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  • Delisle, C., et al. (författare)
  • A web- and mobile phone-based intervention to prevent obesity in 4-year-olds (MINISTOP): a population-based randomized controlled trial
  • 2015
  • Ingår i: Bmc Public Health. - 1471-2458. ; 15
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Childhood obesity is an increasing health problem globally. Overweight and obesity may be established as early as 2-5 years of age, highlighting the need for evidence-based effective prevention and treatment programs early in life. In adults, mobile phone based interventions for weight management (mHealth) have demonstrated positive effects on body mass, however, their use in child populations has yet to be examined. The aim of this paper is to report the study design and methodology of the MINSTOP (Mobile-based Intervention Intended to Stop Obesity in Preschoolers) trial. Methods/Design: A two-arm, parallel design randomized controlled trial in 300 healthy Swedish 4-year-olds is conducted. After baseline measures, parents are allocated to either an intervention-or control group. The 6-month mHealth intervention consists of a web-based application (the MINSTOP app) to help parents promote healthy eating and physical activity in children. MINISTOP is based on the Social Cognitive Theory and involves the delivery of a comprehensive, personalized program of information and text messages based on existing guidelines for a healthy diet and active lifestyle in pre-school children. Parents also register physical activity and intakes of candy, soft drinks, vegetables as well as fruits of their child and receive feedback through the application. Primary outcomes include body fatness and energy intake, while secondary outcomes are time spent in sedentary, moderate, and vigorous physical activity, physical fitness and intakes of fruits and vegetables, snacks, soft drinks and candy. Food and energy intake (Tool for Energy balance in Children, TECH), body fatness (pediatric option for BodPod), physical activity (Actigraph wGT3x-BT) and physical fitness (the PREFIT battery of five fitness tests) are measured at baseline, after the intervention (six months after baseline) and at follow-up (12 months after baseline). Discussion: This novel study will evaluate the effectiveness of a mHealth program for mitigating gain in body fatness among 4-year-old children. If the intervention proves effective it has great potential to be implemented in child-health care to counteract childhood overweight and obesity.
  • Döringer, Nora, et al. (författare)
  • Motivational Interviewing to Prevent Childhood Obesity: A Cluster RCT
  • 2016
  • Ingår i: Pediatrics. - 0031-4005. ; 137:5
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: The objective was to evaluate a manualized theory-driven primary preventive intervention aimed at early childhood obesity. The intervention was embedded in Swedish child health services, starting when eligible children were 9 to 10 months of age and continuing until the children reached age 4. METHODS: Child health care centers in 8 Swedish counties were randomized into intervention and control units and included 1355 families with 1369 infants. Over similar to 39 months, families in the intervention group participated in 1 group session and 8 individual sessions with a nurse trained in motivational interviewing, focusing on healthy food habits and physical activity. Families in the control group received care as usual. Primary outcomes were children's BMI, overweight prevalence, and waist circumference at age 4. Secondary outcomes were children's and mothers' food and physical activity habits and mothers' anthropometrics. Effects were assessed in linear and log-binominal regression models using generalized estimating equations. RESULTS: There were no statistically significant differences in children's BMI (beta = -0.11, 95% confidence interval [CI]: -0.31 to 0.08), waist circumference (beta = -0.48, 95% CI: -0.99 to 0.04), and prevalence of overweight (relative risk = 0.95, 95% CI: 0.69 to 1.32). No significant intervention effects were observed in mothers' anthropometric data or regarding mothers' and children's physical activity habits. There was a small intervention effect in terms of healthier food habits among children and mothers. CONCLUSIONS: There were no significant group differences in children's and mothers' anthropometric data and physical activity habits. There was, however, some evidence suggesting healthier food habits, but this should be interpreted with caution.
  • Fröberg, Andreas, 1985-, et al. (författare)
  • Accelerometer-measured physical activity among adolescents in a multicultural area characterized by low socioeconomic status
  • 2018
  • Ingår i: International Journal of Adolescent Medicine and Health. - 0334-0139. ; 30:3
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: The aim of this cross-sectional study was to describe and analyze accelerometer-measured sedentary time and physical activity (PA) among adolescents in a multicultural area characterized by low socioeconomic status (SES). METHOD: Seventh-graders (n=114 (girls n=66), mean age: 12.8±0.5 y) were recruited from three schools in a multicultural area of the city of Gothenburg, Sweden. Sedentary time and PA were measured with ActiGraph™ accelerometers. RESULT: Of total wear-time, 70 (±6)% was sedentary, with girls being more sedentary than boys. Girls had less light PA (LPA) and moderate-to-vigorous PA (MVPA) than boys. Similar patterns were shown during in-school and out-of-school hours. During wear-time, 53% had a mean of ≥60 min of MVPA per day, but only 6% of the girls and 24% of the boys were sufficiently physically active every day. Girls had more sedentary bouts of ≥10 min and fewer MVPA bouts of ≥5 min per day than boys. Those who participated in organized sports spent a mean of 15 more minutes of MVPA per day compared to those who did not. No association was observed between body mass index (BMI) and sedentary time and PA. CONCLUSION: Only a few adolescents from a Swedish multicultural area characterized by low SES met the PA recommendations every day, and girls were more sedentary and less physically active than boys. Adolescents involved in organized sports had more of MVPA per day than their non-involved peers. Sedentary time and PA were not related to BMI.
  • Fröberg, Andreas, 1985-, et al. (författare)
  • Combinations of epoch durations and cut-points to estimate sedentary time and physical activity among adolescents
  • 2017
  • Ingår i: Measurement in Physical Education and Exercise Science. - 1091-367X .- 1532-7841. ; 21:3, s. 154-160
  • Tidskriftsartikel (refereegranskat)abstract
    • The purpose of the current study was to investigate how combinations of different epoch durations and cut-points affect the estimations of sedentary time and physical activity in adolescents. Accelerometer data from 101 adolescents were derived and 30 combinations were used to estimate sedentary time, light, moderate, vigorous, and combined moderate-to-vigorous physical activity. Data were analyzed with repeated measurement analyses of variance. Large differences of sedentary time and times of different physical activity intensities were observed between 1 s and longer epoch durations using virtually all cut-points. Generally, sedentary time, moderate physical activity, vigorous physical activity, and combined moderate-to-vigorous physical activity progressively decreased, whereas light physical activity increased with longer epoch durations. The extreme differences between cut-points were large and increased with longer epoch durations for sedentary time and for all physical activity intensities except for vigorous physical activity per epoch duration. Caution is required when cross-comparing studies using different epoch durations and cut-points. To accurately register adolescents’ spontaneous intermittent physical activity behavior, short epoch durations are recommended.
  • Hansson, Lena M, et al. (författare)
  • Associations Between Swedish Mothers' and 3- and 5-Year-Old Children's Food Intake.
  • 2016
  • Ingår i: Journal of nutrition education and behavior. - 1878-2620. ; 48:8, s. 520-529.e1
  • Tidskriftsartikel (refereegranskat)abstract
    • To investigate associations between mothers' and children's food intake.Cross-sectional study. Background variables collected through self-reports and from the register of the total population. Mothers recorded their own and their children's food intake in a diary during 2 4-day periods.Eight counties in mid Sweden.Three- and 5-year-old children and their mothers were randomly selected from the register of the total population. A total of 2,045 families were invited, 355 of whom accepted. Mothers who accepted were older and to a larger extent born in Sweden. The final sample of mother-child pairs with complete food records was 189.Mothers' and children's food intake (16 food items).Spearman rank-order correlation with 95% confidence intervals (2-sided). Moderation was investigated using generalized estimation equations with robust variance.The strongest correlations between mothers' and children's food intake were found for pizza and oily fish (r = .70-.80). The weakest correlations were found for sugared drinks and fruit and berries (r = .24-.26). Children's age moderated the relationship between mothers' and children's intake of savoury snacks, as did place of residence for pizza intake.There were substantial correlations between children's and mothers' intake of various foods. Modeling of mothers' intake might be more effective in influencing young children's intake of certain foods, whereas other strategies, such as encouraging parents to influence food availability (eg, gatekeeping), might be more useful for some foods.
  • Hörnell, Agneta, et al. (författare)
  • Perspective : An extension of the STROBE statement for observational studies in nutritional epidemiology (STROBE-nut): Explanation and elaboration
  • 2017
  • Ingår i: Advances in Nutrition. - American Society for Nutrition. - 2161-8313. ; 8:5, s. 652-678
  • Tidskriftsartikel (refereegranskat)abstract
    • 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.
  • Lachat, Carl, et al. (författare)
  • Strengthening the Reporting of Observational Studies in Epidemiology—Nutritional Epidemiology (STROBE-nut) : : An Extension of the STROBE Statement
  • 2016
  • Ingår i: PLoS Medicine. - Public Library of Science. - 1549-1277. ; 13:6
  • Tidskriftsartikel (refereegranskat)abstract
    • 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.
  • Nystrom, C. D., et al. (författare)
  • A Mobile Phone Based Method to Assess Energy and Food Intake in Young Children: A Validation Study against the Doubly Labelled Water Method and 24 h Dietary Recalls
  • 2016
  • Ingår i: Nutrients. - 2072-6643. ; 8:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Mobile phones are becoming important instruments for assessing diet and energy intake. We developed the Tool for Energy Balance in Children (TECH), which uses a mobile phone to assess energy and food intake in pre-school children. The aims of this study were: (a) to compare energy intake (EI) using TECH with total energy expenditure (TEE) measured via doubly labelled water (DLW); and (b) to compare intakes of fruits, vegetables, fruit juice, sweetened beverages, candy, ice cream, and bakery products using TECH with intakes acquired by 24 h dietary recalls. Participants were 39 healthy, Swedish children (5.5 +/- 0.5 years) within the ongoing Mobile-based Intervention Intended to Stop Obesity in Preschoolers (MINISTOP) obesity prevention trial. Energy and food intakes were assessed during four days using TECH and 24 h telephone dietary recalls. Mean EI (TECH) was not statistically different from TEE (DLW) (5820 +/- 820 kJ/24 h and 6040 +/- 680kJ/24 h, respectively). No significant differences in the average food intakes using TECH and 24 h dietary recalls were found. All food intakes were correlated between TECH and the 24 h dietary recalls (r = 0.665-0.896, p < 0.001). In conclusion, TECH accurately estimated the average intakes of energy and selected foods and thus has the potential to be a useful tool for dietary studies in pre-school children, for example obesity prevention trials.
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