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  • 1. Al-Delaimy, WK
    et al.
    Van Kappel, AL
    Ferrari, P
    Slimani, N
    Steghens, JP
    Bingham, S
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Odontology, Cariology.
    Wallström, P
    Overvad, K
    Tjonneland, A
    Key, TJ
    Welch, AA
    Bas Bueno-De-Mesquita, H
    Peeters, PH
    Boeing, H
    Linseisen, J
    Clavel-Chapelon, F
    Guibout, C
    Navarro, C
    Quiros, JR
    Palli, D
    Celentano, E
    Trichopoulou, A
    Benetou, V
    Kaaks, R
    Riboli, E
    Plasma levels of six carotenoids in nine European countries: report from the European Prospective Investigation into Cancer and Nutrition (EPIC).2004In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 7, no 6, p. 713-722Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In addition to their possible direct biological effects, plasma carotenoids can be used as biochemical markers of fruit and vegetable consumption for identifying diet-disease associations in epidemiological studies. Few studies have compared levels of these carotenoids between countries in Europe. OBJECTIVE: Our aim was to assess the variability of plasma carotenoid levels within the cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC). METHODS: Plasma levels of six carotenoids--alpha-carotene, beta-carotene, beta-cryptoxanthin, lycopene, lutein and zeaxanthin--were measured cross-sectionally in 3043 study subjects from 16 regions in nine European countries. We investigated the relative influence of gender, season, age, body mass index (BMI), alcohol intake and smoking status on plasma levels of the carotenoids. RESULTS: Mean plasma level of the sum of the six carotenoids varied twofold between regions (1.35 micromol l(-1) for men in Malmö, Sweden vs. 2.79 micromol l(-1) for men in Ragusa/Naples, Italy; 1.61 micromol l(-1) for women in The Netherlands vs. 3.52 micromol l(-1) in Ragusa/Naples, Italy). Mean levels of individual carotenoids varied up to fourfold (alpha-carotene: 0.06 micromol l(-1) for men in Murcia, Spain vs. 0.25 micromol l(-1) for vegetarian men living in the UK). In multivariate regression analyses, region was the most important predictor of total plasma carotenoid level (partial R(2)=27.3%), followed by BMI (partial R(2)=5.2%), gender (partial R(2)=2.7%) and smoking status (partial R(2)=2.8%). Females had higher total carotenoid levels than males across Europe. CONCLUSIONS: Plasma levels of carotenoids vary substantially between 16 different regions in Italy, Greece, Spain, France, Germany, the UK, Sweden, Denmark and The Netherlands. Compared with region of residence, the other demographic and lifestyle factors and laboratory measurements have limited predictive value for plasma carotenoid levels in Europe.

  • 2. Assi, Nada
    et al.
    Moskal, Aurelie
    Slimani, Nadia
    Viallon, Vivian
    Chajes, Veronique
    Freisling, Heinz
    Monni, Stefano
    Knueppel, Sven
    Foerster, Jana
    Weiderpass, Elisabete
    Lujan-Barroso, Leila
    Amiano, Pilar
    Ardanaz, Eva
    Molina-Montes, Esther
    Salmeron, Diego
    Ramon Quiros, Jose
    Olsen, Anja
    Tjonneland, Anne
    Dahm, Christina C.
    Overvad, Kim
    Dossus, Laure
    Fournier, Agnes
    Baglietto, Laura
    Fortner, Renee Turzanski
    Kaaks, Rudolf
    Trichopoulou, Antonia
    Bamia, Christina
    Orfanos, Philippos
    De Magistris, Maria Santucci
    Masala, Giovanna
    Agnoli, Claudia
    Ricceri, Fulvio
    Tumino, Rosario
    de Mesquita, H. Bas Bueno
    Bakker, Marije F.
    Peeters, Petra H. M.
    Skeie, Guri
    Braaten, Tonje
    Winkvist, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Khaw, Kay-Tee
    Wareham, Nicholas J.
    Key, Tim
    Travis, Ruth
    Schmidt, Julie A.
    Merritt, Melissa A.
    Riboli, Elio
    Romieu, Isabelle
    Ferrari, Pietro
    A treelet transform analysis to relate nutrient patterns to the risk of hormonal receptor-defined breast cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC)2016In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 19, no 2, p. 242-254Article in journal (Refereed)
    Abstract [en]

    Objective Pattern analysis has emerged as a tool to depict the role of multiple nutrients/foods in relation to health outcomes. The present study aimed at extracting nutrient patterns with respect to breast cancer (BC) aetiology. Design Nutrient patterns were derived with treelet transform (TT) and related to BC risk. TT was applied to twenty-three log-transformed nutrient densities from dietary questionnaires. Hazard ratios (HR) and 95 % confidence intervals computed using Cox proportional hazards models quantified the association between quintiles of nutrient pattern scores and risk of overall BC, and by hormonal receptor and menopausal status. Principal component analysis was applied for comparison. Setting The European Prospective Investigation into Cancer and Nutrition (EPIC). Subjects Women (n 334 850) from the EPIC study. Results The first TT component (TC1) highlighted a pattern rich in nutrients found in animal foods loading on cholesterol, protein, retinol, vitamins B-12 and D, while the second TT component (TC2) reflected a diet rich in -carotene, riboflavin, thiamin, vitamins C and B-6, fibre, Fe, Ca, K, Mg, P and folate. While TC1 was not associated with BC risk, TC2 was inversely associated with BC risk overall (HRQ5 v. Q1=089, 95 % CI 083, 095, P-trend<001) and showed a significantly lower risk in oestrogen receptor-positive (HRQ5 v. Q1=089, 95 % CI 081, 098, P-trend=002) and progesterone receptor-positive tumours (HRQ5 v. Q1=087, 95 % CI 077, 098, P-trend<001). Conclusions TT produces readily interpretable sparse components explaining similar amounts of variation as principal component analysis. Our results suggest that participants with a nutrient pattern high in micronutrients found in vegetables, fruits and cereals had a lower risk of BC.

  • 3. Bamia, Christina
    et al.
    Trichopoulos, Dimitrios
    Ferrari, Pietro
    Overvad, Kim
    Bjerregaard, Lone
    Tjønneland, Anne
    Halkjaer, Jytte
    Clavel-Chapelon, Françoise
    Kesse, Emmanuelle
    Boutron-Ruault, Marie-Christine
    Boffetta, Paolo
    Nagel, Gabriele
    Linseisen, Jacob
    Boeing, Heiner
    Hoffmann, Kurt
    Kasapa, Christina
    Orfanou, Anastasia
    Travezea, Chrysoula
    Slimani, Nadia
    Norat, Teresa
    Palli, Domenico
    Pala, Valeria
    Panico, Salvatore
    Tumino, Rosario
    Sacerdote, Carlotta
    Bueno-de-Mesquita, H Bas
    Waijers, Patricia M C M
    Peeters, Petra H M
    van der Schouw, Yvonne T
    Berenguer, Antonio
    Martinez-Garcia, Carmen
    Navarro, Carmen
    Barricarte, Aurelio
    Dorronsoro, Miren
    Berglund, Göran
    Wirfält, Elisabet
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Odontology, Cariology.
    Johansson, Gerd
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Nutritional Research.
    Bingham, Sheila
    Khaw, Kay-Tee
    Spencer, Elizabeth A
    Key, Tim
    Riboli, Elio
    Trichopoulou, Antonia
    Dietary patterns and survival of older Europeans: the EPIC-Elderly Study (European Prospective Investigation into Cancer and Nutrition).2007In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 10, no 6, p. 590-8Article in journal (Refereed)
  • 4.
    Dapi N., Léonie
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Janlert, Urban
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Energy and nutrient intake in relation to sex and socioeconomic status among adolescents in urban Cameroon, Africa2011In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 14, no 5, p. 904-913Article in journal (Other academic)
    Abstract [en]

    OBJECTIVE: To assess energy and nutrient intakes and physical activity of adolescents in urban Cameroon according to sex and socio-economic status (SES).

    DESIGN: Cross-sectional study with adolescents randomly selected from schools in low-, middle- and high-SES areas. Weight and height were measured and information about food intake and physical activity was obtained through repeated individual 24 h recalls. Under- and over-reporting of energy intake and inadequacy of nutrient intake were assessed.

    SETTING: Yaoundé, Cameroon.

    SUBJECTS: Boys and girls aged 12-16 years (n 227).

    RESULTS: Boys had a lower BMI and reported higher energy expenditures and physical activity levels (PAL) than girls. Under-reporting of energy intake was large among boys and girls regardless of PAL; boys under-reported more than girls. Among those with low PAL, over-reporting of energy intake was common. Over 50 % of boys and girls had protein below the recommendations. The intake of fat varied; 26 % of the adolescents were below and 25 % were above the recommendations. Inadequate intakes of vitamin B1, vitamin B3 and Fe were more common among girls, while boys more often had inadequate intake of vitamin A. Adolescents with low SES were more likely to be below the recommendations for fat and vitamins B2, B3, B6 and B12 than those with high SES.

    CONCLUSIONS: A high proportion of boys and girls reported inadequate intakes. However under- and over-reporting were also very common. Boys under-reported energy intake more than girls and inadequate nutrient intake was more frequently reported by adolescents with low SES than by those with high SES.

  • 5. Draper, Catherine E.
    et al.
    Tomaz, Simone A.
    Jones, Rachel A.
    Hinkley, Trina
    Twine, Rhian
    Kahn, Kathleen
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; INDEPTH Network, Accra, Ghana.
    Norris, Shane A.
    Cross-sectional associations of physical activity and gross motor proficiency with adiposity in South African children of pre-school age2019In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 22, no 4, p. 614-623Article in journal (Refereed)
    Abstract [en]

    Objective: The study aimed to investigate the relationship between physical activity, gross motor skills and adiposity in South African children of pm-school age.

    Design: Cross-sectional study.

    Setting: High-income urban, and low-income urban and rural settings in South Africa.

    Participants: Children (3-6 years old, n 268) were recruited from urban high-income (n 46), urban low-income (n 91) and rural low-income (n 122) settings. Height and weight were measured to calculate the main outcome variables: BMI and BMI-for-age Z-score (BAZ). Height-for-age and weight-for-age Z-scores were also calculated. Actigraph GT3X+ accelerometers were used to objectively measure physical activity; the Test of Gross Motor Development (Version 2) was used to assess gross motor skills.

    Results: More children were overweight/obese and had a higher BAZ from urban low-income settings compared with urban high-income settings and rural low-income settings. Being less physically active was associated with thinness, but not overweight/obesity. Time spent in physical activity at moderate and vigorous intensities was positively associated with BMI and BAZ. Gross motor proficiency was not associated with adiposity in this sample.

    Conclusions: The findings of this research highlight the need for obesity prevention particularly in urban low-income settings, as well as the need to take into consideration the complexity of the relationship between adiposity, physical activity and gross motor skills in South African pre-school children.

  • 6. Dratva, Julia
    et al.
    Bertelsen, Randi
    Janson, Christer
    Johannessen, Ane
    Benediktsdóttir, Bryndis
    Bråbäck, Lennart
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Dharmage, Shyamali C
    Forsberg, Bertil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Gislason, Thorarinn
    Jarvis, Debbie
    Jogi, Rain
    Lindberg, Eva
    Norback, Dan
    Omenaas, Ernst
    Skorge, Trude D
    Sigsgaard, Torben
    Toren, Kjell
    Waatevik, Marie
    Wieslander, Gundula
    Schlünssen, Vivi
    Svanes, Cecilie
    Real, Francisco Gomez
    Validation of self-reported figural drawing scales against anthropometric measurements in adults2016In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 19, no 11, p. 1944-1951Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of the present study was to validate figural drawing scales depicting extremely lean to extremely obese subjects to obtain proxies for BMI and waist circumference in postal surveys.

    DESIGN: Reported figural scales and anthropometric data from a large population-based postal survey were validated with measured anthropometric data from the same individuals by means of receiver-operating characteristic curves and a BMI prediction model.

    SETTING: Adult participants in a Scandinavian cohort study first recruited in 1990 and followed up twice since.

    SUBJECTS: Individuals aged 38-66 years with complete data for BMI (n 1580) and waist circumference (n 1017).

    RESULTS: Median BMI and waist circumference increased exponentially with increasing figural scales. Receiver-operating characteristic curve analyses showed a high predictive ability to identify individuals with BMI > 25·0 kg/m2 in both sexes. The optimal figural scales for identifying overweight or obese individuals with a correct detection rate were 4 and 5 in women, and 5 and 6 in men, respectively. The prediction model explained 74 % of the variance among women and 62 % among men. Predicted BMI differed only marginally from objectively measured BMI.

    CONCLUSIONS: Figural drawing scales explained a large part of the anthropometric variance in this population and showed a high predictive ability for identifying overweight/obese subjects. These figural scales can be used with confidence as proxies of BMI and waist circumference in settings where objective measures are not feasible.

  • 7. Engeset, Dagrun
    et al.
    Hofoss, Dag
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Olsen, Anja
    Tjønneland, Anne
    Skeie, Guri
    Dietary patterns and whole grain cereals in the Scandinavian countries: differences and similarities. The HELGA project2015In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 18, no 5, p. 905-915Article in journal (Refereed)
    Abstract [en]

    Objective: To identify dietary patterns with whole grains as a main focus to see if there is a similar whole grain pattern in the three Scandinavian countries; Denmark, Sweden and Norway. Another objective is to see if items suggested for a Nordic Food Index will form a typical Nordic pattern when using factor analysis. Setting: The HELGA study population is based on samples of existing cohorts: the Norwegian Women and Cancer Study, the Swedish Vasterbotten cohort and the Danish Diet, Cancer and Health study. The HELGA study aims to generate knowledge about the health effects of whole grain foods. Subjects: The study included a total of 119 913 participants. Design: The associations among food variables from FFQ were investigated by principal component analysis. Only food groups common for all three cohorts were included. High factor loading of a food item shows high correlation of the item to the specific diet pattern. Results: The main whole grain for Denmark and Sweden was rye, while Norway had highest consumption of wheat. Three similar patterns were found: a cereal pattern, a meat pattern and a bread pattern. However, even if the patterns look similar, the food items belonging to the patterns differ between countries. Conclusions: High loadings on breakfast cereals and whole grain oat were common in the cereal patterns for all three countries. Thus, the cereal pattern may be considered a common Scandinavian whole grain pattern. Food items belonging to a Nordic Food Index were distributed between different patterns.

  • 8.
    Goris, Janny M
    et al.
    School of Population Health, MPH Program (partially funded by Queensland Health), The University of Queensland, Herston, QLD, Australia.
    Petersen, Solveig
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Child and Adolescent Psychiatry. Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Stamatakis, Emmanuel
    Department of Epidemiology and Public Health, National Institute for Health Research, University College London, London, UK.
    Veerman, J Lennert
    School of Population Health, The University of Queensland, Herston, QLD, Australia.
    Television food advertising and the prevalence of childhood overweight and obesity: a multicountry comparison2010In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 13, no 7, p. 1003-1012Article in journal (Refereed)
    Abstract [en]

    Objective To estimate the contribution of television (TV) food advertising to the prevalence of obesity among 6–11-year-old children in Australia, Great Britain (England and Scotland only), Italy, The Netherlands, Sweden and the United States.

    Design Data from contemporary representative studies on the prevalence of childhood obesity and on TV food advertising exposure in the above countries were entered into a mathematical simulation model. Two different effect estimators were used to calculate the reduction in prevalence of overweight and obesity in the absence of TV food advertising in each country; one based on literature and one based on experts’ estimates.

    Setting Six- to eleven-year-old children in six Western countries.

    Results Estimates of the average exposure of children to TV food advertising range from 1·8 min/d in The Netherlands to 11·5 min/d in the United States. Its contribution to the prevalence of childhood obesity is estimated at 16 %–40 % in the United States, 10 %–28 % in Australia and Italy and 4 %–18 % in Great Britain, Sweden and The Netherlands.

    Conclusions The contribution of TV advertising of foods and drinks to the prevalence of childhood obesity differs distinctly by country and is likely to be significant in some countries.

  • 9. Huseinovic, E.
    et al.
    Winkvist, A.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Slimani, N.
    Park, M. K.
    Freisling, H.
    Boeing, H.
    Buckland, G.
    Schwingshackl, L.
    Weiderpass, E.
    Rostgaard-Hansen, A. L.
    Tjønneland, A.
    Affret, A.
    Boutron-Ruault, M. C.
    Fagherazzi, G.
    Katzke, V.
    Kühn, T.
    Naska, A.
    Orfanos, P.
    Trichopoulou, A.
    Pala, V.
    Palli, D.
    Ricceri, F.
    Santucci de Magistris, M.
    Tumino, R.
    Engeset, D.
    Enget, T.
    Skeie, G.
    Barricarte, A.
    Bonet, C. B.
    Chirlaque, M. D.
    Amiano, P.
    Quirós, J. R.
    Sánchez, M. J.
    Dias, J. A.
    Drake, I.
    Wennberg, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Boer, J. M. A.
    Ocké, M. C.
    Verschuren, W. M. M.
    Lassale, C.
    Perez-Cornago, A.
    Riboli, E.
    Ward, H.
    Bertéus Forslund, H.
    Meal patterns across ten European countries: results from the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study2016In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 19, no 15, p. 2769-2780Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To characterize meal patterns across ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study.

    DESIGN: Cross-sectional study utilizing dietary data collected through a standardized 24 h diet recall during 1995-2000. Eleven predefined intake occasions across a 24 h period were assessed during the interview. In the present descriptive report, meal patterns were analysed in terms of daily number of intake occasions, the proportion reporting each intake occasion and the energy contributions from each intake occasion.

    SETTING: Twenty-seven centres across ten European countries.

    SUBJECTS: Women (64 %) and men (36 %) aged 35-74 years (n 36 020).

    RESULTS: Pronounced differences in meal patterns emerged both across centres within the same country and across different countries, with a trend for fewer intake occasions per day in Mediterranean countries compared with central and northern Europe. Differences were also found for daily energy intake provided by lunch, with 38-43 % for women and 41-45 % for men within Mediterranean countries compared with 16-27 % for women and 20-26 % for men in central and northern European countries. Likewise, a south-north gradient was found for daily energy intake from snacks, with 13-20 % (women) and 10-17 % (men) in Mediterranean countries compared with 24-34 % (women) and 23-35 % (men) in central/northern Europe.

    CONCLUSIONS: We found distinct differences in meal patterns with marked diversity for intake frequency and lunch and snack consumption between Mediterranean and central/northern European countries. Monitoring of meal patterns across various cultures and populations could provide critical context to the research efforts to characterize relationships between dietary intake and health.

  • 10. Huseinovic, Ena
    et al.
    Winkvist, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska Academy, University of Gothenburg, Box 459, SE-405 30, Gothenburg, Sweden.
    Freisling, Heinz
    Slimani, Nadia
    Boeing, Heiner
    Buckland, Genevieve
    Schwingshackl, Lukas
    Olsen, Anja
    Tjønneland, Anne
    Stepien, Magdalena
    Boutron-Ruault, Marie-Christine
    Mancini, Francesca
    Artaud, Fanny
    Kühn, Tilman
    Katzke, Verena
    Trichopoulou, Antonia
    Naska, Androniki
    Orfanos, Philippos
    Tumino, Rosario
    Masala, Giovanna
    Krogh, Vittorio
    Santucci de Magistris, Maria
    Ocké, Marga C
    Brustad, Magritt
    Jensen, Torill Enget
    Skeie, Guri
    Rodríguez-Barranco, Miguel
    Huerta, José María
    Ardanaz, Eva
    Quirós, José Ramón
    Jakszyn, Paula
    Sonestedt, Emily
    Ericson, Ulrika
    Wennberg, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Key, Timothy J
    Aune, Dagfinn
    Riboli, Elio
    Weiderpass, Elisabete
    Bertéus Forslund, Heléne
    Timing of eating across ten European countries: results from the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study2019In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 22, no 2, p. 324-335Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To examine timing of eating across ten European countries.

    DESIGN: Cross-sectional analysis of the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study using standardized 24 h diet recalls collected during 1995-2000. Eleven predefined food consumption occasions were assessed during the recall interview. We present time of consumption of meals and snacks as well as the later:earlier energy intake ratio, with earlier and later intakes defined as 06.00-14.00 and 15.00-24.00 hours, respectively. Type III tests were used to examine associations of sociodemographic, lifestyle and health variables with timing of energy intake.

    SETTING: Ten Western European countries.

    SUBJECTS: In total, 22 985 women and 13 035 men aged 35-74 years (n 36 020).

    RESULTS: A south-north gradient was observed for timing of eating, with later consumption of meals and snacks in Mediterranean countries compared with Central and Northern European countries. However, the energy load was reversed, with the later:earlier energy intake ratio ranging from 0·68 (France) to 1·39 (Norway) among women, and from 0·71 (Greece) to 1·35 (the Netherlands) among men. Among women, country, age, education, marital status, smoking, day of recall and season were all independently associated with timing of energy intake (all P<0·05). Among men, the corresponding variables were country, age, education, smoking, physical activity, BMI and day of recall (all P<0·05).

    CONCLUSIONS: We found pronounced differences in timing of eating across Europe, with later meal timetables but greater energy load earlier during the day in Mediterranean countries compared with Central and Northern European countries.

    The full text will be freely available from 2020-02-01 09:57
  • 11. Johansson, G
    et al.
    Wikman, Å
    Åhrén, Ann-Marie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Underreporting of energy intake in repeated 24-hour recalls related to gender, age, weight status, day of interview, educational level, reported food intake, smoking habits and area of living.2001In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 4, no 4, p. 919-927Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aims of the present study were (1) to evaluate the degree to which underreporting of energy intake by repeated 24-hour recalls was related to gender, age, weight status, day of interview, educational level, smoking habits and area of living, and (2) to compare the dietary characteristics of underreporters with those of others. DESIGN: Cross-sectional study. Ten 24-hour recalls were performed during a one-year period. SETTING: The Västerbotten intervention programme of cardiovascular disease and diabetes in Northern Sweden. SUBJECTS: Ninety-four men and 99 women in four age groups: 30, 40, 50 and 60 years. RESULTS: The prevalence of men and women with a food intake level (FIL; reported energy intake divided by estimated basal metabolic rate) below 1.2 was 44% and 47%, respectively. The youngest age group had higher FIL values than the oldest age group for both men (1.5 versus 1.1) and women (1.4 versus 1.1). The prevalence and magnitude of underreporting were directly related to body mass index (BMI; correlation coefficient: -0.47 (men) and -0.55 (women)). Smokers had a lower FIL value (1.1) than non-smokers (1.3). The nutrient density was lower for the group with high FIL values for protein and calcium and higher for fat and sucrose. The upper FIL group often had higher intake frequencies and larger portion sizes than the lower FIL group. CONCLUSIONS: Underreporting of energy intake is prevalent when 24-hour recalls are used, but the prevalence differs between sub-groups in the population. BMI was the main predictor of underreporting but also old age and smoking seem to contribute in this aspect. Socially desirable food items were not underreported to the same extent as socially undesirable food items. The intake frequencies and portion sizes partly explained the differences in FIL.

  • 12.
    Johansson, Ingegerd
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Wikman, Å
    Biessy, C
    Riboli, E
    Kaaks, R
    Validation and calibration of food-frequency questionnaire measurements in the Northern Sweden Health and Disease cohort.2002In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 5, no 3, p. 487-96Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To evaluate the reproducibility of, and to compare and calibrate, diet measures by the Northern Sweden 84-item food-frequency questionnaire (FFQ) with measures from 24-hour diet recalls (24-HDR). DESIGN: Randomly selected respondents from the EPIC (diet-cancer) and MONICA (diet-cardiovascular disease) study cohort in Northern Sweden were invited to answer the FFQ twice over a one-year interval (FFQ1 and FFQ2), and to complete ten 24-hour recalls (reference method) in the months between. Plasma beta-carotene concentrations were determined from a subset of 47 participants. SETTING: Västerbotten and Norrbotten, Northern Sweden. PARTICIPANTS: Ninety-six men and 99 women, who completed the study. RESULTS: The reproducibility of the FFQ was high in terms of both mean energy and nutrient intakes and relative ranking of participants by intake levels (median Pearson correlation of 0.68). Moderately higher food intake frequencies were recorded by FFQ1 compared with 24-hour recalls for dairy products, bread/cereals, vegetables, fruits and potato/rice/pasta, whereas meat, fish, sweet snacks and alcoholic beverage intakes were lower. The median Spearman coefficient of correlation between FFQ1 and the average of ten 24-HDR measurements was 0.50. Daily energy and nutrient intakes were similar for FFQ1 and 24-HDR measurements, except for fibre, vitamin C, beta-carotene and retinol (FFQ1>24-HDR) and sucrose and cholesterol Pearson coefficients of correlation between FFQ1 and 24-HDR corrected for attenuation due to residual day-to-day variation in the 24-HDR measurements ranged from 0.36 to 0.79 (median 0.54). Adjustment for energy had only very moderate effects on the correlation estimates. Calibration coefficients estimated by linear regression of the 24-HDR on the FFQ1 measurements varied between 0.30 and 0.59 for all nutrients except alcohol, which had calibration coefficients close to 1.0. These low calibration coefficients indicate that relative risk estimates corresponding to an absolute difference in dietary intake levels measured by the FFQ will generally be biased towards 1.0. Plasma beta-carotene levels had a Pearson coefficient of correlation of 0.47 with the 24-HDR measurements, and of 0.23 with FFQ1 measurements. CONCLUSIONS: The Northern Sweden FFQ measurements have good reproducibility and an estimated level of validity similar to that of FFQ measurements in other prospective cohort studies. The results from this study will form the basis for the correction of attenuation and regression dilution biases in relative risk estimates, in future studies relating FFQ measurements to disease outcomes.

  • 13. Julian, Cristina
    et al.
    Mouratidou, Theodora
    Vicente-Rodriguez, Germán
    Gracia-Marco, Luis
    Valtueña, Jara
    González-Gross, Marcela
    Ferrari, Marika
    Gottrand, Frederic
    Manias, Yannis
    de la O, Alejandro
    Widhalm, Kurt
    Molnár, Dénes
    Kafatos, Antonios
    Sjöström, Michael
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Kersting, Mathilde
    Gunter, Marc J.
    De Henauw, Stefaan
    Moreno, Luis A.
    Huybrechts, Inge
    Dietary sources and sociodemographic and lifestyle factors affecting vitamin D and calcium intakes in European adolescents: the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Study2017In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 20, no 9, p. 1593-1601Article in journal (Refereed)
    Abstract [en]

    Objective; To investigate dietary sources of Ca and vitamin D (VitD) intakes, and the associated sociodemographic and Lifestyle Factors, among European adolescents. Design: Linear regression mixed models were used to examine sex-specific associations of Ca and Via) intakes with parental education, family affluence (FAS), physical activity and television (TV) watching while controlling for age, Tanner stage, energy intake and diet quality. Setting: The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Cross-Sectional Study. Subjects: Adolescents aged 12.5-17.5 years In 1804). Results: Milk and cheese were the main sources of Ca (23 and 19% contribution to overall Ca intake, respectively). Fish products were the main VitD source (30 % contribution to overall VitD intake). Ca intake was positively associated with maternal education (beta) =56.41; 95% Cl 1.98, 110.82) and negatively associated with TV viewing in boys (beta=-0.43; 95% CI -0.79, -0.07); however, the significance of these associations disappeared when adjusting for diet quality. In girls, Ca intake was positively associated with mother's (beta=73.08; 95% CI 34.41, 111.74) and father's education (beta =43.29; 95% CI 5.44, 81.14) and FAS (beta=37.45; 95% Cl 2.25, 72.65). This association between Ca intake and mother's education remained significant after further adjustment for diet quality (beta=41.66; 95 % CI 0.94, 82.38). Girls with high-educated mothers had higher Ca intake. Conclusions: Low-educated families with poor diet quality may be targeted when strategizing health promotion programmes to enhance dietary Ca.

  • 14. Kimani-Murage, Elizabeth W.
    et al.
    Kahn, Kathleen
    Pettifor, John M.
    Tollman, Stephen M.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Klipstein-Grobusch, Kerstin
    Norris, Shane A.
    Predictors of adolescent weight status and central obesity in rural South Africa2011In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 14, no 6, p. 1114-1122Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate predictors of adolescent obesity in rural South Africa. Design: Cross-sectional study. Height, weight and waist circumference were measured using standard procedures. Overweight and obesity in adolescents aged 10-17 years were assessed using the International Obesity Taskforce cut-offs, while the WHO adult cut-offs were used for participants aged 18-20 years. Waist-to-height ratio of >0.5 defined central obesity in those at Tanner stages 3-5. Linear and logistic regression analysis was used to evaluate risk factors. Setting: Agincourt sub-district, rural South Africa. Subjects: Participants (n 1848) were aged 10-20 years. Results: Combined overweight and obesity was higher in girls (15%) than boys (4%), as was central obesity (15% and 2%, respectively). With regard to overweight/obesity, fourfold higher odds were observed for girls and twofold higher odds were observed for participants from households with the highest socio-economic status (SES). The odds for overweight/obesity were 40% lower if the household head had not completed secondary level education. For central obesity, the odds increased 10% for each unit increase in age; girls had sevenfold higher odds v. boys; postpubertal participants had threefold higher odds v. pubertal participants; those with older mothers aged 501 years had twofold higher odds v. those whose mothers were aged 35-49 years; those in highest SES households had twofold higher odds v. those in lowest SES households. Conclusions: In rural South Africa, adolescent females are most at risk of obesity which increases with age and appears to be associated with higher SES. To intervene effectively, it is essential to understand how household factors influence food choice, diet and exercise.

  • 15. Klingberg, Sofia
    et al.
    Winkvist, Anna
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Faculty of Medicine, Department of Biobank Research.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Evaluation of plant sterol intake estimated with the Northern Sweden FFQ2013In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 16, no 3, p. 460-467Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate plant sterol intake estimated with the eighty-four-item Northern Sweden FFQ against repeated 24 h dietary recalls (24-HDR) as the reference method. Design: Randomly recruited participants from the Vasterbotten Intervention Programme (VIP) responded to an FFQ (FFQ1). Over the subsequent 12 months, ten repeated 24-HDR were carried out. After this, a second FFQ (FFQ2) was completed. Setting: Vasterbotten county, northern Sweden. Subjects: Ninety-six men and ninety-nine women. Results: The Pearson correlation coefficient for absolute total plant sterol intake estimated with FFQ1 and 24-HDR was 0.58 and 0.55 for the men and women, respectively. Cross-classification of participants into quartiles of absolute plant sterol intake estimated with FFQ1 and 24-HDR showed that 90% of the men and 83% of the women were classified into the same or an adjacent quartile. For energy-adjusted plant sterol intake, 71% of the men and 74% of the women were classified into the same or an adjacent quartile. The agreement for cross-classification of participants into quartiles between FFQ1 and FFQ2 was good for both absolute and energy-adjusted plant sterol intake. Conclusions: The FFQ is able to capture absolute plant sterol intake to the same extent as other nutrients, and to rank individuals according to both their absolute and energy-adjusted plant sterol intake. The reproducibility of the FFQ was good, suggesting that the method is reliable. This makes it possible to use plant sterol data from the FFQ in large-scale studies of the association between plant sterol intake and disease.

  • 16.
    Krachler, Benno
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Eliasson, Mats
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Trends in food intakes in Swedish adults 1986-1999: findings from the Northern Sweden MONICA (Monitoring of Trends and Determinants in Cardiovascular Disease) Study.2005In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 8, no 6, p. 628-635Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To determine changes in reported food frequency in adults between 1986 and 1999. DESIGN: Four consecutive cross-sectional surveys. SETTING: Counties of Norrbotten and Västerbotten, Northern Sweden. SUBJECTS: The Northern Sweden MONICA (Monitoring of Trends and Determinants in Cardiovascular Disease) population, four independent cross-sectional surveys in 1986, 1990, 1994 and 1999. Randomly selected age-stratified samples of the population aged 25-64 years. Analysis is based on 2982 males and 3087 females who completed an 84-item food-frequency questionnaire. RESULTS: Between 1986 and 1999, average reported consumption of 3%-fat milk decreased from 42 to 7 intakes month(-1) in men and from 28 to 4 intakes month(-1) in women. Reported use of 1.5%-fat milk increased from 6 to 27 intakes month(-1) in men and from 6 to 24 in women. Monthly intakes of potatoes and root vegetables decreased from 38 to 27 in men and from 39 to 32 in women. Consumption of pasta increased from 4 to 7 intakes month(-1) in both sexes. Intakes of solid fats with 80% fat content dropped from 92 to 62 per month in men and from 78 to 52 per month in women, whereas use of 40%-fat spread increased from 12 to 22 intakes month(-1) in men and from 5 to 26 in women. Monthly intakes of vegetable oil increased from 3 to 12 in men and from 3 to 15 in women. The percentage of overweight or obese individuals (body mass index >25 kg m(-2)) increased from 52 to 65% in men and from 41 to 52% in women (P for linear trend in all these changes, <0.001). CONCLUSIONS: Our data indicate reduced consumption of foods with a high content of saturated fats. In spite of that, there is an unbroken trend towards increased obesity.

  • 17. Kyrø, Cecilie
    et al.
    Skeie, Guri
    Dragsted, Lars O
    Christensen, Jane
    Overvad, Kim
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Lund, Eiliv
    Slimani, Nadia
    Johnsen, Nina F
    Halkjær, Jytte
    Tjønneland, Anne
    Olsen, Anja
    Intake of whole grains in Scandinavia is associated with healthy lifestyle, socio-economic and dietary factors2011In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 14, no 10, p. 1787-1795Article in journal (Refereed)
    Abstract [en]

    Objective: To identify the dietary, lifestyle and socio-economic factors associated with the intake of whole grains (WG) in Norway, Sweden and Denmark.

    Design: A cross-sectional study.

    Setting: Subsample of the Scandinavian cohort ‘HELGA’ consisting of three prospective cohorts: The Norwegian Women and Cancer Study; The Northern Sweden Health and Disease Study; and the Danish Diet, Cancer and Health Study.

    Subjects: A total of 8702 men and women aged 30–65 years. Dietary data are from one 24 h dietary recall and data on socio-economic status and lifestyle factors including anthropometric values are from the baseline collection of data.

    Results: Vegetables, fruits, dairy products, fish and shellfish, coffee, tea and margarine were directly associated with the intake of WG, whereas red meat, white bread, alcohol and cakes and biscuits were inversely associated. Smoking and BMI were consistently inversely associated with the intake of WG. Furthermore, length of education was directly associated with the intake of WG among women.

    Conclusions: The intake of WG was found to be directly associated with healthy diet, lifestyle and socio-economic factors and inversely associated with less healthy factors, suggesting that these factors are important for consideration as potential confounders when studying WG intake and disease associations.

  • 18.
    Larsson, Christel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Klock, K
    Nordrehaug Åstrøm, A
    Johansson, Gunnar
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Food habits of young Swedish and Norwegian vegetarians and omnivores2001In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 4, no 5, p. 1005-1014Article in journal (Refereed)
    Abstract [en]

    Objective: To determine the prevalence of vegetarianism and compare food habits among vegetarian and omnivorous adolescents in Sweden and Norway.

    Design: Cross-sectional study by questionnaire in Sweden and Norway to gather information about food habits.

    Setting: The municipalities of Umeå and Stockholm in Sweden, and Bergen in Norway.

    Subjects: In total 2041 ninth-grade students (578 from Umeå, 504 from Stockholm and 959 from Bergen), mean age 15.5 years, were included. The response rate was 95% in Umeå, 91% in Stockholm and 83% in Bergen.

    Results: There was a significantly higher prevalence of vegetarianism in Umeå (15.6%) than in Stockholm (4.8%) and Bergen (3.8%). Vegetarians generally wanted more information about a healthy diet and vegetarian females ate dietary supplements to prevent deficiencies more often than omnivorous females (P < 0.01). The young male vegetarians more or less excluded animal products from their diet without changing their food frequency intake or modifying their dietary habits in other respects, while the young female vegetarians more often consumed vegetables and dietary supplements (P < 0.05). However, there was no difference between the intake of fruits/berries, alcoholic beverages, ice cream, sweets/chocolates and fast foods by vegetarians compared with omnivores.

    Conclusions: There were three to four times more vegetarians in Umeå than in Stockholm and Bergen. The food habits of the young vegetarians differed from those of omnivorous adolescents and also in some respects from previously published comparative studies of vegetarians' and omnivores' food habits. It is uncertain whether the health benefits shown in previous studies on vegetarianism will be experienced by this young generation of vegetarians.

  • 19. Nyholm, Maria
    et al.
    Lissner, Lauren
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, School of Dentistry.
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Faculty of Medicine, Department of Biobank Research.
    Weinehall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Winkvist, Anna
    Exploring dietary patterns, obesity and sources of bias: the Västerbotten Intervention Programme (VIP)2013In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 16, no 4, p. 631-638Article in journal (Refereed)
    Abstract [en]

    Objective: Dietary patterns capture the overall diet and thereby provide information on how nutrients are consumed in combinations, and have been suggested to be a better method than studying single nutrients. The present study explored the relationship between dietary patterns at baseline and incidence of obesity at 10-year follow-up in women.

    Design: A longitudinal study using baseline measurements from 1992-1996, including food intake, medication, heredity, socio-economic status, lifestyle and measured body composition, and follow-up data collected in 2002-2006 including measured body composition.

    Setting: Data from the Västerbotten Intervention Programme (VIP) in Sweden.

    Subjects: A total of 6545 initially non-obese women aged 30-50 years.

    Results: Among women reporting plausible energy intakes, the 'Fruit and vegetables cluster' predicted the highest incidence of obesity (OR = 1·76, 95 % CI 1·11, 2·76; P = 0·015) compared with women in the other food pattern groups combined. When adjusting for metabolic factors and BMI at baseline, the risk for obesity in the 'Fruit and vegetables cluster' was attenuated to non-significance. In contrast, high intake of fruit per se was associated with a decreased risk of developing obesity (OR = 0·69, 95 % CI 0·51, 0·91; P = 0·010).

    Conclusions: Dietary pattern groups identified by cluster analysis are likely to reflect characteristics in addition to diet, including lifestyle, previous and current health status and risk factors for future disease, whereas intake of fruit per se was a stable indicator and less affected by baseline characteristics. These results underscore the need for complementary methods in understanding diet-disease relationships.

  • 20. Orfanos, Philippos
    et al.
    Naska, Androniki
    Trichopoulos, Dimitrios
    Slimani, Nadia
    Ferrari, Pietro
    van Bakel, Marit
    Deharveng, Genevieve
    Overvad, Kim
    Tjønneland, Anne
    Halkjær, Jytte
    Santucci de Magistris, Maria
    Tumino, Rosario
    Pala, Valeria
    Sacerdote, Carlotta
    Masala, Giovanna
    Skeie, Guri
    Engeset, Dagrun
    Lund, Eiliv
    Jakszyn, Paula
    Barricarte, Aurelio
    Chirlaque, Maria-Dolores
    Martinez-Garcia, Carmen
    Amiano, Pilar
    Quirós, J Ramon
    Bingham, Sheila
    Welch, Ailsa
    Spencer, Elizabeth A
    Key, Timothy J
    Rohrmann, Sabine
    Linseisen, Jakob
    Ray, Jennifer
    Boeing, Heiner
    Peeters, Petra H
    Bueno-de-Mesquita, H Bas
    Ocke, Marga
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Odontology, Cariology.
    Johansson, Gerd
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Nutritional Research.
    Berglund, Göran
    Manjer, Jonas
    Boutron-Ruault, Marie-Christine
    Touvier, Mathilde
    Clavel-Chapelon, Françoise
    Trichopoulou, Antonia
    Eating out of home and its correlates in 10 European countries. The European Prospective Investigation into Cancer and Nutrition (EPIC) study.2007In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 10, no 12, p. 1515-1525Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To compare the average out-of-home (OH) consumption of foods and beverages, as well as energy intake, among populations from 10 European countries and to describe the characteristics of substantial OH eaters, as defined for the purpose of the present study, in comparison to other individuals. DESIGN: Cross-sectional study. Dietary data were collected through single 24-hour dietary recalls, in which the place of consumption was recorded. For the present study, substantial OH eaters were defined as those who consumed more than 25% of total daily energy intake at locations other than the household premises. Mean dietary intakes and the proportion of substantial OH eaters are presented by food group and country. Logistic regression analyses were used to estimate the odds of being a substantial OH eater in comparison to not being one, using mutually adjusted possible non-dietary determinants. SETTING: Ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). SUBJECTS: The subjects were 34 270 individuals, 12 537 men and 21 733 women, aged 35-74 years. RESULTS: The fraction of energy intake during OH eating was generally higher in northern European countries than in the southern ones. Among the food and beverage groups, those selectively consumed outside the home were coffee/tea/waters and sweets and, to a lesser extent, cereals, meats, added lipids and vegetables. Substantial OH eating was positively associated with energy intake and inversely associated with age and physical activity. Substantial OH eating was less common among the less educated compared with the more educated, and more common during weekdays in central and north Europe and during the weekend in south Europe. CONCLUSIONS: Eating outside the home was associated with sedentary lifestyle and increased energy intake; it was more common among the young and concerned in particular coffee/tea/waters and sweets.

  • 21.
    Prawirohartono, Endy P
    et al.
    Department of Child Health, Medical School, Gadjah Mada University, Sardjito Hospital, Jalan Kesehatan no. 1, Sekip, Yogyakarta 55284, Indonesia.
    Nyström, Lennarth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Ivarsson, Anneli
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Lind, Torbjörn
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    The impact of prenatal vitamin A and zinc supplementation on growth of children up to 2 years of age in rural Java, Indonesia.2011In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 14, no 12, p. 2197-2206Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To determine whether prenatal vitamin A and/or Zn supplementation affects postnatal growth. DESIGN: Follow-up of a randomized controlled trial monitoring growth in children from birth up to 24 months of age. SETTING: Central Java, Indonesia. SUBJECTS: Children (n 343) of mothers participating in a double-blinded, randomized controlled study of vitamin A and/or Zn supplementation during pregnancy. We report the effects of prenatal supplementation on infant growth, measured as weight-for-age Z-scores (WAZ), height-for-age Z-scores (HAZ) and weight-for-height Z-scores (WHZ ), from 0 to 24 months, as well as differences in growth faltering among the supplementation groups. RESULTS: For HAZ, the absolute differences between the vitamin A-only and vitamin A + Zn groups at 3 and 9 months were 0·34 sd and 0·37 sd, respectively, and the absolute difference between the vitamin A-only and Zn-only groups at 18 months was 0·31 sd. Compared with placebo, none of the supplements affected growth. Defining growth faltering as a downward crossing of two or more major percentile lines, 50-75 % of the children were found to be growth faltering within 9 months of age, whereas 17 % and 8 % scored <-2 sd for WAZ and HAZ, respectively. Prenatal supplementation did not reduce the prevalence of growth faltering. CONCLUSIONS: Prenatal vitamin A supplementation had a small but significant effect on postnatal growth of children's length until 18 months of age compared with supplementation with either vitamin A + Zn or Zn alone, but not compared with placebo. It had no effects on other anthropometric measures and did not reduce the prevalence of growth faltering. Future studies should duplicate these findings before recommendations can be made.

  • 22. Roswall, Nina
    et al.
    Olsen, Anja
    Boll, Katja
    Christensen, Jane
    Halkjær, Jytte
    Sørensen, Thorkild Ia
    Dahm, Christina C
    Overvad, Kim
    Clavel-Chapelon, Françoise
    Boutron-Ruault, Marie C
    Cottet, Vanessa
    Teucher, Birgit
    Kaaks, Rudolf
    Boeing, Heiner
    von Ruesten, Anne
    Trichopoulou, Antonia
    Oikonomou, Eleni
    Vasilopoulou, Effie
    Pala, Valeria
    Sacerdote, Carlotta
    Mattiello, Amalia
    Masala, Giovanna
    Peeters, Petra Hm
    Bueno-de-Mesquita, H Bas
    Engeset, Dagrun
    Skeie, Guri
    Åsli, Lene A
    Amiano, Pilar
    Jakszyn, Paula
    Ardanaz, Eva
    Huerta, José M
    Quirós, José R
    Molina-Montes, Esther
    Nilsson, Lena Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Wirfält, Elisabet
    Drake, Isabel
    Mulligan, Angela A
    Khaw, Kay T
    Romaguera, Dora
    Vergnaud, Anne-Claire
    Key, Tim
    Riboli, Elio
    Tjønneland, Anne
    Consumption of predefined 'Nordic' dietary items in ten European countries: an investigation in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort2014In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 17, no 12, p. 2650-2659Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Health-beneficial effects of adhering to a healthy Nordic diet index have been suggested. However, it has not been examined to what extent the included dietary components are exclusively related to the Nordic countries or if they are part of other European diets as well, suggesting a broader preventive potential. The present study describes the intake of seven a priori defined healthy food items (apples/pears, berries, cabbages, dark bread, shellfish, fish and root vegetables) across ten countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) and examines their consumption across Europe. DESIGN: Cross-sectional study. A 24 h dietary recall was administered through a software program containing country-specific recipes. Sex-specific mean food intake was calculated for each centre/country, as well as percentage of overall food groups consumed as healthy Nordic food items. All analyses were weighted by day and season of data collection. SETTING: Multi-centre, European study. SUBJECTS: Persons (n 36 970) aged 35-74 years, constituting a random sample of 519 978 EPIC participants. RESULTS: The highest intakes of the included diet components were: cabbages and berries in Central Europe; apples/pears in Southern Europe; dark bread in Norway, Denmark and Greece; fish in Southern and Northern countries; shellfish in Spain; and root vegetables in Northern and Central Europe. Large inter-centre variation, however, existed in some countries. CONCLUSIONS: Dark bread, root vegetables and fish are strongly related to a Nordic dietary tradition. Apples/pears, berries, cabbages, fish, shellfish and root vegetables are broadly consumed in Europe, and may thus be included in regional public health campaigns.

  • 23.
    Rydén, Petra
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Hagfors, Linda
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Diet cost, diet quality and socio-economic position: how are they related and what contributes to differences in diet costs?2011In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 14, no 9, p. 1680-1692Article in journal (Refereed)
    Abstract [en]

    Objective: To examine diet costs in relation to dietary quality and socio-economic position, and to investigate underlying reasons for differences in diet costs.

    Design: Dietary intake was assessed by a 4 d food diary and evaluated using the 2005 Healthy Eating Index (HEI). National consumer food prices collected by Statistics Sweden and from two online stores/supermarkets were used to estimate diet costs.

    Setting: Sweden.

    Subjects: A nationally representative sample of 2160 children aged 4, 8 or 11 years.

    Results: Higher scores on the HEI resulted in higher diet costs and, conversely, higher diet costs were linked to increased total HEI scores. Children who consumed the most healthy and/or expensive diets ate a more energy-dilute and varied diet compared with those who ate the least healthy and/or least expensive diets. They also consumed more fish, ready meals and fruit. Regression analysis also linked increased food costs to these food groups. There was a positive, but weak, relationship between HEI score and diet cost, parental education and parental occupation respectively.

    Conclusions: Healthy eating is associated with higher diet cost in Swedish children, in part because of price differences between healthy and less-healthy foods. The cheapest and most unhealthy diets were found among those children whose parents were the least educated and had manual, low-skill occupations. Our results pose several challenges for public health policy makers, as well as for nutrition professionals, when forming dietary strategies and providing advice for macro- and microlevels in society.

  • 24. Schmeer, Kammi K.
    et al.
    Piperata, Barbara A.
    Herrera Rodriguez, Andres
    Salazar Torres, Virgilio Mariano
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Centro de Investigación en Demografía y Salud (CIDS), Universidad Nacional Autónoma de Nicaragua – León (UNAN-León), León, Nicaragua.
    Centeno Cardenas, Francisco Jose
    Maternal resources and household food security: evidence from Nicaragua2015In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 18, no 16, p. 2915-2924Article in journal (Refereed)
    Abstract [en]

    Objective: Women (especially mothers) are theorized as critical to reducing household food insecurity through their work and caregiver roles. The present study tests these assumptions, assessing how maternal economic and social resources are associated with food insecurity in households with young children. Design: Data from a population-based sample of households was collected in Leon, Nicaragua (n 443). Data include a newly validated measure of household food insecurity (ELCSA), maternal resource measures, and household economic status and demographics. Regression analysis tests the statistical associations (P<0.05) of maternal resources with household, adult-specific and child-specific food insecurity. Setting: Municipality of Leon, Nicaragua. Subjects: Households with children aged 3-11 years in rural and urban Leon. Results: Only 25 % of households with young children were food secure, with 50 % mildly food insecure and 25 % moderately/severely food insecure. When mothers contributed substantially to household income, the odds of moderate/severe household food insecurity were 34 % lower than when their spouse/partner was the main provider. The odds of food insecurity were 60 % lower when mothers managed household money, 48 % lower when mothers had a secondary (v. primary) education, 65 % higher among single mothers and 16 % lower with each indicator of social support. Results were similar for adult-and child-specific food insecurity. Conclusions: This research provides new evidence that maternal economic and social resources are important for reducing household food insecurity and adult- and child-specific food insecurity. Women's social status, social support and access to economic resources need to be enhanced as a part of policies aimed to reduce food insecurity in high-poverty settings.

  • 25. Slimani, N
    et al.
    Kaaks, R
    Ferrari, P
    Casagrande, C
    Clavel-Chapelon, F
    Lotze, G
    Kroke, A
    Trichopoulos, D
    Trichopoulou, A
    Lauria, C
    Bellegotti, M
    Ocké, MC
    Peeters, PH
    Engeset, D
    Lund, E
    Agudo, A
    Larranaga, N
    Mattisson, I
    Andren, C
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Odontology, Cariology.
    Davey, G
    Welch, AA
    Overvad, K
    Tjonneland, A
    Van Staveren, WA
    Saracci, R
    Riboli, E
    European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study: rationale, design and population characteristics.2002In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 5, no 6B, p. 1125-1145Article in journal (Refereed)
    Abstract [en]

    The European Prospective Investigation into Cancer and Nutrition (EPIC), which covers a large cohort of half a million men and women from 23 European centres in 10 Western European countries, was designed to study the relationship between diet and the risk of chronic diseases, particularly cancer. Information on usual individual dietary intake was assessed using different validated dietary assessment methods across participating countries. In order to adjust for possible systematic over- or underestimation in dietary intake measurements and correct for attenuation bias in relative risk estimates, a calibration approach was developed. This approach involved an additional dietary assessment common across study populations to re-express individual dietary intakes according to the same reference scale. A single 24-hour diet recall was therefore collected, as the EPIC reference calibration method, from a stratified random sample of 36 900 subjects from the entire EPIC cohort, using a software program (EPIC-SOFT) specifically designed to standardise the dietary measurements across study populations. This paper describes the design and populations of the calibration sub-studies set up in the EPIC centres. In addition, to assess whether the calibration sub-samples were representative of the entire group of EPIC cohorts, a series of subjects' characteristics known possibly to influence dietary intakes was compared in both population groups. This was the first time that calibration sub-studies had been set up in a large multi-centre European study. These studies showed that, despite certain inherent methodological and logistic constraints, a study design such as this one works relatively well in practice. The average response in the calibration study was 78.3% and ranged from 46.5% to 92.5%. The calibration population differed slightly from the overall cohort but the differences were small for most characteristics and centres. The overall results suggest that, after adjustment for age, dietary intakes estimated from calibration samples can reasonably be interpreted as representative of the main cohorts in most of the EPIC centres.

  • 26.
    Svensson, Åsa
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Renström, Frida
    Bluck, Les
    Lissner, Lauren
    Franks, Paul W.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition. Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Dietary intake assessment in women with different weight and pregnancy status using a short questionnaire2014In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 17, no 9, p. 1939-1948Article in journal (Refereed)
    Abstract [en]

    Objective: First, to evaluate the ability of a short dietary questionnaire (SDQ) to estimate energy intake (EI) on group and individual levels compared with total energy expenditure (TEE) measured by the doubly labelled water method. Second, to compare the SDQ's performance in estimating energy, nutrient and food intakes with a sixty-six-item FFQ used in large-scale Swedish epidemiological research. Design: Cross-sectional. Setting: Umea, Sweden. Subjects: In total, sixty-five non-pregnant women, of whom thirty-one were overweight or obese, and twenty-five pregnant, normal-weight women completed the protocol. Results: On average, the SDQ captured 78% and 79% of absolute TEE in the non-pregnant and pregnant normal-weight women, respectively. Furthermore, the SDQ captured an average of 57% of TEE in the overweight/obese nonpregnant women. The Spearman correlation of EI and TEE was significant in the overweight and obese women only (rho=0.37, 95% CI 0.02, 0.64). There was no significant difference between the SDQ and the more extensive FFQ in the ability to assess EI when compared with TEE. Intakes of most nutrients and foods were significantly higher when assessed with the SDQ compared with the FFQ. Conclusions: A new short dietary questionnaire with an alternative design underestimated EI of non-pregnant and pregnant, overweight and obese women on a group level but was able to rank the overweight/obese women according to EI. Furthermore, the short questionnaire captured as much or more of the energy, nutrient and food intakes of non-pregnant normal-weight and overweight/obese women on the group level as a traditional, more extensive FFQ.

  • 27.
    Tesfaye, Fikru
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Wall, Stig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Concurrent comparison of energy intake and expenditure among adults in Butajira District, Ethiopia2008In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 11, no 7, p. 675-683Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To estimate and compare dietary energy intake (DEI) and total energy expenditure (TEE) among adults, using questionnaires. DESIGN: Comparative, cross-sectional study. SETTING: Community-based, at the demographic surveillance site (DSS) in Butajira District of Ethiopia. SUBJECTS: A total of 619 adults, 18-64 years of age, were randomly selected from among the urban and rural population of Butajira using the DSS sampling frame. Habitual dietary intake and physical activity were assessed using questionnaires. BMR was estimated using a regression equation, and TEE was calculated from BMR and the metabolic energy equivalent task (MET) and duration of reported activities. Physical activity level (PAL) was calculated as TEE/BMR, while food intake level (FIL) was calculated as DEI/BMR. The mean DEI:TEE ratio was used to evaluate reported DEI at the population level, while individual misreporters were identified by applying the Goldberg cut-off points at three levels of PAL. RESULTS: Based on the Goldberg method, 57% of the study participants were identified as acceptable reporters of DEI, among whom mean TEE was 8.21 (95% CI 8.01, 8.42) MJ (1963 (95% CI 1914, 2012) kcal), mean DEI was 8.13 (95% CI 7.93, 8.34) MJ (1944 (95% CI 1895, 1993) kcal) and mean DEI:TEE was 1.01 (95% CI 0.99, 1.04). CONCLUSION: The dietary history and physical activity questionnaires provide comparable estimates of mean energy intake and expenditure at a population level. Acceptable reporters have to be identified in order to obtain better estimates. Questionnaire-based estimates of energy intake should not be interpreted without an inherent system of comparison or validation.

  • 28. Wahlin, Ake
    et al.
    Bäckman, Lars
    Hultdin, Johan
    Adolfsson, Rolf
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Nilsson, Lars-Göran
    Reference values for serum levels of vitamin B12 and folic acid in a population-based sample of adults between 35 and 80 years of age.2002In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 5, no 3, p. 505-11Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To examine folic acid and vitamin B12 status in a group of 1000 persons sampled from the community of Umeå, Sweden, and aged 35, 40, 45, 50, 55, 60, 65, 70, 75 or 80 years. Reference data for folate and age-stratified reference data for vitamin B12 are presented, together with an examination of potential confounders. MEASUREMENTS: All subjects participated in extensive health examinations and interviews, and laboratory blood testing was performed. RESULTS: A series of exclusion criteria were applied, and data from 961 subjects were analysed. Vitamin B12 levels were found to decrease with increasing age, whereas folate levels remained constant across the age span studied. None of the vitamins was found to vary with sex, education, smoking or alcohol consumption, body mass index, prescription-free vitamin supplements, level of haemoglobin, or mean cell volume of erythrocytes. Further, none of these factors was associated with the age-related decrease of vitamin B12 level. CONCLUSIONS: The offered reference ranges should be used only in order to rule out deficiency. For B12 levels, the age of the subject should be considered such that, for elderly people in particular, values above the medians should be considered as indicative of normal vitamin status.

  • 29.
    Wennberg, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Gustafsson, Per E
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Wennberg, Patrik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Poor breakfast habits in adolescence predict the metabolic syndrome in adulthood2015In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 18, no 1, p. 122-129Article in journal (Refereed)
    Abstract [en]

    Objective: To analyse whether poor breakfast habits in adolescence predict the metabolic syndrome and its components in adulthood. Previous studies suggest that regular breakfast consumption improves metabolic parameters. Design: Prospective. Breakfast habits and other lifestyle variables at age 16 years were assessed from questionnaires. Poor breakfast habits were defined as skipping breakfast or only drinking or eating something sweet. At age 43 years, the effective sample consisted of 889 participants defined as having the metabolic syndrome or not, using the International Diabetes Federation criteria. Logistic regression was used to calculate odds ratios and confidence intervals. Setting: The Northern Swedish Cohort, a longitudinal population-based cohort with 27-year follow-up. Subjects: Adolescents (age 16 years). Results: Prevalence of the metabolic syndrome at age 43 years was 27.0%. Of the participants, 9.9% were classified with poor breakfast habits at age 16 years. Adjusted odds for the metabolic syndrome at age 43 years was OR = 1.68 (95% CI 1.01, 2.78) for those with poor breakfast habits at age 16 years compared with breakfast eaters. Looking at the metabolic syndrome components, poor breakfast habits at age 16 years were associated with central obesity (OR = 1.71; 95% CI 1.00, 2.92) and high fasting glucose (OR = 1.75; 95% CI 1.01, 3.02) at age 43 years, even after multivariate adjustments. Conclusions: Poor breakfast habits in adolescence predicted the metabolic syndrome in adulthood. Of the metabolic syndrome components, poor breakfast habits in adolescence predicted central obesity and high fasting glucose in adulthood. Further research is needed to fully understand the relationship between early breakfast habits and adult metabolic syndrome.

  • 30.
    Wennberg, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Social medicine.
    Gustafsson, Per
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Social medicine.
    Wennberg, Patrik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Social medicine.
    Irregular eating of meals in adolescence and the metabolic syndrome in adulthood: results from a 27-year prospective cohort2016In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 19, no 3, p. 667-673Article in journal (Refereed)
    Abstract [en]

    Objective: The objective was to investigate whether irregular eating of meals in adolescence predicts the metabolic syndrome and its components in adulthood, and if any specific meal is of particular importance. Design: Prospective cohort study with 27 years of follow-up. Information on meals (breakfast, school lunch and dinner with family), lifestyle (alcohol consumption, smoking habits, physical activity, consumption of sweets and pastries) at age 16 years was assessed from questionnaires, and presence or not of the metabolic syndrome and its components were defined at age 43 years in 889 participants (82.1 % of total cohort). Logistic regression was used to calculate odds ratios and confidence intervals. Setting: The Northern Swedish Cohort; all school-leavers of the 9th grade in the town Lulea in 1981. Subjects: Adolescents (age 16 years). Results: Irregular eating of meals at age 16 years was associated with higher prevalence of the metabolic syndrome at age 43 years (OR=1.74; 95 % CI 1.12, 2.71), but this was explained by concurrent unhealthy lifestyle at age 16 years. Poor breakfast at age 16 years was the only meal associated with the metabolic syndrome at age 43 years, independent of other meals, BMI (kg/m2) and lifestyle at age 16 years (OR = 1.67; 95 % CI 1.00, 2.80). Conclusions: Irregular eating of meals in adolescence predicted the metabolic syndrome in adulthood, but not independently of BMI and lifestyle in adolescence. Poor breakfast in adolescence was the only specific meal associated with future metabolic syndrome, even after adjustments. Breakfast eating should be encouraged in adolescence.

  • 31.
    Wennberg, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Vessby, Bengt
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Evaluation of relative intake of fatty acids according to the Northern Sweden FFQ with fatty acid levels in erythrocyte membranes as biomarkers2009In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, p. 1-8Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate the validity of the Northern Sweden eighty-four-item FFQ to estimate intake of fatty acids relative to 24 h diet recalls (24-HDR) and fatty acids in erythrocyte membranes.

    DESIGN: Participants, randomly recruited from the population-based Västerbotten Intervention Project, answered the eighty-four-item FFQ. During the following year each participant carried out ten 24-HDR. Intake of fatty acids measured by the FFQ was compared with intake by the 24-HDR and fatty acid levels in erythrocytes.

    SETTING: The county of Västerbotten in northern Sweden.

    SUBJECTS: Ninety-six men and ninety-nine women.

    RESULTS: Spearman correlation coefficients (rs) between intakes of the fatty acids 14 : 0, 15 : 0, 16 : 0, 17 : 0, 18 : 2n-6, 18 : 3n-3, 20 : 5n-3 and 22 : 6n-3 estimated by the FFQ and the 24-HDR were all significant and ranged from 0.29 (22 : 6n-3 in men and women) to 0.60 (16 : 0 in men), whereas significant correlations between FFQ-estimated intake and erythrocyte membrane content were only seen for milk fatty acids 14 : 0, 15 : 0 and 17 : 0 (rs = 0.23-0.34) and fish fatty acids 20 : 5n-3 and 22 : 6n-3 (rs = 0.42-0.51).

    CONCLUSION: The Northern Sweden eighty-four-item FFQ gives a satisfactory estimate of the intake of fish fatty acids (20 : 5n-3 and 22 : 6n-3) and milk fatty acids (15 : 0 and 17 : 0), whereas its validity for fatty acids 18 : 2n-6 and 18 : 3n-3, derived mainly from vegetable oils, cannot be shown.

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