision of the Nutrition Now resource on child diet and diet-related outcomes, with special attention to the influence of socio-economic position, b) gather information on the effectiveness of the implementation process to inform forthcoming scale-up and c) perform trial- and model-based economic evaluations. This is a hybrid type 1 implementation study, focusing on evaluation of effectiveness. A quasi-experimental design with pre- and post-tests, where one municipality gets access to the resource (n~800), while a matched non-equivalent control municipality (n~800) does not, will be used. Effectiveness will be assessed by examining e.g., diet outcomes, developmental outcomes, and feeding practices. The resource will be implemented in ECEC settings and made available to pregnant women and parents through the Norwegian system of maternal and child health (MCH) care. The implementation process includes iterative adjustments and implementation strategies from the implementation framework Expert Recommendations for Implementing Change (ERIC) informed by dialogues with stakeholders. Implementation outcomes (e.g., acceptability and adoption) will be assessed through questionnaires and interviews with parents, ECEC and MCH staff, with particular attention to ethnic diverse groups. Both within-trial and modelling-based economic evaluation will be performed. Nutrition Now will bridge the existing evidence-to-practice gap through rigorous scientific effectiveness evaluation of municipal scale up and inform subsequent county scale up. The study is the first to implement efficacious nutrition interventions in early life with potential for health improvement using technology to maximise the reach and impact of both parental and MCH dietary guidance and ECEC practice. CLINICAL TRIAL REGISTRATION https://www.isrctn.com/, identified ISRCTN10694967.
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Affiliation(s)
- Nina Cecilie Øverby
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
- *Correspondence: Nina Cecilie Øverby,
| | - Elisabet Rudjord Hillesund
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Sissel Heidi Helland
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Christine Helle
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Andrew Keith Wills
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Admassu Nadew Lamu
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Natalie Garzon Osorio
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Henrik Lian
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Torunn Iveland Ersfjord
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Wim Van Daele
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Tormod Bjørkkjær
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Erlend Nuland Valen
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Mekdes Kebede Gebremariam
- Department of Community Medicine and Global Health , Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Erik Grasaas
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Charlotte Kiland
- Department of Political Science and Management, Faculty of Social Sciences, University of Agder, Kristiansand, Norway
| | - Ulrica von Thiele Schwarz
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Procome, Medical Management Centre, LIME, Karolinska Institutet, Stockholm, Sweden
| | - Marianne Hope Abel
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Penny Love
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, VIC, Australia
| | - Karen Campbell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, VIC, Australia
| | - Harry Rutter
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
- Department of Social and Policy Sciences, University of Bath, Bath, United Kingdom
| | - Mary Elizabeth Barker
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
| | - Frøydis Nordgård Vik
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
| | - Anine Christine Medin
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway
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Øverby NC, Medin AC, Valen EL, Salvesen L, Wills AK, Engeset D, Vik FN, Hillesund ER. Effectiveness of a digital dietary intervention program targeting young adults before parenthood: protocol for the PREPARED randomised controlled trial. BMJ Open 2021; 11:e055116. [PMID: 34853111 PMCID: PMC8638463 DOI: 10.1136/bmjopen-2021-055116] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION The importance of preconception health for lifelong physical and mental health in the next generation has gained increasing recognition in recent years. Preconception paternal and maternal risk factors such as obesity and inadequate diet affect the metabolic and cardiovascular health of their offspring later in life. This highlights the importance of diet and dietary behaviour in the years before parenthood. In our project, PREPARED, we will evaluate the effectiveness of a digital intervention targeting young adults. Our primary aim is to improve participants' preconception diet, and our secondary aim is to improve preconception quality of life and maternal and child perinatal outcomes. METHODS AND ANALYSIS We plan to recruit 7000 men and women individually, aged 20-35 years without children, to be randomised to an intervention or a control group. The intervention group will receive access to a digital resource for 6 months promoting a healthy diet for their health now, later in life and for the next generation. Follow-up is up to 20 years or until they have their first child. To evaluate intervention effects, we will collect dietary data (2×24-hour dietary recalls and a screener). For those participants for which birth ensues, we will link study data with data from the Medical Birth Registry of Norway on maternal and child perinatal outcomes. ETHICS AND DISSEMINATION The study is approved by the Regional Ethics Committee, the Norwegian Data Protection Service and our Faculty Ethical Committee (REC: 78104, NSD: 907212, FEC 20/10119). Participation is voluntary and all participants will provide informed consent. Participants can withdraw their consent without giving any reason. Findings will be communicated to the public through a project website and social media, and to professionals through conferences and peer-reviewed papers. TRIAL REGISTRATION NUMBER ISRCTN44294662.
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Affiliation(s)
- Nina Cecilie Øverby
- Department of Nutrition and Public Health, Universitetet i Agder, Kristiansand, Vest-Agder, Norway
| | - Anine C Medin
- Department of Nutrition and Public Health, Universitetet i Agder, Kristiansand, Vest-Agder, Norway
| | - Erlend Larsen Valen
- Department of Nutrition and Public Health, Universitetet i Agder, Kristiansand, Vest-Agder, Norway
| | - Lorentz Salvesen
- Department of Nutrition and Public Health, Universitetet i Agder, Kristiansand, Vest-Agder, Norway
| | - Andrew Keith Wills
- Department of Nutrition and Public Health, Universitetet i Agder, Kristiansand, Vest-Agder, Norway
| | - Dagrun Engeset
- Department of Nutrition and Public Health, Universitetet i Agder, Kristiansand, Vest-Agder, Norway
| | - Frøydis N Vik
- Department of Nutrition and Public Health, Universitetet i Agder, Kristiansand, Vest-Agder, Norway
| | - Elisabet R Hillesund
- Department of Nutrition and Public Health, Universitetet i Agder, Kristiansand, Vest-Agder, Norway
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15
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Blomkvist EAM, Wills AK, Helland SH, Hillesund ER, Øverby NC. Effectiveness of a kindergarten-based intervention to increase vegetable intake and reduce food neophobia amongst 1-year-old children: a cluster randomised controlled trial. Food Nutr Res 2021; 65:7679. [PMID: 34776826 PMCID: PMC8559443 DOI: 10.29219/fnr.v65.7679] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 03/03/2021] [Revised: 06/10/2021] [Accepted: 08/17/2021] [Indexed: 11/20/2022] Open
Abstract
Background Children's first years of life are crucial to their future health. Studies show that a varied diet with a high intake of vegetables is positive in several domains of health. The present low vegetable intake amongst children is, therefore, a concern. Food neophobia is a common barrier to vegetable intake in children. As most Norwegian children attend kindergarten from an early age, kindergartens could contribute to the prevention of food neophobia and the promotion of vegetable intake. Objective The aim of this study was to assess the effect of a cluster randomised trial amongst 1-year-old children in kindergarten to reduce food neophobia and promote healthy eating. Methods Kindergartens were randomly allocated to either a control group or one of two intervention groups. Both intervention groups (diet and diet + Sapere-method) were served a warm lunch meal including three alternating intervention vegetables, whilst the intervention group 2 (diet + Sapere) in addition received tools for weekly sensory lessons. The intervention was digitally administered via information and recipes on a study website. The control group did not receive any information. Parents completed digitally distributed questionnaires addressing food neophobia and food habits at baseline and post-intervention. Results The parents of 144 1-year-old children in 46 kindergartens completed the questionnaires, which were included in the main analysis. The results suggested a higher intake of the intervention vegetables in group 2 (diet + Sapere) compared to the control group. The effect on total vegetable intake was inconclusive. No effect was observed on the level of food neophobia in either of the intervention group. Conclusion This digitally delivered dietary and sensory intervention promoted the intake of intervention-targeted vegetables with inconclusive effect on total vegetable intake due to large loss to follow-up. No effect on the level of food neophobia was detected.
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Affiliation(s)
- Eli Anne Myrvoll Blomkvist
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Andrew K Wills
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway.,Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Sissel Heidi Helland
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Elisabet Rudjord Hillesund
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Nina Cecilie Øverby
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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16
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Rai AS, Sletner L, Jenum AK, Øverby NC, Stafne SN, Lekva T, Pripp AH, Sagedal LR. Identifying women with gestational diabetes based on maternal characteristics: an analysis of four Norwegian prospective studies. BMC Pregnancy Childbirth 2021; 21:615. [PMID: 34496778 PMCID: PMC8427855 DOI: 10.1186/s12884-021-04086-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 03/31/2021] [Accepted: 08/29/2021] [Indexed: 12/28/2022] Open
Abstract
Background There is still no worldwide agreement on the best diagnostic thresholds to define gestational diabetes (GDM) or the optimal approach for identifying women with GDM. Should all pregnant women perform an oral glucose tolerance test (OGTT) or can easily available maternal characteristics, such as age, BMI and ethnicity, indicate which women to test? The aim of this study was to assess the prevalence of GDM by three diagnostic criteria and the predictive accuracy of commonly used risk factors. Methods We merged data from four Norwegian cohorts (2002–2013), encompassing 2981 women with complete results from a universally offered OGTT. Prevalences were estimated based on the following diagnostic criteria: 1999WHO (fasting plasma glucose (FPG) ≥7.0 or 2-h glucose ≥7.8 mmol/L), 2013WHO (FPG ≥5.1 or 2-h glucose ≥8.5 mmol/L), and 2017Norwegian (FPG ≥5.3 or 2-h glucose ≥9 mmol/L). Multiple logistic regression models examined associations between GDM and maternal factors. We applied the 2013WHO and 2017Norwegian criteria to evaluate the performance of different thresholds of age and BMI. Results The prevalence of GDM was 10.7, 16.9 and 10.3%, applying the 1999WHO, 2013WHO, and the 2017Norwegian criteria, respectively, but was higher for women with non-European background when compared to European women (14.5 vs 10.2%, 37.7 vs 13.8% and 27.0 vs 7.8%). While advancing age and elevated BMI increased the risk of GDM, no risk factors, isolated or in combination, could identify more than 80% of women with GDM by the latter two diagnostic criteria, unless at least 70–80% of women were offered an OGTT. Using the 2017Norwegian criteria, the combination “age≥25 years or BMI≥25 kg/m2” achieved the highest sensitivity (96.5%) with an OGTT required for 93% of European women. The predictive accuracy of risk factors for identifying GDM was even lower for non-European women. Conclusions The prevalence of GDM was similar using the 1999WHO and 2017Norwegian criteria, but substantially higher with the 2013WHO criteria, in particular for ethnic non-European women. Using clinical risk factors such as age and BMI is a poor pre-diagnostic screening method, as this approach failed to identify a substantial proportion of women with GDM unless at least 70–80% were tested. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04086-9.
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Affiliation(s)
- Anam Shakil Rai
- Department of Research, Sorlandet Hospital, 4604, Kristiansand, Norway.
| | - Line Sletner
- Department of Pediatric and Adolescents Medicine, Akershus University Hospital, Akershus, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anne Karen Jenum
- Department of General Medicine, General Practice Research Unit (AFE), Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Nina Cecilie Øverby
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Signe Nilssen Stafne
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Clinical Services, St.Olavs Hospital Trondheim University Hospital, Trondheim, Norway
| | - Tove Lekva
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
| | - Are Hugo Pripp
- Oslo Centre of Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Linda Reme Sagedal
- Department of Research, Sorlandet Hospital, 4604, Kristiansand, Norway.,Department of Obstetrics and Gynaecology, Sorlandet Hospital, Kristiansand, Norway
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17
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Illøkken KE, Johannessen B, Barker ME, Hardy-Johnson P, Øverby NC, Vik FN. Free school meals as an opportunity to target social equality, healthy eating, and school functioning: experiences from students and teachers in Norway. Food Nutr Res 2021; 65:7702. [PMID: 34349612 PMCID: PMC8287658 DOI: 10.29219/fnr.v65.7702] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 05/05/2021] [Accepted: 06/01/2021] [Indexed: 01/18/2023] Open
Abstract
Background There are no national arrangements for free school meals provision in Norway despite this being an important opportunity to improve children’s and adolescents’ nutritional status and ultimately their physical and cognitive development. During a one academic year (2014–2015), a group of Norwegian sixth graders were served a free healthy school meal in a project called ‘The School Meal Project’. Objective To explore students’ and teachers’ experiences of receiving free school meals after the free school meal in 2015 and 5 years later. Design In-depth, semi-structured interviews with separate groups in 2015 and in 2020 were conducted face to face or via telephone or digital platforms. The findings are based on 13 students (aged 12–16) and 5 teacher interviews. Findings Thematic analysis identified four main themes that describe the perceived benefits of receiving free school meals: 1) the meal as a social event where students made new friends and learned new skills; 2) as an aid to forming healthy eating habits; and as an opportunity to 3) improve school functioning and 4) increase social equality among students. Discussion Our analysis suggests that the free school meal may influence healthy behaviors not only at the individual level but also at the social-, physical-, and macro-levels. Methodological limitations, including self-selection bias, should be considered when interpreting our findings. Conclusion This study provides unique insights into the social benefits for students of receiving free school meals. Our findings illustrate the potential of free school meals: eating healthy foods, sharing a meal together, and interaction between students and teachers at mealtime, to promote health, learning, and equality. In order to maximize these benefits through national implementation of free school meals, more understanding is needed of possible facilitators and barriers related to the provision and uptake of free school meals.
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Affiliation(s)
- Kristine E Illøkken
- Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway
| | - Berit Johannessen
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | - Mary E Barker
- Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway.,Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University Hospitals Southampton Foundation Trust, Southampton, UK
| | - Polly Hardy-Johnson
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Nina Cecilie Øverby
- Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway
| | - Frøydis Nordgård Vik
- Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway
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18
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Agnihotri N, Rudjord Hillesund E, Bere E, Wills AK, Brantsaeter AL, Øverby NC. Development and description of New Nordic Diet scores across infancy and childhood in the Norwegian Mother, Father and Child Cohort Study (MoBa). Matern Child Nutr 2021; 17:e13150. [PMID: 33528109 PMCID: PMC8189223 DOI: 10.1111/mcn.13150] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 01/08/2021] [Accepted: 01/12/2021] [Indexed: 12/17/2022]
Abstract
In recent years, examining dietary patterns has become a more common way of investigating potential associations between diet and adverse health outcomes. The New Nordic Diet (NND) is a potentially healthy and sustainable dietary pattern characterized by foods that are locally available and traditionally consumed in the Nordic countries. The diet has been typically examined in adult populations, and less is known about compliance to the NND from infancy throughout childhood. In the current study, we therefore aimed to develop and describe child age‐specific NND scores. This study is based on the Norwegian Mother, Father and Child Cohort Study (MoBa) and uses data from the Medical Birth Registry of Norway (MBRN). We have previously developed a NND score for the maternal diet during pregnancy, and the development of the child diet scores was based on the rationale of this score. Food frequency data from n = 89 715 at child age 6 months, n = 76 432 at 18 months, n = 58 884 at 3 years, and n = 35 978 at 7 years were used to construct subscales in accordance with the maternal diet score. Subscales were composed of responses to a selection of food and drink items or other questions and were dichotomized by the median, yielding four age‐specific diet scores where the possible scoring ranged from 0 to 6 at 6 months and 3 years and from 0 to 9 at 18 months and 7 years. The developed scores will be used to examine associations with childhood overweight and cognitive and mental development in future studies.
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Affiliation(s)
- Neha Agnihotri
- Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway
| | | | - Elling Bere
- Department of Health and Inequalities and Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway.,Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Andrew Keith Wills
- Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway.,Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Anne Lise Brantsaeter
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Nina Cecilie Øverby
- Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway
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19
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Agnihotri N, Øverby NC, Bere E, Wills AK, Brantsaeter AL, Hillesund ER. Childhood adherence to a potentially healthy and sustainable Nordic diet and later overweight: The Norwegian Mother, Father and Child Cohort Study (MoBa). Matern Child Nutr 2020; 17:e13101. [PMID: 33103349 PMCID: PMC7988855 DOI: 10.1111/mcn.13101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 08/28/2020] [Accepted: 09/29/2020] [Indexed: 12/19/2022]
Abstract
The New Nordic Diet (NND) is a potentially healthy and sustainable dietary pattern represented by locally available and traditionally consumed foods in the Northern countries. The diet has been commonly examined in adult populations, but less is known regarding its potential associations with overweight/obesity in children. We have previously developed child diet scores measuring compliance to the NND at child age 6 and 18 months and 3 and 7 years. In this study, we aimed to describe child and maternal characteristics and assess potential associations between the age‐specific diet scores and child overweight at 8 years. This study is based on the Norwegian Mother, Father and Child Cohort Study (MoBa), including 14,989 mother–child pairs and uses data from the Medical Birth Registry of Norway (MBRN). The scores measured NND compliance as a total score and categorized into low, medium and high NND compliance at each age point. Using logistic regression models, we investigated the association between each age‐specific score and the odds of overweight at 8 years. In crude analyses, adherence to the NND at 6 months was inversely associated with odds of overweight at 8 years in the continuous score (odds ratio = 0.95, 95% CI [0.91, 0.98]) and when comparing high versus low NND adherence (odds ratio = 0.81, 95% CI [0.70, 0.94]). The association was almost entirely attenuated in the adjusted models. In conclusion, child NND adherence up to 7 years of age was not associated with odds of overweight at 8 years in adjusted analyses.
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Affiliation(s)
- Neha Agnihotri
- Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway
| | - Nina Cecilie Øverby
- Department of Nutrition and Public Health, University of Agder, Kristiansand, Norway
| | - Elling Bere
- Department of Health and Inequalities and Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway.,Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | | | - Anne Lise Brantsaeter
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
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20
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Røed M, Vik FN, Hillesund ER, Lippevelde WV, Øverby NC. Associations between parental food choice motives, health-promoting feeding practices, and infants' fruit and vegetable intakes: the Food4toddlers study. Food Nutr Res 2020; 64:3730. [PMID: 33240032 PMCID: PMC7672479 DOI: 10.29219/fnr.v64.3730] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 10/09/2019] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 12/18/2022] Open
Abstract
Background Parents influence their infants’ diets and are the providers of healthy foods such as fruit and vegetables. Parental motives can influence infant’s diets directly or through parental feeding practices. Objective This study aimed to assess the associations between parental food choice motives and infants’ fruit and vegetable intakes and to examine whether parental feeding practices mediated these associations. Design A total of 298 parents participated in the Norwegian Food4toddlers study. Before the child’s first birthday (mean age = 10.9 months), the parents completed an online baseline questionnaire. Five parental food choice motives were assessed: health, convenience, sensory appeal, price, and familiarity. Infants’ fruit and vegetable intakes and three health-promoting feeding practices were also assessed. For each food choice motive and its relation to fruit or vegetable intake, three single mediation models were conducted. Mediation effects were examined using MacKinnon’s product of coefficients procedure, and bootstrap confidence intervals (CIs) were used for inferential testing. Results Higher scores on the motive of health were positively associated with infants’ vegetable intake (τ = 0.394, P < 0.001). No other significant associations were found between food choice motives and fruit or vegetable intake. The feeding practice of shaping a healthy environment mediated the relationships between health motive and both fruit (αβ = 0.067, CI: 0.001–0.146) and vegetable (αβ = 0.105, CI: 0.042–0.186) intakes. The feeding practice of encouraging balance and variety mediated the relationships between health motive and vegetable (αβ = 0.085, CI: 0.030–0.150) intake and between sensory appeal motive and vegetable intake (αβ = 0.047, CI: 0.005–0.103). Conclusion High levels of parental health motive are associated with higher infant vegetable intake. Our study contributes to understand the structure of parental feeding behaviors that may have implication for nutrition interventions targeting parents.
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Affiliation(s)
- Margrethe Røed
- Department of Nutrition and Public Health, Faculty of Health and Sports Sciences, University of Agder, PO box 422, 4604 Kristiansand, Norway
| | - Frøydis Nordgård Vik
- Department of Nutrition and Public Health, Faculty of Health and Sports Sciences, University of Agder, PO box 422, 4604 Kristiansand, Norway
| | - Elisabet Rudjord Hillesund
- Department of Nutrition and Public Health, Faculty of Health and Sports Sciences, University of Agder, PO box 422, 4604 Kristiansand, Norway
| | - Wendy Van Lippevelde
- Department of Nutrition and Public Health, Faculty of Health and Sports Sciences, University of Agder, PO box 422, 4604 Kristiansand, Norway.,Department of Marketing, Innovation and Organisation, Faculty of Economics & Business administration, Ghent University, Tweekerkenstraat 2, 9000 Ghent, Belgium
| | - Nina Cecilie Øverby
- Department of Nutrition and Public Health, Faculty of Health and Sports Sciences, University of Agder, PO box 422, 4604 Kristiansand, Norway
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21
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Røed M, Vik FN, Hillesund ER, Van Lippevelde W, Medin AC, Øverby NC. Process Evaluation of an eHealth Intervention (Food4toddlers) to Improve Toddlers' Diet: Randomized Controlled Trial. JMIR Hum Factors 2020; 7:e18171. [PMID: 32628612 PMCID: PMC7381021 DOI: 10.2196/18171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 02/09/2020] [Revised: 05/08/2020] [Accepted: 05/09/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Parents seek trustworthy information online to promote healthy eating for their toddlers. Such information must be perceived as relevant and easy to implement and use. OBJECTIVE The objectives of this study were to conduct a process evaluation of the electronic health (eHealth) intervention (Food4toddlers) targeting food environment, parental feeding practices, and toddlers' diet and to examine possible differences in these areas according to education and family composition. METHODS A 2-armed randomized controlled trial, including 298 parent-toddler dyads from Norway, was conducted in 2017. In total, 148 parents in the intervention group received access to an intervention website for 6 months. Data on website usage were retrieved from the learning management platform used (NEO). Participants' satisfaction with the intervention was asked for in a postintervention questionnaire. Chi-square and t tests were used to examine differences in usage and satisfaction between education and family composition groups. RESULTS Most participants were mothers (144/148, 97.2%), lived in two-adult households (148/148, 100%), and were born in Norway (132/148, 89.1%). Mean parental age was 31.5 years (SD 4.2). More than 87.8% (129/147) had a university education degree and 56.5% (83/147) had over 4 years of university education. Most (128/148, 86.5%) intervention participants entered the website at least once (mean days of access 7.4 [SD 7.1]). Most parents reported the website as appropriate to the child's age (71/83, 86%) and self-explanatory (79/83, 95%) and appreciated the interface (52/83, 63%) and layout (46/83, 55%). In total, 61% (51/83) stated that they learned something new from the intervention. Parents with over 4 years of university education and in 1-child households used the intervention website more than those with 4 years or less of university education (8.4 vs 5.9 days in total, P=.04) and households with more than 1 child (8.3 vs 5.8 days in total, P=.04), respectively. CONCLUSIONS The Food4toddlers intervention website was found to be relevant by most participants in the intervention group, although usage of the website differed according to educational level and family composition. For eHealth interventions to be effective, intervention materials such as websites must be used by the target group. Our results highlight the need to include users from different groups when developing interventions. TRIAL REGISTRATION ISRCTN Registry ISRCTN92980420; http://www.isrctn.com/ISRCTN92980420.
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Affiliation(s)
- Margrethe Røed
- Department of Nutrition and Public Health, Faculty of Health and Sports Sciences, University of Agder, Kristiansand, Norway
| | - Frøydis Nordgård Vik
- Department of Nutrition and Public Health, Faculty of Health and Sports Sciences, University of Agder, Kristiansand, Norway
| | - Elisabet Rudjord Hillesund
- Department of Nutrition and Public Health, Faculty of Health and Sports Sciences, University of Agder, Kristiansand, Norway
| | - Wendy Van Lippevelde
- Department of Nutrition and Public Health, Faculty of Health and Sports Sciences, University of Agder, Kristiansand, Norway.,Department of Marketing, Innovation and Organisation, Ghent University, Ghent, Belgium
| | - Anine Christine Medin
- Department of Nutrition and Public Health, Faculty of Health and Sports Sciences, University of Agder, Kristiansand, Norway
| | - Nina Cecilie Øverby
- Department of Nutrition and Public Health, Faculty of Health and Sports Sciences, University of Agder, Kristiansand, Norway
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22
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Øverby NC, Blomkvist EAM, Hillesund ER. Associations between breastfeeding mode and duration and food neophobia in toddlerhood: A cross-sectional study among Norwegian toddlers. Food Nutr Res 2020; 64:3615. [PMID: 32180693 PMCID: PMC7054643 DOI: 10.29219/fnr.v64.3615] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 06/20/2019] [Revised: 01/28/2020] [Accepted: 01/29/2020] [Indexed: 01/17/2023] Open
Abstract
Background Research on the association between breastfeeding duration and food neophobia is inconclusive. Breastfeeding and measures to reduce food neophobia are highly recommended to ensure a healthy diet early in life. Objective The aim of this study was to evaluate the association between breastfeeding duration and food neophobia in young Norwegian children. Design Participants (n = 246) were recruited through kindergartens in four Norwegian counties in 2017. The parents of 1-year-olds filled in questionnaires, including standardized questions on breastfeeding and food neophobia. Cross-sectional results are presented. Comparisons of child neophobia score at 16 months of age according to breastfeeding status at various timepoints during infancy were explored in linear regression models adjusted for maternal education and parental food neophobia. Results Still being breastfed at 12 months and being exclusively breastfed at 5 months were independently associated with slightly higher food neophobia score at the mean age of 16 months compared to shorter duration of breastfeeding. We found no other associations between breastfeeding duration and child food neophobia. Discussion Our study adds to the somewhat scarce literature regarding associations between breastfeeding mode and duration and later food neophobia; some literature shows protective relations between breastfeeding and food fussiness, and others report opposite or null findings. Conclusion We found that both being breastfed at 12 months and being exclusively breastfed at 5 months were independently associated with slightly higher food neophobia score at the mean age of 16 months compared to shorter duration of breastfeeding. As the data are derived from a cross-sectional study, these findings should be interpreted with caution.
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Affiliation(s)
- Nina Cecilie Øverby
- Faculty of Health and Sport Sciences, Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway
| | - Eli Anne Myrvoll Blomkvist
- Faculty of Health and Sport Sciences, Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway
| | - Elisabet Rudjord Hillesund
- Faculty of Health and Sport Sciences, Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway
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Blomkvist EAM, Hillesund ER, Helland SH, Simhan I, Øverby NC. Diet and Neurodevelopmental Score in a Sample of One-Year-Old Children-A Cross-Sectional Study. Nutrients 2019; 11:nu11071676. [PMID: 31330901 PMCID: PMC6683026 DOI: 10.3390/nu11071676] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 07/17/2019] [Accepted: 07/19/2019] [Indexed: 01/28/2023] Open
Abstract
Environmental factors in the first years of life are crucial for a child’s neurodevelopment. Research on the association between breastfeeding and neurodevelopment is inconclusive, while research on the possible association between other dietary factors and neurodevelopment is inadequate in children as young as one year of age. The aim of the present study was to investigate associations between both breastfeeding and other dietary factors and the neurodevelopment of one-year-old children in Norway. Methods: Participants were recruited from kindergartens in four Norwegian counties in 2017. A questionnaire including questions about dietary factors and breastfeeding, and a standardised age-related questionnaire on neurodevelopment (the Ages and Stages Questionnaire), were completed by parents of one-year-olds. Linear regressions adjusting for relevant covariates were conducted to explore the associations. Results: In our sample of 212 one-year-old children, a longer duration of breastfeeding was associated with higher neurodevelopmental scores. Dietary intake of fish, fruits and vegetables was also strongly associated with higher neurodevelopmental scores, even after adjustment for breastfeeding and maternal education. Conclusion: Our results indicate that healthy dietary factors are important for neurodevelopment in young children, with measurable effects already at the age of one year.
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Affiliation(s)
- Eli Anne Myrvoll Blomkvist
- Faculty of Health and Sport Sciences, Department of Public Health, Sport and Nutrition, University of Agder, 4630 Kristiansand, Norway.
| | - Elisabet Rudjord Hillesund
- Faculty of Health and Sport Sciences, Department of Public Health, Sport and Nutrition, University of Agder, 4630 Kristiansand, Norway
| | - Sissel Heidi Helland
- Faculty of Health and Sport Sciences, Department of Public Health, Sport and Nutrition, University of Agder, 4630 Kristiansand, Norway
| | - Indra Simhan
- Department of Child and Adolescent Mental Health, Sorlandet Hospital, 4615 Kristiansand, Norway
| | - Nina Cecilie Øverby
- Faculty of Health and Sport Sciences, Department of Public Health, Sport and Nutrition, University of Agder, 4630 Kristiansand, Norway
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24
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Røed M, Hillesund ER, Vik FN, Van Lippevelde W, Øverby NC. The Food4toddlers study - study protocol for a web-based intervention to promote healthy diets for toddlers: a randomized controlled trial. BMC Public Health 2019; 19:563. [PMID: 31088438 PMCID: PMC6518752 DOI: 10.1186/s12889-019-6915-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 06/29/2018] [Accepted: 04/29/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Eating habits are established during childhood and track into adolescence and later in life. Given that these habits have a large public health impact and influence the increasing rates of childhood obesity worldwide, there is a need for effective, evidence-based prevention trials promoting healthy eating habits in the first 2 years of life. The aim of this study was to develop and evaluate the effect of an eHealth intervention called Food4toddlers, aiming to promote healthy dietary habits in toddlers by targeting parents' awareness of their child's food environment (i.e., how food is provided or presented) and eating environment (e.g., feeding practices and social interaction). This paper describes the rationale, development, and evaluation design of this project. METHODS/DESIGN We developed a 6-month eHealth intervention, with the extensive user involvement of health care nurses and parents of toddlers. This intervention is in line with the social cognitive theory, targeting the interwoven relationship between the person, behavior, and environment, with an emphasis on environmental factors. The intervention website includes recipes, information, activities, and collaboration opportunities. The Food4toddlers website can be used as a mobile application. To evaluate the intervention, a two-armed pre-post-follow-up randomized controlled trial is presently being conducted in Norway. Parents of toddlers (n = 404) were recruited via social media (Facebook) and 298 provided baseline data of their toddlers at age 12 months. After baseline measurements, participants were randomly allocated to an intervention group or control group. Primary outcomes are the child's diet quality and food variety. All participants will be followed up at age 18 months, 2 years, and 4 years. DISCUSSION The results of this trial will provide evidence to increase knowledge about the effectiveness of an eHealth intervention targeting parents and their toddler's dietary habits. TRIAL REGISTRATION ISRCTN92980420 . Registered 13 September 2017. Retrospectively registered.
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Affiliation(s)
- Margrethe Røed
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, PO box 422, 4604, Kristiansand, Norway.
| | - Elisabet R Hillesund
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, PO box 422, 4604, Kristiansand, Norway
| | - Frøydis N Vik
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, PO box 422, 4604, Kristiansand, Norway
| | - Wendy Van Lippevelde
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, PO box 422, 4604, Kristiansand, Norway.,Department of Marketing, Innovation and Organization, Ghent University, Tweekerkenstraat 2, 9000, Ghent, Belgium
| | - Nina Cecilie Øverby
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, PO box 422, 4604, Kristiansand, Norway
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25
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Blomkvist EAM, Helland SH, Hillesund ER, Øverby NC. A cluster randomized web-based intervention trial to reduce food neophobia and promote healthy diets among one-year-old children in kindergarten: study protocol. BMC Pediatr 2018; 18:232. [PMID: 30007401 PMCID: PMC6046098 DOI: 10.1186/s12887-018-1206-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 07/02/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND A child's first years of life are crucial for cognitive development and future health. Studies show that a varied diet with a high intake of vegetables is positive for both weight and cognitive development. The present low intake of vegetables in children's diets is therefore a concern. Food neophobia can be a barrier for vegetable intake in children. Our hypothesis is that interventions that can increase children's intake of vegetables should be introduced early in life to overcome children's neophobia. This study aims to develop, measure and compare the effect of two different interventions among one-year-old children in kindergartens to reduce food neophobia and promote healthy diets. METHODS The kindergartens are randomized to one of three groups: two different intervention groups and one control group. We aimed to include a total of 210 children in the study. The first intervention group will be served a warm lunch meal with a variety of vegetables, 3 days a week during the intervention period of 3 months. The second intervention group will be served the same meals and, in addition, kindergarten staff will be asked to implement pedagogical tools including sensory lessons, adapted from the Sapere method, and advices on meal practice and feeding practices. The control group continues their usual meal practices. Parents and kindergarten staff will complete questionnaires regarding food neophobia, food habits and cognitive development at baseline and post intervention. A similar intervention among 2-year-old children in kindergarten has been implemented and evaluated earlier. We will investigate whether a digital version of this intervention has an effect, because digital interventions can be easily implemented nationwide. We will also investigate whether there are benefits of conducting such interventions in younger children, before the onset of food neophobia. Questionnaires, information videos and recipes will be digitally distributed. DISCUSSION Results of this study will provide new knowledge about whether a sensory education and a healthy meal intervention targeting children, kindergarten staff and parents will reduce levels of food neophobia in children, improve parental and kindergarten feeding practices, improve children's dietary variety, improve children's cognitive development and reduce childhood overweight. TRIAL REGISTRATION ISRCTN98064772 .
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Affiliation(s)
- Eli Anne Myrvoll Blomkvist
- Faculty of Health and Sport Sciences, Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway
| | - Sissel Heidi Helland
- Faculty of Health and Sport Sciences, Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway
| | - Elisabet Rudjord Hillesund
- Faculty of Health and Sport Sciences, Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway
| | - Nina Cecilie Øverby
- Faculty of Health and Sport Sciences, Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway
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26
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Hillesund ER, Seland S, Bere E, Sagedal LR, Torstveit MK, Lohne-Seiler H, Vistad I, Øverby NC. Preeclampsia and gestational weight gain in the Norwegian Fit for Delivery trial. BMC Res Notes 2018; 11:282. [PMID: 29739447 PMCID: PMC5941786 DOI: 10.1186/s13104-018-3396-4] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 05/03/2018] [Indexed: 11/30/2022] Open
Abstract
Objective Excessive gestational weight gain is linked to risk of preeclampsia, but it is not clear whether the association is causal. The purpose of this paper was to examine gestational weight gain in the Norwegian Fit for Delivery study among women who developed preeclampsia compared to those who did not, and to further explore associations between weight gain and preeclampsia by including data on body composition (bioimpedance) assessed in the last trimester of pregnancy. Results A total of 550 women were eligible for the study. Women who developed preeclampsia gained more weight than women who did not (difference 3.7 kg, p = 0.004), with a 3.5 kg difference in total body water observed in week 36 (p = 0.040). Adjusted for age, education, pre-pregnancy body mass index (BMI), randomization, and fat mass, a one kg increase in GWG was associated with 1.3 times higher odds of preeclampsia (OR: 1.31, 95% CI 1.15–1.49, p < 0.001). An independent inverse association between fat mass in week 36 and odds of preeclampsia was observed (OR: 0.79, 95% CI 0.68–0.92, p = 0.002). Given the observed difference in total body water, these findings point to excess fluid as the component driving the association between gestational weight gain and preeclampsia in the present study. Trial registration The NFFD trial has the Clinical Trials registration: clinicaltrial.gov NCT0100168
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Affiliation(s)
- E R Hillesund
- Department of Public Health, Sport and Nutrition, University of Agder, Serviceboks 422, 4604, Kristiansand, Norway.
| | - S Seland
- Department of Public Health, Sport and Nutrition, University of Agder, Serviceboks 422, 4604, Kristiansand, Norway.,Department of Obstetrics and Gynecology, Sørlandet Hospital HF, Serviceboks 416, 4604, Kristiansand, Norway
| | - E Bere
- Department of Public Health, Sport and Nutrition, University of Agder, Serviceboks 422, 4604, Kristiansand, Norway
| | - L R Sagedal
- Department of Obstetrics and Gynecology, Sørlandet Hospital HF, Serviceboks 416, 4604, Kristiansand, Norway.,Department of Research, Sørlandet Hospital HF, Serviceboks 416, 4604, Kristiansand, Norway
| | - M K Torstveit
- Department of Public Health, Sport and Nutrition, University of Agder, Serviceboks 422, 4604, Kristiansand, Norway
| | - H Lohne-Seiler
- Department of Public Health, Sport and Nutrition, University of Agder, Serviceboks 422, 4604, Kristiansand, Norway
| | - I Vistad
- Department of Obstetrics and Gynecology, Sørlandet Hospital HF, Serviceboks 416, 4604, Kristiansand, Norway.,Department of Research, Sørlandet Hospital HF, Serviceboks 416, 4604, Kristiansand, Norway
| | - N C Øverby
- Department of Public Health, Sport and Nutrition, University of Agder, Serviceboks 422, 4604, Kristiansand, Norway
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27
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Johannessen B, Helland SH, Bere E, Øverby NC, Fegran L. "A bumpy road": Kindergarten staff's experiences with an intervention to promote healthy diets in toddlers. Appetite 2018; 127:37-43. [PMID: 29704540 DOI: 10.1016/j.appet.2018.04.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 03/25/2018] [Accepted: 04/09/2018] [Indexed: 11/25/2022]
Abstract
This study explores the experiences of kindergarten staff with a multi-component kindergarten-based intervention, the aims of which were to reduce levels of food neophobia and to promote healthy diets in toddlers (aged 2-3 years). A qualitative design was chosen for the study, and the data are based on three focus group interviews. Altogether, 15 kindergarten staff were interviewed using a semi-structured interview guide. The focus group interviews were analyzed using qualitative content analysis. Five main themes emerged from the interviews: i) Successful development of sensory knowledge, ii) Food neophobia, iii) Implementing new routines, a challenge for some, iv) Lack of cooking skills, and v) Inspired to continue. A main finding was that all kindergarten staff perceived the sensory education sessions as successful and reported that both toddlers and staff expanded their food vocabulary and increased their attention to sensory impressions of food. However, the staff reported that some toddlers were less willing to taste new lunch dishes than to taste new foods in the sensory education sessions. The staff also noted that the guidelines for feeding practices resulted in unfamiliar situations at the lunch table. The staff agreed that cooking novel foods was time consuming and left less time for other tasks. Finally, all kindergarten staff expressed that they would like to continue with portions of the food intervention. Our main interpretation is that the intervention presented several challenges, especially regarding cooking and feeding practices. If kindergartens are to be a place to promote healthy eating habits in the early years, sufficient time and resources for cooking seem to be needed and food and feeding practices included in the curriculum of kindergartens and higher education for kindergarten teachers. TRIAL REGISTRATION ISRCTN74823448.
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Affiliation(s)
- Berit Johannessen
- Department of Health and Nursing Sciences, Faculty of Health and Sport Sciences, University of Agder, PO Box 422, 4604 Kristiansand, Norway.
| | - Sissel H Helland
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, PO Box 422, 4604 Kristiansand, Norway.
| | - Elling Bere
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, PO Box 422, 4604 Kristiansand, Norway.
| | - Nina Cecilie Øverby
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, PO Box 422, 4604 Kristiansand, Norway.
| | - Liv Fegran
- Department of Health and Nursing Sciences, Faculty of Health and Sport Sciences, University of Agder, PO Box 422, 4604 Kristiansand, Norway.
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28
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Bratland-Sanda S, Øverby NC, Bottegaard A, Heia M, Støren Ø, Sundgot-Borgen J, Torstveit MK. Maximal Strength Training as a Therapeutic Approach in Long-Standing Anorexia Nervosa: A Case Study of a Woman With Osteopenia, Menstrual Dysfunction, and Compulsive Exercise. Clin Case Stud 2018. [DOI: 10.1177/1534650118755949] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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] [Indexed: 11/16/2022]
Abstract
In persons with anorexia nervosa (AN), compulsive exercise and osteopenia are common symptoms. Although treatment of osteopenia besides weight regain is lacking, maximal strength training (MST) has been found to be effective in other populations. Such training has not been prescribed to those with AN due to uncertainty of tolerance. We therefore examined use of MST in a woman with long-standing AN, osteopenia, menstrual dysfunction, and compulsive exercise. The MST intervention consisted of four exercises: three sets of five repetitions maximum (RM), 3 times per week for 16 weeks. We examined muscle strength, bone mineral density (BMD), AN psychopathology, and compulsive exercise at baseline, posttest, and 6-month follow-up. Attendance rate was 100%. The subject improved muscle strength by 20% to 40%. BMD in lumbar spine improved by 4% to posttest, and by 8% from baseline to 6-month follow-up. The BMD T-scores shifted from values classified as osteopenic to normal values throughout the course of the intervention, despite continuance of menstrual dysfunction and lack of weight gain. No changes in AN psychopathology or levels of compulsive exercise were detected. Perceived psychological benefits including new bodily experiences were self-reported by the subject, emphasizing the importance of close follow-up by competent instructors.
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Affiliation(s)
| | | | | | - Morten Heia
- University College of Southeast Norway, Bø, Norway
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29
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Beinert C, Hernes S, Haugen M, Øverby NC. No long-term effect of a 2-days intervention on how to prepare homemade food, on toddlers' skepticism for new food and intake of fruits and vegetables and sweet beverages: a randomized, controlled trial. BMC Res Notes 2017; 10:607. [PMID: 29162136 PMCID: PMC5697102 DOI: 10.1186/s13104-017-2931-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 11/14/2017] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE Optimal nutrition from early age reduces the risk of developing non-communicable diseases later in life. The aim of this study was to examine the long-term effect on toddlers' fruit and vegetable intake and sweet beverages, and skepticism for new food, of a 2-days' intervention on how to prepare homemade food for toddlers. RESULTS The effect of the cooking intervention was evaluated by a randomized, controlled trial where 110 parents of 4-6 months old infants were included. Child diet and food skepticism were measured at 6, 15 and 24 months of age. There were no differences between the control and intervention group in the consumption of fruits and vegetables and intake of water or sweet beverages at 15 and 24 months. There were no differences between the control and intervention group, respectively, in percentage reporting having children who were skeptical regarding new food at baseline (29% vs 20%, p = .372), nor at 3 and 9 months after the intervention (20 vs 18%, p = .804 and 43% vs 32%, p = .383). The intervention did not influence intake of fruits and vegetables, nor did it reduce food skepticism among toddlers. Trial registration first food for infants ISRCTN45864056, 20.05.2016. Retrospectively registered.
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Affiliation(s)
- C Beinert
- Department of Public Health, Sport and Nutrition, University of Agder, PO 422, 4604, Kristiansand, Norway
| | - S Hernes
- Department of Public Health, Sport and Nutrition, University of Agder, PO 422, 4604, Kristiansand, Norway
| | - M Haugen
- Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, Nydalen, P.Box 4404, 0403, Oslo, Norway
| | - N C Øverby
- Department of Public Health, Sport and Nutrition, University of Agder, PO 422, 4604, Kristiansand, Norway. .,Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, PO Box 422, 4604, Kristiansand, Norway.
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30
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Helle C, Hillesund ER, Omholt ML, Øverby NC. Early food for future health: a randomized controlled trial evaluating the effect of an eHealth intervention aiming to promote healthy food habits from early childhood. BMC Public Health 2017; 17:729. [PMID: 28931384 PMCID: PMC5607575 DOI: 10.1186/s12889-017-4731-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [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: 05/23/2017] [Accepted: 09/11/2017] [Indexed: 11/10/2022] Open
Abstract
Background Childhood overweight and obesity is a global public health challenge. Primary prevention initiatives targeting parents have been called for to encourage a positive feeding environment and healthy eating habits that may lay a good foundation for future health. At the same time, there is a need for interventions which combine accessibility and scalability with cost effectiveness. Today’s parents are extensive Internet-users, but only a few randomized controlled trials have investigated the use of Internet to promote healthy eating habits in early childhood. In Early Food for Future Health we have developed and will evaluate an Internet-based tool for parents of children between 6 and 12 months, aiming to increase knowledge about infant nutrition and foster protective feeding behavior. Methods During springtime 2016, parents of children aged between 3 and 5 months were recruited through Norwegian child health centres and announcements on Facebook. After completing the baseline questionnaire, 718 parents were individually randomized to intervention- or control group. The intervention group received monthly emails with links to an age-appropriate web-site when their child was between 6 and 12 months. The control group received ordinary care from the child health centres. The data-collection is ongoing. All participants will be followed up at ages 12 and possibly 24 and 48 months, with questionnaires relating to eating behaviour and feeding practices, food variety and diet quality. Discussion Providing guidance and counseling to parents of infants is an important task for health authorities and the public child health services. Early Food for Future health is an intervention focusing on promoting early healthy food-habits which may prevent childhood overweight and obesity. If proven to be effective, Early Food for Future Health can be used by parents and public health nurses for supplementary guidance on feeding practices and diet. This study has the potential to provide greater insight and understanding regarding early parental feeding practices, child eating behavior and the development and efficacy of Internet-based public health interventions. Trial registration ISRCTN13601567.
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Affiliation(s)
- Christine Helle
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, PO Box 422, 4604, Kristiansand, Norway.
| | - Elisabet Rudjord Hillesund
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, PO Box 422, 4604, Kristiansand, Norway
| | - Mona Linge Omholt
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, PO Box 422, 4604, Kristiansand, Norway
| | - Nina Cecilie Øverby
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, PO Box 422, 4604, Kristiansand, Norway
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31
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Øverby NC, Hernes S, Haugen M. Effect of dietary interventions during weaning period on parental practice and lipoproteins and vitamin D status in two-year-old children. Food Nutr Res 2017; 61:1350127. [PMID: 28804440 PMCID: PMC5533129 DOI: 10.1080/16546628.2017.1350127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 12/21/2016] [Accepted: 06/23/2017] [Indexed: 01/07/2023] Open
Abstract
Objective: Evaluate if a two-day course for parents on nutrition and applied baby food preparation had an effect on child’s intake of home-made foods, lipid concentration, and vitamin D status. Design: Randomized controlled trial at age 6 months and follow-up at ages 15 and 24 months. Setting: Four health care clinics in Kristiansand, Norway. Subjects: Thirty-nine pairs of 6-month-old children and their parents in the intervention group and 20 pairs in the control group. Results: At age 15 months, the intervention group had lower intakes of ready-made porridge (2.0 vs. 5.8 servings per week (p < 0.05)), lower intake of canned baby food (2.9 vs. 6.3 servings per week (p < 0.05)) and higher intakes of home-made porridge (4.8 servings vs. 0.9 servings per week (p < 0.001)) compared with the control group. The intervention group had higher HDL cholesterol concentrations at 2 years than the control group, 1.08 mol/l compared to 0.89 mol/l (p < 0.05). Conclusions: This is the first study to show that providing dietary information and applied baby food preparation to parents during the weaning period may have impact on the children’s diet at 15 and 24 months and improve their lipid profile. Our results call for studies with more power and longer follow-up.
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Affiliation(s)
- Nina Cecilie Øverby
- Department of Public health, Sport and Nutrition, University of Agder, Kristiansand, Norway
| | - Sigrunn Hernes
- Department of Public health, Sport and Nutrition, University of Agder, Kristiansand, Norway
| | - Margaretha Haugen
- Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
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Helland SH, Bere E, Bjørnarå HB, Øverby NC. Food neophobia and its association with intake of fish and other selected foods in a Norwegian sample of toddlers: A cross-sectional study. Appetite 2017; 114:110-117. [DOI: 10.1016/j.appet.2017.03.025] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 03/08/2017] [Accepted: 03/16/2017] [Indexed: 12/19/2022]
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33
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Djupegot IL, Nenseth CB, Bere E, Bjørnarå HBT, Helland SH, Øverby NC, Torstveit MK, Stea TH. The association between time scarcity, sociodemographic correlates and consumption of ultra-processed foods among parents in Norway: a cross-sectional study. BMC Public Health 2017; 17:447. [PMID: 28506318 PMCID: PMC5433068 DOI: 10.1186/s12889-017-4408-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 05/04/2017] [Indexed: 02/02/2023] Open
Abstract
Background Use of ultra-processed foods has expanded rapidly over the last decades and high consumption has been positively associated with risk of e.g. overweight, obesity and type 2 diabetes. Ultra-processed foods offer convenience as they require minimal time for preparation. It is therefore reasonable to assume that such foods are consumed more often among people who experience time scarcity. The main aim of this study was to investigate the association between time scarcity and consumption of ultra-processed foods among parents of 2-year olds in Norway. A secondary aim was to investigate the association between sociodemographic correlates, weight status and consumption of ultra-processed foods. Methods This cross-sectional study included 497 participants. Chi-square and cross tabulations were used to calculate proportions of high vs. low consumption of ultra-processed foods in relation to time scarcity, sociodemographic correlates and weight status. Binary logistic regression analyses were performed to test the relationship between independent variables and consumption of ultra-processed foods. Results Participants reporting medium and high time scarcity were more likely to have a high consumption of ultra-processed dinner products (OR = 3. 68, 95% CI = 2. 32–5.84 and OR = 3.10, 1.80–5.35, respectively) and fast foods (OR = 2.60, 1.62–4.18 and OR = 1.90, 1.08–3.32, respectively) compared to those with low time scarcity. Further, participants with medium time scarcity were more likely to have a high consumption of snacks and soft drinks compared to participants with low time scarcity (OR = 1.63, 1.06–2.49). Finally, gender, ethnicity, educational level, number of children in the household and weight status were identified as important factors associated with the consumption of certain types of ultra-processed foods. Conclusions Results from the present study showed that time scarcity, various sociodemographic factors and weight status was associated with consumption of processed foods. Future studies with a longitudinal design are needed to further explore these patterns over a longer period of time. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4408-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ingrid Laukeland Djupegot
- Department of Public Health, Sport and Nutrition, University of Agder, Postboks 422, 4604, Kristiansand, Norway
| | - Camilla Bengtson Nenseth
- Department of Public Health, Sport and Nutrition, University of Agder, Postboks 422, 4604, Kristiansand, Norway
| | - Elling Bere
- Department of Public Health, Sport and Nutrition, University of Agder, Postboks 422, 4604, Kristiansand, Norway
| | | | - Sissel Heidi Helland
- Department of Public Health, Sport and Nutrition, University of Agder, Postboks 422, 4604, Kristiansand, Norway
| | - Nina Cecilie Øverby
- Department of Public Health, Sport and Nutrition, University of Agder, Postboks 422, 4604, Kristiansand, Norway
| | - Monica Klungland Torstveit
- Department of Public Health, Sport and Nutrition, University of Agder, Postboks 422, 4604, Kristiansand, Norway
| | - Tonje Holte Stea
- Department of Public Health, Sport and Nutrition, University of Agder, Postboks 422, 4604, Kristiansand, Norway.
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Hillesund ER, Vik FN, Øverby NC. Kosthold og folkehelse i et generasjonsperspektiv. Tidsskriftet 2017; 137:17-0816. [DOI: 10.4045/tidsskr.17.0816] [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: 11/02/2022] Open
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Stea TH, Haugen T, Berntsen S, Guttormsen V, Øverby NC, Haraldstad K, Meland E, Abildsnes E. Using the Intervention Mapping protocol to develop a family-based intervention for improving lifestyle habits among overweight and obese children: study protocol for a quasi-experimental trial. BMC Public Health 2016; 16:1092. [PMID: 27756346 PMCID: PMC5070224 DOI: 10.1186/s12889-016-3766-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 09/10/2016] [Accepted: 10/12/2016] [Indexed: 12/22/2022] Open
Abstract
Background In light of the high prevalence of childhood overweight and obesity, there is a need of developing effective prevention programs to address the rising prevalence and the concomitant health consequences. The main aim of the present study is to systematically develop and implement a tailored family-based intervention for improving lifestyle habits among overweight and obese children, aged 6–10 years old, enhancing parental self-efficacy, family engagement and parent-child interaction. A subsidiary aim of the intervention study is to reduce the prevalence of overweight and obesity among those participating in the intervention study. Methods/design The Intervention Mapping protocol was used to develop a tailored family-based intervention for improving lifestyle habits among overweight and obese children. In order to gather information on local opportunities and barriers, interviews with key stakeholders and a 1-year pilot study was conducted. The main study has used a quasi-experimental controlled design. Locally based Healthy Life Centers and Public Health Clinics are responsible for recruiting families and conducting the intervention. The effect of the study will be measured both at completion of the 6 months intervention study and 6 and 18 months after the intervention period. An ecological approach was used as a basis for developing the intervention. The behavioral models and educational strategies include individual family counselling meetings, workshops focusing on regulation of family life, nutrition courses, and physical activity groups providing tailored information and practical learning sessions. Parents will be educated on how to use these strategies at home, to further support their children in improving their behaviors. Discussion A systematic and evidence-based approach was used for development of this family-based intervention study targeting overweight and obese children, 6–10 years old. This program, if feasible and effective, may be adjusted to local contexts and implemented in all municipal health care institutions in Norway. Trial registration NCT02247219. Prospectively registered on October 26, 2014.
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Affiliation(s)
- Tonje Holte Stea
- Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway.
| | - Tommy Haugen
- Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway
| | - Sveinung Berntsen
- Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway
| | - Vigdis Guttormsen
- Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway
| | - Nina Cecilie Øverby
- Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway
| | - Kristin Haraldstad
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | - Eivind Meland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Eirik Abildsnes
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Bjørnarå HB, Øverby NC, Stea TH, Torstveit MK, Hillesund ER, Andersen LF, Berntsen S, Bere E. The association between adherence to the New Nordic Diet and diet quality. Food Nutr Res 2016; 60:31017. [PMID: 27257844 PMCID: PMC4891969 DOI: 10.3402/fnr.v60.31017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 04/19/2016] [Accepted: 05/10/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Previous studies have reported a positive association between scoring on healthy Nordic diet scales and the intake of healthy foods and nutrients, and also with higher intake of meat, sweets, cakes, and energy in general. These studies have used the same food frequency questionnaire (FFQ) responses for constructing the diet score as for calculating intakes of foods and nutrients. Thus, it is not clear whether the coexistence of healthy and less healthy dietary aspects among adherers to Nordic diets would occur even though separate methods were applied for exploring these relations. OBJECTIVE To assess the association between adherence to the New Nordic Diet (NND), derived from an FFQ, and diet quality, determined from two 24-h dietary recall interviews. DESIGN In total, 65 parents of toddlers in Southern Norway answered the NND FFQ and two 24-h dietary recall interviews. NND adherence was determined from the FFQ and categorized into low, medium, and high adherence. The two 24-h recalls provided data for the intake of specific foods and nutrients, selected on the basis of the Norwegian food-based guidelines as an indicator of a healthy diet. The Kruskal-Wallis test was used for assessing differences in food and nutrient intake across NND groups. RESULTS High NND adherence derived from FFQ was associated with a high intake of fruits (p=0.004) and fiber (p=0.02), and a low intake of meat (p=0.004) and margarines (p=0.05), derived from recalls. A larger proportion of high NND adherers (68%) complied with the national dietary recommendation targeting meat intake compared with low NND adherers (29%) (p=0.04). CONCLUSION The present study showed that higher NND adherence measured with FFQ was associated with a higher intake of selected healthy foods and nutrients, measured with recalls. However, a higher intake of meat, sweets, and energy, as earlier reported, was not observed.
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Affiliation(s)
- Helga Birgit Bjørnarå
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway;
| | - Nina Cecilie Øverby
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Tonje Holte Stea
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Monica Klungland Torstveit
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Elisabet Rudjord Hillesund
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | | | - Sveinung Berntsen
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Elling Bere
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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Helland SH, Bere E, Øverby NC. Study protocol for a multi-component kindergarten-based intervention to promote healthy diets in toddlers: a cluster randomized trial. BMC Public Health 2016; 16:273. [PMID: 26987876 PMCID: PMC4794829 DOI: 10.1186/s12889-016-2952-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 03/11/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is concern about the lack of diversity in children's diets, particularly low intakes of fruit and vegetables and high intakes of unhealthy processed food. This may be a factor in the rising prevalence of obesity. A reason for the lack of diversity in children's diets may be food neophobia. This study aimed to promote a healthy and varied diet among toddlers in kindergarten. The primary objectives were to reduce food neophobia in toddlers, and promote healthy feeding practices among kindergarten staff and parents. Secondary objectives were to increase food variety in toddlers' diets and reduce future overweight and obesity in these children. METHODS This is an ongoing, cluster randomized trial. The intervention finished in 2014, but follow-up data collection is not yet complete. Eighteen randomly selected kindergartens located in two counties in Norway with enrolled children born in 2012 participated in the intervention. The kindergartens were matched into pairs based on background information, and randomly assigned to the intervention or control groups. A 9-week multi-component intervention was implemented, with four main elements: 1) kindergarten staff implemented a pedagogical tool (Sapere method) in daily sessions to promote willingness to try new food; 2) kindergarten staff prepared and served the toddlers a cooked lunch from a menu corresponding to the pedagogical sessions; 3) kindergarten staff were encouraged to follow 10 meal principles on modeling, responsive feeding, repeated exposure, and enjoyable meals; and 4) parents were encouraged to read information and apply relevant feeding practices at home. The control group continued their usual practices. Preference taste tests were conducted to evaluate behavioral food neophobia, and children's height and weight were measured. Parents and staff completed questionnaires before and after the intervention. Data have not yet been analyzed. DISCUSSION This study provides new knowledge about whether or not a Sapere-sensory education and healthy meal intervention targeting children, kindergarten staff, and parents will: reduce levels of food neophobia in toddlers; improve parental and kindergarten feeding practices; improve children's dietary variety; and reduce childhood overweight and obesity. TRIAL REGISTRATION ISRCTN74823448 DOI 10.1186/ISRCTN74823448.
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Affiliation(s)
- Sissel H Helland
- Department of Public health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, PO Box 422, 4604, Kristiansand, Norway.
| | - Elling Bere
- Department of Public health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, PO Box 422, 4604, Kristiansand, Norway
| | - Nina Cecilie Øverby
- Department of Public health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, PO Box 422, 4604, Kristiansand, Norway
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Sagedal LR, Sanda B, Øverby NC, Bere E, Torstveit MK, Lohne-Seiler H, Hillesund ER, Pripp AH, Henriksen T, Vistad I. The effect of prenatal lifestyle intervention on weight retention 12 months postpartum: results of the Norwegian Fit for Delivery randomised controlled trial. BJOG 2016; 124:111-121. [DOI: 10.1111/1471-0528.13863] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2015] [Indexed: 11/28/2022]
Affiliation(s)
- LR Sagedal
- Department of Obstetrics and Gynecology; Sørlandet Hospital; Kristiansand Norway
- Department of Research; Sørlandet Hospital; Kristiansand Norway
| | - B Sanda
- Department of Obstetrics and Gynecology; Sørlandet Hospital; Kristiansand Norway
- Department of Public Health, Sports and Nutrition; University of Agder; Kristiansand Norway
| | - NC Øverby
- Department of Public Health, Sports and Nutrition; University of Agder; Kristiansand Norway
| | - E Bere
- Department of Public Health, Sports and Nutrition; University of Agder; Kristiansand Norway
| | - MK Torstveit
- Department of Public Health, Sports and Nutrition; University of Agder; Kristiansand Norway
| | - H Lohne-Seiler
- Department of Public Health, Sports and Nutrition; University of Agder; Kristiansand Norway
| | - ER Hillesund
- Department of Public Health, Sports and Nutrition; University of Agder; Kristiansand Norway
| | - AH Pripp
- Oslo Centre of Biostatistics and Epidemiology; Research Support Services; Oslo University Hospital; Oslo Norway
| | - T Henriksen
- Section of Obstetrics, Women and Children's Division; Oslo University Hospital; University of Oslo; Oslo Norway
| | - I Vistad
- Department of Obstetrics and Gynecology; Sørlandet Hospital; Kristiansand Norway
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Sagedal LR, Øverby NC, Bere E, Torstveit MK, Lohne-Seiler H, Småstuen M, Hillesund ER, Henriksen T, Vistad I. Lifestyle intervention to limit gestational weight gain: the Norwegian Fit for Delivery randomised controlled trial. BJOG 2016; 124:97-109. [DOI: 10.1111/1471-0528.13862] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2015] [Indexed: 12/30/2022]
Affiliation(s)
- LR Sagedal
- Department of Obstetrics and Gynaecology/Department of Research; Sørlandet Hospital; Kristiansand Norway
| | - NC Øverby
- Department of Public Health, Sports and Nutrition; University of Agder; Kristiansand Norway
| | - E Bere
- Department of Public Health, Sports and Nutrition; University of Agder; Kristiansand Norway
| | - MK Torstveit
- Department of Public Health, Sports and Nutrition; University of Agder; Kristiansand Norway
| | - H Lohne-Seiler
- Department of Public Health, Sports and Nutrition; University of Agder; Kristiansand Norway
| | - M Småstuen
- Department of Medicine; University of Oslo; Blindern Oslo Norway
| | - ER Hillesund
- Department of Public Health, Sports and Nutrition; University of Agder; Kristiansand Norway
| | - T Henriksen
- Section of Obstetrics; Women and Children's Division; Oslo University Hospital and University of Oslo; Nydalen Oslo Norway
| | - I Vistad
- Department of Obstetrics and Gynaecology/Department of Research; Sørlandet Hospital; Kristiansand Norway
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Bjørnarå HB, Hillesund ER, Torstveit MK, Stea TH, Øverby NC, Bere E. An assessment of the test-retest reliability of the New Nordic Diet score. Food Nutr Res 2015; 59:28397. [PMID: 26268707 PMCID: PMC4534623 DOI: 10.3402/fnr.v59.28397] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 07/06/2015] [Accepted: 07/21/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There is a growing interest in the New Nordic Diet (NND) as a potentially health promoting, environmentally friendly, and palatable regional diet. Also, dietary scores are gaining ground as a complementary approach for examining relations between dietary patterns and various health outcomes. A score assessing adherence to the NND has earlier been published, yet not tested for reliability. OBJECTIVE To assess the test-retest reliability of the NND score in a sample of parents of toddlers, residing in Southern Norway. DESIGN A questionnaire survey was completed on two occasions, approximately 14 days apart, by 67 parents of toddlers [85% females, mean age 34 years (SD=5.3 years)]. The NND score was constructed from 24 items and comprised 10 subscales that summarize meal pattern and intake of typical Nordic foods. Each subscale was dichotomized by the median and assigned values of '0' or '1'. Adding the subscales yielded a score ranging from 0 to 10, which was further trichotomized. Test-retest reliability of the final NND score and individual subscales was assessed by Pearson's correlation coefficient and Spearman's rank correlation coefficient, respectively. Additionally, cross tabulation and kappa measure of agreement (k) were used to assess the test-retest agreement of classification into the NND score, and the subscales. RESULTS Test-retest correlations of the NND score and subscales were r=0.80 (Pearson) and r=0.54-0.84 (Spearman), respectively, all p<0.001. There were 69% (k=0.52) and 67-88% (k=0.32-0.76) test-retest correct classification of the trichotomized score and the dichotomized subscales, respectively. CONCLUSION The NND score and the 10 subscales appear to have acceptable test-retest reliability when tested in a sample of parents of toddlers.
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Affiliation(s)
- Helga Birgit Bjørnarå
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway;
| | - Elisabet Rudjord Hillesund
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Monica Klungland Torstveit
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Tonje Holte Stea
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Nina Cecilie Øverby
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Elling Bere
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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Myr RK, Bere E, Øverby NC. Test-retest reliability of a new questionnaire on the diet and eating behavior of one year old children. BMC Res Notes 2015; 8:16. [PMID: 25616767 PMCID: PMC4320631 DOI: 10.1186/s13104-014-0966-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 12/30/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND As part of a sub-study in the ongoing Norwegian RCT 'Fit for Delivery', a new questionnaire, using a combination of food frequency, scale, and categorical questions to gather data on the diets and eating patterns of one year olds, was developed and tested for reliability by test-retest. RESULTS Of 102 parents recruited to the study, 94 completed both test and retest. Correlation coefficients (Spearman's r, and/or Cohen's kappa, where applicable) were high for all categories of question, with a mean value of 0.72 for Spearman's r for food frequency variables, and a mean value of 0.75 for Cohen's kappa for non-numeric variables such as breast feeding status, showing very high test-retest reliability. CONCLUSIONS This newly developed diet and eating habit questionnaire had strong test-retest reliability in a test population similar to the study population, for which it was developed. This indicates that the questionnaire is reliable in this population.
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Affiliation(s)
- Rachel Kristin Myr
- Department of Public Health, Sports and Nutrition, University of Agder, Serviceboks 422, 4604, Kristiansand, Norway.
| | - Elling Bere
- Department of Public Health, Sports and Nutrition, University of Agder, Serviceboks 422, 4604, Kristiansand, Norway.
| | - Nina Cecilie Øverby
- Department of Public Health, Sports and Nutrition, University of Agder, Serviceboks 422, 4604, Kristiansand, Norway.
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Høigaard R, Kovač VB, Øverby NC, Haugen T. Academic self-efficacy mediates the effects of school psychological climate on academic achievement. ACTA ACUST UNITED AC 2014; 30:64-74. [PMID: 24708286 DOI: 10.1037/spq0000056] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study investigated the effects of proximal and distal constructs on adolescent's academic achievement through self-efficacy. Participants included 482 ninth- and tenth- grade Norwegian students who completed a questionnaire designed to assess school-goal orientations, organizational citizenship behavior, academic self-efficacy, and academic achievement. The results of a bootstrapping technique used to analyze relationships between the constructs indicated that school-goal orientations and organizational citizenship predicted academic self-efficacy. Furthermore, school-goal orientation, organizational citizenship, and academic self-efficacy explained 46% of the variance in academic achievement. Mediation analyses revealed that academic self-efficacy mediated the effects of perceived task goal structure, perceived ability structure, civic virtue, and sportsmanship on adolescents' academic achievements. The results are discussed in reference to current scholarship, including theories underlying our hypothesis. Practical implications and directions for future research are suggested.
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Affiliation(s)
| | - Velibor Bobo Kovač
- Department of Education, Faculty of Humanities and Education, University of Agder
| | | | - Tommy Haugen
- Department of Public Health, Sport, and Nutrition
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Abstract
Aim: The academic performance of children impacts future educational attainment which may increase socioeconomic status which again influences their health. One of several factors that might affect academic performance is the diet. The aim of this study was to investigate the cross sectional relation between diet and self-reported reading-, writing-, and mathematical difficulties in Norwegian adolescents. Methods: In total, 475 ninth- and tenth-grade students out of 625 eligible ones from four different secondary schools in three different municipalities in Vest-Agder County, Norway, participated, giving a participation rate of 77%. The students filled in a questionnaire with food frequency questions of selected healthy and unhealthy food items, questions of meal frequency and different learning difficulties. Results: Regular breakfast was significantly associated with decreased odds of both writing and reading difficulties (OR: 0.44 (0.2–0.8), p = 0.01) and mathematical difficulties (OR: 0.33 (0.2–0.6), p ≤ 0.001). In addition, having lunch, dinner and supper regularly were associated with decreased odds of mathematical difficulties. Further, a high intake of foods representing a poor diet (sugar-sweetened soft drinks, sweets, chocolate, savory snacks, pizza and hot dogs) was significantly associated with increased odds of mathematical difficulties. Conclusions: Having a less-frequent intake of unhealthy foods and not skipping meals are associated with decreased odds of self-reported learning difficulties in Norwegian adolescents in this study. The results of this study support the need for a larger study with a more representative sample.
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Affiliation(s)
- Nina Cecilie Øverby
- Faculty of Health and Sport Sciences, Institute of Public Health, Sport and Nutrition, University of Agder, Norway
| | - Eva Lüdemann
- Faculty of Health and Sport Sciences, Institute of Public Health, Sport and Nutrition, University of Agder, Norway
| | - Rune Høigaard
- Faculty of Health and Sport Sciences, Institute of Public Health, Sport and Nutrition, University of Agder, Norway
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Øverby NC, Sonestedt E, Laaksonen DE, Birgisdottir BE. Dietary fiber and the glycemic index: a background paper for the Nordic Nutrition Recommendations 2012. Food Nutr Res 2013; 57:20709. [PMID: 23538683 PMCID: PMC3608853 DOI: 10.3402/fnr.v57i0.20709] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 02/18/2013] [Accepted: 02/25/2013] [Indexed: 11/14/2022] Open
Abstract
The aim of this study is to review recent data on dietary fiber (DF) and the glycemic index (GI), with special focus on studies from the Nordic countries regarding cardiometabolic risk factors, type 2 diabetes, cardiovascular disease, cancer, and total mortality. In this study, recent guidelines and scientific background papers or updates on older reports on DF and GI published between 2000 and 2011 from the US, EU, WHO, and the World Cancer Research Fund were reviewed, as well as prospective cohort and intervention studies carried out in the Nordic countries. All of the reports support the role for fiber-rich foods and DF as an important part of a healthy diet. All of the five identified Nordic papers found protective associations between high intake of DF and health outcomes; lower risk of cardiovascular disease, type 2 diabetes, colorectal and breast cancer. None of the reports and few of the Nordic papers found clear evidence for the GI in prevention of risk factors or diseases in healthy populations, although association was found in sub-groups, e.g. overweight and obese individuals and suggestive for prevention of type 2 diabetes. It was concluded that DF is associated with decreased risk of different chronic diseases and metabolic conditions. There is not enough evidence that choosing foods with low GI will decrease the risk of chronic diseases in the population overall. However, there is suggestive evidence that ranking food based on their GI might be of use for overweight and obese individuals. Issues regarding methodology, validity and practicality of the GI remain to be clarified.
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Affiliation(s)
- Nina Cecilie Øverby
- Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway
| | - Emily Sonestedt
- Department of Clinical Sciences – Malmö, Lund University, Malmö, Sweden
| | | | - Bryndis Eva Birgisdottir
- Unit for Nutrition Research, Landspitali-University Hospital and University of Iceland, Reykjavik, Iceland
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Øverby NC, Klepp KI, Bere E. Introduction of a school fruit program is associated with reduced frequency of consumption of unhealthy snacks. Am J Clin Nutr 2012; 96:1100-3. [PMID: 23034961 DOI: 10.3945/ajcn.111.033399] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND A diet high in fruit and vegetables (FV) is inversely related to chronic diseases, and some studies suggest that increasing the intake of FV reduces the intake of unhealthy snacks. OBJECTIVES The objectives were to analyze changes in the frequency of consumption of unhealthy snacks (soda, candy, and potato chips) from 2001 to 2008 in Norwegian children, to assess whether being part of a school fruit program reduces the frequency of unhealthy snack consumption, and to explore differences in sex and socioeconomic status. DESIGN Within the project Fruits and Vegetables Make the Marks, 1488 sixth- and seventh-grade pupils from 27 Norwegian elementary schools completed a questionnaire in 2001, and 1339 sixth- and seventh-grade pupils from the same schools completed the same questionnaire in 2008. In 2001, none of the schools had any organized school fruit program. In 2008, 15 schools participated in a program and 12 did not participate in any program. RESULTS From 2001 to 2008, the frequency of unhealthy snack consumption decreased from 6.9 to 4.6 times/wk (P < 0.001). The decrease was largest in the schools that had been included in the national free school fruit program (-2.8 times/wk). The effect of the school fruit programs was significant in reducing the frequency of unhealthy snack consumption in children of parents without higher education (from 7.8 to 4.0 times/wk; P = 0.004). CONCLUSIONS The frequency of unhealthy snack consumption decreased from 2001 to 2008 in schoolchildren in Norway. The decrease was most evident among children at schools participating in the national free school fruit program and in children with a low socioeconomic status.
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Affiliation(s)
- Nina Cecilie Øverby
- University of Agder, Department of Public Health, Sport and Nutrition, Kristiansand, Norway.
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Øverby NC, Margeirsdottir HD, Brunborg C, Dahl-Jørgensen K, Andersen LF. Sweets, snacking habits, and skipping meals in children and adolescents on intensive insulin treatment. Pediatr Diabetes 2008; 9:393-400. [PMID: 18774998 DOI: 10.1111/j.1399-5448.2008.00381.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [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] [Indexed: 11/28/2022] Open
Abstract
AIM To examine the association between skipping meals and snacking events and dietary and clinical characteristics in children and adolescents using modern insulin treatment. METHODS Dietary intake was recorded for 4 d in food diaries in 655 young diabetic patients. Number of meals and snacking events was recorded in a separated questionnaire, while clinical data were obtained from case record forms. Skipping meals refer to consuming a main meal (e.g., breakfast) five times a week or less. RESULTS Modern insulin treatment may favor a more flexible lifestyle. This study shows that there are fewer young diabetic patients who skip meals than non-diabetic controls (p < 0.001) even when using modern intensified insulin treatment. However, skipping meals among young diabetic patients was associated with negative characteristics such as having suboptimal hemoglobin A1c (HbA1c) (OR 4.7, p = 0.02), higher low-density lipoprotein (LDL) cholesterol levels (OR 4.0, p < 0.001), watching more TV (OR 3.6, p < 0.001), being overweight (OR 2.8, p = 0.03), as well as having a higher intake of added sugar (OR 2.1, p = 0.01) and lower intake of fiber (OR 0.2, p = 0.04) compared with those not skipping meals. Having more than two snacking events during the day was associated with higher HbA1c, higher intake of added sugar and sweets, and spending more hours in front of the TV or personal computer. CONCLUSIONS In general, fewer children and adolescents with type 1 diabetes skip meals compared with healthy peers. Those who skip meals and have more snacking events have poorer glycemic control and less healthy dietary and leisure habits.
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Affiliation(s)
- N C Øverby
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.
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