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  • 1. Adamsson, Viola
    et al.
    Ellegård, Lasse
    Rossander Hulthén, Lena
    Hambraeus, Leif
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Validity of reported energy intake and energy expenditure of Swedish elite cross-country skiers2004In: Public Health Nutrition 8th Nordic Nutrition Conference, Tønsberg, Norway, 2004Conference paper (Other (popular science, discussion, etc.))
  • 2. Adamsson, Viola
    et al.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Viktigt att granska kostundersökningar2005In: Svensk Idrottsmedicin, ISSN 1103-7652, no 2, 14-17 p.Article in journal (Other academic)
  • 3.
    Ahlgren, Christina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Hammarström, Anne
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Sandberg, Susanne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    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 .
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Engagement in New Dietary Habits: Obese Women's Experiences from Participating in a 2-Year Diet Intervention2016In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 23, no 1, 84-93 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Dietary weight loss interventions most often result in weight loss, but weight maintenance on a long-term basis is the main problem in obesity treatment. There is a need for an increased understanding of the behaviour patterns involved in adopting a new dietary behavior and to maintain the behaviour over time.

    PURPOSE: The purpose of this paper is to explore overweight and obese middle-aged women's experiences of the dietary change processes when participating in a 2-year-long diet intervention.

    METHODS: Qualitative semi-structured interviews with 12 overweight and obese women (54-71 years) were made after their participation in a diet intervention programme. The programme was designed as a RCT study comparing a diet according to the Nordic nutrition recommendations (NNR diet) and a Palaeolithic diet (PD). Interviews were analysed according to Grounded Theory principles.

    RESULTS: A core category "Engagement phases in the process of a diet intervention" concluded the analysis. Four categories included the informants' experiences during different stages of the process of dietary change: "Honeymoon phase", "Everyday life phase", "It's up to you phase" and "Crossroads phase". The early part of the intervention period was called "Honeymoon phase" and was characterised by positive experiences, including perceived weight loss and extensive support. The next phases, the "Everyday life phase" and "It's up to you phase", contained the largest obstacles to change. The home environment appeared as a crucial factor, which could be decisive for maintenance of the new dietary habits or relapse into old habits in the last phase called "Crossroads phase".

    CONCLUSION: We identified various phases of engagement in the process of a long-term dietary intervention among middle-aged women. A clear personal goal and support from family and friends seem to be of major importance for long-term maintenance of new dietary habits. Gender relations within the household must be considered as a possible obstacle for women engaging in diet intervention.

  • 4.
    Alvehus, Malin
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Ryberg, Mats
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Blomquist, Caroline
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Sandberg, Susanne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Ingegerd, Söderström
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Burén, Jonas
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Decreased TLR4 and Increased MIF Adipose Gene Expression Following Long-Term Diet InterventionManuscript (preprint) (Other academic)
  • 5.
    Boraxbekk, Carl-Johan
    et al.
    Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Umeå University, Faculty of Social Sciences, Centre for Population Studies (CPS).
    Stomby, Andreas
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Ryberg, Mats
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. Göteborgs Universitet.
    Nyberg, Lars
    Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI).
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Diet-Induced Weight Loss alters Functional Brain Responses during an Episodic Memory Task2015In: Obesity Facts, ISSN 1662-4025, E-ISSN 1662-4033, Vol. 8, 261-272 p.Article in journal (Refereed)
    Abstract [en]

    Objective: It has been suggested that overweight is negatively associated with cognitive functions. The aim of this study was to investigate whether a reduction in body weight by dietary interventions could improve episodic memory performance and alter associated functional brain responses in overweight and obese women. Methods: 20 overweight postmenopausal women were randomized to either a modified paleolithic diet or a standard diet adhering to the Nordic Nutrition Recommendations for 6 months. We used functional magnetic resonance imaging to examine brain function during an episodic memory task as well as anthropometric and biochemical data before and after the interventions. Results: Episodic memory performance improved significantly (p = 0.010) after the dietary interventions. Concomitantly, brain activity increased in the anterior part of the right hippocampus during memory encoding, without differences between diets. This was associated with decreased levels of plasma free fatty acids (FFA). Brain activity increased in pre-frontal cortex and superior/middle temporal gyri. The magnitude of increase correlated with waist circumference reduction. During episodic retrieval, brain activity decreased in inferior and middle frontal gyri, and increased in middle/superior temporal gyri. Conclusions: Diet-induced weight loss, associated with decreased levels of plasma FFA, improves episodic memory linked to increased hippocampal activity.

  • 6.
    Bäcklund, Catharina
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Sundelin, G
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Validation of SenseWear Pro2 Armband when assessing energy expenditure in overweight and obese children2008In: European Child Obesity Group conference, Porto, Portugal, 2008Conference paper (Other academic)
  • 7.
    Bäcklund, Catharina
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Effect of a 1-year lifestyle intervention on physical activity in overweight and obese children2011In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 13, no 3, 87-96 p.Article in journal (Refereed)
    Abstract [en]

    This study evaluated the effect of a family-based multifactor intervention programme on physical activity among overweight or obese children. Children (n = 105, mean age 10.6 ± 1.07 years) with overweight or obesity were randomized into an intervention or control group. The intervention group participated in a 1-year programme aiming at lifestyle changes regarding food habits and physical activity. All children's physical activity was measured using SenseWear Armband at baseline and after 1 year. The children in both groups had a physical activity level (PAL) of 1.67 (0.27) at baseline. When comparing the intervention and control groups, no significant differences were found in physical activity outcome variables after 1 year of intervention. Contrarily to the hypotheses, both groups decreased their energy expenditure and time spent at >3 MET, and there was no change in steps and screen time after 1 year. Despite extensive efforts, the intervention showed no significant positive effect on overweight and obese children's PAL. Further studies are needed to obtain more knowledge on how to maintain or increase the PAL successfully among overweight and obese children.

    Read More: http://informahealthcare.com/doi/abs/10.3109/14038196.2011.566353

  • 8.
    Bäcklund, Catharina
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Effects on physical activity of a 2-year lifestyle intervention in overweight and obese children2011In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 13, no 3, 97-109 p.Article in journal (Refereed)
    Abstract [en]

    The aim was to examine the effect on physical activity of a 2-year family-based lifestyle intervention among overweight and obese Swedish children 8–12 years of age; 105 children were randomized to either intervention or control group. The intervention group was offered a 2-year lifestyle programme. Physical activity was measured using SenseWear Pro2 Armband during 4 consecutive days before and after the intervention. When comparing the intervention and control groups, no significant differences were found in the physical activity outcome variables after 2 years of intervention. However, the intervention group decreased their number of steps per day by 13%, p = 0.003 but had an unchanged screen time, whereas the control group had an unchanged number of steps but increased their screen time by 15%, p = 0.02, from baseline to 2-year measurement. There were no significant change in the intervention group, whereas significantly fewer children in the control group achieved the physical activity recommendations at 2-year measurement (88%) compared with at baseline (98%), p = 0.007. Future interventions regarding physical activity among overweight and obese children are of great importance even though the present one showed limited effects. In the continuing work, a greater effect may be received with an extended and more intense intervention regarding physical activity, focusing on reducing sedentary time rather than increasing the physical activity level.

    Read More: http://informahealthcare.com/doi/abs/10.3109/14038196.2011.562540

  • 9.
    Bäcklund, Catharina
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Evaluation of 2-year family-based lifestyle intervention regarding physical activity among children with overweight and obesity2011Conference paper (Refereed)
  • 10.
    Bäcklund, Catharina
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Problems in enhancing physical activity among overweight and obese children2010Conference paper (Refereed)
    Abstract [en]

    Introduction: Physical inactivity is regarded as one of the main factors that have contributed to the rapid increase in prevalence of childhood obesity in recent decades. The aim of this study was to evaluate whether participation in a family-based multifactor intervention program could increase physical activity among overweight and obese children.

    Methods: 105 children, mean age 10.5 years (SD±1.09), with overweight and obesity living in northern Sweden were recruited and randomized into an intervention or control group. The intervention group was invited to participate in a program aiming at improving lifestyle regarding food habits and physical activity. The children’s physical activity was measured during 4 days at baseline and after 1 year with SenseWear Armband.

    Results: There were no statistically significant differences between the groups neither at either baseline or 1 year, regarding energy expenditure, steps/day, time being sedentary (< 3 MET), and time being active at different MET-levels. For all children, time being active ≥ 3 MET significantly decreased with 44.5 (111) min/d from baseline to 1-year. Despite the decrease in physical activity, the children were physically active ≥ 3 MET during 4.1 (1.6) h/d at 1-year.

    Conclusion: Physical activity decreased with increased age among overweight and obese children, despite extensive effort of intervention. To make future interventions worthwhile it is important to consider the participant’s physical activity level before entering the study, when planning and setting up the intervention program; to comprise the participant’s individual goals regarding physical activity; and to focus specifically on decreasing time being sedentary.

  • 11.
    Bäcklund, Catharina
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Validity of an armband measuring energy expenditure in overweight and obese children2010In: Medicine & Science in Sports & Exercise, ISSN 0195-9131, E-ISSN 1530-0315, Vol. 42, no 6, 1154-1161 p.Article in journal (Refereed)
    Abstract [en]

    Purpose: To examine the ability of the SenseWear Pro2 Armband (SWA) to accurately assess energy expenditure in free-living overweight or obese children during a two-week period, by comparison with energy expenditure measured using the doubly labeled water (DLW) method. A second aim was to examine which software version, Innerview Professional 5.1 or Sensewear Professional 6.0, are the most appropriate for use together with SWA in overweight and obese children.

    Method: A random sample of 22 healthy, overweight or obese children (11 girls and 11 boys) aged 8-11 years was recruited from an ongoing intervention study. Energy expenditure in free-living conditions was simultaneously assessed with the SWA and DLW methods during a 14-day period. All data from the SWA were analyzed using InnerView Professional software versions 5.1 (SWA 5.1) and 6.1 (SWA 6.1).

    Results: An accurate estimation in energy expenditure was obtained when SWA 5.1 was used, showing a non-statistically significant difference corresponding to 17 (1200) kJ[middle dot]d-1 compared with the energy expenditure measured using the DLW method. However, when SWA 6.1 was used a statistically significant (18%) underestimation of energy expenditure was obtained, corresponding to 1962 (1034) kJ[middle dot]d-1 compared with the DLW method.

    Conclusion: The SWA together with software version 5.1, but not 6.1, is a valid method for accurately measuring energy expenditure at group level of free-living overweight and obese children.

  • 12.
    Bäcklund, Catharina
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Validity of measured energy expenditure in overweight and obese children when using Inner View Professional software v5.1 and 6.1 together with SenseWear Pro2 Armband2009In: 7th International Conference on Diet and Activity Methods, 2009Conference paper (Refereed)
    Abstract [en]

    The aim was to investigate the validity of SenseWear Pro2 Armband (SWA) when assessing energy expenditure of overweight and obese children. A random selection of 22 children with an isoBMI>25 were recruited from 8-11 year olds participating in an intervention study. Energy expenditure in free-living condition was assessed during 14 days by using SWA. The armband was worn 24h/d, and removed only for water activities. Total energy expenditure was measured with double labelled water (DLW) method during the same period covered by SWA. During the data collection, an updated version of the software used by SWA was released and data were analysed with both software version. The validity when using software version 5.1 (SWA5.1) and 6.1 (SWA6.1) was investigated by comparison with measured energy expenditure by DLW method. In total, 11 girls and 11 boys with mean age of 10.3±0.99 years and isoBMI 22.8±0.62 participated. The average wearing time of SWA was 12 days (range 7-14) and 23.3 h/day (range 18.8-24.0). There was no statistically significant difference in mean physical activity level (PAL) by SWA5.1 compared by DLW-method. A minor non-significant underestimation of energy expenditure 0.02±1.20 MJ/day (95%CI -0.55,0.52) measured by SWA5.1 compared with DLW-method was shown. However, the children's PAL according to SWA6.1 was 1.37 compared with 1.68 according to DLW method. When assessed by SWA6.1 there was a significant underestimation of energy expenditure by 1.96±1.03MJ/day (95%CI-2.42,-1.50) compared with DLW-method. The differences between SWA5.1 andSWA6.1 may be partly explained bya statistically significant difference in the amount of time the two software versions have registered time spent on different activity levels (MET<3, MET3-<6, MET6-<9, MET≥9). When comparing time spent on sedentary activities (MET<3) significantly less time was assessed by SWA5.1 compared with SWA6.1, 18±2.1 h/d and 20±2.4 h/d respectively. These differences became more apparent at higher METs. A significantly longer time spent on activities with MET≥9, was assessed by SWA5.1 compared with SWA6.1, 11±26 min/d and 2.5±5.3 min/d respectively. In conclusion, the SWA with software v 5.1, but not with software v 6.1, is a valid device to accurately measure energy expenditure at group level in overweight and obese children during free-living condition.

  • 13.
    Chorell, Elin
    et al.
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Rydberg, Mats
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Antti, Henrik
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    A metabolomic evaluation of short and long term effects of different macronutrient intake in overweight and obese postmenopausal womenManuscript (preprint) (Other academic)
  • 14.
    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, 904-913 p.Article 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.

  • 15. Doring, Nora
    et al.
    Hansson, Lena M.
    Andersson, Elina Scheers
    Bohman, Benjamin
    Westin, Maria
    Magnusson, Margaretha
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition. Univ Gothenburg, Dept Food & Nutr & Sport Sci, Gothenburg, Sweden.
    Sundblom, Elinor
    Willmer, Mikaela
    Blennow, Margareta
    Heitmann, Berit L.
    Forsberg, Lars
    Wallin, Sanna
    Tynelius, Per
    Ghaderi, Ata
    Rasmussen, Finn
    Primary prevention of childhood obesity through counselling sessions at Swedish child health centres: design, methods and baseline sample characteristics of the PRIMROSE cluster-randomised trial2014In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, no 335Article in journal (Refereed)
    Abstract [en]

    Background: Childhood obesity is a growing concern in Sweden. Children with overweight and obesity run a high risk of becoming obese as adults, and are likely to develop comorbidities. Despite the immense demand, there is still a lack of evidence-based comprehensive prevention programmes targeting pre-school children and their families in primary health care settings. The aims are to describe the design and methodology of the PRIMROSE cluster-randomised controlled trial, assess the relative validity of a food frequency questionnaire, and describe the baseline characteristics of the eligible young children and their mothers. Methods/Design: The PRIMROSE trial targets first-time parents and their children at Swedish child health centres (CHC) in eight counties in Sweden. Randomisation is conducted at the CHC unit level. CHC nurses employed at the participating CHC received training in carrying out the intervention alongside their provision of regular services. The intervention programme, starting when the child is 8-9 months of age and ending at age 4, is based on social cognitive theory and employs motivational interviewing. Primary outcomes are children's body mass index and waist circumference at four years. Secondary outcomes are children's and mothers' eating habits (assessed by a food frequency questionnaire), and children's and mothers' physical activity (measured by accelerometer and a validated questionnaire), and mothers' body mass index and waist circumference. Discussion: The on-going population-based PRIMROSE trial, which targets childhood obesity, is embedded in the regular national (routine) preventive child health services that are available free-of-charge to all young families in Sweden. Of the participants (n = 1369), 489 intervention and 550 control mothers (75.9%) responded to the validated physical activity and food frequency questionnaire at baseline (i.e., before the first intervention session, or, for children in the control group, before they reached 10 months of age). The food frequency questionnaire showed acceptable relative validity when compared with an 8-day food diary. We are not aware of any previous RCT, concerned with the primary prevention of childhood obesity through sessions at CHC that addresses healthy eating habits and physical activity in the context of a routine child health services programme.

  • 16.
    Hammarström, Anne
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition. Department of Food and Nutrition, and Sport Science, University of Gothenburg, Sweden.
    Ahlgren, Christina
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Experiences of barriers and facilitators to weight-loss in a diet intervention: a qualitative study of women in Northern Sweden2014In: BMC Women's Health, ISSN 1472-6874, E-ISSN 1472-6874, Vol. 14, 59- p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: There is a lack of research about the experiences of participating in weight-reducing interventions. The aim of this study was to explore barriers and facilitators to weight-loss experienced by participants in a diet intervention for middle-aged to older women in the general population in Northern Sweden.

    METHOD: In the intervention the women were randomised to eat either a Palaeolithic-type diet or a diet according to Nordic Nutrition recommendations for 24 months. A strategic selection was made of women from the two intervention groups as well as from the drop-outs in relation to social class, civil status and age. Thematic structured interviews were performed with twelve women and analysed with qualitative content analyses.

    RESULTS: The results showed that the women in the dietary intervention experienced two main barriers - struggling with self (related to difficulties in changing food habits, health problems, lack of self-control and insecurity) and struggling with implementing the diet (related to social relations and project-related difficulties) - and two main facilitators- striving for self-determination (related to having clear goals) and receiving support (from family/friends as well as from the project) - for weight-loss. There was a greater emphasis on barriers than on facilitators.

    CONCLUSION: It is important to also include drop-outs from diet interventions in order to fully understand barriers to weight-loss. A gender-relational approach can bring new insights into understanding experiences of barriers to weight-loss.

  • 17.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Challenges in assessing diet and validity of reported intake of children and adolescents.2012Conference paper (Refereed)
  • 18.
    Larsson, Christel
    Institutionen för kost och idrottsvetenskap, Göteborgs universitet.
    Forskarmöte om nutrition, fysisk aktivitet, hälsa och tillväxt bland skolbarn2011In: Dietistaktuellt, ISSN 1102-9285, Vol. 20, no 5, 40-41 p.Article, book review (Other (popular science, discussion, etc.))
  • 19.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Mat,hälsa och identitet: Att övergå från blandkost till vegetarisk kost2004In: Thule. Kungliga Skytteanska Samfundets årsbok, ISSN 0280-8692, 39-44 p.Article in journal (Other academic)
  • 20.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Metodrapport - svenska barns matvanor - nationell undersökning på 4, 8 och 11 åringar2004In: Statens LivsmedelsverkArticle in journal (Other (popular science, discussion, etc.))
  • 21.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Referat för sessionen "Obesity Governance Project" vid "The 10th Nordic nutrition conference"2012In: Nordisk nutritionArticle, book review (Other (popular science, discussion, etc.))
  • 22.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Så äter svenska barn2003In: Vår Föda, Vol. 3, no 6, 26-7 p.Article in journal (Other (popular science, discussion, etc.))
  • 23.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Vegetarisk kost bland ungdomar2000In: Vegetar, Vol. December, 14- p.Article in journal (Other (popular science, discussion, etc.))
  • 24.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Young vegetarians and omnivores: Dietary habits and other health-related aspects2001Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    In the middle of the 1990s many adolescents became vegetarians. There was concern among adults about whether these new young vegetarians got enough energy and nutrients from their dietary intake. The aim of this thesis was to investigate the prevalence of young vegetarians, the food and lifestyle habits, dietary intake and nutritional status of vegetarian and omnivorous adolescents. The prevalence of adolescents eating a vegetarian school lunch in 124 Swedish secondary schools was investigated by interviewing matrons. Information about prevalence of vegetarians, food and lifestyle habits, of 2041 15-year old students from Umeå, Stockholm and Bergen, was obtained by a questionnaire. The dietary intake and nutritional status of thirty 16-20 year-old vegans were compared with thirty age, sex and height matched omnivores.

    Five percent of the adolescents (16-20 years) in Sweden were found to eat vegetarian food at school lunch. In Umeå there was a significantly higher prevalence (15.6%) of 15-year-old vegetarians compared with Stockholm (4.8%) and Bergen (3.8%). It was also found that more females than males (15 years old) chose a vegetarian dietary regime. Even though the female vegetarians consumed vegetables significantly more often than the omnivores, the intake (32 times/month) was not as often as might be expected of a vegetarian population. The male vegetarians reported eating vegetables not even once a day (25 times/month). No difference in the consumption frequency of fruits/berries, alcoholic beverages, sweets/chocolates and fast foods was seen between vegetarians and omnivores. However, female vegetarians more often than female omnivores consumed dietary supplements. Furthermore, lifestyle characteristics of vegetarians were similar those of omnivores regarding exercise, use of alcohol and smoking habits.

    No significant difference in validity of reported energy expenditure or energy and protein intakes was found between vegans and omnivores. Young vegans (16-20 year-olds) were seen to have a higher calculated intake of vegetables, legumes, and dietary supplements and a lower intake of ice creams, cakes/cookies, and candies/chocolate than omnivores. The dietary intake was below the average requirements of riboflavin for 73% of the vegans, vitamin B12 for all vegans, vitamin D for 43% of the vegans, calcium for 77% of the vegans and selenium for all vegans and 43% of the omnivores. If intake of supplements was included the intake of e.g. calcium and selenium was still lower than the average requirements for 67% and 73% of the vegans respectively. Low iron stores were as prevalent among vegans as among omnivores (20% and 23% with low stores) and three vegans had low vitamin B12 concentrations in blood.

    The findings imply that food and lifestyle habits of young vegetarians are different than what previous studies of vegetarians have shown. There is a need for future research of the long-term health effects of being vegetarian.

  • 25.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Young vegetarians and omnivores: dietary habits and other health-related aspects2002In: Scandinavian Journal of Nutrition/Næringsforskning, ISSN 1102-6480, E-ISSN 1651-2359, Vol. 46, no 1, 48-49 p.Article in journal (Refereed)
  • 26.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Överviktiga barns hälsa: studier om effekten av levnadsvanor och matvanor2006In: Primärvårdens nyheter Pedistrik/nutrition, Vol. 6, 4-6 p.Article in journal (Other academic)
  • 27.
    Larsson, Christel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Burgård Konde, Åsa
    Ryden, Petra
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Maten efter ett år - vad barnen äter, vad kostråden säger och vad maten kostar2012In: Barnläkaren, Vol. 5, 8-11 p.Article in journal (Other (popular science, discussion, etc.))
  • 28.
    Larsson, Christel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Haugejorden, Olle
    Johansson, Gunnar
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Klock, Kristine
    Nordrehaug Åstrom, Anne
    Food habit characteristics of young vegetarians2000In: Swedish medical society conference 2000, 2000Conference paper (Other academic)
  • 29.
    Larsson, Christel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Hernell, Olle
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Lind, Torbjörn
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Moderately elevated body mass index is associated with metabolic variables and cardiovascular risk factors in Swedish children2011In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, no 1, 102-108 p.Article in journal (Refereed)
    Abstract [en]

    Aim: To evaluate associations between anthropometrics and metabolic variables as well as cardiovascular risk factors among children.

    Methods: Subjects were recruited from a cohort of 274 healthy children in Umeå, Sweden. Anthropometric measures, blood pressure and venous blood samples were collected at age 10 years and simultaneously from parents.

    Results: Altogether 144 children (53%), 142 mothers and 123 fathers participated. The prevalence of overweight and obesity among the children was 18 and 2%, respectively. Overweight children (above age- and sex-specific cut offs corresponding adult BMI ≥ 25 kg/m2), compared to normal weight children, had significantly higher BMI already during infancy and higher S-insulin and Homeostatic Model Assessment (HOMA) index at 10 years. The children’s BMI was positively associated with waist (boys’ r = 0.67, girls’ r = 0.81), hip (r = 0.68), waist/hip ratio (girls’ r = 0.37), waist/height ratio (boys’ r = 0.59, girls’ r = 0.80), sagittal abdominal diameter (r = 0.75), S-insulin (r = 0.45), HOMA index (r = 0.49), systolic blood pressure (r = 0.24), mothers’ BMI (girls’ r = 0.42) and mothers’ waist (girls’ r = 0.42).

    Conclusion: Children at 10 years of age with moderately elevated BMI had higher levels of some metabolic variables and cardiovascular risk factors than did normal weight children, and there was a correlation between BMI and some metabolic variables as well as cardiovascular risk factors.

  • 30.
    Larsson, Christel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Johansson, Gunnar
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Can food frequency questionnaire measure a difference in food intake of young vegans and omnivores?2003In: The fifth international conference on dietary assessment methods, 2003Conference paper (Other academic)
  • 31.
    Larsson, Christel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Johansson, Gunnar
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Dietary intake and nutritional status of young vegans and omnivores in Sweden2001In: The proceedings of the nutrition society, 2001, 60; 69 A- p.Conference paper (Other academic)
  • 32.
    Larsson, Christel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Johansson, Gunnar
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
     Dietary intake and nutritional status of young vegans and omnivores in Sweden2002In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 76, no 1, 100-106 p.Article in journal (Refereed)
  • 33.
    Larsson, Christel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Johansson, Gunnar
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Food sources of young Swedish vegans and omnivores: Emphasis on fruit and vegetable intake as well as sources of nutrients2004In: Public Health Nutrition 8th Nordic Nutrition Conference, Tønsberg, Norway, 2004Conference paper (Refereed)
  • 34.
    Larsson, Christel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Johansson, Gunnar
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Nutritional density of a vegan diet compared with an omnivorous diet eaten by adolescents2002In: Forth International Congress on Vegetarian Nutrition, 2002Conference paper (Other academic)
  • 35.
    Larsson, Christel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Johansson, Gunnar
    Prevalence of vegetarian school lunches in Swedish secondary schools1999In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 70, 633-634 p.Article in journal (Other academic)
  • 36.
    Larsson, Christel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Johansson, Gunnar
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Prevalence of vegetarians in Swedish secondary schools1997In: Scandinavian Journal of Nutrition/Næringsforskning, ISSN 1102-6480, E-ISSN 1651-2359, Vol. 41, 117-20 p.Article in journal (Refereed)
  • 37.
    Larsson, Christel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Johansson, Gunnar
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Unga vegetarianer i svenska skolor: förekomst, kostvanor och livsstil2002In: Skolhälsovård, ISSN 1102-3112, Vol. 2001-2002, no 3, 6-9 p.Article in journal (Other (popular science, discussion, etc.))
  • 38.
    Larsson, Christel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Johansson, Gunnar
    Vegetarian school lunches of Swedish secondary school students1996In: Swedish Medical Society Conference 1996, 1996Conference paper (Other (popular science, discussion, etc.))
  • 39.
    Larsson, Christel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Johansson, Gunnar
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Young Swedish vegans have different sources of nutrients than young omnivores2005In: Journal of the American Dietetic Association, ISSN 0002-8223, E-ISSN 1878-3570, Vol. 105, no 9, 1438-41 p.Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to identify sources of nutrients in diets of young Swedish vegans and omnivores. Three months of dietary intakes were investigated by diet history interviews. Volunteers were recruited through advertising and visits to schools in the city of Umeå, Sweden. Thirty vegans, 15 female and 15 male, aged 17.5±1.0 years, were compared with 30 sex-, age-, and height-matched omnivores. Vegans had different sources of nutrients than young omnivores and relied to a great extent on dietary supplements as a source of vitamin B-12, vitamin D, calcium, and selenium. Dietary intake of vegetables, fruits, and berries exceeded 500 g/day for 21 of the 30 vegans, whereas the same held true for only 1 of the 30 omnivores. Instead of animal products, young vegans rely on dietary supplements, legumes, vegetables, fruits, and berries as sources of nutrients.

  • 40.
    Larsson, Christel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Johansson, Gunnar
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Westerterp, K
    Validation of dietary intake of young vegans and omnivores in Sweden2000In: Scandinavian Journal of Nutrition/Næringsforskning, ISSN 1102-6480, E-ISSN 1651-2359, Vol. 44, 123- p.Article in journal (Other academic)
  • 41.
    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, 1005-1014 p.Article 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.

  • 42.
    Larsson, Christel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Klock, Kritine
    Department of Odontology-Community Dentistry (K.S.K., A.N.A., O.H.), University of Bergen, Bergen, Norway.
    Nordrehaug Åstrøm, Anne
    Department of Odontology-Community Dentistry (K.S.K., A.N.A., O.H.), University of Bergen, Bergen, Norway.
    Haugejorden, Olle
    Department of Odontology-Community Dentistry (K.S.K., A.N.A., O.H.), University of Bergen, Bergen, Norway.
    Johansson, Gunnar
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Lifestyle-related characteristics of adolescent low-meat-consumers and omnivores in Sweden and Norway2002In: Journal of Adolescent Health, ISSN 1054-139X, E-ISSN 1879-1972, Vol. 31, no 2, 190-198 p.Article in journal (Refereed)
    Abstract [en]

    Methods: A total of 2041 students (578 from Umeå, Sweden; 504 from Stockholm, Sweden; and 959 from Bergen, Norway), with a mean age of 15.5 years, completed a questionnaire. Information was collected about physical characteristics, and health, family situation, social, exercise, alcohol, and tobacco habits. The response rate was 95% in Umeå, 91% in Stockholm, and 83% in Bergen. Statistical analyses included Chi-square and Mann-Whitney U tests.

    Results: There was no reported difference between low-meat consumers and omnivores with respect to alcohol use, smoking, weight, or amount of exercise. Female low-meat consumers more frequently used smokeless tobacco, reported having more sick days during the last year, attached less importance to “being healthy,” and had been depressed more often than female omnivores. Male low-meat consumers reported, to a greater extent than male omnivores, having been tired without reason, having often had headaches and having been depressed. Female low-meat consumers had parents with a higher average level of education than did female omnivores and more often spent time with friends after school.

    Conclusions: Vegetarianism or low-meat consumption is mainly a female phenomenon among adolescents in this study. The study indicates that the lifestyle of young low-meat consumers differs from the lifestyle found in previous studies of vegetarians with respect to the respondents’ exercise habits, their perception of their own health, and their use of alcohol and tobacco. Contrary to findings from other studies, adherence to a low-meat diet may not correlate with other health promotion practices among adolescents in Sweden and Norway.

  • 43.
    Larsson, Christel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Lind, T
    Hernell, O
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Anthropometric data and metabolic risk factors in Swedish children2008In: The 9th Nordic Nutrition Conference, Copenhagen, Denmark, 2008Conference paper (Other academic)
  • 44.
    Larsson, Christel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Rönnlund, Ulla
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Johansson, Gunnar
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Dahlgren, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Umeå University, Faculty of Social Sciences, Department of Sociology.
    Veganism a status passage: the process of becoming a vegan among youths in Sweden2003In: Appetite, ISSN 0195-6663, E-ISSN 1095-8304, Vol. 41, no 1, 61-67 p.Article in journal (Refereed)
    Abstract [en]

    In a town in northern Sweden, 3.3% of the 15-year-old adolescents were vegans in 1996. This study describes the process of becoming a vegan among adolescents and interprets the informants' descriptions by constructing categories, which later on were related to relevant theories. Group interviews were conducted with three vegans and in-depth interviews were performed with three other vegan adolescents. The methodology was grounded theory and the adolescents' perceptions were analyzed in the framework of symbolic interactionism. Three types of vegans were identified: the Conformed Vegan, the Organized Vegan, and the Individualistic Vegan. The decision to become a vegan was reported to be influenced by perceived internal reasons such as ethics, health, distaste for meat, and preference for vegetarian food. In addition, friends, family, school, media, and music influenced the decision to become a vegan. The perceived consequences of becoming a vegan were positive as well as negative and differed between the three types of vegans. Veganism as a new type of status passage with specific characteristics was illustrated. No modifications or new properties were discovered that add to the theory of status passage which indicates that the general model is applicable also in a vegan context.

  • 45.
    Larsson, Christel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Rönnlund, Ulla
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Johansson, Gunnar
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Dahlgren, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Veganism as status passage: the process of becoming a vegan among youths in Sweden2002In: Fourth International Congress on Vegetarian Nutrition, Loma Linda, USA., 2002Conference paper (Refereed)
  • 46.
    Larsson, Christel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Westerterp, Klaas R
    Department of Human Biology, Maastricht University, Maastricht, Netherlands.
    Johansson, Gunnar
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Validity of reported energy expenditure and energy and protein intakes of Swedish vegan and omnivore adolescents2002In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 75, no 2, 268-274 p.Article in journal (Refereed)
    Abstract [en]

    Background: It is difficult to obtain accurate reports of dietary intake; therefore, reported dietary intakes must be validated. Researchers need low-cost methods of estimating energy expenditure to validate reports of energy intake in groups with different lifestyles and eating habits.

    Objective: We sought to validate the reported energy expenditure and energy and protein intakes of Swedish adolescent vegans and omnivores.

    Design: We compared 16 vegans (7 females and 9 males; mean age: 17.4 ± 0.8 y) with 16 omnivores matched for sex, age, and height. Energy expenditure as reported in a physical activity interview and energy and protein intakes as reported by diet history were validated by using the doubly labeled water method and by measuring urinary nitrogen excretion.

    Results: The validity of reported energy expenditure and energy and protein intakes was not significantly different between vegans and omnivores. The physical activity interview had a bias toward underestimating energy expenditure by 1.4 ± 2.6 MJ/d (95% CI: 2.4, 0.5 MJ/d). The diet-history interview had a bias toward underestimating energy intake by 1.9 ± 2.7 MJ/d (95% CI: 2.9, 1.0 MJ/d) but showed good agreement with the validation method for nitrogen (protein) intake (underestimate of 0.40 ± 1.90 g N/d; 95% CI: 1.10, 0.29 g N/d).

    Conclusions: The physical activity and diet-history interviews underestimated energy expenditure and energy intake, respectively. Energy intake and expenditure were underestimated to the same extent, and the degree of underestimation was not significantly different between vegans and omnivores. Valid protein intakes were obtained with the diet-history method for both vegans and omnivores.

  • 47.
    Lindvall, Kristina
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Emmelin, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Weinhall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    The able to be stable ones – Exploring the concept of primary weight maintenance.2008In: The 9 th Nordic nutrition conference, Copenhagen, Denmark., 2008Conference paper (Refereed)
  • 48.
    Lindvall, Kristina
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Jenkins, Paul
    Emmelin, Maria
    Lund Univ, Dept Clin Sci Social Med & Global Hlth.
    Scribani, Melissa
    Bassett Healthcare Network Res Inst.
    Norberg, Margareta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Centre for Population Studies (CPS).
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Weinehall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Centre for Population Studies (CPS).
    Primary weight maintenance: an observational study exploring candidate variables for intervention2013In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 12, 97- p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Previous studies have focused on weight maintenance following weight loss, i.e. secondary weight maintenance (SWM). The long-term results of SWM have been rather modest and it has been suggested that preventing initial weight gain, i.e. primary weight maintenance (PWM), may be more successful. Therefore, developing a prevention strategy focused on PWM, enabling normal weight or overweight individuals to maintain their weight, would be of great interest. The aim of this study was to identify attitudes, strategies, and behaviors that are predictive of PWM in different age, sex and BMI groups in Northern Sweden. METHODS: A questionnaire was mailed to 3497 individuals in a Swedish population that had two measured weights taken ten years apart, as participants in the Västerbotten Intervention Programme. Subjects were between 41-63 years of age at the time of the survey, had a baseline BMI of 20-30, and a ten year percent change in BMI greater than -3%. The respondents were divided into twelve subgroups based on baseline age (30, 40 and 50), sex and BMI (normal weight and overweight). Analysis of variance (ANOVA), correlation, and linear regression were performed to identify independent predictors of PWM. RESULTS: Of the 166 predictors tested, 152 (91.6%) were predictive of PWM in at least one subgroup. However, only 7 of these 152 variables (4.6%) were significant in 6 subgroups or more. The number of significant predictors of PWM was higher for male (35.8) than female (27.5) subgroups (p=0.044). There was a tendency (non significant) for normal weight subgroups to have a higher number of predictors (35.3) than overweight subgroups (28.0). Adjusted R-squared values ranged from 0.1 to 0.420. CONCLUSIONS: The large number of PWM predictors identified, and accompanying high R-squared values, provide a promising first step towards the development of PWM interventions. The large disparity in the pattern of significant variables between subgroups suggests that these interventions should be tailored to the person's demographic (age, sex and BMI). The next steps should be directed towards evaluation of these predictors for causal potential.

  • 49.
    Lindvall, Kristina
    et al.
    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.
    Weinehall, Lars
    Umeå University, Faculty of Social Sciences, Demographic Data Base. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Emmelin, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Weight maintenance as a tight rope walk: a grounded theory study2010In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 10, no 51Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Overweight and obesity are considerable public health problems internationally as well as in Sweden. The long-term results of obesity treatment are modest as reported by other studies. The importance of extending the focus to not only comprise obesity treatment but also prevention of weight gain is therefore being emphasized. However, despite the suggested change in focus there is still no consensus on how to prevent obesity or maintain weight. This study reports findings from a qualitative study focusing on attitudes, behaviors and strategies important for primary weight maintenance in a middle-aged population.

    METHODS: In depth interviews were conducted with 23 maintainers and four slight gainers in Sweden. The interviews were transcribed and an analysis of weight maintenance was performed using Grounded Theory.

    RESULTS: Based on the informants' stories, describing attitudes, behaviors and strategies of importance for primary weight maintenance, a model illustrating the main findings, was constructed. Weight maintenance was seen as "a tightrope walk" and four strategies of significance for this "tightrope walk" were described as "to rely on heritage", "to find the joy", "to find the routine" and "to be in control". Eleven "ideal types" were included in the model to illustrate different ways of relating to the main strategies. These "ideal types" described more specific attitudes and behaviors such as; eating food that is both tasteful and nutritious, and choosing exercise that provides joy. However, other somewhat contradictory behaviors were also found such as; only eating nutritious food regardless of taste, and being physically active to control stress and emotions.

    CONCLUSION: This study show great variety with regards to attitudes, strategies and behaviors important for weight maintenance, and considerations need to be taken before putting the model into practice. However, the results from this study can be used within primary health care by enhancing the understanding of how people differ in their relation to food and physical activity. It informs health personnel about the need to differentiate advices related to body weight, not only to different sub-groups of individuals aiming at losing weight but also to sub-groups of primary weight maintainers aiming at maintaining weight.

  • 50.
    Mellberg, Caroline
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Sandberg, Susanne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Ryberg, Mats
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Eriksson, Marie
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.
    Brage, S
    MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
    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.
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Long-term effects of a Palaeolithic-type diet in obese postmenopausal women: a 2-year randomized trial2014In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 68, no 3, 350-7 p.Article in journal (Refereed)
    Abstract [en]

    Background/Objectives: Short-term studies have suggested beneficial effects of a Palaeolithic-type diet (PD) on body weight and metabolic balance. We now report the long-term effects of a PD on anthropometric measurements and metabolic balance in obese postmenopausal women, in comparison with a diet according to the Nordic Nutrition Recommendations (NNR).

    Subjects/Methods: Seventy obese postmenopausal women (mean age 60 years, body mass index 33 kg/m(2)) were assigned to an ad libitum PD or NNR diet in a 2-year randomized controlled trial. The primary outcome was change in fat mass as measured by dual-energy X-ray absorptiometry.

    Results: Both groups significantly decreased total fat mass at 6 months (-6.5 and-2.6 kg) and 24 months (-4.6 and-2.9 kg), with a more pronounced fat loss in the PD group at 6 months (P<0.001) but not at 24 months (P=0.095). Waist circumference and sagittal diameter also decreased in both the groups, with a more pronounced decrease in the PD group at 6 months (-11.1 vs-5.8 cm, P=0.001 and-3.7 vs-2.0 cm, P<0.001, respectively). Triglyceride levels decreased significantly more at 6 and 24 months in the PD group than in the NNR group (P<0.001 and P=0.004). Nitrogen excretion did not differ between the groups.

    Conclusions: A PD has greater beneficial effects vs an NNR diet regarding fat mass, abdominal obesity and triglyceride levels in obese postmenopausal women; effects not sustained for anthropometric measurements at 24 months. Adherence to protein intake was poor in the PD group. The long-term consequences of these changes remain to be studied.

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