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- Svensson, Åsa, 1981-, et al.
(author)
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Overweight and obese children´s ability to report energy intake using digital camera food records during a 2-year study
- 2012
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In: Journal of Nutrition and Metabolism. - : Hindawi Limited. - 2090-0724 .- 2090-0732. ; :247389
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Journal article (peer-reviewed)abstract
- The objective was to evaluate overweight and obese children's ability to report reproducible and valid estimates of energy intake (EI) by using digital camera food records (FR) during a 2-year study, compared with objectively measured total energy expenditure (TEE). Seventy-three overweight/obese children, aged 8–12 years at inclusion, kept FR with the help of digital cameras for 16 days in total, on 7 occasions during a 2-year period. On the same days, their TEE was registered with SenseWear Armband (SWA). The children underestimated their EI by −2.8 (2.4) MJ/d on the first assessment occasion (95% CI: −3.3, −2.3). Reporting accuracy did not differ between the 7 assessment occasions (P=0.15). Variables negatively associated with reporting accuracy relative to TEE were increased age (95% CI: −0.07, −0.01) and BMI z-score (95% CI: −0.18, −0.06). Further, reporting accuracy relative to TEE was lower for girls than boys (95% CI: −0.14, −0.01) and on weekdays compared with weekend days (95% CI: −0.08, −0.001). In conclusion, overweight and obese children were able to report their EI using a digital camera FR with good reproducibility over a 2-year period, even though their EI was underestimated compared with objectively measured TEE.
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- Cecilia, Olsson, et al.
(author)
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School meals do not have a given place in Swedish school's quality management
- 2016
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In: Health Education Journal. - : SAGE Publications. - 0017-8969 .- 1748-8176. ; 75:8, s. 961-971
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Journal article (peer-reviewed)abstract
- Objectives: Sweden is one of three countries worldwide which has a legal requirement to ensure that pupils in compulsory school should be offered free, nutritious school meals. Furthermore, the law states that school meal provision should be included in schools' internal quality management (IQM) system. The objective of this study was to examine to what extent schools in Sweden are following the legal requirement to include school meals in IQM and the relationship between this inclusion and the application of government advisory guidelines regarding school meals.Design: Cross-sectional study. Setting: Head teachers evenly distributed across all regions in Sweden representing municipality schools, independent schools and Sami schools. Method: Web-based questionnaire completed by 216 head teachers.Results: About half of the schools did not meet the legal requirement to include schools meals in the IQM. Furthermore, familiarity with and use of the National Food Agency (NFA) guidelines and the web-based tool School Food Sweden, as well as activities considered as part of a pedagogical school meal and the inclusion of school meals in interdisciplinary work, were reported to be less common in schools not including school meals in their IQM system.Conclusion: Findings suggest that when there is inclusion of school meals in a school's quality management system, the school is also more likely to include school meals as part of educational activities. By acknowledging school meal provision as part of the educational process, possibilities are opened up for health-promoting activities to prevent non-communicable disease.
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- Chorell, Elin, 1981-, et al.
(author)
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Improved peripheral and hepatic insulin sensitivity after lifestyle interventions in type 2 diabetes is associated with specific metabolomic and lipidomic signatures in skeletal muscle and plasma
- 2021
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In: Metabolites. - : MDPI. - 2218-1989 .- 2218-1989. ; 11:12
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Journal article (peer-reviewed)abstract
- Lifestyle interventions with weight loss can improve insulin sensitivity in type 2 diabetes (T2D), but mechanisms are unclear. We explored circulating and skeletal muscle metabolite signatures of altered peripheral (pIS) and hepatic insulin sensitivity (hIS) in overweight and obese T2D individuals that were randomly assigned a 12-week Paleolithic-type diet with (diet-ex, n = 13) or without (diet, n = 13) supervised exercise. Baseline and post-intervention measures included: mass spectrometry-based metabolomics and lipidomics of skeletal muscle and plasma; pIS and hIS; ectopic lipid deposits in the liver and skeletal muscle; and skeletal muscle fat oxidation rate. Both groups lowered BMI and total % fat mass and increased their pIS. Only the diet-group improved hIS and reduced ectopic lipids in the liver and muscle. The combined improvement in pIS and hIS in the diet-group were associated with decreases in muscle and circulating branched-chain amino acid (BCAA) metabolites, specifically valine. Improved pIS with diet-ex was instead linked to increased diacylglycerol (34:2) and triacylglycerol (56:0) and decreased phosphatidylcholine (34:3) in muscle coupled with improved muscle fat oxidation rate. This suggests a tissue crosstalk involving BCAA-metabolites after diet intervention with improved pIS and hIS, reflecting reduced lipid influx. Increased skeletal muscle lipid utilization with exercise may prevent specific lipid accumulation at sites that perturb insulin signaling.
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- Juniusdottir, Ragnheidur, et al.
(author)
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Composition of school meals in Sweden, Finland and Iceland : Official guidelines and comparison with practice and availability
- 2018
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In: Journal of School Health. - : Wiley-Blackwell. - 0022-4391 .- 1746-1561. ; 88:10, s. 744-753
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Journal article (peer-reviewed)abstract
- BACKGROUND: Nutritious and attractive school meals can improve health equality and public health. Current official guidelines and recommendations on food and nutrient composition of school meals in 3 Nordic countries; Sweden, Finland, and Iceland, are described and compared with actual practice, ie, availability of foods and nutrients in served reference meals in 3 selected areas in each country.METHODS: A country comparison was made between official guidelines, and actual practice was studied in participating schools. Reference portions of school meals (N = 170) provided in 24 compulsory schools were photographed and weighed. Food and nutrient availability were compared with official guidelines in each country.RESULTS: Emphasis of recommendations on whole‐grain bread in Sweden, whole grains in Finland, and fish in Iceland were reflected in food availability. The energy content of the meals provided was lower than guidelines and there was a large variation in energy content between days.CONCLUSIONS: The guidelines regarding food availability were quite well followed, but the large variation in energy and nutrient content of provided school meals between days indicates a need for standardization.
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- Lindblom, Cecilia, Universitetslektor, 1979-, et al.
(author)
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Challenges to Interdisciplinary teaching for nutrition and health in Swedish compulsory schools
- 2020
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In: International Journal of Home Economics. - Bonn : International Federation for Home Economics. - 1999-561X. ; 13:1, s. 15-29
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Journal article (peer-reviewed)abstract
- The Swedish National Agency for Education states that educational provision should involve pupil opportunities for interdisciplinary work and the experience of learning in different ways. In this context, the current study aimed to explore the actual operation of interdisciplinary teaching (IDT) in Swedish compulsory schools, i.e. from preschool (6 years) to grade 9 (16 years) regarding nutrition and health. To investigate this, two web-based nationwide questionnaires were sent out in 2014 to compulsory schools in Sweden. One questionnaire was aimed at teachers in five subjects: Home and Consumer Studies (HCS), Natural Science Subjects (NSS) (Biology, Chemistry, Physics), and Physical Education and Health (PEH). The second questionnaire was for school principals. A total of 388 teachers and 216 principals answered the respective questionnaire. The study showed that 40% of the teachers and 59% of the principals reported that their school worked in an interdisciplinary way regarding nutrition and health education. Practical scheduling problems and a lack of time for planning were seen as the main barriers by both teachers and principals, but to a much larger extent by teachers. A prerequisite for successful IDT is that teachers have a chance to meet and plan, and this study indicates that frame factors have a critical impact on what is possible regarding IDT in Swedish schools. It is crucial that principals appreciate their part in facilitating IDT. Increased interdisciplinary teaching for nutrition and health (IDT-NH) might increase school potential for the better integration of knowledge and understanding about the importance of lifestyle for health, the environment and society.
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- Otten, Julia, 1973-, et al.
(author)
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Benefits of a Paleolithic diet with and without supervised exercise on fat mass, insulin sensitivity, and glycemic control : a randomized controlled trial in individuals with type 2 diabetes
- 2017
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In: Diabetes/Metabolism Research Reviews. - : Wiley. - 1520-7552 .- 1520-7560. ; 33:1
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Journal article (peer-reviewed)abstract
- BackgroundMeans to reduce future risk for cardiovascular disease in subjects with type 2 diabetes are urgently needed.MethodsThirty-two patients with type 2 diabetes (age 59 ± 8 years) followed a Paleolithic diet for 12 weeks. Participants were randomized to either standard care exercise recommendations (PD) or 1-h supervised exercise sessions (aerobic exercise and resistance training) three times per week (PD-EX).ResultsFor the within group analyses, fat mass decreased by 5.7 kg (IQR: −6.6, −4.1; p < 0.001) in the PD group and by 6.7 kg (−8.2, −5.3; p < 0.001) in the PD-EX group. Insulin sensitivity (HOMA-IR) improved by 45% in the PD (p < 0.001) and PD-EX (p < 0.001) groups. HbA1c decreased by 0.9% (−1.2, −0.6; p < 0.001) in the PD group and 1.1% (−1.7, −0.7; p < 0.01) in the PD-EX group. Leptin decreased by 62% (p < 0.001) in the PD group and 42% (p < 0.001) in the PD-EX group. Maximum oxygen uptake increased by 0.2 L/min (0.0, 0.3) in the PD-EX group, and remained unchanged in the PD group (p < 0.01 for the difference between intervention groups). Male participants decreased lean mass by 2.6 kg (−3.6, −1.3) in the PD group and by 1.2 kg (−1.3, 1.0) in the PD-EX group (p < 0.05 for the difference between intervention groups).ConclusionsA Paleolithic diet improves fat mass and metabolic balance including insulin sensitivity, glycemic control, and leptin in subjects with type 2 diabetes. Supervised exercise training may not enhance the effects on these outcomes, but preserves lean mass in men and increases cardiovascular fitness.
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- Otten, Julia, 1973-, et al.
(author)
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The liver-alpha-cell axis after a mixed meal and during weight loss in type 2 diabetes
- 2021
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In: Endocrine Connections. - : Bioscientifica. - 2049-3614. ; 10:9, s. 1101-1110
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Journal article (peer-reviewed)abstract
- Objective: Glucagon and amino acids may be regulated in a feedback loop called the liver-alpha-cell axis with alanine or glutamine as suggested signal molecules. We assessed this concept in individuals with type 2 diabetes in the fasting state, after ingestion of a protein-rich meal, and during weight loss. Moreover, we investigated if postprandial glucagon secretion and hepatic insulin sensitivity were related.Methods: This is a secondary analysis of a 12-week weight-loss trial (Paleolithic diet ± exercise) in 29 individuals with type 2 diabetes. Before and after the intervention, plasma glucagon and amino acids were measured in the fasting state and during 180 min after a protein-rich mixed meal. Hepatic insulin sensitivity was measured using the hyperinsulinemic-euglycemic clamp with [6,6-2H2]glucose as a tracer.Results: The postprandial increase of plasma glucagon was associated with the postprandial increase of alanine and several other amino acids but not glutamine. In the fasted state and after the meal, glucagon levels were negatively correlated with hepatic insulin sensitivity (rS = −0.51/r = −0.58, respectively; both P < 0.05). Improved hepatic insulin sensitivity with weight loss was correlated with decreased postprandial glucagon response (r = −0.78; P < 0.001).Conclusions: Several amino acids, notably alanine, but not glutamine could be key signals to the alpha cell to increase glucagon secretion. Amino acids may be part of a feedback mechanism as glucagon increases endogenous glucose production and ureagenesis in the liver. Moreover, postprandial glucagon secretion seems to be tightly related to hepatic insulin sensitivity.
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- Waling, Maria, 1981-, et al.
(author)
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A one-year intervention has modest effects on energy and macronutrient intakes of overweight and obese Swedish children.
- 2010
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In: The Journal of nutrition. - : Elsevier BV. - 1541-6100 .- 0022-3166. ; 140:10, s. 1793-8
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Journal article (peer-reviewed)abstract
- To decrease BMI in overweight and obese children, improved dietary intake and increased physical activity are key elements. Our objective was to evaluate the impact of a 1-y food and physical activity intervention on energy and macronutrient intake in overweight and obese children. A randomized open trial was conducted with 92 overweight or obese 10.4 ± 1.08-y-old children. The intervention included 14 group sessions with different themes regarding food and physical activity. Dietary intake was assessed with diet history interviews covering 14 d at baseline and 4-d food records after 1 y and was evaluated according to national dietary recommendations. The control group participated in the same measurements as the intervention group but did not take part in group sessions. After 1 y, both groups had decreased their energy intake (EI) relative to total energy expenditure, but the effect was more pronounced for the intervention group than for the control group. At 1 y follow-up, a larger proportion of children in the intervention group compared with the control group met the recommended intake of refined sugar (P = 0.019). However, the groups did not differ in the proportion children who met the recommended intake of dietary fiber. Further, SFA intake relative to total EI did not differ between the groups at 1 y follow-up. In conclusion, despite a rather comprehensive intervention, only modest effects were achieved with respect to reduced EI and improved macronutrient intake.
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