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  • 1. Aarts, Clara
    et al.
    Hörnell, Agneta
    Umeå University.
    Kylberg, Elisabeth
    Hofvander, Yngve
    Gebre-Medhin, Mehari
    Breastfeeding patterns in relation to thumb sucking and pacifier use.1999In: Pediatrics, ISSN 1098-4275, Vol. 104, no 4, p. e50-Article in journal (Refereed)
    Abstract [en]

    Objective:The primary aim was to assess, the association of the quantity and quality of dietary fat intake from 6 to 12 months of age and serum lipids at 12 months.Subjects/Methods:Three hundred healthy term Swedish infants were recruited in a longitudinal prospective study at the age of 6 months; 276 remained in the study at 12 months. Food records and anthropometric data were collected monthly from 6 to 12 months; serum lipids were analysed at 6 and 12 months.Results:Swedish infants had a total fat intake within the Nordic recommendations, but intake of polyunsaturated fatty acids (PUFA) was low (5.6 percent of total energy (E%)) and intake of saturated fatty acids (SAFA) was high (15.1 E%). Higher PUFA intake was associated with lower total serum cholesterol (TC, B=-0.13, P=0.003), lower low-density-lipoprotein cholesterol (LDL-C, B=-0.12, P=0.004) and apolipoprotein B (B=-0.03) (P=0.034) in girls but not in boys. When data from the present study were compared to data from similar studies in Finland and Iceland, it appears that the quality of the dietary fat has greater impact on serum lipid levels than the quantity of fat in the diet.Conclusions:Higher PUFA and lower SAFA intakes may reduce TC and LDL-C early in life, particularly in girls. Further, with respect to lowering serum lipid concentrations in early childhood it seems appropriate to set focus on fat quality rather than the quantity.Sponsorships:Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning (Formas), Swedish Research Council, Medicine, Stiftelsen Oskar Foundation, Sven Jerring Foundation, Samariten Foundation, Stiftelsen Goljes minne and Semper AB.European Journal of Clinical Nutrition advance online publication, 20 June 2007; doi:10.1038/sj.ejcn.1602824.

  • 2. Aarts, Clara
    et al.
    Kylberg, Elisabeth
    Hörnell, Agneta
    Umeå University.
    Hofvander, Yngve
    Gebre-Medhin, Mehari
    Greiner, T
    How exclusive is exclusive breastfeeding? A comparison of data since birth with current status data.2000In: Int J Epidemiol, ISSN 0300-5771, Vol. 29, no 6, p. 1041-6Article in journal (Refereed)
  • 3.
    Abrahamsson, Lillemor
    et al.
    Institutionen för kostvetenskap, Uppsala universitet.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Ekblad, Jenny
    FoU Malmö stad, Malmö.
    Nutrition under livscykeln2013In: Näringslära för högskolan: från grundläggande till avancerad nutrition / [ed] Abrahamsson Lillemor, Andersson Agneta, Nilsson Gerd, Stockholm: Liber, 2013, 6, p. 379-403Chapter in book (Other academic)
  • 4.
    Berggren, Linda
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Olsson, Cecilia
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Talvia, S.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Rönnlund, Maria
    Umeå University, Faculty of Social Sciences, Department of applied educational science.
    Waling, Maria
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    The lived experiences of school lunch: an empathy-based study with children in Sweden2019In: Children's Geographies, ISSN 1473-3285, E-ISSN 1473-3277Article in journal (Refereed)
    Abstract [en]

    School lunch is in general regulated through policies and agendas constituted by the perspectives of adults. In this article, we focus on children’s lived experiences of school lunch with a special emphasis on emotions and how they relate to social and physical dimensions. This study draws on empathy-based stories written by 10–11 year olds (n = 171) from schools in Sweden. We identified three themes: Interaction and exposure, Routines and restrictions and Food and eating. The children’s lived experiences of school lunch and the emotions attached to them are closely associated and intertwined with the socio-spatial dimension of school lunch. A pleasant meal experience seems to require harmonization between the physical and social space whilst negative experiences contain tensions between them, something that actors working with school lunch and school lunch environments should take in consideration when resourcing, planning and scheduling school lunch, and also when designing new school restaurants.

  • 5.
    Berggren, Linda
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Talvia, Sanna
    Child and Youth Research institute, Turku, Finland,.
    Fossgard, Eldbjørg
    Faculty of Education, Bergen University College, Bergren, Norway,.
    Björk Arnfjörð, Unnur
    School of Education, University of Iceland.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Ólafsdóttir, Anna
    School of Education, University of Iceland.
    Gunnarsdóttir, Ingibjörg
    The National University Hospital of Iceland , Unit for Nutrition Research, Reykjavik, Iceland.
    Wergedahl, Hege
    Faculty of Education, Bergen University College, Bergren, Norway,.
    Lagström, Hanna
    University of Turku, Turku Institute of Child and Youth Research, Turku, Finland.
    Waling, Maria
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Olsson, Cecilia
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Perspectives about health outcomes related to food among Nordic children2016Conference paper (Refereed)
    Abstract [en]

    Perspectives about health outcomes related to food among Nordic children

    Linda Berggren* 1, Sanna Talvia2, Eldbjørg Fossgard3, Unnur Björk Arnfjörð4, Agneta Hörnell 1, Anna Ólafsdóttir 4,Ingibjörg Gunnarsdóttir 5, Hege Wergedahl 3, Hanna Lagström 6, Maria Waling1, Cecilia Olsson1

    1Umeå University, Department of food and nutrition, Umeå, Sweden, 2Child and Youth Research institute, Turku, Finland,3Faculty of Education, Bergen University College, Bergren, Norway, 4School of Education, University of Iceland, 5TheNational University Hospital of Iceland , Unit for Nutrition Research, Reykjavik, Iceland, 6University of Turku, TurkuInstitute of Child and Youth Research, Turku, Finland

    Preferred presentation type: Only Poster

    Background and aims: Dietary intake in school has previously been studied but little is known about Nordic children’sperspectives on food healthiness in the school lunch context. This study aims to explore 10-year-old Nordic children’sperspectives on outcomes of healthy eating in the school lunch context.

    Methods: Seventy-two focus groups were conducted in Sweden, Finland, Norway and Iceland with a total of 423participants. A flexible topic guide and 14 preselected photos displaying different school lunch contexts were used asstimuli material. Interviews were transcribed and analyzed using thematic analysis.

    Results: Children reasoned that school lunch are and should be healthy since the food eaten at school has short andlong term outcomes related to cognitive and physical health. It was commonly expressed that food eaten in school affectsschool work and functioning in learning activities. It was also stated that food eaten in school can have negative andpositive effects on your mood, e.g. eating unhealthy food or an insufficient amount of food, puts you in a bad mood whichcan affect the rest of the school day. The discussions mainly relied on negative short term effects such as feeling ill andreduced stamina. Some food and food groups such as vegetables, milk and fish, were mentioned in a more positivesense highlighting the positive short- and long term outcomes on health. When describing the long-term outcomes ofeating, children mentioned that healthy eating helps to build muscles, grow and prevent diseases, such as cancer anddiabetes. Sugar and fat was frequently mentioned as being the cause of overweight and some other diseases.

    Conclusion: In general, Nordic children have an adequate understanding of established relations between food andhealth. Yet, we know that many pupils do not eat according to recommendations. This highlights the importance of takingthe complexity of food choice into consideration in nutritional education.

    Disclosure of Interest: None to declare

  • 6.
    Berggren, Linda
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Talvia, Sanna
    Fossgard, Eldbjørg
    Björk Arnfjörð, Unnur
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Ólafsdóttir, Anna Sigríður
    Gunnarsdóttir, Ingibjörg
    Wergedahl, Hege
    Lagström, Hanna
    Waling, Maria
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Olsson, Cecilia
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Nordic children's conceptualizations of healthy eating in relation to school lunch2017In: Health Education, ISSN 0965-4283, E-ISSN 1758-714X, Vol. 117, no 2, p. 130-147Article in journal (Refereed)
    Abstract [en]

    Purpose: Pupils' perspective should be better taken into account when developing nutrition education at school. The purpose of this paper is to explore Nordic children's perspectives on the healthiness of meals in the context of school lunches.

    Design/methodology/approach: In total, 78 focus group discussions were conducted with 10-11-year-old girls and boys (n=457) from schools in Finland, Iceland, Norway and Sweden, which were participating in the Nordic school meal project ProMeal during the school year 2013-2014. A flexible discussion guide and stimulus material in the form of 14 photographs displaying different school lunch contexts were used. The discussions were analyzed using thematic analysis.

    Findings: These Nordic children seem to share the adult-set aim of healthy eating in the school context as a socio-cultural norm. Although healthy eating was constructed as a rational, normative and acceptable way to eat at school, unhealthy eating was emphasized as negotiably acceptable when eaten occasionally and under certain circumstances (e.g. at special occasions). Unhealthy eating also comprised emotionally laden descriptions such as enjoyment and disgust.

    Practical implications: Children's conceptualizations of healthy eating are connected to nutritional, socio-cultural, emotional and normative dimensions, which should be reflected also when developing nutrition education in school.

    Originality/value: The need for research exploring children's experiences of, and understandings about, school lunch motivated this unique multicenter study with a large number of participating children. In the focus groups a child-oriented, photo-elicitation method was used.

  • 7.
    Bohm, Ingela
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Lindblom, Cecilia
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Åbacka, Gun
    Bengs, Carita
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Absence, deviance and unattainable ideals: Discourses on vegetarianism in the Swedish school subject Home and Consumer Studies2016In: Health Education Journal, ISSN 0017-8969, E-ISSN 1748-8176, Vol. 75, no 6, p. 676-688Article in journal (Refereed)
    Abstract [en]

    Objective: This study aimed to describe Discourses on vegetarian food in the Swedish school subject Home and Consumer Studies. Design: The study involved the observation of naturally occurring classroom talk, with audio recording and in some cases video-taping. Setting: The study was conducted during Home and Consumer Studies lessons in five different northern Swedish schools. Method: Fifty-nine students and five teachers were observed, recorded and in some cases video-taped. The resulting data were analysed with a focus on big 'D' Discourses. Results: Results indicated that gendered Discourses of absence, deviance and unattainability restricted some students' access to vegetarian food. The absence of meat was constructed as simultaneously healthy and unhealthy, a lack of cultural familiarity with vegetarian cooking made finding recipes difficult and students perceived the loss of taste as very negative. The vegetarian was seen as deviant, with vegetarianism being conceptually equated with sickness. Access to meat-free food required a commitment to a vegetarian lifestyle, and this was seen as a sacrifice and as too much work, not only for the individual but also for others. Conclusion: To counteract the restricted access to vegetarian food, Home and Consumer Studies teachers can redesign activities in the subject with the help of critical food literacy. For example, cooking could focus on popular plant-based dishes instead of 'empty' vegetarian themes, all students could be allowed to share vegetarian dishes instead of reserving them for vegetarians, the possibly strict rules of vegetarianism could be relaxed for those who do not wish to commit to them and vegetarian food could be deliberately connected to strength and masculinity. However, this presupposes sufficient economic resources and ample food storage space.

  • 8.
    Bohm, Ingela
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Lindblom, Cecilia
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Åbacka, Gun
    Vasa Faculty of Education, Åbo Akademi University, Vasa, Finland.
    Bengs, Carita
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    "He just has to like ham": the centrality of meat in home and consumer studies2015In: Appetite, ISSN 0195-6663, E-ISSN 1095-8304, Vol. 95, p. 101-112Article in journal (Refereed)
    Abstract [en]

    This study aimed to describe Discourses on meat in the school subject Home and Consumer Studies in five different northern Swedish schools. Fifty-nine students and five teachers from five different schools were recorded and in some cases video-taped during lessons. Results indicate that meat was seen as central to nutritional health, sensory experience, culture and social relationships. This positive view was challenged by an alternative Discourse where meat was threatening to health, sensory experience and psychological comfort, but this was not strong enough to affect centrality. Even when participants sought to promote the health advantages of reducing meat consumption, the dominant centrality Discourse was strengthened. This implies that the possible tension between physical and psychosocial/emotional health can make the benefits of a reduction difficult both to convey and accept. A form of critical food literacy may help teachers deconstruct the arbitrary power of the centrality Discourse, but it may also strengthen meat-eater identities because the social norms that guide food choice become salient. A redesign of Discourses might facilitate a reduction in meat consumption, but such a paradigm shift is dependent on the development of society as a whole, and can only be briefly touched upon within the limited timeframes and resources of Home and Consumer Studies.

  • 9.
    Bohm, Ingela
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Lindblom, Cecilia
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Åbacka, Gun
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    'Don't give us an assignment where we have to use spinach!': food choice and discourse in home and consumer studies2016In: International Journal of Consumer Studies, ISSN 1470-6423, E-ISSN 1470-6431, Vol. 40, no 1, p. 57-65Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to describe classroom Discourses about vegetables during the planning, cooking, eating and evaluation of meals in the Swedish school subject Home and Consumer Studies. Fifty-nine students and five teachers were recruited from five northern Swedish villages and towns, and then observed, recorded and in some cases video-taped during lessons that took place between 2010 and 2012. Based on 56 instances of talk about vegetables, four Discourses were identified and related to the three aspects of Belasco's culinary triangle of contradictions: identity, responsibility and convenience. The results indicated that the identity-based sensory and cultural Discourses sometimes clashed with the more responsibility-oriented health and evaluation Discourses. The health Discourse was only used when there was an element of evaluation, with assignments connected to grades. In all other cases, the sensory and cultural Discourses guided vegetable use. Sometimes different sensory or cultural assumptions could clash with each other, for example when the teacher insisted on the use of a specific recipe regardless of a student's taste preferences. Since these preferences did not always harmonize with curricular demands for responsibility, there might be a risk of basing grades on aspects of students' identity. Alternatively, students might feel constrained to argue against their own identity in order to be favourably evaluated. Then again, if teachers always bow to student tastes, this limits their chances of learning about food and physical health. Viewing the dilemma through the lens of the culinary triangle of contradictions may help teachers and researchers develop teaching methods that take all aspects of food choice into account.

  • 10.
    Bostedt, Göran
    et al.
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Economics. Department of Forest Economics, Swedish University of Agricultural Sciences, Umeå, Sweden.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Nyberg, Gert
    SLU.
    Agroforestry Extension and Dietary Diversity: An Analysis of the Importance of Fruit and Vegetable Consumption in West Pokot, Kenya2016In: Food Security, ISSN 1876-4517, E-ISSN 1876-4525, Vol. 8, no 1, p. 271-284Article in journal (Refereed)
    Abstract [en]

    Worldwide, the challenges of nomadic, pastoralist systems are causing their slow but steady disappearance in favour of sedentary agropastoralism. This paper draws upon an existing household data set from a survey collected and organized by the Swedish non-governmental organization (NGO) Vi Agroforestry, directed at a livestock-based, agro-pastoralist area in West Pokot County, western Kenya. The study focuses on the question of food diversity and malnutrition and the role of agroforestry extension services, i.e. knowledge spread, transfer and development. Our basic hypothesis is that certain fruit and vegetable related food groups are under-consumed in West Pokot, especially in the dryland areas. The results of the study shows that agroforestry, combined with advice through extension efforts can imply a transition path for pastoralists which involves improved dietary diversity, especially concerning food groups that include roots, tubers, fruits and leafy vegetables. From the results certain restrictions that hinder this transition become clear. An important but often overlooked factor is lack of information and knowledge as a determinant of household behavior in developing countries. NGOs such as Vi Agroforestry can play an important role in overcoming this restriction by providing extension services. Developing countries in general are not information-rich environments, a fact that is especially the case for poor citizens living in rural areas. The paper illustrates that careful attention to the information and knowledge available to households is necessary when designing development cooperation.

  • 11.
    Brugård Konde, Åsa
    et al.
    Livsmedelsverket.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Mat för spädbarn 0-1 år2012In: Barnläkaren, ISSN 1651-0534, no 5, p. 6-8Article in journal (Other academic)
  • 12. Dapi, Léonie N
    et al.
    Tambe, Ayuk Bertrand
    Axberg, Frida
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Lundström, Linnéa
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    After giving birth to a baby, breastfeeding becomes your responsibility: infant feeding perceptions and practices among women in Yaoundé, Bamenda and Bandja, Cameroon, Africa2018In: International Research Journal of Public and Environmental Health, ISSN 2360-8803, Vol. 5, no 3, p. 38-45Article in journal (Refereed)
    Abstract [en]

    The Ministry of Public Health of Cameroon advises mothers to follow the World Health Organization’s recommendation of exclusive breastfeeding during the first six months of life and to continue breastfeeding along with appropriate complementary foods up to two years or beyond. Despite these recommendations, malnutrition due to inadequate feeding practices is still prevalent in Cameroon. Therefore, this study aims to explore infant feeding perceptions and identify factors influencing infant feeding practices in Cameroon. Forty-nine women aged 19 to 38 who had infants aged 6 days to 15 months were purposively selected from hospitals during the vaccination days and interviewed until saturation. The research tools included six qualitative group interviews, with each group comprising 6 to 10 women. The study was conducted in the rural area of Bandja and the urban areas of Yaoundé and Bamenda. Data were analysed using content analysis. In the study, breastfeeding was agreed upon as the best way to feed infants and was commonly practised for 1 to 2 years. Nevertheless, few infants were breastfed exclusively. Complementary foods were often nutritionally inadequate; many children were not given fruit, vegetables or foods of animal origin on a daily basis. Cultural beliefs, tradition, community norms and low educational and economic levels negatively influenced the implementation of appropriate infant feeding recommendations. The short duration of exclusive breastfeeding and the poor food diversity are the main problems. In response, it is necessary to strengthen the position of women, increase the period of maternal leave, introduce sustainable and practical education for both parents about breastfeeding, and provide good, local complementary foods.

  • 13.
    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.

  • 14. Eli, Karin
    et al.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Malek, Mahnoush Etminan
    Nowicka, Paulina
    Water, juice, or soda?: Mothers and grandmothers of preschoolers discuss the acceptability and accessibility of beverages2017In: Appetite, ISSN 0195-6663, E-ISSN 1095-8304, Vol. 112, p. 133-142Article in journal (Refereed)
    Abstract [en]

    Intake of sugary beverages is strongly associated with weight gain and obesity among children; however, differences between mothers' and grandmothers' attitudes and practices concerning young children's beverage consumption remain unclear. This is notable since about a quarter of families in the US and the UK rely on grandparents as the main providers of informal childcare. The aim of this study is to examine mothers' and maternal grandmothers' attitudes, knowledge, and practices regarding preschool aged children's beverage consumption. The analysis focuses on identifying intergenerational similarities and differences, given the potential impact that such differences might have on young children's beverage consumption habits. Twenty-two semi-structured interviews, representing eleven families, were analyzed using thematic analysis. The sample included all mother – maternal grandmother dyads from The Grandparents Study, which took place in Eugene, Oregon, USA. More than half of mothers and grandmothers met overweight/obesity criteria. Among the children (mean age 4.7 years; five girls and six boys), seven met overweight/obesity criteria. Most mothers and grandmothers were unemployed, and most reported an annual household income below 30,000 USD. The analysis identified three thematic categories: 1) mothers and grandmothers agree about the hierarchy of healthiness between and within beverages, though juice occupies an ambivalent position; 2) mothers and grandmothers cite role modeling and the home environment as important in regulating preschoolers' beverage intake; 3) mothers and grandmothers balance between restricting sugary beverages and using these beverages as treats. The results suggest that when mothers and grandmothers use soda, juice, and juice-drinks as treats, they do so within a wider dynamic of balancing practices, and within two intersecting domains: the hierarchy of beverages, including the still ambivalent status of juice as healthy or unhealthy, and the definition of 'special occasion'.

  • 15. Huseinovic, Ena
    et al.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Esberg, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Winkvist, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health. Department of Internal Medicine and Clinical Nutrition, the Sahlgrenska Academy, University of Gothenburg, Sweden.
    Changes in food intake patterns during 2000–2007 and 2008–2016 in the population-based Northern Sweden Diet Database2019In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 18, article id 36Article in journal (Refereed)
    Abstract [en]

    Background: Food intake patterns provide a summary of dietary intake. Few studies have examined trends in food intake patterns over time in large, population-based studies. We examined food intake patterns and related sociodemographic and individual characteristics in the large Northern Sweden Diet Database during the two time windows 2000–2007 and 2008–2016.

    Methods: In total, 100 507 participants (51% women) who had filled in a 64-item food frequency questionnaire and provided background and sociodemographic data between 2000 and 2016 were included. Food intake patterns were evaluated for women and men separately for the two time windows 2000–2007 and 2008–2016, respectively. Latent class analysis was used to identify distinct, latent clusters based on 40 food groups.

    Results: Among both women and men, a greater proportion of participants were classified into food intake patterns characterized by high-fat spread and high-fat dairy during 2008–2016 compared to 2000–2007. In the earlier time window, these high-fat clusters were related to lower educational level and smoking. Simultaneously, the proportion of women and men classified into a cluster characterized by high intake of fruit, vegetables, and fibre decreased from the earlier to the later time window.

    Conclusion: From a public health perspective, the increase in clusters with a high conditional mean for high-fat spread and high-fat dairy and decrease in clusters with a high conditional mean for fruit and vegetables, during the time period 2008–2016 compared to 2000–2007, is worrisome as it indicates a shift away from the recommended food habits. Subgroups of women and men with less healthy dietary patterns in the time window 2008–2016 with lower education, lower age, higher body mass index, lower levels of physical activity and more smoking were identified and future interventions may be targeted towards these groups.

  • 16.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    DIETS: dietitians improving the education and training standards2011Other (Other (popular science, discussion, etc.))
    Abstract [sv]

    Artikeln är en presentation av nätverket "Dietitians Improving the Education and Training Standards" (DIETS). DIETS är ett tematiskt nätverk som syftar till att genom kosten förbättra folkhälsan i Europa. Omkring 100 partners, huvudsakligen yrkesorganisationer och organisationer för högre utbildning, från omkring 30 europeiska länder ingår. I det europeiska perspektivet täcker beteckningen dietitian in både dietister och kostekonomer/kostvetare (närmare preciserat som clinical, administrative eller public health dietitians). Man kan läsa mer om nätverket och dess aktiviteter påwww.thematicnetworkdietetics.eu/everyone.

  • 17.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Effects of a gluten-free diet on gastrointestinal symptoms in celiac disease2005In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 81, no 6, p. 1452-1453Article in journal (Other academic)
  • 18.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Graviditet och amning2015In: Kost, nutrition och hälsa: en klinisk handbok / [ed] Tommy Cederholm, Elisabet Rothenberg, Lund: Studentlitteratur AB, 2015, p. 121-126Chapter in book (Other academic)
  • 19.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Food and Nutrition.
    Kap IX. Barn och mat. Små barn och mat.2005In: Lyckliga barn. En bok om föräldraskap, ICA Bokförlag , 2005Chapter in book (Other (popular science, discussion, etc.))
  • 20.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Food and Nutrition.
    Living well with celiac disease?: invited editorial2008In: J Pediatr Gastroenterol Nutr, ISSN 1536-4801, Vol. 47, no 5, p. 544-6Article in journal (Refereed)
  • 21.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Mat, matvanor och nutrition för barn och ungdomar2012In: Nordisk Nutrition, ISSN 1654-8337, no 3, p. 17-19Article in journal (Other academic)
    Abstract [sv]

    Artikeln är ett referat från 10th Nordic Nutrition Conference, 3-5 Juni, 2012, Reykjavik, Island.

  • 22.
    Hörnell, Agneta
    et al.
    Umeå University.
    Aarts, Clara
    Kylberg, Elisabeth
    Hofvander, Yngve
    Gebre-Medhin, Mehari
    Breastfeeding patterns in exclusively breastfed infants: a longitudinal prospective study in Uppsala, Sweden.1999In: Acta Paediatr, ISSN 0803-5253, Vol. 88, no 2, p. 203-11Article in journal (Refereed)
  • 23.
    Hörnell, Agneta
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Berg, Christina
    Forsum, Elisabet
    Larsson, Christel
    Sonestedt, Emily
    Akesson, Agneta
    Lachat, Carl
    Hawwash, Dana
    Kolsteren, Patrick
    Byrnes, Graham
    De Keyzer, Willem
    Van Camp, John
    Cade, Janet E.
    Greenwood, Darren C.
    Slimani, Nadia
    Cevallos, Myriam
    Egger, Matthias
    Huybrechts, Inge
    Wirfalt, Elisabet
    Perspective: An Extension of the STROBE Statement for Observational Studies in Nutritional Epidemiology (STROBE-nut): Explanation and Elaboration2017In: Advances in Nutrition, ISSN 2161-8313, Vol. 8, no 5, p. 652-678Article in journal (Refereed)
    Abstract [en]

    Nutritional epidemiology is an inherently complex and multifaceted research area. Dietary intake is a complex exposure and is challenging to describe and assess, and links between diet, health, and disease are difficult to ascertain. Consequently, adequate reporting is necessary to facilitate comprehension, interpretation, and generalizability of results and conclusions. The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statement is an international and collaborative initiative aiming to enhance the quality of reporting of observational studies. We previously presented a checklist of 24 reporting recommendations for the field of nutritional epidemiology, called "the STROBE-nut." The STROBE-nut is an extension of the general STROBE statement, intended to complement the STROBE recommendations to improve and standardize the reporting in nutritional epidemiology. The aim of the present article is to explain the rationale for, and elaborate on, the STROBE-nut recommendations to enhance the clarity and to facilitate the understanding of the guidelines. Examples from the published literature are used as illustrations, and references are provided for further reading.

  • 24.
    Hörnell, Agneta
    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.
    Silfverdal, Sven-Arne
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Amning och tillvänjning till fast föda för friska fullgångna barn: En kunskapsöversikt från Barnläkarföreningen och Livsmedelsverket2013In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 110, no 8, p. 405-409Article in journal (Refereed)
  • 25.
    Hörnell, Agneta
    et al.
    Umeå University.
    Hofvander, Yngve
    Kylberg, Elisabeth
    Introduction of solids and formula to breastfed infants: a longitudinal prospective study in Uppsala, Sweden.2001In: Acta Paediatr, ISSN 0803-5253, Vol. 90, no 5, p. 477-82Article in journal (Refereed)
  • 26.
    Hörnell, Agneta
    et al.
    Umeå University.
    Hofvander, Yngve
    Kylberg, Elisabeth
    Solids and formula: association with pattern and duration of breastfeeding.2001In: Pediatrics, ISSN 1098-4275, Vol. 107, no 3, p. E38-Article in journal (Refereed)
  • 27.
    Hörnell, Agneta
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Lagstrom, Hanna
    Lande, Britt
    Thorsdottir, Inga
    Protein intake from 0 to 18 years of age and its relation to health: a systematic literature review for the 5th Nordic Nutrition Recommendations2013In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 57, p. 21083-Article, review/survey (Refereed)
    Abstract [en]

    The present systematic literature review is a part of the 5th revision of the Nordic Nutrition Recommendations. The aim was to assess the health effects of different levels of protein intake in infancy and childhood in a Nordic setting. The initial literature search resulted in 435 abstracts, and 219 papers were identified as potentially relevant. Full paper selection resulted in 37 quality-assessed papers (4A, 30B, and 3C). A complementary search found four additional papers (all graded B). The evidence was classified as convincing, probable, limited-suggestive, and limited-inconclusive. Higher protein intake in infancy and early childhood is convincingly associated with increased growth and higher body mass index in childhood. The first 2 years of life is likely most sensitive to high protein intake. Protein intake between 15 E% and 20 E% in early childhood has been associated with an increased risk of being overweight later in life, but the exact level of protein intake above which there is an increased risk for being overweight later in life is yet to be established. Increased intake of animal protein in childhood is probably related to earlier puberty. There was limited-suggestive evidence that intake of animal protein, especially from dairy, has a stronger association with growth than vegetable protein. The evidence was limited-suggestive for a positive association between total protein intake and bone mineral content and/ or other bone variables in childhood and adolescence. Regarding other outcomes, there were too few published studies to enable any conclusions. In conclusion, the intake of protein among children in the Nordic countries is high and may contribute to increased risk of later obesity. The upper level of a healthy intake is yet to be firmly established. In the meantime, we suggest a mean intake of 15 E% as an upper limit of recommended intake at 12 months, as a higher intake may contribute to increased risk for later obesity.

  • 28.
    Hörnell, Agneta
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Lagström, Hanna
    Lande, Britt
    Thorsdottir, Inga
    Breastfeeding, introduction of other foods and effects on health: a systematic literature review for the 5th Nordic Nutrition Recommendations2013In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 57Article, review/survey (Refereed)
    Abstract [en]

    The present systematic literature review is part of the 5th revision of the Nordic Nutrition Recommendations. The overall aim was to review recent scientific data valid in a Nordic setting on the short-and long-term health effects of breastfeeding (duration of both any and exclusive breastfeeding) and introduction of foods other than breast milk. The initial literature search resulted in 2,011 abstracts; 416 identified as potentially relevant. Full paper review resulted in 60 quality assessed papers (6A, 48B, and 6C). A complementary search found some additional papers. The grade of evidence was classified as convincing, probable, limited-suggestive, and limited-no conclusion. The evidence was convincing of a protective dose/duration effect of breastfeeding against overweight and obesity in childhood and adolescence, overall infections, acute otitis media, and gastrointestinal and respiratory tract infections. The evidence was probable that exclusive breastfeeding for longer than 4 months is associated with slower weight gain during the second half of the first year which could be part of the reason behind the reduced risk of later overweight or obesity. There was also probable evidence that breastfeeding is a protective factor against inflammatory bowel disease, celiac disease, and diabetes (type 1 and 2), provides beneficial effects on IQ and developmental scores of children as well as a small reductive effect on blood pressure and blood cholesterol levels in adulthood. Other associations explored were limited-suggestive or inconclusive. In conclusion, convincing and probable evidence was found for benefits of breastfeeding on several outcomes. The recommendation in NNR2004 about exclusive breastfeeding for 6 months and continued partial breastfeeding thereafter can stand unchanged. The relatively low proportion of infants in the Nordic countries following this recommendation indicates that strategies that protect, support and promote breastfeeding should be enhanced, and should also recognize the benefits for long-term health.

  • 29.
    Hörnell, Agneta
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Lande, Britt
    Hagström, Hanna
    Thorsdottir, Inga
    Många hälsofördelar med amning2013In: Nordisk Nutrition, ISSN 1654-8337, no 1, p. 19-21Article in journal (Other (popular science, discussion, etc.))
  • 30.
    Hörnell, Agneta
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Lande, Britt
    Hagström, Hanna
    Thorsdottir, Inga
    Proteinintaget bör begränsas åtminstone de första två levnadsåren2013In: Nordisk Nutrition, ISSN 1654-8337, no 1, p. 22-24Article in journal (Other (popular science, discussion, etc.))
  • 31.
    Hörnell, Agneta
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Lande, Britt
    Lagström, Hanna
    Thorsdottir, Inga
    Breastfeeding2014In: Nordic Nutrition Recommendations 2012: integrating nutrition and physical activity, Copenhagen: Nordic Council of Ministers , 2014, 5, p. 85-102Chapter in book (Refereed)
  • 32.
    Hörnell, Agneta
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Lind, Torbjörn
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Silfverdal, Sven Arne
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Maten i skolan - långt mellan kostråden och verkligheten2009In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 106, no 5, p. 287-90Article in journal (Refereed)
    Abstract [sv]

    Skolan bör ha en positiv roll i folkhälsoarbetet, dels genom att ge eleverna kunskap om sambanden mellan hälsa, kost, fysisk aktivitet och livsstil, dels genom att erbjuda god och näringsriktig mat och möjlighet till regelbunden fysisk aktivitet. Skolmaten utgör fortfarande en utjämnande faktor när det gäller näringsintag mellan barn från resursstarka och resurssvaga områden. Svenska skolbarn till och med årskurs 9 garanteras kostnadsfri mat i skolan genom nu gällande lagstiftning. Livsmedelsverkets råd »Bra mat i skolan« och »Bra mat i förskolan« kompletterar de svenska näringsrekommendationerna och underlättar planeringen för måltider i skolan.

  • 33.
    Hörnell, Agneta
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Waling, Maria
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Olafsdottir, Anna Sigridur
    School of Education, University of Iceland, Reykjavik, Iceland.
    Lagström, Hanna
    Turku Institute of Child and Youth Research, University of Turku, Turku, Finland.
    Wergedahl, Hege
    Faculty of Education, Bergen University College, Bergen, Norway,.
    Jonsson, Bert
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Olsson, Cecilia
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Fossgard, Eldbjörg
    Faculty of Education, Bergen University College, Bergen, Norway.
    Holthe, Asle
    Faculty of Education, Bergen University College, Bergen, Norway.
    Talvia, Sanna
    Turku Institute of Child and Youth Research, University of Turku, Turku, Finland.
    Gunnarsdottir, Ingibjörg
    Unit for Nutrition Research, Landspitali, The National University Hospital of Iceland, and Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
    School meals and health: the PROMEAL-study2016In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 60, no 1, article id 31961Article in journal (Refereed)
  • 34.
    Hörnell, Agneta
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Winkvist, Anna
    Department of Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg .
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Weinehall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Mis-reporting, previous health status and health status of family may seriously bias the association between food patterns and disease2010In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 9, no 48Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Food pattern analyses are popular tools in the study of associations between diet and health. However, there is a need for further evaluation of this methodology. The aim of the present cross-sectional study was to evaluate the relationship between food pattern groups (FPG) and existing health, and to identify factors influencing this relationship.

    METHODS: The inhabitants of Västerbotten County in northern Sweden are invited to health check-ups when they turn 30, 40, 50, and 60 years of age. The present study includes data collected from almost 60,000 individuals between 1992 and 2005. Associations between FPG (established using K-means cluster analyses) and health were analyzed separately in men and women.

    RESULTS: The health status of the participants and their close family and reporting accuracy differed significantly between men and women and among FPG. Crude regression analyses, with the high fat FPG as reference, showed increased risks for several health outcomes for all other FPGs in both sexes. However, when limiting analysis to individuals without previous ill-health and with adequate energy intake reports, most of the risks instead showed a trend towards protective effects.

    CONCLUSIONS: Food pattern classifications reflect both eating habits and other own and family health related factors, a finding important to remember and to adjust for before singling out the diet as a primary cause for present and future health problems. Appropriate exclusions are suggested to avoid biases and attenuated associations in nutrition epidemiology.

  • 35.
    Jonsson, Bert
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Waling, Maria
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Olafsdottir, Anna S
    Lagström, Hanna
    Wergedahl, Hege
    Olsson, Cecilia
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Fossgard, Eldbjörg
    Holthe, Asle
    Talvia, Sanna
    Gunnarsdottir, Ingibjörg
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    The effect of schooling on basic cognition in selected Nordic Countries2017In: Europe's Journal of Psychology, ISSN 1841-0413, E-ISSN 1841-0413, Vol. 13, no 4, p. 645-666Article in journal (Refereed)
    Abstract [en]

    The present study investigated schooling effects on cognition. Cognitive data were collected as part of a research project (ProMeal) that investigated school meals and measured the intake of school lunch in relation to children’s health, cognitive function, and classroom learning in four Nordic countries, among children between 10–11 years of age. It was found that Finnish pupils attending 4th grade were not, on any measure, outperformed by Norwegian and Icelandic pupils attending 5th and Swedish pupils attending 4th grade on a task measuring working memory capacity, processing speed, inhibition, and in a subsample on response- and attention control. Moreover, boys were found to perform superior to girls on tasks measuring processing speed. However, girls were found to perform better on tasks related to attention and self-control. The results are discussed in relation to the reciprocal association between cognition and schooling and whether these results reflect quality differences between schools in the four Nordic countries; most notably in comparison to Finland.

  • 36. Juniusdottir, Ragnheidur
    et al.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Gunnarsdottir, Ingibjorg
    Lagstrom, Hanna
    Waling, Maria
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Olsson, Cecilia
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Talvia, Sanna
    Olafsdottir, Anna S.
    Composition of school meals in Sweden, Finland and Iceland: Official guidelines and comparison with practice and availability2018In: Journal of School Health, ISSN 0022-4391, E-ISSN 1746-1561, Vol. 88, no 10, p. 744-753Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Nutritious and attractive school meals can improve health equality and public health. Current official guidelines and recommendations on food and nutrient composition of school meals in 3 Nordic countries; Sweden, Finland, and Iceland, are described and compared with actual practice, ie, availability of foods and nutrients in served reference meals in 3 selected areas in each country.

    METHODS: A country comparison was made between official guidelines, and actual practice was studied in participating schools. Reference portions of school meals (N = 170) provided in 24 compulsory schools were photographed and weighed. Food and nutrient availability were compared with official guidelines in each country.

    RESULTS: Emphasis of recommendations on whole‐grain bread in Sweden, whole grains in Finland, and fish in Iceland were reflected in food availability. The energy content of the meals provided was lower than guidelines and there was a large variation in energy content between days.

    CONCLUSIONS: The guidelines regarding food availability were quite well followed, but the large variation in energy and nutrient content of provided school meals between days indicates a need for standardization.

  • 37.
    Kautto, Ethel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Ivarsson, Anneli
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Norström, Fredrik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Högberg, L
    Division of Pediatrics, Department of Clinical and Experimental Medicine, Faculty of Health Science, Linköping University, Linköping, Sweden and Department of Pediatrics in Norrköping, County Council of Östergötland, Norrköping, Sweden.
    Carlsson, A
    Department of Pediatrics, SUS University Hospital, Lund University, Lund, Sweden.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Nutrient intake in adolescent girls and boys diagnosed with coeliac disease at an early age is mostly comparable to their non-coeliac contemporaries2014In: Journal of human nutrition and dietetics (Print), ISSN 0952-3871, E-ISSN 1365-277X, Vol. 27, no 1, p. 41-53Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Food habits, nutrient needs and intakes differ between males and females, although few nutritional studies on patients with coeliac disease (CD) have reported results stratified by gender.

    OBJECTIVES: To compare energy and nutrient intakes among 13-year olds diagnosed with CD in early childhood with those of a non-coeliac (NC) age- and gender-matched control group, and also with estimated average requirements (EAR).

    METHODS: A case-control study was conducted in Sweden 2006-2007 within the coeliac screening study ETICS (Exploring The Iceberg of Coeliacs in Sweden). Dietary intake was assessed among 37 adolescents (23 girls) diagnosed with CD at median age 1.7 years (CD group) and 805 (430 girls) NC controls (NC group) using a food-frequency questionnaire covering 4 weeks. Reported energy intake was validated by comparison with the calculated physical activity level (PAL).

    RESULTS: Regardless of CD status, most adolescents reported an intake above EAR for most nutrients. However, both groups had a low intake of vitamin C, with 13% in the CD-group and 25% in the NC-group below EAR, and 21% of boys in the CD-group below EAR for thiamine. The intake of fatty acids was unbalanced, with a high intake of saturated and a low intake of unsaturated fats. Girls and boys in the CD-group had an overall lower nutrient density in reported food intake compared to girls and boys in the NC-group.

    CONCLUSIONS: Nutrient intake of adolescent girls and boys with CD was mostly comparable to intakes of NC controls. Dietitians should take the opportunity to reinforce a generally healthy diet when providing information about the gluten-free diet.

  • 38.
    Kautto, Ethel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Olsson, Cecilia
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Ivarsson, Anneli
    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.
    Alex, Lena
    Umeå University, Faculty of Medicine, Department of Nursing.
    An on-going gendered endeavour in silence: young women struggling with celiac diseaseManuscript (preprint) (Other academic)
    Abstract [en]

    Women with celiac disease are in the literature described as feeling exposed to negative emotions and experiences related to the treatment of celiac disease - the gluten-free diet. In order to explore the daily experiences of being diagnosed to celiac disease we interviewed seven Swedish young women diagnosed to celiac disease by screening in early adolescence. The semi structured interviews were analysed inductively by using content analysis. The analysis showed that the young women continued to strive with their treatment and their relations toward others, even years after diagnosis. The young women found themselves in an environment where their strict adherence to the dietary treatment was an obstacle and could prevent the feeling of connectedness. We argue that the emphasized/normative femininity that these young women relate to complicates their daily life diagnosed with celiac disease.

  • 39.
    Kautto, Ethel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Olsson, Cecilia
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Ivarsson, Anneli
    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.
    Aléx, Lena
    Umeå University, Faculty of Medicine, Department of Nursing.
    Living with celiac disease seen from a male perspectiveManuscript (preprint) (Other academic)
    Abstract [en]

    Men diagnosed with celiac disease are in earlier scientific studies known to be less troubled by their experiences of living with disease than women with celiac disease. Previous studies, concentrating on men with celiac disease have been mostly quantitative, and the studies has dealt with physiology and pathology. The aim of this study was to give voice to young men with screening-detected celiac disease and to highlight the situations that they encounter in their daily lives five years after the screening. Seven Swedish young men were interviewed. They had been diagnosed with celiac disease as 12-13 years-olds through a large Swedish school based celiac screening-study. The semi-structured interviews were analyzed from a gender perspective using content analysis. The findings resulted in a main theme, conquering the disease and becoming a man, which was underpinned by several themes and sub-themes. The analysis showed that the young men’s experiences of living with celiac disease in their daily life, largely depended on their use of characteristics known to be in accordance with dominating masculinity; such as being self-assured, demanding, and behaving authoritative. In food situations, when the young men had the ability to make use of such characteristics in their informal group, they experienced much less negative aspects of the disease. If the young men did not have a position in their informal group where they could develop those features, their situation was expressed as being tough, they were bullied and withdrew from social meals. It seemed important for the young men to dissociate themselves from being seen as a person who had a life-long chronic disease.

  • 40.
    Kautto, Ethel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Olsson, Cecilia
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Ivarsson, Anneli
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Lyon, Phil
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Alex, Lena
    Umeå University, Faculty of Medicine, Department of Nursing.
    Living with celiac disease: norms of femininity and the complications of everyday life2017In: International Journal of Celiac Disease, ISSN 2334-3427, Vol. 5, no 3, p. 115-124Article in journal (Refereed)
    Abstract [en]

    Women with celiac disease are often described as being exposed to negative emotions and experiences related to the treatment of celiac disease, the gluten-free diet. To explore the daily consequences of diagnosis and their daily experiences of living with celiac disease, interviews were conducted with seven Swedish young women who had been diagnosed with celiac disease by screening in early adolescence. The semi-structured interview transcripts were content analysed using a gender perspective. The analysis showed that these young women`s daily experiences were coloured by the conjunction of their dietary treatment, their social relationships, and social norms. This means that recurrent food situations often clash with the normative constructions of femininity and social norms of eating with an adverse effect on dietary compliance.

  • 41.
    Kautto, Ethel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Olsson, Cecilia
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Ivarsson, Anneli
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Lyon, Phil
    School of Arts, Social Sciences and Management, Queen Margaret University, UK.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Alex, Lena
    Umeå University, Faculty of Medicine, Department of Nursing.
    Seeking a new normality: masculinity, interaction and a gluten free diet2016In: International Journal of Celiac Disease, ISSN 2334-3486, Vol. 4, no 4, p. 138-145Article in journal (Refereed)
    Abstract [en]

    From earlier studies, men diagnosed with celiac disease are known to be less troubled by their experiences of living with the disease than are diagnosed women. Previous studies, concentrating on men with celiac disease have been mostly quantitative, and have a bio-medical emphasis. The aim of this study was to explore the social experience of young men with screening-detected celiac disease and to highlight daily life situations five years after diagnosis. Seven young men, diagnosed with celiac disease when they were 13 years-olds through a large Swedish school-based celiac screening-study, were interviewed. The semi-structured interviews were analyzed from a gender perspective which resulted in three themes; being subjected to changes, striving for normality and emphasizing commitment. These were underpinned by several sub-themes. The young men dissociated themselves from being seen as a person with a life-long chronic disease. The analysis also showed that the young men’s daily experiences of living with celiac disease largely depended on their use of characteristics known to be associated with masculinity: such as being self-assured, demanding, and behaving authoritatively. In food situations, where the young men had the ability to make use of such characteristics in their informal group, they experienced fewer negative aspects of the disease. If the young men did not hold a strong position in their informal group, their situation was insecure and vulnerable and this could lead to avoidance of contacts and social meal situations.

  • 42.
    Kautto, Ethel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Rydén, Petra
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Ivarsson, Anneli
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Olsson, Cecilia
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Norström, Fredrik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Högberg, Lotta
    Carlsson, Annelie
    Hagfors, Linda
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    What happens to food choices when a gluten-free diet is required?: A prospective longitudinal population-based study among Swedish adolescent with coeliac disease and their peers2014In: Journal of Nutritional Science, ISSN 2048-6790, E-ISSN 2048-6790, Vol. 3, no e2Article in journal (Refereed)
    Abstract [en]

    A dietary survey was performed during a large screening study in Sweden among 13-year-old adolescents. The aim was to study how the intake of food groups was affected by a screening-detected diagnosis of celiac disease (CD) and its gluten-free (GF) treatment. Food intake, was reported using a food frequency questionnaires (FFQ) and intake reported by the adolescents who was screened to CD was compared with the intake of two same-aged referent groups: i) adolescents diagnosed to CD prior screening and ii) adolescents without CD.. The food intake groups were measured at baseline before the screening-detected cases were aware of their CD, and 12-18 months later.

    The result showed that the food intakes are affected by a screen detected CD and its dietary treatment. Many flour-based foods were reduced such as pizza, fish fingers, and pastries. The result also indicated that the bread intake was lower before the screened diagnosis compared to the other studied groups, but increased afterwards. Specially manufactured GF-products (e.g. pasta and bread) were frequently used in the screened CDgroup after changing to a GF-diet. Our results suggest that changing to a GF-diet reduces the intake of some popular foods, and the ingredients on the plate are altered, but this do not necessarily include a change of food groups. The availability of manufactured GF-replacement products makes it possible for adolescents to keep many of their old food habits when diagnosed with CD in Sweden.

  • 43.
    Khatun, Masuma
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Food and Nutrition.
    BRAC initiative towards promoting gender and social equity in health: a longitudinal study of child growth in Matlab, Bangladesh.2004In: Public Health Nutrition, ISSN 1368-9800, Vol. 7, no 8, p. 1071-9Article in journal (Refereed)
  • 44. Konrad, M.
    et al.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Gomes, A. M.
    Olsen, S.
    de Looy, A.
    DIETS2: EUROPEAN DIETETIC ADVANCED COMPETENCES-EDAC 20122013In: Annals of Nutrition and Metabolism, ISSN 0250-6807, E-ISSN 1421-9697, Vol. 63, p. 1736-1737Article in journal (Other academic)
    Abstract [en]

    Background and objectives: DIETS2 (Dietitians ensuringeducation, teaching and professional quality) is an EU ThematicNetwork bring together an active network of dietetic (andnutrition) associations and higher education institutions. Theintention is to improve European nutritional health througheducation and practice. ‘Health 2020’ (WHO, 2012) calls fora new working culture fostering cooperation across Europe to enhance healthcare necessitating a great emphasis on lifelonglearning for health professionals. Advanced competencestandards for dietitians, which describe the higher levels ofknowledge and complex responsibilities required, have nowbeen developed.Methods: Invitation to access an on-line questionnaire(Lime-survey) was sent out via European Federation of Associationsof Dietitians (EFAD) and DIETS2 partners in 2011.The questionnaire collected information on demographics,working environments and identified second and third cycledietetic competences.Results: 2030 dietitians from 35 countries over a range ofoccupational fields; Clinical (66%), Public Health (35%), Administrative(30%), Higher Education Teaching (20%) and Research(18%) responded. Competences identified for working atadvanced level were Advanced Knowledge and Understandingof Dietetics; Dietetic Process and Professional Reasoning; ProfessionalRelationships; Professional Autonomy and Accountability;Educator Skills; Research and Development in Dieteticsand its Science; Leadership and Management of ProfessionalDietetics; Entrepreneurial Skills and Business Development ofDietetics. The identified advanced competences (EDAC, 2012)and their performance indicators are now accepted by EFADfor Pan-European application and form the basis for LifelongLearning for dietitians post qualification.Conclusions: The EDAC Framework represents the firstdefinition of the competences required by nutrition and dieteticprofessionals to meet the Health 2020 agenda and provides abenchmark against which health professionals and their clientscan judge their competence.

  • 45. Kylberg, Elisabeth
    et al.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Sahlstedt, L
    Bruce, Åke
    Kostmönster och näringsintag hos en grupp kosttillskottskonsumenter1991In: Vår föda, ISSN 0042-2657, Vol. 43, no 1, p. 16-22Article in journal (Refereed)
  • 46. Lachat, C
    et al.
    Hawwash, D
    Ocké, M C
    Berg, C
    Forsum, E
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Larsson, C L
    Sonestedt, E
    Wirfält, E
    Åkesson, A
    Kolsteren, P
    Byrnes, G
    De Keyzer, W
    Van Camp, J
    Cade, J E
    Slimani, N
    Cevallos, M
    Egger, M
    Huybrechts, I
    Strengthening the Reporting of Observational Studies in Epidemiology - nutritional epidemiology (STROBE-nut): An extension of the STROBE statement2016In: Nutrition Bulletin, ISSN 1471-9827, E-ISSN 1467-3010, Vol. 41, no 3, p. 240-251Article in journal (Refereed)
    Abstract [en]

    Concerns have been raised about the quality of reporting in nutritional epidemiology. Research reporting guidelines such as the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement can improve quality of reporting in observational studies. Herein, we propose recommendations for reporting nutritional epidemiology and dietary assessment research by extending the STROBE statement into Strengthening the Reporting of Observational Studies in Epidemiology - Nutritional Epidemiology (STROBE-nut). Recommendations for the reporting of nutritional epidemiology and dietary assessment research were developed following a systematic and consultative process, co-ordinated by a multidisciplinary group of 21 experts. Consensus on reporting guidelines was reached through a three-round Delphi consultation process with 53 external experts. In total, 24 recommendations for nutritional epidemiology were added to the STROBE checklist. When used appropriately, reporting guidelines for nutritional epidemiology can contribute to improve reporting of observational studies with a focus on diet and health.

  • 47. Lachat, Carl
    et al.
    Hawwash, Dana
    Ocke, Marga C.
    Berg, Christina
    Forsum, Elisabet
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Larsson, Christel
    Sonestedt, Emily
    Wirfalt, Elisabet
    Akesson, Agneta
    Kolsteren, Patrick
    Byrnes, Graham
    De Keyzer, Willem
    Van Camp, John
    Cade, Janet E.
    Slimani, Nadia
    Cevallos, Myriam
    Egger, Matthias
    Huybrechts, Inge
    Strengthening the Reporting of Observational Studies in Epidemiology-Nutritional Epidemiology (STROBE-nut): An Extension of the STROBE Statement2016In: PLoS Medicine, ISSN 1549-1277, E-ISSN 1549-1676, Vol. 13, no 6, article id e1002036Article in journal (Refereed)
    Abstract [en]

    Background: Concerns have been raised about the quality of reporting in nutritional epidemiology. Research reporting guidelines such as the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement can improve quality of reporting in observational studies. Herein, we propose recommendations for reporting nutritional epidemiology and dietary assessment research by extending the STROBE statement into Strengthening the Reporting of Observational Studies in Epidemiology—Nutritional Epidemiology (STROBE-nut).

    Methods and Findings: Recommendations for the reporting of nutritional epidemiology and dietary assessment research were developed following a systematic and consultative process, coordinated by a multidisciplinary group of 21 experts. Consensus on reporting guidelines was reached through a three-round Delphi consultation process with 53 external experts. In total, 24 recommendations for nutritional epidemiology were added to the STROBE checklist.

    Conclusion: When used appropriately, reporting guidelines for nutritional epidemiology can contribute to improve reporting of observational studies with a focus on diet and health.

  • 48.
    Lindblom, Cecilia
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Erixon Arreman, Inger
    Umeå University, Faculty of Social Sciences, Department of applied educational science.
    Bohm, Ingela
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Group work interaction among pupils In Home and Consumer Studies in Sweden2016In: International Journal of Home Economics, ISSN 1999-561X, E-ISSN 1999-561X, Vol. 9, no 1, p. 35-53Article in journal (Other academic)
    Abstract [en]

    The aim of the study was to describe and analyze different types of group work during Home and Consumer Studies lessons in four Swedish schools, located in two different municipalities. Observations of pupils' practical tasks were carried out in six classrooms, and video/sound recorded. Study participants totaled 44 pupils (11 – 16 years old). Qualitative content analysis of the observations showed four different types of group work; 1) integrated, 2) expert (appointed by the kitchen partner/s and self-appointed), 3) divided, and 4) parallel. The most important finding was that pupils belonging to a self-appointed expert group, a divided group or a parallel group did not have the best conditions for learning. The integrated type appeared more conducive to individual learning than the other three. As a result, teachers have to be aware that non-functioning group work can negatively impact pupils' possibility of achieving the grade-related tasks for the subject. 

  • 49.
    Lindblom, Cecilia
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Erixon Arreman, Inger
    Umeå University, Faculty of Social Sciences, Department of applied educational science, Child and Youth education, Special Education and Counselling.
    Bohm, Ingela
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    The importance of time frames in Swedish Home and Consumer Studies2016In: International Journal of Consumer Studies, ISSN 1470-6423, E-ISSN 1470-6431, Vol. 40, no 3, p. 299-308Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore how time frames affect pupils and teachers in cooking activities during lessons of different durations for Home and Consumer Studies, with a specific focus on the pupils’ experiences. To investigate this, classroom observations were carried out in 2011 and 2012, with the help of audio and video recordings in three different schools in Sweden and included altogether 22 pupils (18 girls, 4 boys) in grade 9 (15–16 years). Each class was observed during two separate lessons, lasting between 1 h 50 minutes (110 minutes) and 2 h 20 minutes (140 minutes). The six lessons resulted in 12 hours of video recorded time and 80 hours of sound recordings.

    The study showed that the importance of finishing on time seemed to be ingrained in most pupils in all classes and the end result was perceived as more important than the process of cooking. The study also showed that knowledge of cooking skills and time management seemed important for success in grade-related tasks. Pupils demonstrated different ways of handling the time frames, e.g. using various methods to speed up the cooking process. This study raises important questions about the relationship between national and local time frames and the curriculum aims in Home and Consumer Studies. 

  • 50.
    Lindblom, Cecilia
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Erixon Arreman, Inger
    Umeå University, Faculty of Social Sciences, Department of applied educational science, Child and Youth education, Special Education and Counselling.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Practical conditions for home and consumer studies in Swedish compulsory education: a survey study2013In: International Journal of Consumer Studies, ISSN 1470-6423, E-ISSN 1470-6431, Vol. 37, no 5, p. 556-563Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to map the field of internal and external conditions that Swedish Home and Consumer Studies teachers and pupils have contend with. A questionnaire was constructed and delivered online in November 2010. It contained 27 question covering teacher qualification, quality of premises and equipment, lesson time and collaboration, and the use of national syllabi. A total of 385 persons across the country answered the questionnaire; about 21% of those teaching Home and Consumer Studies in Swedish compulsory school during the school year 2009–2010. These respondents taught in a total of 392 compulsory schools, which equalled about 22% of the schools teaching grades 7–9 in Sweden. Almost a quarter (23%) of the teachers lacked formal training for Home and Consumer Studies. Respondents without an appropriate degree qualification included those trained as nursery school teachers, dietitians and civil engineers. As regards classrooms, while 88% of respondents reported access to fully equipped kitchens with stoves, sinks and work surfaces, 5% used regular classrooms and the remainder were obliged to come up with alternative solutions, such as using portable kitchens in regular classrooms or conducting their lessons in the school restaurant. This study raises many questions about the quality of Home and Consumer Studies provision in a number of schools. The local deficiencies in the nationally decided frame factors for Home and Consumer Studies found by the present study gives us reason to doubt that all pupils achieve the overall learning goals of ‘knowing in practice’ and making informed choices utilizing environmental, economic and health perspectives. This might affect the health and economy of the individuals in the long run, with implications for the national economy and public health. On the basis of these findings, we therefore recommend that current conditions for Home and Consumer Studies and how the subject should operate in schools become a focus for national debate.

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