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1.	Adamsson, Viola, et al. (author) Influence of a healthy Nordic diet on serum fatty acid composition and associations with blood lipoproteins : results from the NORDIET study 2014 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 58, s. 24114- Journal article (other academic/artistic)abstract Background: The fatty acid (FA) composition of serum lipids is related to the quality of dietary fat. The aim of this study was to investigate the effects of a healthy Nordic diet (ND) on the FA composition of serum cholesterol esters (CE-FA) and assess the associations between changes in the serum CE-FA composition and blood lipoproteins during a controlled dietary intervention.Methods: The NORDIET trial was a six-week randomised, controlled, parallel-group dietary intervention study that included 86 adults (53±8 years) with elevated low-density lipoprotein cholesterol LDL-C. Serum CE-FA composition was measured using gas chromatography. Diet history interviews were conducted, and daily intake was assessed using checklists.Results: Food and nutrient intake data indicated that there was a reduction in the fat intake from dairy and meat products and an increase in the consumption of fatty fish with the ND, decreasing the levels of saturated fatty acids (SFA) in the diet, slightly decreasing the levels of monounsaturated fatty acids (MUFA) and moderately increasing the levels of polyunsaturated fatty acids (PUFA). Concomitantly, the levels of CE-SFA 14:0, 15:0 and 18:0, but not 16:0, decreased during the ND, and these changes differed from those observed in the control diet group (p<0.01). In contrast, serum 22:6n-3 increased during the ND compared with the control diet (p<0.01). The changes in CE-SFA 14:0, 15:0 and 18:0 during the intervention correlated positively with those in LDL-C, HDL-C, LDL-C/HDL-C, ApoA1 and ApoB (p<0.01), whereas the changes in CE-PUFA 22:6n-3 were negatively correlated with changes in the corresponding serum lipids.Conclusions: The decreased intake of saturated fat and increased intake of n-3 PUFA in a healthy Nordic diet are partly reflected by changes in the serum CE-FA composition, which are associated with an improved serum lipoprotein pattern.
2.	Adamsson, Viola, et al. (author) What is a healthy Nordic diet? : Foods and nutrients in the NORDIET study 2012 In: Food & Nutrition Research. - Bålsta : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 56, s. 18189- Journal article (peer-reviewed)abstract Background: A healthy Nordic diet (ND), a diet based on foods originating from the Nordic countries, improves blood lipid profile and insulin sensitivity and lowers blood pressure and body weight in hypercholesterolemic subjects. Objective: To describe and compare food and nutrient composition of the ND in relation to the intake of a Swedish reference population (SRP) and the recommended intake (RI) and average requirement (AR), as described by the Nordic nutrition recommendations (NNR). Design: The analyses were based on an estimate of actual food and nutrient intake of 44 men and women (mean age 53 +/- 8 years, BMI 26 +/- 3), representing an intervention arm receiving ND for 6 weeks. Results: The main difference between ND and SRP was the higher intake of plant foods, fish, egg and vegetable fat and a lower intake of meat products, dairy products, sweets and desserts and alcoholic beverages during ND (p<0.001 for all food groups). Intake of cereals and seeds was similar between ND and SRP (p>0.3). The relative intake of protein, fat and carbohydrates during ND was in accordance with RI. Intake of all vitamins and minerals was above AR, whereas sodium intake was below RI. Conclusions: When compared with the food intake of an SRP, ND is primarily a plant-based diet. ND represents a balanced food intake that meets the current RI and AR of NNR 2004 and has a dietary pattern that is associated with decreased morbidity and mortality.
3.	Adolfsson, Päivi, et al. (author) Observed dietary intake in adults with intellectual disability living in the community 2008 In: Food & Nutrition Research. - : Co-Action Publishing. - 1654-6628 .- 1654-661X. ; 52 Journal article (peer-reviewed)abstract Background: Knowledge is lacking about dietary habits among people with intellectual disability (ID) living in community residences under new living conditions.Objective: To describe the dietary habits of individuals with ID living in community residences, focusing on intake of food, energy and nutrients as well as meal patterns.Design: Assisted food records and physical activity records over a 3-day observation period for 32 subjects.Results: Great variation was observed in daily energy intake (4.9-14 MJ) dispersed across several meals, with on average 26% of the energy coming from in-between-meal consumption. Main energy sources were milk products, bread, meat products, buns and cakes. The daily intake of fruit and vegetables (320_221 g) as well as dietary fiber (21_99.6 g) was generally low. For four vitamins and two minerals, 19-34% of subjects showed an intake below average requirement (AR). The physical activity level (PAL) was low for all individuals (1.4_0.1).Conclusion: A regular meal pattern with a relatively high proportion of energy from in-between-meal eating occasions and a low intake of especially fruits were typical of this group of people with ID. However, the total intake of energy and other food items varied a great deal between individuals. Thus, every adult with ID has to be treated as an individual with specific needs. A need for more knowledge about food in general and particularly how fruit and vegetables could be included in cooking as well as encouraged to be eaten as inbetween-meals seems imperative in the new living conditions for adults with ID.
4.	Akesson, Agneta, et al. (author) Health effects associated with foods characteristic of the Nordic diet: a systematic literature review 2013 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-661X .- 1654-6628. ; 57 Research review (peer-reviewed)abstract Background: In preparing the fifth edition of the Nordic Nutrition Recommendations (NNR), the scientific basis of specific food-based dietary guidelines (FBDG) was evaluated. Objective: A systematic review (SR) was conducted to update the NNR evidence based on the association between the consumption of potatoes, berries, whole grains, milk and milk products, and red and processed meat, and the risk of major diet-related chronic diseases. Design: The SR was based on predefined research questions and eligibility criteria for independent duplicate study selection, data extraction, and assessment of methodological quality and applicability. We considered scientific data from prospective observational studies and intervention studies, published since year 2000, targeting the general adult population. Studies of meat and iron status included children, adolescents, and women of childbearing age. Results: Based on 7,282 abstracts, 57 studies met the quality criteria and were evidence graded. The data were too limited to draw any conclusions regarding: red and processed meat intake in relation to cardiovascular disease (CVD) and iron status; potatoes and berries regarding any study outcomes; and dairy consumption in relation to risk of breast cancer and CVD. However, dairy consumption seemed unlikely to increase CVD risk (moderate-grade evidence). There was probable evidence (moderate-grade) for whole grains protecting against type 2 diabetes and CVD, and suggestive evidence (low-grade) for colorectal cancer and for dairy consumption being associated with decreased risk of type 2 diabetes and increased risk of prostate cancer. The WCRF/AICR concludes that red and processed meat is a convincing cause of colorectal cancer. Conclusions: Probable (moderate) evidence was only observed for whole grains protecting against type 2 diabetes and CVD. We identified a clear need for high-quality nutritional epidemiological and intervention studies and for studies of foods of the Nordic diet.
5.	Ali, Mohamed Atiya, et al. (author) Polyamines : total daily intake in adolescents compared to the intake estimated from the Swedish Nutrition Recommendations Objectified (SNO) 2011 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 55, s. 5455- Journal article (peer-reviewed)abstract Background: Dietary polyamines have been shown to give a significant contribution to the body pool of polyamines. Knowing the levels of polyamines (putrescine, spermidine, and spermine) in different foods and the contribution of daily food choice to polyamine intake is of interest, due to the association of these bioactive amines to health and disease. Objective: To estimate polyamine intake and food contribution to this intake in adolescents compared to a diet fulfilling the Swedish Nutrition Recommendations. Design: A cross-sectional study of dietary intake in adolescents and an 'ideal diet' (Swedish nutrition recommendations objectified [SNO]) list of foods was used to compute polyamine intake using a database of polyamine contents of foods. For polyamine intake estimation, 7-day weighed food records collected from 93 adolescents were entered into dietetic software (Dietist XP) including data on polyamine contents of foods. The content of polyamines in foods recommended according to SNO was entered in the same way. Results: The adolescents' mean daily polyamine intake was 316 +/- 170 mu mol/day, while the calculated contribution according to SNO was considerably higher with an average polyamine intake of 541 mu mol/day. In both adolescent's intake and SNO, fruits contributed to almost half of the total polyamine intake. The reason why the intake among the adolescents was lower than the one calculated from SNO was mainly due to the low vegetable consumption in the adolescents group. Conclusions: The average daily total polyamine intake was similar to that previously reported in Europe. With an 'ideal' diet according to Swedish nutrition recommendations, the intake of this bioactive non-nutrient would be higher than that reported by our adolescents and also higher than that previously reported from Europe.
6.	Ali, Mohamed Atiya, et al. (author) Polyamines in foods : development of a food database 2011 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 55, s. 5572- Journal article (peer-reviewed)abstract Background: Knowing the levels of polyamines (putrescine, spermidine, and spermine) in different foods is of interest due to the association of these bioactive nutrients to health and diseases. There is a lack of relevant information on their contents in foods. Objective: To develop a food polyamine database from published data by which polyamine intake and food contribution to this intake can be estimated, and to determine the levels of polyamines in Swedish dairy products. Design: Extensive literature search and laboratory analysis of selected Swedish dairy products. Polyamine contents in foods were collected using an extensive literature search of databases. Polyamines in different types of Swedish dairy products (milk with different fat percentages, yogurt, cheeses, and sour milk) were determined using high performance liquid chromatography (HPLC) equipped with a UV detector. Results: Fruits and cheese were the highest sources of putrescine, while vegetables and meat products were found to be rich in spermidine and spermine, respectively. The content of polyamines in cheese varied considerably between studies. In analyzed Swedish dairy products, matured cheese had the highest total polyamine contents with values of 52.3, 1.2, and 2.6 mg/kg for putrescine, spermidine, and spermine, respectively. Low fat milk had higher putrescine and spermidine, 1.2 and 1.0 mg/kg, respectively, than the other types of milk. Conclusions: The database aids other researchers in their quest for information regarding polyamine intake from foods. Connecting the polyamine contents in food with the Swedish Food Database allows for estimation of polyamine contents per portion.
7.	Almon, Ricardo, et al. (author) Body fat and dairy product intake in lactase persistent and non-persistent children and adolescents 2010 In: Food & Nutrition Research. - Järfälla, Sweden : Co-action Publishing. - 1654-6628 .- 1654-661X. ; 54 Journal article (peer-reviewed)abstract Background: Lactase non-persistent (LNP) individuals may be lactose intolerant and therefore on a more restricted diet concerning milk and milk products compared to lactase persistent (LP) individuals. This may have an impact on body fat mass.Objective This study examines if LP and LNP children and adolescents, defined by genotyping for the LCT-13910 C > T polymorphism, differ from each other with regard to milk and milk product intake, and measures of body fat mass.Design: Children (n=298, mean age 9.6 years) and adolescents (n=386, mean age 15.6 years), belonging to the Swedish part of the European Youth Heart Study, were genotyped for the LCT-13910 C > T polymorphism. Dietary intakes of reduced and full-fat dairy varieties were determined.Results: LNP (CC genotype) subjects consumed less milk, soured milk and yoghurt compared to LP (CT/TT genotype) subjects (p<0.001). Subsequent partitioning for age group attenuated this observation (p=0.002 for children and p=0.023 in adolescents). Six subjects were reported by parents to be 'lactose intolerant', none of whom were LNP. LNP children and adolescents consumed significantly less reduced fat milk and milk products than LP children and adolescents (p=0.009 for children and p=0.001 for adolescents).Conclusions: We conclude that LP is linked to an overall higher milk and dairy intake, but is not linked to higher body fat mass in children and adolescents.
8.	Almon, Ricardo, 1965-, et al. (author) Lactase persistence and milk consumption are associated with body height in Swedish preadolescents and adolescents 2011 In: Food & Nutrition Research. - : CoAction Publishing. - 1654-6628 .- 1654-661X. ; 55 Journal article (peer-reviewed)abstract Background: Body height is a classic polygenic trait. About 80%-90% of height is inherited and 10%-20% owed to environmental factors, of which the most important ones are nutrition and diseases in preadolescents and adolescents.Objective: The aim of this study was to explore potential relations between the LCT (lactase) C > T-13910 polymorphism, milk consumption, and body height in a sample of Swedish preadolescents and adolescents.Design: In a cross-sectional study, using a random sample of preadolescents and adolescents (n = 597), dietary intakes were determined. Anthropometric measurements including sexual maturity (Tanner stage) and birth weight were assessed. Parental body height and socio-economic status (SES) were obtained by questionnaires. Genotyping for the LCT C > T-13910 polymorphism that renders individuals lactase persistent (LP) or lactase non-persistent (LNP) was performed by DNA sequencing. Stepwise backward multivariate linear regression was used.Results: Milk consumption was significantly and positively associated with body height (beta =0.45; 95% CI: 0.040, 0.87, p =0.032). Adjustments were performed for sex, parental height, birth weight, body mass index (BMI), SES, and Tanner stage. This model explains 90% of the observed variance of body height (adjusted R-2 =0.89). The presence of the -13910 T allele was positively associated with body height (beta = 2.05; 95% CI: 0.18, 3.92, p =0.032).Conclusions: Milk consumption is positively associated with body height in preadolescents and adolescents. We show for the first time that a nutrigenetic variant might be able to explain in part phenotypic variation of body height in preadolescents and adolescents. Due to the small sample size further studies are needed.
9.	Andersson, Asa, et al. (author) Vitamin D intake and status in immigrant and native Swedish women : a study at a primary health care centre located at 60 degrees N in Sweden 2013 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 57, s. UNSP 20089- Journal article (peer-reviewed)abstract Background: Immigration to Sweden from lower latitude countries has increased in recent years. Studies in the general population in other Nordic countries have demonstrated that these groups are at risk of developing vitamin D deficiency, but studies in primary health care patients are rare. Objectives: The aim of this study is to examine possible differences in plasma-25(OH)-vitamin D levels and intake of vitamin D between Swedish and immigrant female patients in a primary health care centre located at 60 degrees N, where half of the inhabitants have an immigrant background. Another objective was to estimate what foods contribute with most vitamin D. Design: Thirty-one female patients from the Middle East and Africa and 30 from Sweden were recruited. P-25(OH)D was measured and intake of vitamin D was estimated with a modified food frequency questionnaire (FFQ). Results: Vitamin D deficiency (plasma-25(OH)D<25 nmol/L) was common among immigrant women (61%). One immigrant woman and half of the Swedish women had optimal levels (plasma-25(OH)D>50 nmol/L). There was a positive correlation between the intake of vitamin D from food and plasma-25(OH) D. Only three women, all Swedish, reached the recommended intake of vitamin D from food. The immigrant women had lower intake compared to Swedish women (median: 3.1 vs. 5.1 mu g/day). The foods that contributed with most vitamin D were fatty fish, fortified milk and margarine. Immigrant women consumed less fortified milk and margarine but more meat. Irrespective of origin, patients with plasma-25(OH)D<25 nmol/L consumed less margarine but more meat. Conclusion: Vitamin D deficiency was common in the immigrant patients and their intake of vitamin D was lower. This highlights the need to target information about vitamin D to immigrant women in order to decrease the risk for vitamin D deficiency. The FFQ was well adapted to its purpose to estimate intake of vitamin D.
10.	Andersson, Karin, et al. (author) A two-year clinical lifestyle intervention program for weight loss in obesity 2008 In: Food & nutrition research. - : Co-Action Publishing. - 1654-661X .- 1654-6628. ; 52, s. 1656- Journal article (peer-reviewed)abstract BACKGROUND: In recent randomised prospective studies, lifestyle intervention induced a weight loss of approximately 5%. OBJECTIVE: To describe and evaluate a 2-year on-going group intervention program in clinical practice in terms of weight loss and changes in metabolic risk factors, i.e. sagital abdominal diameter (SAD), triglycerides, fasting blood glucose and blood pressure. DESIGN: The aim of the intervention program was to motivate lifestyle changes concerning food intake and physical activity. The emphasis was on lifestyle modification, followed up at regular visits during 2 years. Subjects evaluated were 100 women with mean BMI 37.6 kg/m(2) and 26 men with mean BMI 36.5 kg/m(2). RESULTS: One hundred of 151 enrolled women and 26 of 36 men completed the program. Mean weight decreased by 3.8 kg in women (from 103.5 to 99.7, p<0.001) and 4.4 kg in men (from 116.5 to 112.1, p<0.05), respectively. SAD decreased by 5% (p=0.001 in women, p=0.01 in men), and triglycerides by 16% in women (p=0.01) and 24% in men (p=0.001), however systolic and diastolic blood pressure increased slightly but significantly. CONCLUSION: It is possible to perform a clinical lifestyle intervention program for outpatients on an ongoing basis with weight loss, lowered SAD and triglycerides, and a similar or lower dropout rate compared to clinical trials.
11.	Arnesen, E. K., et al. (author) Nuts and seeds consumption and risk of cardiovascular disease, type 2 diabetes and their risk factors: a systematic review and meta-analysis 2023 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 67 Journal article (peer-reviewed)abstract Objectives: We aimed to systematically review studies and evaluate the strength of the evidence on nuts/seeds consumption and cardiometabolic diseases and their risk factors among adults. Methods: A protocol was pre-registered in PROSPERO (CRD42021270554). We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials and Scopus up to September 20, 2021 for prospec-tive cohort studies and >= 12-week randomized controlled trials (RCTs). Main outcomes were cardiovascular disease (CVD), coronary heart disease (CHD), stroke and type 2 diabetes (T2D), secondary total-/low density lipoprotein (LDL)-cholesterol, blood pressure and glycaemic markers. Data extraction and risk of bias (RoB) assessments (using RoB 2.0 and RoB-NObS) were performed in duplicate. Effect sizes were pooled using random-effects meta-analyses and expressed as relative risk (RR) or weighted mean differences with 95% confidence intervals (CI); heterogeneity quantified as I2. One-stage dose-response analyses assessed the linear and non-linear associations with CVD, CHD, stroke and T2D. The strength of evidence was classified per the World Cancer Research Fund criteria. Results: After screening 23,244 references, we included 42 papers from cohort studies (28 unique cohorts, 1,890,573 participants) and 18 RCTs (2,266 participants). In the cohorts, mainly populations with low con-sumption, high versus low total nuts/seeds consumption was inversely associated with total CVD (RR 0.81; 95% CI 0.75, 0.86; I-2 = 67%), CVD mortality (0.77; 0.72, 0.82; I-2 = 59.3%), CHD (0.82; 0.76, 0.89; I-2 = 64%), CHD mortality (0.75; 0.65, 0.87; I-2 = 66.9%) and non-fatal CHD (0.85; 0.75, 0.96; I-2 = 62.2%). According to the non-linear dose-response analyses, consumption of 30 g/day of total nuts/seeds was associated with RRs of similar magnitude. For stroke and T2D the summary RR for high versus low intake was 0.91 (95% CI 0.85, 0.97; I-2 = 24.8%) and 0.95 (0.75, 1.21; I-2 = 82.2%). Intake of nuts (median similar to 50 g/day) lowered total (-0.15 mmol/L; -0.22, -0.08; I-2 = 31.2%) and LDL-cholesterol (-0.13 mmol/L; -0.21, -0.05; I-2 = 68.6%), but not blood pressure. Findings on fasting glucose, HbA1c and insulin resistance were conflicting. The results were robust to sensitivity and subgroup analyses. We rated the associations between nuts/seeds and both CVD and CHD as probable. There was limited but suggestive evidence for no association with stroke. No conclusion could be made for T2D. Conclusion: There is a probable relationship between consumption of nuts/seeds and lower risk of CVD, mostly driven by CHD, possibly in part through effects on blood lipids. More research on stroke and T2D may affect the conclusions. The evidence of specific nuts should be further investigated.
12.	Arnesen, E. K., et al. (author) Protein intake in children and growth and risk of overweight or obesity: A systematic review and meta-analysis 2022 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 66, s. 1-23 Journal article (peer-reviewed)abstract Objectives: The aim of this study was to examine the evidence for an association between the dietary protein intake in children and the growth and risk of overweight or obesity up to 18 years of age in settings relevant for the Nordic countries. Methods: We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scopus up to February 26, 2021 for randomized controlled trials (RCTs) or prospective cohort studies assessing for protein intake from foods (total and from different sources) in children. The outcomes include weight, height/length, adiposity indices, and/or risk of overweight and/or obesity. The risk of bias was evaluated with instruments for each respective design (Cochrane's Risk of Bias 2.0 and RoB-NObS). A meta-analysis of five cohort studies was performed. The evidence was classified according to the criteria of the World Cancer Research Fund. Results: The literature search resulted in 9,132 abstracts, of which 55 papers were identified as potentially relevant. In total, 21 studies from 27 publications were included, of which five were RCTs and 16 were cohort studies. The RCTs found generally null effects of high-protein intake in infants on weight gain, nor that lower protein diets negatively affected growth. All included RCTs had some concern regarding the risk of bias and were limited by small sample sizes. Total protein intake and BMI were assessed in 12 co-horts, of which 11 found positive associations. The meta-analysis revealed a pooled effect estimate of 0.06 (95% CI 0.03, 0.1) kg/m2 BMI per one E% increment in total protein (I2 = 15.5). Therefore, the evidence for a positive relationship between total protein intake and BMI was considered probable. Furthermore, there was probable evidence for an association between higher intake of animal protein and increased BMI. There was limited, suggestive evidence for an effect of total protein intake and higher risk of overweight and/or obesity, while no conclusions could be made on the associations between animal vs. plant protein intake and risk of overweight and/or obesity. Discussion: In healthy, well-nourished children of Western populations, there is probably a causal relationship between a high-protein intake in early childhood (<= 18 months) - particularly protein of animal origin - and higher BMI later in childhood, with consistent findings across cohort studies. A lack of RCTs precluded a stronger grading of the evidence.
13.	Arnesen, Erik Kristoffer, et al. (author) The Nordic Nutrition Recommendations 2022 : handbook for qualified systematic reviews 2020 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 64:0 Research review (peer-reviewed)abstract Background: Systematic reviews (SRs) constitute a major part of the Nordic Nutrition Recommendations (NNRs). The step-by-step procedure used to develop SRs has evolved considerably over time and is often tailored to fit the exposure and outcomes in focus.Objective: To describe a detailed procedure for developing qualified SRs commissioned by the NNR2022 project.Design: Scrutinizing procedures of recent SRs commissioned by leading national food and health authorities or international food and health organizations.Results: The following eight steps must be included when developing qualified SRs for the NNR2022 project: 1) define research question, 2) protocol development, 3) literature search, 4) screening and selection of studies, 5) data extraction, 6) assessing risk of bias, 7) synthesis and grading of total strength of evidence, and 8) reporting according to certain standards.Discussion: This guide is based on the guidelines developed for the fifth edition of NNR but includes some important new domains in order to adhere to more recent, authoritative standards.Conclusion: All qualified SRs in the NNR2022 project will follow the protocol described here.
14.	Arnesen, Erik Kristoffer, et al. (author) The Nordic Nutrition Recommendations 2022 : structure and rationale of qualified systematic reviews 2020 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 64:0 Research review (peer-reviewed)abstract Background: Qualified systematic reviews (SRs) will form the main basis for evaluating causal effects of nutrients or food groups on health outcomes in the sixth edition of Nordic Nutrition Recommendations to be published in 2022 (NNR2022).Objective: To describe rationale and structure of SRs used in NNR2022. Design: The SR methodologies of the previous edition of NNR were used as a starting point. Methodologies of recent SRs commissioned by leading national food and health authorities or international food and health organizations were examined and scrutinized. Methodologies for developing SRs were agreed by the NNR2022 Committee in a consensus-driven process.Results: Qualified SRs will be developed by a cross-disciplinary group of experts and reported according to the requirements of the EQUATOR network. A number of additional requirements must also be fulfilled, including 1) a clearly stated set of objectives and research questions with pre-defined eligibility criteria for the studies, 2) an explicit, reproducible methodology, 3) a systematic search that attempts to identify all studies that would meet the eligibility criteria, 4) an assessment of the validity of the findings of the included studies through an assessment of ‘risk of bias’ of the studies, 5) a systematic presentation and synthesis of the characteristics and findings of the included studies, and 6) a grading of the overall evidence. The complete definition and requirements of a qualified SR are described.Discussion: Most SRs published in scientific journals do not fulfill all criteria of the qualified SRs in the NNR2022 project. This article discusses the structure and rationale for requirements of qualified SRs in NNR2022. National food and health authorities have only recently begun to use qualified SRs as a basis for nutrition recommendations.Conclusion: Qualified SRs will be used to inform dietary reference values (DRVs) and food-based dietary guidelines (FBDGs) in the NNR2022 project.
15.	Ashi, Heba, 1983, et al. (author) Childhood obesity in relation to sweet taste perception and dental caries - a cross-sectional multicenter study 2019 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 63 Journal article (peer-reviewed)abstract Background: Obesity is a multifactorial disease that is increasing worldwide and is caused by different environmental and genetic factors, with an increase in the consumption of high-energy-containing food and a decrease in physical activity constituting two of the main reasons. Sweet taste perception may have an effect on the subject's dietary choices and affect his or her predisposition to obesity. Objectives: The aim was to study the sweet taste perception and dental caries in relation to body mass index (BMI) in 13-15-year-old schoolchildren from three different countries and to compare the BMI among the countries. Design: The sweet taste perception level, determined as the sweet taste threshold and preference, was assessed in a total of 669 schoolchildren from Italy, Mexico and Saudi Arabia, examined in school settings. Height and weight were collected and BMI was calculated, after which the children were grouped as underweight, normal, overweight, and obese. For caries registration, the International Caries Detection and Assessment System and Decayed Missing Filled Surfaces indices were used. Results: A statistically significant difference was found for BMI among the children from the three countries (p < 0.001), with the highest mean found among Saudi children, followed by Mexican and Italian children. A statistically significant difference regarding sweet taste threshold when comparing the BMI groups was only found for Saudi Arabia (p < 0.01). No significant correlation was found between BMI and sweet taste threshold or preference and dental caries variables, respectively. Conclusions: BMI was found to differ between countries, with a further significant difference among the groups among the Saudi Arabia schoolchildren.
16.	Astrup, Arne, et al. (author) In memory of Brittmarie Sandström, 1945-2002 2003 In: Scandinavian Journal of Nutrition/Næringsforskning. - : SNF Swedish Nutrition Foundation. - 1102-6480 .- 1651-2359. ; 47:1, s. 3-3 Journal article (other academic/artistic)
17.	Berglund, Fanny, et al. (author) Dietary habits among snus users : a population-based cross-sectional study 2023 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 67 Journal article (peer-reviewed)abstract Background: The dietary habits among snus users are largely unknown and have not been accounted for in observational studies on the health effects of snus use.Aim: To examine whether snus users eat unhealthier than never tobacco users.Methods: A total of 3,397 male participants, examined between 1994 and 2014 in the Northern Sweden Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) study, were included. Snus use and dietary habits were self-reported using questionnaires, from which intakes of different food groups, macronutrients, and a healthy diet score (HDS) were calculated (the latter as a proxy for overall diet quality). The association between snus use and dietary habits was examined by quantile regression models.Results: In the multivariable-adjusted model, current snus users had a lower HDS (median difference: -0.86 [95% confidence interval: -1.32, -0.40]) than never tobacco users. Snus users also consumed fewer weekly servings of fruits and berries (median difference: -1.03 [-1.65, -0.40]), and their estimated percentage of energy intake con -sisted of less carbohydrates (median difference: -1.43 [-2.12, -0.74]) and of more total fat (median difference: 0.99 [0.30, 1.67]), saturated fat (median difference: 0.67 [0.29, 1.05]), monounsaturated fat (median difference: 0.44 [0.20, 0.68]), trans fat (median difference: 0.03 [0.01, 0.06]), and alcohol (median difference: 0.21 [0.02, 0.40]).Conclusion: We observed that snus users had an unhealthier diet than never tobacco users. Future studies on the association between snus use and health outcomes should, therefore, consider diet as a potential confounder.
18.	Brantsaeter, Anne Lise, et al. (author) Does milk and dairy consumption during pregnancy influence fetal growth and infant birthweight? A systematic literature review 2012 In: Food & Nutrition Research. - : Co-Action Publishing. - 1654-6628 .- 1654-661X. ; 56 Research review (peer-reviewed)abstract It is increasingly acknowledged that the maternal diet influences fetal development and health of the child. Milk and milk products contribute essential nutrients and bioactive substances; they are of ample supply and have a long tradition in Nordic countries. To revise and update dietary guidelines for pregnant women valid in Nordic countries, the Pregnancy and Lactation expert group within the NNR5 project identified a need to systematically review recent scientific data on infant growth measures and maternal milk consumption. The objective of this study was to assess the influence of milk and dairy consumption during pregnancy on fetal growth through a systematic review of studies published between January 2000 and December 2011. A literature search was run in June 2011. Two authors independently selected studies for inclusion from the 495 abstracts according to predefined eligibility criteria. A complementary search in January 2012 revealed 64 additional abstracts published during the period June to December 2011, among them one study of interest previously identified. Of the 33 studies extracted, eight were relevant research papers. Five were prospective cohort studies (including a retrospective chart review), one was a case-control study, and two were retrospective cohort studies. For fetal length or infant birth length, three studies reported no association and two reported positive associations with milk or dairy consumption. For birthweight related outcomes, two studies reported no associations, and four studies reported positive associations with milk and/or dairy consumption. There was large heterogeneity in exposure range and effect size between studies. A beneficial fetal growth-increase was most pronounced for increasing maternal milk intake in the lower end of the consumption range. Evidence from prospective cohort studies is limited but suggestive that moderate milk consumption relative to none or very low intake, is positively associated with fetal growth and infant birthweight in healthy, Western populations.
19.	Brunkwall, Louise, et al. (author) Genetic variation in the fat mass and obesity-associated gene (FTO) in association with food preferences in healthy adults. 2013 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-661X .- 1654-6628. ; 57 Journal article (peer-reviewed)abstract Earlier studies have indicated that the fat mass and obesity-associated gene (FTO) is not only associated with BMI and weight but also with appetite and dietary intake.
20.	Bärebring, Linnea, et al. (author) Intake of vitamin B12 in relation to vitamin B12 status in groups susceptible to deficiency: a systematic review 2023 In: Food & Nutrition Research. - 1654-6628 .- 1654-661X. ; 67 Research review (peer-reviewed)abstract Objective: To systematically review the evidence for whether habitual or different levels of experimental intake of vitamin B12 from diet and supplements is sufficient to ensure adequate B12 status in groups most susceptible to vitamin B12 deficiency.Methods: We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials and Scopus up to 21 May 2021, for intervention studies, prospective cohort studies and case-control studies assessing B12 intake from diet and/or supplements in relation to B12 status (s/p-B12, holotranscobalamin, methylmalonic acid, homocysteine or breastmilk B12). Cross-sectional studies were eligible for studies conducted during pregnancy and lactation. Included populations were children (0-18 years), young adults (18-35 years), pregnant or lactating women, older adults (& GE;65 years) and vegans or vegetarians. Study selection, data extraction and risk of bias assessment were conducted by two assessors independently. The evidence was synthesized qualitatively and classified according to the World Cancer Research Fund.Results: The searches yielded 4855 articles of which 89 were assessed in full text and 18 included. Three studies were conducted during pregnancy and three during lactation or infancy - all observational. Eight studies were conducted among older adults; most were interventions among B12-deficient participants. Four studies were eligible for vegetarian and vegans, all interventions. The strength of evidence that habitual B12 intake or an intake in line with the current Nordic recommended intake (RI) is sufficient to ensure adequate status was considered Limited - no conclusion for all included populations.Conclusion: Evidence is insufficient to assess if or which level of B12 intake is sufficient to maintain adequate status for all included populations. Population-based cohort studies and low-to-moderate dose interventions that address this question are highly warranted.
21.	Bärebring, Linnea, et al. (author) Supplementation with long chain n-3 fatty acids during pregnancy, lactation, or infancy in relation to risk of asthma and atopic disease during childhood: a systematic review and meta-analysis of randomized controlled clinical trials 2022 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 66 Research review (peer-reviewed)abstract Objective: To assess whether supplementation with long chain n-3 fatty acids during pregnancy, lactation, or infancy reduces the risk of developing asthma or atopic disease during childhood.Methods: Searches were performed in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scopus up to 2021-09-20, for randomized controlled trials (RCTs) that investigated the effect of supple-mental long chain n-3 fatty acids during pregnancy, lactation, or infancy for the prevention of childhood asthma or allergy. Article selection, data extraction, and risk of bias assessment (Cochrane's Risk of Bias 2.0) were independently conducted by two assessors. The evidence was synthesized qualitatively according to the criteria of the World Cancer Research Fund and meta-analyzed.Results: A total of nine RCTs met inclusion criteria; six were conducted during pregnancy, two during infancy, and one during both pregnancy and infancy. Meta-analysis showed that long chain n-3 fatty acid supplementation during pregnancy significantly reduced the risk of asthma/wheeze in the child (RR 0.62 [95% confidence interval 0.34-0.91], P = 0.005, I2 = 67.4%), but not other outcomes. Supplementation during lactation of infancy showed no effects on any outcome. The strength of evidence that long chain n-3 fatty acid supplementation during pregnancy reduces risk of asthma/wheeze in the offspring was con-sidered limited - suggestive. No conclusion could be made for the effects of long chain n-3 fatty acid supplementation during pregnancy for other atopic diseases, or for supplementation during lactation or infancy for any outcome. Conclusion: The intake of long chain n-3 fatty acid supplements during pregnancy may reduce the risk of asthma and/or wheeze in the offspring, but the strength of evidence is low. There is inconclusive evidence for the effects of long chain n-3 fatty acid supplements during pregnancy for other outcomes, as well as for sup-plementation during lactation or infancy.
22.	Calvén, Anna, et al. (author) Adolescents' attitudes, preferences and perceived behaviours regarding healthy eating and whole grains from a gender and health interest perspective 2023 In: Food & Nutrition Research. - 1654-6628 .- 1654-661X. ; 67:8988, s. 1-15 Journal article (peer-reviewed)abstract Background: A healthy diet is important not only for the growth and development of the human body but also for the prevention of chronic diseases. However, most Swedish adolescents do not follow dietary recommendations, especially the intake of whole grain is very low. To create targeted conditions for healthy food choices amongst adolescents, comprehensive knowledge of factors related to adolescents' unhealthy and healthy eating is needed. Objective: To investigate adolescents' attitudes, preferences and perceived behaviours regarding healthy eating, with a specific focus on whole grains and to evaluate differences between genders and between adolescents with higher versus lower health interest. Design: A total of 1,178 Swedish adolescents responded to a questionnaire about their attitudes, preferences and perceived behabviours towards healthy eating and whole grains, and their general interest in nutrition and health.Results of girls and boys were compared, as well as adolescents with a higher versus lower health interest. Results: Displays information about healthy eating among adolescents and a comprehensive set of factors that may affect their ability to eat healthier. Overall, adolescents had a positive attitude towards food and health, but less than half felt that they managed to eat healthy. The consumption of different whole grain products was low, although the willingness to eat healthier and more whole grain was high. The most reported barrier to healthy eating, as well as increasing whole grain intake, was the unavailability of tasty healthy products, taste being even more important for adolescents with a low health interest than those with a high interest. Whole grain consumption and factors increasing the willingness of whole grain consumption were most prominent not only in adolescents with high health interest but also in girls compared with boys. Conclusion: The results show good potential to improve dietary habits amongst adolescents. Taste and availability of healthy products were rated the most important, whilst knowledge about the products' healthiness was rated the least important, especially amongst those with low health interest. By focusing on the attitudes and preferences of adolescents, the effectiveness may increase of initiatives to improve their dietary habits.
23.	Cho, Karl, et al. (author) Calcium intake in elderly patients with hip fractures 2008 In: Food & nutrition research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 52, s. 1654- Journal article (peer-reviewed)abstract BACKGROUND: Dietary calcium intake is assumed important in the prevention and treatment of osteoporosis. However, people in countries with a high calcium intake from commodities such as milk and milk products have a high incidence of hip fracture. The effect and influence of calcium intake in the prevention of osteoporotic fracture vary from different studies. OBJECTIVE: To investigate premorbid daily calcium intake in patients with low energy hip fractures during four consecutive years. DESIGN: In total 120 patients (mean age 78+/-8.5 (SD) years) were included between 2002 and 2005. The patients answered a structured food frequency questionnaire (FFQ) and interviews on patients' daily calcium intake from food and supplements took place during a 6-month period before the fracture. Dual energy X-ray absorptiometry (DEXA) was performed in a subgroup of 15 patients. RESULTS: The mean daily calcium intake from food and supplementation was 970+/-500 mg. However, 38% of patients had an intake below the recommended 800 mg/day. There was no significant relationship between calcium intake and age, gender, bone mineral density, serum calcium or albumin, type of fracture or body mass index. The mean free plasma calcium concentration was 2.3+/-0.1, i.e. within the reference limit. In 2005, 80% of the patients who underwent DEXA had manifest osteoporosis. There was a trend towards decreased calcium intake over the observation period, with a mean calcium intake below 800 mg/day in 2005. CONCLUSIONS: Hip fracture patients had a mean calcium intake above the recommended daily intake, as assessed by a FFQ. However, more than one-third of patients had an intake below the recommended 800 mg/day. The intake appeared to decrease over the investigated years. The relationship between calcium intake and fracture susceptibility is complex.
24.	Christensen, Jacob Juel, et al. (author) The Nordic Nutrition Recommendations 2022 : principles and methodologies 2020 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 64:0 Research review (peer-reviewed)abstract Background: The Nordic Nutrition Recommendations (NNRs) constitute the scientific basis for national dietary reference values (DRVs) and food-based dietary guidelines (FBDGs) in the Nordic and Baltic countries.Objective: To define principles and methodologies for the sixth edition of NNR to be published in 2022 (NNR2022).Design: The principles and methodologies of the previous edition of NNR were used as a starting point. Recent nutrition recommendations commissioned by other national food and health authorities or international food and health organizations were examined and dissected. Updated principles and methodologies were agreed by the NNR2022 Committee in a consensus-driven process.Results: An organizational model with ‘checks and balances’ was developed to minimize the influence of subjective biases of the committee members and experts. Individual chapters on all included nutrients and food groups will be updated as scoping reviews. Systematic reviews (SRs), which are the main basis for evaluating causal effects of nutrients or food groups on health outcomes, will be embedded in each chapter. A NNR SR Centre will be established for performing de novo SRs on prioritized topics. To avoid duplication and optimize the use of resources, qualified SRs commissioned by other national and international organizations and health authorities will also inform DRVs and FBDGs in NNR2022.Discussion: The evidence-based methods defined in the NNR2022 project are compatible with most contemporary methods used by leading national food and health authorities. Global harmonization of methodological approaches to nutrition recommendations is strongly encouraged.Conclusion: Evidence-informed principles and methodologies underpinned by SRs will ensure that DRVs and FBDGs defined in the NNR2022 project are based on the best available evidence and as far as possible free from overt bias.
25.	Cloetens, Lieselotte, et al. (author) Energy - a scoping review for the Nordic Nutrition Recommendations 2023 project 2023 In: FOOD & NUTRITION RESEARCH. - 1654-6628 .- 1654-661X. ; 67 Journal article (peer-reviewed)abstract We need energy intake to provide energy and nutrients to our cells. The amount of daily energy intake should aim for energy balance, which results in good health. Under- or overconsumption of total daily energy over a longer period leads to increased risk of diseases. In this scoping review, the components of daily energy requirement are defined. Several methods to estimate energy requirements and the amount of total daily energy intake (kJ) related to health are also discussed. Reference values for energy intake in children, adults and pregnant and postpartum women, and older adults are evaluated.Results show that it is challenging to set reference values for energy intake since existing methods are not accurate and precise, and there are several factors that influence the estimated amount of energy. Energy requirement is increased during growth as in childhood, pregnancy and lactation. We conclude that more research in this area is needed, and that new high-quality studies in both Nordic and Baltic countries are needed to obtain new recommendation numbers for energy intake.
26.	Darwiche, Gassan, et al. (author) An Okinawan-based Nordic diet improves anthropometry, metabolic control, and health-related quality of life in Scandinavian patients with type 2 diabetes : A pilot trial 2016 In: Food and Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 60 Journal article (peer-reviewed)abstract Background: Our hypothesis was that a modified diet would improve blood glucose control with beneficial impact on weight management and overall health in established diabetes. Objective: This prospective interventional study investigated the clinical effect of an Okinawan-based Nordic diet on anthropometry, metabolic control, and health-related quality of life (HRQoL) in Scandinavian type 2 diabetes patients. Design: Food was prepared and delivered to 30 type 2 diabetes patients. Clinical information along with data on HRQoL, blood samples, and urine samples were collected during 12 weeks of diet interventions, with follow-up 16 weeks after diet completion. Results: After 12 weeks of dietary intervention, a reduction in body weight (7%) (p < 0.001), body mass index (p < 0.001), and waist circumference (7.0 cm) (p < 0.001) was seen. Improved levels of proinsulin (p = 0.005), insulin (p = 0.011), and fasting plasma glucose (p < 0.001) were found already after 2 weeks; these improved levels remained after 12 weeks when lowered levels of C-peptide (p = 0.015), triglycerides (p = 0.009), total cholesterol (p = 0.001), and low-density lipoprotein-cholesterol (p = 0.041) were also observed. Insulin resistance homeostasis model assessment for insulin resistance was lowered throughout the study, with a 20% reduction in hemoglobin A1c levels (p < 0.001) at week 12, despite reduced anti-diabetes treatment. Lowered systolic blood pressure (9.6 mmHg) (p < 0.001), diastolic blood pressure (2.7 mmHg) (p < 0.001), and heart and respiratory rates (p < 0.001) were accompanied by decreased cortisol levels (p = 0.015) and improvement in HRQoL. At follow-up, increased levels of high-density lipoprotein-cholesterol were found (p = 0.003). Conclusion: This interventional study demonstrates a considerable improvement of anthropometric and metabolic parameters and HRQoL in Scandinavian type 2 diabetes patients when introducing a modified Okinawan-based Nordic diet, independently of exercise or other interventions. Through these dietary changes, anti-diabetes treatment could be decreased or cancelled.
27.	Dierkes, Jutta, et al. (author) Dietary fiber and growth, iron status and bowel function in children 0-5 years old: a systematic review. 2023 In: Food & nutrition research. - : SNF Swedish Nutrition Foundation. - 1654-661X .- 1654-6628. ; 67 Journal article (peer-reviewed)abstract While dietary fiber intake is low in many children, the current trend to plant-based diets is associated with higher fiber intake in children raised on these diets. As older reports indicate that diets providing high fiber intake in children 0-5 years may affect growth, iron status and bowel function, we summarized the available evidence in this systematic review.To identify, critically appraise, and synthesize evidence on the effect of high fiber intake on growth, iron and bowel function in children 0-5 years, with relevance to the Nordic and Baltic countries.Following a pre-registered protocol, we searched MEDLINE, EMBASE, Cochrane Central of Controlled Trials, and Scopus for clinical trials and prospective cohort studies published until November 2021. Two reviewers independently screened retrieved literature, extracted relevant data, and performed risk of bias assessment. Outcomes were growth, iron metabolism and bowel function in children 0-5 years. We narratively described findings from studies that met inclusion criteria.From 5,644 identified records, five articles met the inclusion criteria. Two RCTs had an overall moderate risk of bias, while the three observational studies had serious risk. Overall, we found no robust association between high intake of dietary fiber and growth. In the RCTs, higher intake of fiber had a positive effect on bowel movements and constipation. No studies on fiber intake and iron status were identified.The certainty of the overall evidence was inconclusive for growth and bowel function, while no assessment was made for iron status.We found no clear association between high intake of dietary fiber and growth or bowel function in young children living in affluent countries, albeit with only a limited number of studies. There is a lack of studies investigating health effects of high fiber intake in small children.
28.	Domellöf, Magnus, et al. (author) Health effects of different dietary iron intakes : a systematic literature review for the 5th Nordic Nutrition Recommendations 2013 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 57:21667 Research review (peer-reviewed)abstract Background: The present literature review is part of the NNR5 project with the aim of reviewing and updating the scientific basis of the 4th edition of the Nordic Nutrition Recommendations (NNR) issued in 2004. Objective: The objective of this systematic literature review was to assess the health effects of different intakes of iron, at different life stages (infants, children, adolescents, adults, elderly, and during pregnancy and lactation), in order to estimate the requirement for adequate growth, development, and maintenance of health.Methods: The initial literature search resulted in 1,076 abstracts. Out of those, 276 papers were identified as potentially relevant. Of those, 49 were considered relevant and were quality assessed (A, B, or C). An additional search on iron and diabetes yielded six articles that were quality assessed. Thus, a total of 55 articles were evaluated. The grade of evidence was classified as convincing (grade 1), probable (grade 2), suggestive (grade 3), and inconclusive (grade 4).Results: There is suggestive evidence that prevention or treatment of iron deficiency (ID) and iron deficiency anemia (IDA) improves cognitive, motoric, and behavioral development in young children, and that treatment of IDA improves attention and concentration in school children and adult women. There is insufficient evidence to show negative health effects of iron intakes in doses suggested by the NNR 4. There is insufficient evidence to suggest that normal birth weight, healthy, exclusively breast-fed infants need additional dietary iron before 6 months of life in the Nordic countries. An iron concentration of 4-8 mg/L in infant formulas seems to be safe and effective for normal birth weight infants. There is probable evidence that iron supplements (1-2 mg/kg/day) given up to 6 months of age to infants with low birth weight (<2,500 g) prevents IDA and possibly reduce the risk of behavioral problems later on. There is probable evidence that ID and IDA in pregnant women can be effectively prevented by iron supplementation at a dose of 40 mg/day from week 18-20 of gestation. There is probable evidence that a high intake of heme iron, but not total dietary, non-heme or supplemental iron, is associated with increased risk of type 2 diabetes (T2D) and gestational diabetes.Conclusions: Overall, the evidence does not support a change of the iron intakes recommended in the NNR 4. However, one could consider adding recommendations for infants below 6 months of age, low birth weight infants and pregnant women.
29.	Domellöf, Magnus, 1963-, et al. (author) Iron – a background article for the Nordic Nutrition Recommendations 2023 2024 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 68 Research review (peer-reviewed)abstract Iron absorption from foods is generally lower than that of most other nutrients and is highly variable depending on individual iron status and iron bioavailability in the meal. Several large population groups in the Nordic and Baltic countries are at risk of iron deficiency, including infants, young children, menstruating females, pregnant women as well as vegetarians. Iron deficiency leads to anemia, fatigue, and limited capacity for physical activity. Of particular concern is that iron deficiency anemia in young children is associated with impaired neurodevelopment. A comprehensive literature search has been performed and summarized. New factorial calculations have been performed considering iron losses, iron absorption and iron requirements in various population groups. Recent data on iron intakes and the prevalence of iron deficiency in the Nordic countries are presented. Average requirements and tentative recommended intakes are presented for 12 different population groups. Pregnant women and those with high menstrual blood losses should consume iron-rich food and undergo screening for iron deficiency. Infants should consume iron-rich complementary foods and cow’s milk should be avoided as a drink before 12 months of age and limited to < 500 mL/day in toddlers. Vegetarians should consume a diet including wholegrains, legumes, seeds, and green vegetables together with iron absorption enhancers. There is no evidence that iron intake per se increases the risk of cancer or diabetes. Iron absorption from foods is generally lower than that of most other nutrients and can vary between <2 and 50% depending on individual iron status and iron bioavailability in the meal.
30.	Drake, Isabel, et al. (author) Five meal patterns are differently associated with nutrient intakes, lifestyle factors and energy misreporting in a sub-sample of the Malmö Diet and Cancer cohort. 2009 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-661X .- 1654-6628. ; 53 Journal article (peer-reviewed)abstract OBJECTIVE: Examine how meal patterns are associated with nutrient intakes, lifestyle and socioeconomic factors, and energy misreporting. DESIGN: A cross-sectional study within the Malmö Diet and Cancer (MDC) cohort. Participants reported on the overall types and frequency of meals consumed, and completed a modified dietary history, a lifestyle and socioeconomic questionnaire, and anthropometric measurements. Based on the reported intake of six different meal types, meal pattern groups were distinguished using Ward's cluster analysis. Associations between meal patterns and nutrient intakes, anthropometric, lifestyle and socioeconomic variables were examined using the chi(2)-method and analysis of variance. SUBJECTS: A sub-sample of the MDC study cohort (n=28,098), consisting of 1,355 men and 1,654 women. RESULTS: Cluster analysis identified five groups of subjects with different meal patterns in both men and women. These meal pattern groups differed regarding nutrient intakes, lifestyle and socioeconomic factors. Subjects reporting frequent coffee meals were more likely to report an 'unhealthy' lifestyle, e.g. smoking, high alcohol consumption and low physical activity, while those with a fruit pattern reported a more 'healthy' lifestyle. Women were more likely to underreport their energy intake than men, and the degree of underreporting varied between the meal pattern groups. CONCLUSIONS: The meal pattern groups showed significant differences in dietary quality and socioeconomic and lifestyle variables. This supports previous research suggesting that diet is part of a multifaceted phenomenon. Incorporation of aspects on how foods are combined and eaten into public health advices might improve their efficiency.
31.	Engelheart, Stina, 1976-, et al. (author) Assessment of nutritional status in the elderly : a proposed function-driven model 2018 In: Food & Nutrition Research. - : Taylor & Francis. - 1654-6628 .- 1654-661X. ; 62 Journal article (peer-reviewed)abstract Background: There is no accepted or standardized definition of 'malnutrition'. Hence, there is also no definition of what constitutes an adequate nutritional status. In elderly people, assessment of nutritional status is complex and is complicated by multi-morbidity and disabilities combined with nutrition-related problems, such as dysphagia, decreased appetite, fatigue, and muscle weakness.Objective: We propose a nutritional status model that presents nutritional status from a comprehensive functional perspective. This model visualizes the complexity of the nutritional status in elderly people.Design and results: The presented model could be interpreted as the nutritional status is conditional to a person's optimal function or situation. Another way of looking at it might be that a person's nutritional status affects his or her optimal situation. The proposed model includes four domains: (1) physical function and capacity; (2) health and somatic disorders; (3) food and nutrition; and (4) cognitive, affective, and sensory function. Each domain has a major impact on nutritional status, which in turn has a major impact on the outcome of each domain.Conclusions: Nutritional status is a multifaceted concept and there exist several knowledge gaps in the diagnosis, prevention, and optimization of treatment of inadequate nutritional status in elderly people. The nutritional status model may be useful in nutritional assessment research, as well as in the clinical setting.
32.	Forsberg, Sarah, et al. (author) Sensory preferences and requirements amongst Swedish older adults with motoric eating difficulties 2022 In: Food and Nutrition Research. - : Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 66, s. 1-12 Journal article (peer-reviewed)abstract Background Finger foods, foods that can be eaten without cutlery, may be a strategy to increase autonomy and food intake amongst older adults with motoric eating difficulties. In order to develop optimal finger foods, knowledge about sensory preferences and requirements in the target population is needed. Objective To assess sensory preferences and requirements amongst Swedish older adults with motoric eating difficulties. Design Check-all-that-apply (CATA), a methodology that does not require much cognitive effort, was used to collect survey data about sensory preferences and requirements for everyday meals from 15 older adults with motoric eating difficulties. The CATA-questionnaire was structured according to the Swedish meal order (breakfast, lunch, dinner, snack and fika) and consisted of 29 attributes compiled through a literature review. Results T hrough both qualitative and quantitative data analysis, it was found that flavourful, flavour intensity, spicy and both Swedish and ethnic flavours were important attributes related to food flavour. Although most participants preferred crispy and coarse textures, a few participants found soft, smooth and fine textures important. Moreover, colourful meals and serving components separated on the plate were important for the appearance of lunch and dinner. Discussion A diverse range of flavours, flavour enhancement and a balance between the basic tastes and spiciness may increase the flavour perception. Finger foods should be offered in the full range of flavours available to the general older adults’ population. The variation in the demand for texture may be related to chewing and swallowing difficulties, and textures that require moderate chewing and easy swallowing are, therefore, optimal for finger foods. Separating meal components on the plate may make it easier to distinguish the components. Conclusion Chemosensory impairments, chewing and swallowing difficulties, and visual disturbances are important to consider in the development of finger foods.
33.	Forsum, Elisabet, et al. (author) Weight loss before conception: A systematic literature review 2013 In: Food & Nutrition Research. - : Co-Action Publishing. - 1654-6628 .- 1654-661X. ; 57 Research review (peer-reviewed)abstract The prevalence of overweight and obesity in women has increased during the last decades. This is a serious concern since a high BMI before conception is an independent risk factor for many adverse outcomes of pregnancy. Therefore, dietary counseling, intended to stimulate weight loss in overweight and obese women prior to conception has recently been recommended. However, dieting with the purpose to lose weight may involve health risks for mother and offspring. We conducted a systematic literature review to identify papers investigating the effects of weight loss due to dietary interventions before conception. The objective of this study is to assess the effect of weight loss prior to conception in overweight or obese women on a number of health-related outcomes in mother and offspring using studies published between January 2000 and December 2011. Our first literature search produced 486 citations and, based on predefined eligibility criteria, 58 were selected and ordered in full text. Two group members read each paper. Fifteen studies were selected for quality assessment and two of them were considered appropriate for inclusion in evidence tables. A complementary search identified 168 citations with four papers being ordered in full text. The two selected studies provided data for overweight and obese women. One showed a positive effect of weight loss before pregnancy on the risk of gestational diabetes and one demonstrated a reduced risk for large-for-gestational-age infants in women with a BMI above 25 who lost weight before pregnancy. No study investigated the effect of weight loss due to a dietary intervention before conception. There is a lack of studies on overweight and obese women investigating the effect of dietary-induced weight loss prior to conception on health-related variables in mother and offspring. Such studies are probably lacking since they are difficult to conduct. Therefore, alternative strategies to control the body weight of girls and women of reproductive age are needed.
34.	Fredriksson, Ellinor, et al. (author) Validation of four questions on food habits from the Swedish board of health and social welfare by 3-day food records in medical and nursing students 2014 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 58 Journal article (peer-reviewed)abstract Background: The Swedish board for health and social welfare (SoS) has presented four questions on dietary habits as indicators of adherence to dietary recommendations. However, these questions have not been evaluated. Objective: To evaluate if four questions on dietary habits correlate with dietary intake assessed by food records. Design: A total of 279 medical and nursing students, 170 women and 109 men, completed four questions on usual consumption frequency of vegetables, fruits, fish, and sweets. Depending on scoring from 0 to 12 points, subjects were classified as having low (0-4 points), average (5-8 points), or high (9-12 points) adherence to dietary recommendations as proposed by SoS. Nutrient intake was calculated from 3-day food records. Mean dietary intake, expressed per 10 MJ of fibre, ascorbic acid, folate, vitamin D, sucrose, fish, and fruits and vegetables, was analysed for each group and differences assessed by ANOVA. Results: Energy intake was 11.8 +/- 3.0 MJ in male and 8.5 +/- 2.2 MJ in female students. Most students, 64%, were classified as average adherers to dietary recommendations, whereas only 6% were classified as low and 30% as high. Dietary intake of fibre, ascorbic acid, and folate was significantly higher in the high adherence group compared to both the other groups (p < 0.01), but vitamin D significantly so only compared to the average group (p < 0.002). Intake of fruits and vegetables was significantly different between all groups (p < 0.003), with increasing amounts with increasing adherence. The low adherence group had higher intake of sucrose than the other groups (p < 0.005). Median fish intake was nil in the low and average adherence groups, with significant difference between high and average adherence groups (p-0.001). Conclusions: Four questions on the consumption frequency of vegetables, fruits, fish, and sweets correlate well with the dietary intake of fibre, ascorbic acid, folate, vitamin D, fish, sucrose, and fruits and vegetables as assessed by 3-day food records in health-conscious medical and nursing students.
35.	Guzman, Miguel, et al. (author) Nutritional status in patients with cutaneous leishmaniasis and a study of the effects of zinc supplementation together with antimony treatment. 2014 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-661X .- 1654-6628. ; 58 Journal article (peer-reviewed)abstract The role of micronutrient status for the incidence and clinical course of cutaneous leishmaniasis is not much studied. Still zinc supplementation in leishmaniasis has shown some effect on the clinical recovery, but the evidence in humans is limited.
36.	Hallström, Elinor, et al. (author) A novel wheat variety with elevated content of amylose increases resistant starch formation and may beneficially influence glycaemia in healthy subjects. 2011 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-661X .- 1654-6628. ; 55 Journal article (peer-reviewed)abstract Previous studies indicate that elevated amylose content in products from rice, corn, and barley induce lower postprandial glycaemic responses and higher levels of resistant starch (RS). Consumption of slowly digestible carbohydrates and RS has been associated with health benefits such as decreased risk of diabetes and cardiovascular disease.
37.	Haskå, Lina, et al. (author) A water-soluble fraction from a by-product of wheat increases the formation of propionic acid in rats compared with diets based on other by-product fractions and oligofructose. 2011 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-661X .- 1654-6628. ; 55 Journal article (peer-reviewed)abstract Background: Dietary fibre is fermented by the colonic microbiota to carboxylic acids (CA), with potential health effects associated in particular with butyric and propionic acid. Objective: To investigate the formation of CA in the hindgut of healthy rats fed dietary fibre from different fractions of wheat shorts, a by-product of the milling of wheat. Design: Rats were fed dietary fibre (80 g/kg feed per day for 7 days) from wheat shorts and fractions thereof (ethanol-soluble, water-soluble and insoluble fractions), oligofructose (OF) diet and a mixture of oligofructose and raffinose (OR) diet. Results: The water-soluble fraction, with a high content of arabinoxylan (AX), increased the formation of propionic acid in the hindgut and lowered the ratio of acetic to propionic acid in the portal blood of rats. High levels and proportions of butyric acid were seen in rats fed the OR diet. The pattern of CA resulting from the ethanol-soluble diet, mainly composed of fructan and raffinose, was more similar to that of the OF diet than the OR diet. Conclusions: The high formation of propionic acid with the water-soluble fraction may be attributed to the high AX content. The results also indicate that the wheat fructans produced more propionic acid and less butyric acid than oligofructose. It may furthermore be speculated that the increased formation of butyrate with the OR diet was due to synergistic effects of the components in this diet.
38.	Hede, GW, et al. (author) Nutritional assessment and post-procedural complications in older stroke patients after insertion of percutaneous endoscopic gastrostomy - a retrospective study 2016 In: Food & nutrition research. - : SNF Swedish Nutrition Foundation. - 1654-661X .- 1654-6628. ; 60, s. 30456- Journal article (peer-reviewed)
39.	Hefni, Mohammed E., et al. (author) Enhancement of the folate content in Egyptian pita bread. 2012 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 56 Journal article (peer-reviewed)abstract INTRODUCTION: Egypt has a high incidence of neural tube defects related to folate deficiency. One major food source for folate is pita (baladi) bread, which is consumed daily. Bioprocessing (e.g. germination) has been reported to increase the folate content in cereals. The aim was to produce pita bread with increased folate content using germinated wheat flour (GWF).METHODS: Prior to milling the effects of germination and drying conditions on folate content in wheat grains were studied. Pita bread was baked from wheat flour substituted with different levels of GWF. The folate content in dough and bread and rheological properties of dough were determined.RESULTS: Germination of wheat grains resulted in, depending on temperature, 3- to 4-fold higher folate content with a maximum of 61 µg/100 g DM (dry matter). The folate content in both flour and bread increased 1.5 to 4-fold depending on the level of flour replacement with GWF. Pita bread baked with 50% sieved GWF was acceptable with respect to colour and layer separation, and had a folate content of 50 µg/100 g DM compared with 30 µg/100 g DM in conventional pita bread (0% GWF).CONCLUSION: Using 50% GWF, pita bread with increased folate content, acceptable for the Egyptian consumer, was produced. Consumption of this bread would increase the average daily folate intake by 75 µg.
40.	Heyman Lindén, Lovisa, et al. (author) Lingonberries alter the gut microbiota and prevent low-grade inflammation in high-fat diet fed mice 2016 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 60 Journal article (peer-reviewed)abstract Background: The gut microbiota plays an important role in the development of obesity and obesity-associated impairments such as low-grade inflammation. Lingonberries have been shown to prevent diet-induced obesity and low-grade inflammation. However, it is not known whether the effect of lingonberry supplementation is related to modifications of the gut microbiota. The aim of the present study was to describe whether consumption of different batches of lingonberries alters the composition of the gut microbiota, which could be relevant for the protective effect against high fat (HF)-induced metabolic alterations. Methods: Three groups of C57BL/6J mice were fed HF diet with or without a supplement of 20% lingonberries from two different batches (Lingon1 and Lingon2) during 11 weeks. The composition and functionality of the cecal microbiota were assessed by 16S rRNA sequencing and PICRUSt. In addition, parameters related to obesity, insulin sensitivity, hepatic steatosis, inflammation and gut barrier function were examined. Results: HF-induced obesity was only prevented by the Lingon1 diet, whereas both batches of lingonberries reduced plasma levels of markers of inflammation and endotoxemia (SAA and LBP) as well as modified the composition and functionality of the gut microbiota, compared to the HF control group. The relative abundance of Akkermansia and Faecalibacterium, genera associated with healthy gut mucosa and antiinflammation, was found to increase in response to lingonberry intake. Conclusions: Our results show that supplementation with lingonberries to an HF diet prevents low-grade inflammation and is associated with significant changes of the microbiota composition. Notably, the antiinflammatory properties of lingonberries seem to be independent of effects on body weight gain.
41.	Hjelmesæth, Jøran, et al. (author) Human body weight, nutrients, and foods: a scoping review : Human body weight, nutrients and foods 2022 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 66 Research review (peer-reviewed)abstract Background: The aim of this article (scoping review) is to elucidate the current knowledge for the potential role of body weight for setting and updating Dietary Reference Values (DRVs) and Food-Based Dietary Guidelines (FBDGs). The following research questions were formulated: What is known about the association between intakes of specific nutrient and/or foods (exposure/intervention) and body weight (outcome) in the general population? What is known about the association between body weight (exposure) and intakes of specific nutrient and/or foods (outcomes)? Is there any evidence suggesting specific effects of foods or nutrients on body weight independent of caloric content? Methods: To identify potentially relevant articles, PubMed was searched from January 1, 2011 to June 9, 2021. The search strategy was drafted by the NNR2022 Committee. The final results were exported into EndNote. Systematic reviews (SRs), scoping reviews (ScRs), reviews, and meta-analyses (MAs) on the topic ‘Body weight’ published between January 1, 2011 and June 9, 2021, including human participants from the general population, in English or Scandinavian language (Norwegian, Swedish, or Danish), were considered eligible. Main findings: First, the overall body of evidence based on findings from SRs and MAs of observational and clinical studies indicates that changes in intakes of specific nutrients (sugar, fiber, and fat) and/or foods (sugar sweetened beverages, fiber rich food, and vegetables) are associated with modest or small short-term changes (0.3–1.3 kg) in body weight in the general population (with or without obesity/overweight), while long-term studies are generally lacking. Second, no study in our search assessed any association between body weight (exposure) and intakes of specific nutrients or foods (outcomes). Third, limited evidence suggests, but does not prove, that some foods or nutrients may have specific effects on body weight or body weight measures independent of caloric content (e.g. nuts and dairy). These findings may inform the setting and updating of DRVs and FBDGs in NNR2022.
42.	Holmberg, Christopher, 1984, et al. (author) Marketing and promotion of branded food items by adolescent Instagram users 2016 In: Presented at the 11th Nordic Nutrition Conference (NNC 2016) in Gothenburg, Sweden. Abstract published in Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. ; 60:31961 Conference paper (other academic/artistic)
43.	Holmer, A, et al. (author) Acceptance of Nordic snack bars in children aged 8-11 years 2012 In: Food & Nutrition Research. - 1654-6628 .- 1654-661X. ; 56:10484 Journal article (peer-reviewed)abstract Background: A health promoting diet is suggested to be tailored to regional circumstances to preserve the cultural diversity in eating habits, as well as contribute to more environmentally friendly eating. It may influence consumer acceptance, however, if the components of the diet differs considerably from their habitual food. Objective: This study aimed to investigate whether snack bars composed of Nordic ingredients were accepted by 8-11 year-old Danish (n=134) and Swedish (n=109) children. Design: A seven-point hedonic scale was used to measure the children’s acceptance of five snack bars that varied in their composition of whole grains, berries and nuts. A preference rank ordering of the five bars was also performed. Results: The results showed that samples that were rated highest in liking and were most preferred in both countries were a kamut/pumpkin bar and an oat/cranberry bar. The sample with the lowest rating that was also least preferred was a pumpernickel/sea buckthorn bar. Flavour was the most important determinant of overall liking followed by texture, odour and appearance. Conclusions: Children’s acceptances and preferences were highly influenced by the sensory characteristics of the bars, mainly flavour. In agreement with earlier studies, the novel food ingredients seemed to influence children’s preferences. The Nordic snack bars may have a potential to be a snack option for Danish and Swedish school children, but repeated exposures to the products are recommended to increase children’s acceptance.
44.	Holmer, A., et al. (author) Acceptance of Nordic snack bars in children aged 8-11 years 2012 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 56 Journal article (peer-reviewed)abstract Background: A health promoting diet is suggested to be tailored to regional circumstances to preserve the cultural diversity in eating habits, as well as contribute to more environmentally friendly eating. It may influence consumer acceptance, however, if the components of the diet differs considerably from their habitual food. Objective: This study aimed to investigate whether snack bars composed of Nordic ingredients were accepted by 8-11 year-old Danish (n = 134) and Swedish (n = 109) children. Design: A seven-point hedonic scale was used to measure the children's acceptance of five snack bars that varied in their composition of whole grains, berries and nuts. A preference rank ordering of the five bars was also performed. Results: The results showed that samples that were rated highest in liking and were most preferred in both countries were a kamut/pumpkin bar and an oat/cranberry bar. The sample with the lowest rating that was also least preferred was a pumpernickel/sea buckthorn bar. Flavour was the most important determinant of overall liking followed by texture, odour and appearance. Conclusions: Children's acceptances and preferences were highly influenced by the sensory characteristics of the bars, mainly flavour. In agreement with earlier studies, the novel food ingredients seemed to influence children's preferences. The Nordic snack bars may have a potential to be a snack option for Danish and Swedish school children, but repeated exposures to the products are recommended to increase children's acceptance. © 2012 Anna Holmer et al.
45.	Håkansson, Andreas, et al. (author) Diet inequality prevails among consumers interested and knowledgeable in nutrition 2015 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 59 Journal article (peer-reviewed)abstract Previous studies have demonstrated a correlation between diet cost and adherence to nutritional recommendations among consumers in general. This has adverse effects on diet and health inequality. It could be hypothesized that consumers knowledgeable in nutrition escape this correlation
46.	Håkansson, Andreas (author) Has it become increasingly expensive to follow a nutritious diet? : Insights from a new price index for nutritious diets in Sweden 1980-2012 2015 In: Food & Nutrition Research. - 1654-6628 .- 1654-661X. ; 59 Journal article (peer-reviewed)abstract BACKGROUND: Health-related illnesses such as obesity and diabetes continue to increase, particularly in groups of low socioeconomic status. The increasing cost of nutritious food has been suggested as an explanation.OBJECTIVE: To construct a price index describing the cost of a diet adhering to nutritional recommendations for a rational and knowledgeable consumer and, furthermore, to investigate which nutrients have become more expensive to obtain over time.METHODS: Linear programming and goal programming were used to calculate two optimal and nutritious diets for each year in the interval under different assumptions. The first model describes the rational choice of a cost-minimizing consumer; the second, the choice of a consumer trying to deviate as little as possible from average consumption. Shadow price analysis was used to investigate how nutrients contribute to the diet cost.RESULTS: The cost of a diet adhering to nutritional recommendations has not increased more than general food prices in Sweden between 1980 and 2012. However, following nutrient recommendations increases the diet cost even for a rational consumer, particularly for vitamin D, iron, and selenium. The cost of adhering to the vitamin D recommendation has increased faster than the general food prices.CONCLUSIONS: Not adhering to recommendations (especially those for vitamin D) offers an opportunity for consumers to lower the diet cost. However, the cost of nutritious diets has not increased more than the cost of food in general between 1980 and 2012 in Sweden.
47.	Håkansson, Andreas (author) Has it become increasingly expensive to follow a nutritious diet? : Insights from a new price index for nutritious diets in Sweden 1980-2012 2015 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 59 Journal article (peer-reviewed)abstract BACKGROUND: Health-related illnesses such as obesity and diabetes continue to increase, particularly in groups of low socioeconomic status. The increasing cost of nutritious food has been suggested as an explanation. OBJECTIVE: To construct a price index describing the cost of a diet adhering to nutritional recommendations for a rational and knowledgeable consumer and, furthermore, to investigate which nutrients have become more expensive to obtain over time. METHODS: Linear programming and goal programming were used to calculate two optimal and nutritious diets for each year in the interval under different assumptions. The first model describes the rational choice of a cost-minimizing consumer; the second, the choice of a consumer trying to deviate as little as possible from average consumption. Shadow price analysis was used to investigate how nutrients contribute to the diet cost. RESULTS: The cost of a diet adhering to nutritional recommendations has not increased more than general food prices in Sweden between 1980 and 2012. However, following nutrient recommendations increases the diet cost even for a rational consumer, particularly for vitamin D, iron, and selenium. The cost of adhering to the vitamin D recommendation has increased faster than the general food prices. CONCLUSIONS: Not adhering to recommendations (especially those for vitamin D) offers an opportunity for consumers to lower the diet cost. However, the cost of nutritious diets has not increased more than the cost of food in general between 1980 and 2012 in Sweden.
48.	Höglund, Evelina, et al. (author) A meal concept designed for older adults - Small, enriched meals including dessert. 2018 In: Food & nutrition research. - : SNF Swedish Nutrition Foundation. - 1654-661X .- 1654-6628. ; 62 Journal article (peer-reviewed)abstract Background: The population of older adults is growing and many are at risk of disease-related malnutrition. This is a serious condition which increases the risk for other diseases and distress, human suffering and puts a high load on health care costs. Meal concepts tailored to suit the needs of older adults are required to decrease the incidence of disease-related malnutrition.Objective: To evaluate sensory perception regarding a concept of small, protein and energy-enriched multi-component meals designed according to the nutritional needs of older adults.Design: A meal concept of small main courses with complementary desserts and protein and energy-enriched products was evaluated using triangle tests, hedonic evaluation and focus group discussion. Enriched sauces and meals were compared to corresponding commercial products regarding appearance, taste, consistency and overall acceptance.Results: The concept of a small main course with a complementary dessert was generally perceived as positive by the target group. The acceptance scores for the enriched meals were generally lower than for the commercial meals, mainly owing to the packaging of the enriched meals which required covering the food in sauce. Enriched sauces contained approximately 90% more protein than the commercial sauces. However, protein enrichment affected the sensory properties of the sauces and they were perceived as thicker, creamier and less flavour-intensive.Conclusions: A concept based on small, protein and energy-enriched meals supplemented with a dessert was considered suitable for increasing the energy and protein intakes of older adults provided that the method of enrichment ensures attractive sensorial properties.
49.	Hörnell, Agneta, et al. (author) Breastfeeding, introduction of other foods and effects on health : a systematic literature review for the 5th Nordic Nutrition Recommendations 2013 In: Food & Nutrition Research. - : SNF Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 57 Research review (peer-reviewed)abstract 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.
50.	Hörnell, Agneta, Professor, 1964-, et al. (author) Infant feeding : a scoping review for Nordic Nutrition Recommendations 2023 2024 In: Food & Nutrition Research. - : Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 68 Research review (peer-reviewed)abstract 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.

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