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Hörnell, Agneta, ProfessorORCID iD iconorcid.org/0000-0002-5464-5686
Publications (10 of 89) Show all publications
Kyanjo, J. L., Turinawe, A., Hörnell, A. & Lindvall, K. (2025). Balancing maternal employment and child nutrition and health: a grounded theory study of rural communities in Northeastern Uganda. BMC Public Health, 25(1), Article ID 769.
Open this publication in new window or tab >>Balancing maternal employment and child nutrition and health: a grounded theory study of rural communities in Northeastern Uganda
2025 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 25, no 1, article id 769Article in journal (Refereed) Published
Abstract [en]

Background: Child undernutrition remains a serious public health concern particularly in poor households where limited financial resources hinder proper child nutrition. Improving women’s access to productive resources and employment is crucial for addressing undernutrition. However, maternal employment may reduce the amount of time available for childcare, leading to poor child nutrition and health. This study explored rural community perceptions and experiences regarding maternal employment in relation to aspects of child nutrition and health in northeastern Uganda to inform the design of interventions that can effectively support maternal employment without compromising child nutrition and health.

Methods: Twelve gender-separated focus group discussions (FGDs) were conducted with pastoral and agro-pastoral communities in northeastern Uganda. Data from the FGDs were analysed using a constructivist grounded theory approach.

Results: Analysis of the FGD data revealed that cultural norms and economic pressure were crucial factors in maternal employment decisions. We constructed a model that represents maternal employment as a delicate balance to maximize the benefits for child nutrition and health while minimizing the negative consequences. The model comprises the core category, mothers’ solitary struggle for better child nutrition and health, and four interrelated categories: (1) mothers conforming to societal expectations, (2) mediating the effect of maternal employment on child nutrition and health, (3) suffering consequences of maternal employment, and (4) mothers striving for better child nutrition and health.

Conclusion: Access to income emerged as the main pathway through which maternal employment leads to better child nutrition and health. However, this benefit often comes at the cost of reduced time for childcare, which is perceived to be detrimental to child nutrition and health. Based on these results, enhancing access to productive resources and employment, particularly for women is crucial for addressing undernutrition. To ensure that maternal employment does not compromise childcare, policies must support the development and access to childcare options that are affordable and appropriate for women in rural areas and in informal employment to effectively balance employment and childcare.

Place, publisher, year, edition, pages
Springer Nature, 2025
Keywords
Child nutrition and health, Focus group discussion, Grounded theory, Maternal employment, Sociocultural norms
National Category
Nutrition and Dietetics Epidemiology Public Health, Global Health and Social Medicine
Identifiers
urn:nbn:se:umu:diva-236195 (URN)10.1186/s12889-025-21978-z (DOI)001432960300014 ()40001081 (PubMedID)2-s2.0-85218678077 (Scopus ID)
Funder
Swedish Research Council Formas, 2020-00478Familjen Erling-Perssons Stiftelse
Available from: 2025-03-13 Created: 2025-03-13 Last updated: 2025-03-13Bibliographically approved
Bohm, I., Åbacka, G., Hörnell, A. & Bengs, C. (2025). "Can we add a little sugar?": The contradictory discourses around sweet foods in Swedish home economics. Pedagogy, Culture & Society, 33(1), 105-121
Open this publication in new window or tab >>"Can we add a little sugar?": The contradictory discourses around sweet foods in Swedish home economics
2025 (English)In: Pedagogy, Culture & Society, ISSN 1468-1366, E-ISSN 1747-5104, Vol. 33, no 1, p. 105-121Article in journal (Refereed) Published
Abstract [en]

Sweet foods occupy an ambiguous position in many people’s diets, perhaps especially for children and adolescents. The twin expectation that they both covet and limit their intake can create a dilemma not only in the home, but also in the school subject Home Economics (HE), which among other themes has a focus on food and health. In this study, we explored how Discourses on sweet foods were formed, reproduced, and challenged during 26 lessons in northern Sweden. Overall, sweet foods were constructed as desirable but also as unhealthy, disgusting, and unnecessary. They were used as a form of capital where ownership, distribution, and fairness were important, and students could mark friendships by sharing and gifting. Conversely, they could also use sweet foods to police, ridicule, question, or punish each other. Conflicts could arise around less-than-perfect results and students could withhold sweet foods from each other as a form of social rejection. Vague limits to intake placed responsibility for intake on the students themselves. We suggest that a contextualisation of the social, cultural, and health aspects of sweet foods in HE might help students acquire a more holistic Discourse of sweet foods and mitigate their social weaponisation.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2025
Keywords
hem- och konsumentkunskap, diskursanalys, sötsaker
National Category
Sociology (excluding Social Work, Social Psychology and Social Anthropology)
Research subject
Food and Nutrition
Identifiers
urn:nbn:se:umu:diva-206582 (URN)10.1080/14681366.2023.2190754 (DOI)001101612000001 ()2-s2.0-85152450276 (Scopus ID)
Available from: 2023-04-12 Created: 2023-04-12 Last updated: 2025-01-10Bibliographically approved
Hörnell, A. & Lagström, H. (2024). Infant feeding: a scoping review for Nordic Nutrition Recommendations 2023. Food & Nutrition Research, 68, Article ID 10456.
Open this publication in new window or tab >>Infant feeding: a scoping review for Nordic Nutrition Recommendations 2023
2024 (English)In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 68, article id 10456Article, review/survey (Refereed) Published
Abstract [en]

The 2012 edition of the Nordic Nutrition Recommendations (NNR) included recommendations on breastfeeding, based on the most recent guidelines and recommendations from major national food and health authorities and organizations, systematic reviews, and some original research. For NNR 2023, the scope has been expanded and also includes formula feeding and the introduction of solid food. The main focus in this scoping review is on infants aged 0-12 months but also considers parts both before and beyond the first year, as the concept of 'the first 1000 days' emphasizes the importance of factors during pregnancy and the first 2 years of life for immediate and later health: physical as well as emotional and mental health. Breastmilk is the natural and sustainable way to feed an infant during the first months of life. Numerous studies have indicated immediate as well as long-term beneficial effects of breastfeeding on health for both the infant and the breastfeeding mother, and from a public health perspective, it is therefore important to protect, support, and promote breastfeeding. For full-term, normal weight infants, breastmilk is sufficient as the only form of nutrition for the first 6 months, except for vitamin D that needs to be given as supplement. The World Health Organization (WHO) and several other authoritative bodies therefore recommend exclusive breastfeeding during the first 6 months. Starting solids at about 6 months is necessary for both nutritional and developmental reasons. According to the European Food Safety Authority (EFSA) and the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN), solid foods are safe to give from 4 months although exclusive breastfeeding until 6 months is the desirable goal. Breastfeeding can continue together with complementary foods as long as it is mutually desired by the mother and child. If breastfeeding is not enough or for some reason discontinued before the infant is 4 months of age, the infant should be fed infant formula, and, when possible, breastfeeding should be continued alongside the formula feeding. If the infant is 4 months or older, starting with solids together with continued breastfeeding and/or formula feeding is an option. Infant formulas have been developed for infants who are not breastfed or do not get enough breastmilk. Home-made formula should not be given.

Place, publisher, year, edition, pages
Swedish Nutrition Foundation, 2024
Keywords
breastfeeding, breastfeeding statistics, breastmilk, health effects of infant feeding, infant formula, introduction of solid foods, Nordic and Baltic countries
National Category
Nutrition and Dietetics Pediatrics
Identifiers
urn:nbn:se:umu:diva-221790 (URN)10.29219/fnr.v68.10456 (DOI)2-s2.0-85185961684 (Scopus ID)
Available from: 2024-03-18 Created: 2024-03-18 Last updated: 2025-02-11Bibliographically approved
Larsson, M., Lindman, I., Hörnell, A. & Abrahamson, J. (2024). Prospective study of food intake changes in adolescent elite athletes. BMJ Nutrition, Prevention & Health, 7(2), Article ID e000954.
Open this publication in new window or tab >>Prospective study of food intake changes in adolescent elite athletes
2024 (English)In: BMJ Nutrition, Prevention & Health, E-ISSN 2516-5542, Vol. 7, no 2, article id e000954Article in journal (Refereed) Published
Abstract [en]

Background: Inadequate energy intake among athletes can lead to low energy availability (LEA) which in turn can result in negative effects on athletic performance and physical and psychological health. This syndrome is known as relative energy deficiency in sports (REDs).

Objective: To map perceived changes in overall food intake among adolescent athletes during the previous year, as well as weekly changes during a 3-month period and to examine how these changes are associated with mental health, physical load and sex.

Methods: A total of 168 high school athletes from eight different sports participated. A baseline questionnaire examined changes in training habits and food intake in the past year, mental health (short version of the Warwick-Edinburgh Mental Well-being Scale (SWEMWBS)), injury history and previous periods of poor psychological health. Weekly digital questionnaires for 3 months tracked weekly physical and mental load and changes in food intake. Comparative and correlation analyses were performed with p<0.05 considered significant.

Results: A decreased food intake during the previous year was reported more often among athletes experiencing periods of poor mental health than those without such periods (10% vs 2%; p=0.034). Athletes who decreased their food intake reported lower mental well-being than athletes who increased their food intake (mean difference in SWEMWBS=4.69±1.57; p=0.021). Over a 3-month period, most athletes did not change their food intake, yet fluctuations in physical load were reported.

Conclusion: This study showed that athletes experiencing lower mental health or period(s) of poor mental health reported decreased food intake more often than those with better mental health or those without period(s) of poor mental health. In addition, the mismatch found between perceived weekly changes in overall food intake and changes in physical load during the same time period could potentially result in an increased risk for LEA.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2024
National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:umu:diva-233199 (URN)10.1136/bmjnph-2024-000954 (DOI)001379680000001 ()2-s2.0-85213717311 (Scopus ID)
Projects
Healthy Injury-Free Adolescent Athletes Project (HIFAA)
Funder
Lars Hierta Memorial Foundation
Available from: 2024-12-27 Created: 2024-12-27 Last updated: 2025-02-11Bibliographically approved
Olsson, C., Hörnell, A. & Waling, M. (2023). High availability of vegetables and fruit through government-funded school lunch is not reflected in 4th grade pupils' intake. Food & Nutrition Research, 67, Article ID 9405.
Open this publication in new window or tab >>High availability of vegetables and fruit through government-funded school lunch is not reflected in 4th grade pupils' intake
2023 (English)In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 67, article id 9405Article in journal (Refereed) Published
Abstract [en]

Background: An increased intake of vegetable and fruit (VF) through school meals can contribute to the prevention of non-communicable diseases.

Objective: The purpose of this study was to investigate what types of VF 4th grade pupils (10–11 years old) choose, how much they eat when they are given the opportunity to serve themselves from the daily vegetable buffet available at lunch, and whether this varies with socioeconomic background and gender.

Design: A cross-sectional study design was used where pupils’ VF intake was measured during 5 days with a photographic method. In total, 196 pupils from nine public schools participated.

Results: The results show that pupils on average ate less than one type of VF per day from the vegetable buffet. Girls, pupils with a higher socio-economic status (SES) and those with a more frequent VF intake at home, ate more types of VF per day from the vegetable buffet than their counterparts. The median intake of VF from the vegetable buffet was generally low, 20.4 g/day. The intake was two thirds higher for pupils with higher SES in comparison with pupils with lower SES; 25 g/day versus14 g/day (P = 0.001). No gender differences in grams per day of VF were identified (P = 0.123).

Discussion: This study indicates that a well-stocked vegetable buffet as part of government-funded school lunch does not automatically contribute substantially to the recommended daily intake of VF among a sample of 4th grade pupils in a high-income country like Sweden.

Conclusions: The results of the study can be interpreted as a missed opportunity to increase the intentional consumption of VF among pupils in a way that would have implications for public health as well as attenuating differences between socioeconomic groups.

Place, publisher, year, edition, pages
Swedish Nutrition Foundation, 2023
Keywords
dietary intake, fruit, pupils, school lunch, vegetables
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-212709 (URN)10.29219/fnr.v67.9405 (DOI)37533447 (PubMedID)2-s2.0-85165984031 (Scopus ID)
Funder
NordForsk, 54761
Available from: 2023-08-15 Created: 2023-08-15 Last updated: 2025-02-11Bibliographically approved
Rapo, S., Mattson Sydner, Y., Kautto, E. & Hörnell, A. (2021). Exploring patient satisfaction with hospital foodservice: a Swedish study using the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire. Nutrition & Dietetics, 78(5), 487-495
Open this publication in new window or tab >>Exploring patient satisfaction with hospital foodservice: a Swedish study using the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire
2021 (English)In: Nutrition & Dietetics, ISSN 1446-6368, E-ISSN 1747-0080, Vol. 78, no 5, p. 487-495Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of this study was to explore patient satisfaction with hospital foodservice in the Swedish setting, using a validated instrument, adding this context to the existing body of research.

Methods: The study was carried out at three hospitals employing cyclic menus and conventional cook-serve foodservice systems with centralised tray assemblies and hot-trolley distributions to the wards for service. Patient satisfaction was explored using a translated version of the validated Acute Care Hospital Foodservice Patient Satisfaction Questionnaire. Groups were compared with Mann-Whitney U-test and Kruskal Wallis test with a set significance level of P < .05.

Results: Questionnaires from 439 patients were included in the analysis. The majority (80%) reported an overall satisfaction of "good" or "very good." Questions related to Staff and Service received mostly the highest possible ratings, while questions related to Food Quality and Meal Size had slightly lower ratings and higher variation. Comparisons between groups showed that differences were small even when statistically significant. Low appetite and a long hospital stay had an adverse effect on overall satisfaction and food quality-related questions. Men and younger patients reported more often being hungry after and between meals.

Conclusions: Hospital foodservice faces the challenge of catering to multiple patient needs. Monitoring patient satisfaction is crucial to ensure that foodservice operations remain evidence based. The Acute Care Hospital Foodservice Patient Satisfaction Questionnaire provided a general overview that indicated foodservice areas with potential for improvement, although patient satisfaction overall was high. However, patient satisfaction is a complex measure and reflexivity is required when interpreting empirical results.

Place, publisher, year, edition, pages
Blackwell Publishing, 2021
Keywords
evidence-based practice, food services, patient satisfaction, quality management
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-181644 (URN)10.1111/1747-0080.12665 (DOI)000627111400001 ()33691342 (PubMedID)2-s2.0-85102248901 (Scopus ID)
Available from: 2021-06-09 Created: 2021-06-09 Last updated: 2025-02-11Bibliographically approved
Hörnell, A. (2021). Nutrition i yngre åldrar (7ed.). In: Christina Berg; Lars Ellegård; Christel Larsson (Ed.), Näringslära för högskolan: (pp. 418-435). Stockholm: Liber
Open this publication in new window or tab >>Nutrition i yngre åldrar
2021 (Swedish)In: Näringslära för högskolan / [ed] Christina Berg; Lars Ellegård; Christel Larsson, Stockholm: Liber, 2021, 7, p. 418-435Chapter in book (Other academic)
Place, publisher, year, edition, pages
Stockholm: Liber, 2021 Edition: 7
National Category
Nutrition and Dietetics
Research subject
Food and Nutrition
Identifiers
urn:nbn:se:umu:diva-189004 (URN)9789147131075 (ISBN)
Available from: 2021-10-31 Created: 2021-10-31 Last updated: 2025-02-11Bibliographically approved
Hörnell, A. (2021). Nutrition vid graviditet och amning (7ed.). In: Christina Berg; Lars Ellegård; Christel Larsson (Ed.), Näringslära för högskolan: (pp. 406-417). Stockholm: Liber
Open this publication in new window or tab >>Nutrition vid graviditet och amning
2021 (Swedish)In: Näringslära för högskolan / [ed] Christina Berg; Lars Ellegård; Christel Larsson, Stockholm: Liber, 2021, 7, p. 406-417Chapter in book (Other academic)
Place, publisher, year, edition, pages
Stockholm: Liber, 2021 Edition: 7
National Category
Nutrition and Dietetics
Research subject
Food and Nutrition
Identifiers
urn:nbn:se:umu:diva-189003 (URN)9789147131075 (ISBN)
Available from: 2021-10-31 Created: 2021-10-31 Last updated: 2025-02-11Bibliographically approved
Lindblom, C., Erixon Arreman, I., Olsson, C., Landfors, H., Waling, M. & Hörnell, A. (2020). Challenges to Interdisciplinary teaching for nutrition and health in Swedish compulsory schools. International Journal of Home Economics, 13(1), 15-29
Open this publication in new window or tab >>Challenges to Interdisciplinary teaching for nutrition and health in Swedish compulsory schools
Show others...
2020 (English)In: International Journal of Home Economics, E-ISSN 1999-561X, Vol. 13, no 1, p. 15-29Article in journal (Refereed) Published
Abstract [en]

The Swedish National Agency for Education states that educational provision should involve pupil opportunities for interdisciplinary work and the experience of learning in different ways. In this context, the current study aimed to explore the actual operation of interdisciplinary teaching (IDT) in Swedish compulsory schools, i.e. from preschool (6 years) to grade 9 (16 years) regarding nutrition and health. To investigate this, two web-based nationwide questionnaires were sent out in 2014 to compulsory schools in Sweden. One questionnaire was aimed at teachers in five subjects: Home and Consumer Studies (HCS), Natural Science Subjects (NSS) (Biology, Chemistry, Physics), and Physical Education and Health (PEH). The second questionnaire was for school principals. A total of 388 teachers and 216 principals answered the respective questionnaire. The study showed that 40% of the teachers and 59% of the principals reported that their school worked in an interdisciplinary way regarding nutrition and health education. Practical scheduling problems and a lack of time for planning were seen as the main barriers by both teachers and principals, but to a much larger extent by teachers. A prerequisite for successful IDT is that teachers have a chance to meet and plan, and this study indicates that frame factors have a critical impact on what is possible regarding IDT in Swedish schools. It is crucial that principals appreciate their part in facilitating IDT. Increased interdisciplinary teaching for nutrition and health (IDT-NH) might increase school potential for the better integration of knowledge and understanding about the importance of lifestyle for health, the environment and society.

Place, publisher, year, edition, pages
Bonn: International Federation for Home Economics, 2020
Keywords
Home and Consumer Studies, Interdiciplinary Teaching, Nutrition and Health, Education, Compulsory schools
National Category
Educational Sciences
Research subject
Food and Nutrition
Identifiers
urn:nbn:se:umu:diva-175496 (URN)
Available from: 2020-09-30 Created: 2020-09-30 Last updated: 2024-03-13Bibliographically approved
Sundqvist, J., Walter, U. & Hörnell, A. (2020). Eat, sleep, fly, repeat: meal patterns among Swedish business travellers. Journal of Gastronomy and Tourism, 4(2), 55-66
Open this publication in new window or tab >>Eat, sleep, fly, repeat: meal patterns among Swedish business travellers
2020 (English)In: Journal of Gastronomy and Tourism, ISSN 2169-2971, E-ISSN 2169-298X, Vol. 4, no 2, p. 55-66Article in journal (Refereed) Published
Abstract [en]

Over half of the annual guests at Swedish hotels are supplied by the corporate sector. These guests are made up of individuals who travel for meetings, conferences, or presentations as a part of their job. Access to meals while travelling is essential and introduces added complexity to the business travellers’ everyday lives. These meals, and the pattern in which they are consumed, are part of the individual traveller’s personal and group identities. Therefore, the aim of this article is to study if business travellers deviate from their habitual meal patterns and if so - what changes they make. To further the understanding of this group’s meal patterns, a questionnaire was created and distributed. It was answered by 538 self-identified business travellers. These business travellers were made up of three groups – solo travellers, group travellers, and individuals who travelled both in groups as well as alone. Pearson’s chi-squared test was used to analyse differences in actions related to the meal pattern between groups. The analysis showed that changes in the meal pattern did occur in some instances. However, the majority of the business travellers adhered to their habitual meal pattern while adjusting their behaviour depending on the time of day. Managers of catering suppliers gaining insight into the meal habits of business travellers could help to ease an otherwise stressful situation by supplying meals, as a context, that fit with the business travellers’ habitual patterns and meal contexts.

Place, publisher, year, edition, pages
Cognizant Communication Corporation, 2020
Keywords
meal behaviour, meal practice, business tourism, hospitality management
National Category
Other Social Sciences not elsewhere specified
Identifiers
urn:nbn:se:umu:diva-165528 (URN)10.3727/216929719X15736343324841 (DOI)
Available from: 2019-11-26 Created: 2019-11-26 Last updated: 2020-08-19Bibliographically approved
Projects
Gender differences in how stroke and myocardial infarction are related to fish consumption, methylmercury, fish fatty acids, and selenium [2007-2024_Formas]; Umeå UniversitySenior research fellow, PhD Sanna Talvia, Turku Institute for Child and Youth Research, University of Turku, Finland visits Umeå University to promote Nordic school meal research [2015-01354_Forte]; Umeå University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-5464-5686

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