Christel Larsson

• University of Gothenburg

Purpose Swedish adolescents’ free and added sugars intake exceeds recommended levels. This poses potential health problems; however, little is known about dietary sources within the Swedish population. This study investigated dietary sources of sugars among Swedish adolescents, as well as timing and location of free sugars intake. Methods A nation...

Objective The Keyhole is an internationally recognized front-of-pack nutrition label, guiding consumers to healthier food options. It indicates products in accordance with specific criteria for dietary fats, sugars, fibres, salt, and whole grains. The objective of this study was to simulate the potential impact of the Keyhole on adolescents’ energy...

Background/Objectives Obesity is the main risk factor for obstructive sleep apnoea, commonly occurring in females who are overweight after menopause. We aimed to study the effect of a palaeolithic diet on sleep apnoea in females with overweight after menopause from the population. Methods Seventy healthy, non-smoking females with a mean age of 60...

Background: Dieting is a risk factor of both eating disorders and obesity. The aim was to examine time trends of dieting in Swedish adolescents, and explore how dieting and body weight dissatisfaction are related to self-reported health, wellbeing and health behaviours. Methods: Analyses of cross-sectional Swedish data from HBSC (Health Behaviou...

A high intake of added and free sugars is associated with poor diet quality, caries, and potentially has a role in non-communicable diseases. As a result, dietary guidelines advice limitation. However, there is no standardized method for estimation of added and free sugars in food items and consequently intake is difficult to measure. This study ai...

Objective: To investigate how weight loss by different diets impacts on postprandial levels of glucagon-like peptide 1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), and glucagon. Methods: In this single-centre, parallel group 2-year trial, 70 healthy postmenopausal obese women were randomized to the Paleolithic diet or a healthy cont...

In this paper, we describe and critically reflect on the possibilities and challenges of developing and implementing an empowerment-based school intervention regarding healthy food and physical activity, involving participants from a Swedish multicultural area characterized by low socioeconomic status. The two-year intervention was continually deve...

Purpose: We studied effects of diet-induced postmenopausal weight loss on gene expression and activity of proteins involved in lipogenesis and lipolysis in adipose tissue. Methods: Fifty-eight postmenopausal women with overweight (BMI 32.5 ± 5.5) were randomized to eat an ad libitum Paleolithic-type diet (PD) aiming for a high intake of protein...

Physical activity (PA) decreases with age, and interventions are needed to promote PA during adolescence, especially, among those in low-socioeconomic status (SES) areas. The aim of this study was to investigate whether a two-year, empowerment-based health-promotion school intervention had any effects on changes in (a) moderate-to-vigorous PA (MVPA...

Purpose:This study aimed to describe adolescents’ experiences of participating in a health-promoting school-based intervention regarding food and physical activity, with a focus on empowering aspects. Method: The school was located in a urban disadvantaged community in Sweden, characterized by poorer self-reported health and lower life expectancy t...

Results from focus group interviews with adolescent participants. The adolescents have participated in an empowerment-based intervention focusing on healthy food and physical activity habits. The intervention was school-based, set in a disadvantaged and multicultural area in Gothenburg, Sweden.

The aim of the present study is to explore experienced home economics (HE) teachers’ perceptions of the influencing factors that condition their teaching opportunities regarding the revised mission to implement sustainable development (SD) in food-related education. Five purposefully selected HE teachers participated in individual, semi-structured,...

Conflicting findings remain regarding associations between lifestyle behaviors and coronary artery calcium (CAC). We investigated concomitant associations of healthy food intake and cardiorespiratory fitness (CRF) with CAC. Data from 706 men and women 50-64 years old from the Swedish SCAPIS pilot trial were analyzed. A CAC score was calculated usin...

The aim of this study is to explore conditioning factors influencing learning opportunities in food-related education taught from a perspective of sustainable development. Over the course of the eighth-grade school year, data were derived from field studies of two classes taught in Home and Consumer Studies with an exploratory case-study design. Da...

Background/objectives: Different diets are used for weight loss. A Paleolithic-type diet (PD) has beneficial metabolic effects, but two of the largest iodine sources, table salt and dairy products, are excluded. The objectives of this study were to compare 24-h urinary iodine concentration (24-UIC) in subjects on PD with 24-UIC in subjects on a di...

Despite increasing socioeconomic inequalities in the health and well-being of adolescents, the voices of adolescents in disadvantaged communities regarding facilitators of physical activity (PA) have received relatively little attention. In response, the purpose of this study was to illuminate what adolescents in a multicultural community of low so...

Nutritional epidemiology is an inherently complex and multifaceted research area. Dietary intake is a complex exposure, challenging to describe and assess, and links between diet, health and disease are difficult to ascertain. Consequently, adequate reporting is necessary to facilitate comprehension, interpretation and generalizability of results a...

Conclusion: Based on the adolescents' voices, feeling of enjoyment had a great impact on their PA engagement, and the presence of peers, variation and options, and perceived competence contributed to enjoyment related to PA. Moreover, feelings of autonomy and competence enabled the adolescents to challenge gender boundaries related to PA. Further,...

This study aimed to illuminate factors that undermine the healthy habits of adolescents from a multicultural community with low socioeconomic status (S.E.S.) in Sweden with regard to physical activity (P.A.) and food, as stated in their own voices. Adolescents (n = 53, 12–13 y/o) were recruited from one school situated in a multicultural community...

Objective: Abdominal fat accumulation after menopause is associated with low-grade inflammation and increased risk of metabolic disorders. Effective long-term lifestyle treatment is therefore needed. Methods: Seventy healthy postmenopausal women (age 60 ± 5.6 years) with BMI 32.5 ± 5.5 were randomized to a Paleolithic-type diet (PD) or a prudent...

Background: Traditional obesity prevention programs are time- and cost-intensive. Mobile phone technology has been successful in changing behaviors and managing weight; however, to our knowledge, its potential in young children has yet to be examined. Objective: We assessed the effectiveness of a mobile health (mHealth) obesity prevention program o...

The purpose of the current study was to investigate how combinations of different epoch durations and cut-points affect the estimations of sedentary time and physical activity in adolescents. Accelerometer data from 101 adolescents were derived and 30 combinations were used to estimate sedentary time, light, moderate, vigorous, and combined moderat...

Background: The 2016 Swedish Report Card on Physical Activity (PA) for Children and Youth is a unique compilation of the existing physical and health related data in Sweden. The aim of this article is to summarize the procedure and results from the report card. Methods: Nationally representative surveys and individual studies published between 2...

Concerns have been raised about the quality of reporting in nutritional epidemiology. Research reporting guidelines such as the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement can improve quality of reporting in observational studies. Herein, we propose recommendations for reporting nutritional epidemiology a...

Table S1. Responses received during the Delphi rounds.

Background: Sleep apnoea is common in females, especially in overweight females after menopause. Aims: To study the effect of a palaeolithic diet on sleep apnoea and daytime sleepiness in overweight females. Methods: Seventy obese, healthy, postmenopausal females were randomised to a palaeolithic diet based on lean meat, fish, eggs, vegetables, f...

Purpose: The aim of this cross-sectional study was to describe and analyze accelerometer-measured sedentary time and physical activity (PA) among adolescents in a multicultural area characterized by low socioeconomic status (SES). Method: Seventh-graders (n=114 (girls n=66), mean age: 12.8±0.8 y) were recruited from three schools in a multicultu...

Aim: The aim of this study was to measure the percentage of sedentary light and moderate-to-vigorous physical activity (%MVPA) provided by physical education (PE) lessons for Swedish second, fifth and eight grade students, aged eight, 11 and 14. Methods: We observed 39 PE lessons and divided them into seven lesson categories: ball play, ball gam...

Background: The use of new technology has the potential to increase participation rates in dietary studies and improve the validity of collected dietary data. However, to evaluate the usability of developed dietary methods, qualitative studies of participants' experiences and perceptions are needed. Objective: To explore adolescents' experiences...

Objective: To investigate associations between mothers' and children's food intake. Design: Cross-sectional study. Background variables collected through self-reports and from the register of the total population. Mothers recorded their own and their children's food intake in a diary during 2 4-day periods. Setting: Eight counties in mid Swede...

Background: Concerns have been raised about the quality of reporting in nutritional epidemiology. Research reporting guidelines such as the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement can improve quality of reporting in observational studies. Herein, we propose recommendations for reporting nutritional e...

Objective: The objective was to evaluate a manualized theory-driven primary preventive intervention aimed at early childhood obesity. The intervention was embedded in Swedish child health services, starting when eligible children were 9 to 10 months of age and continuing until the children reached age 4. Methods: Child health care centers in 8 S...

Background: Accumulation of myocardial triglycerides (MTG) is associated with impaired left ventricular (LV) remodelling and function in obese and diabetic subjects. The role of MTG accumulation in development of heart failure in this group of patients is unknown. Short-term studies suggest that diets that lead to weight loss could mobilize MTG, w...

Background Menopause is associated with increased abdominal fat and increased risk of developing diabetes and cardiovascular disease. Objectives The present study evaluated the plasma metabolic response in relation to insulin sensitivity after weight loss via diet intervention. Methods This work includes two studies; i) Ten women on a 5 weeks Paleo...

Little is known what the term sustainable development entails in relation to the school subject of home and consumer studies and the subject’s knowledge area of food. The aim is to illustrate how food is expressed in national syllabuses of home and consumer studies at present and in the past, and its operationalization into sustainable development....

Background/objectives: Our objective was to investigate changes in liver fat and insulin sensitivity during a 2-year diet intervention. An ad libitum Paleolithic diet was compared to a conventional, low-fat diet. Subjects/methods: Seventy healthy, obese, postmenopausal women were randomized to either a Paleolithic diet or a conventional, low-fat...

Mobile phones are becoming important instruments for assessing diet and energy intake. We developed the Tool for Energy Balance in Children (TECH), which uses a mobile phone to assess energy and food intake in pre-school children. The aims of this study were: (a) to compare energy intake (EI) using TECH with total energy expenditure (TEE) measured...

Childhood obesity is an increasing health problem globally. Overweight and obesity may be established as early as 2-5 years of age, highlighting the need for evidence-based effective prevention and treatment programs early in life. In adults, mobile phone based interventions for weight management (mHealth) have demonstrated positive effects on body...

Background There is a great need for dietary assessment methods that suit the adolescent lifestyle and give valid intake data. Objective To develop a mobile phone app and evaluate its ability to assess energy intake (EI) and total energy expenditure (TEE) compared with objectively measured TEE. Furthermore, to investigate the impact of factors on r...

Previous research has focused exclusively on weight loss or weight maintenance following weight loss, i.e. secondary weight maintenance (SWM). The long-term results of SWM have been modest, suggesting that preventing initial weight gain among normal weight or overweight individuals, i.e. primary weight maintenance (PWM), may be more successful. The...

It has been suggested that overweight is negatively associated with cognitive functions. The aim of this study was to investigate whether a reduction in body weight by dietary interventions could improve episodic memory performance and alter associated functional brain responses in overweight and obese women. 20 overweight postmenopausal women were...

Dietary weight loss interventions most often result in weight loss, but weight maintenance on a long-term basis is the main problem in obesity treatment. There is a need for an increased understanding of the behaviour patterns involved in adopting a new dietary behavior and to maintain the behaviour over time. The purpose of this paper is to explor...

Background/objectives: Tissue-specific glucocorticoid metabolism is altered in obesity, and may increase cardiovascular risk. This dysregulation is normalized by short-term calorie restriction and weight loss, an effect that varies with dietary macronutrient composition. However, tissue-specific glucocorticoid metabolism has not been studied durin...

Objectives: To compare the intake of total sugars, foods and drinks rich in added sugar, and energy in children on weekdays (Monday-Thursday), Fridays and weekends. Methods: Dietary intake (g, kJ, energy %) was assessed using a computerized 24-h recall method in a sample of 2- to 9-year-old children from Belgium, Cyprus, Estonia, Germany, Hungar...

There is a lack of research about the experiences of participating in weight-reducing interventions. The aim of this study was to explore barriers and facilitators to weight-loss experienced by participants in a diet intervention for middle-aged to older women in the general population in Northern Sweden. In the intervention the women were randomis...

Background: Childhood obesity is a growing concern in Sweden. Children with overweight and obesity run a high risk of becoming obese as adults, and are likely to develop comorbidities. Despite the immense demand, there is still a lack of evidence-based comprehensive prevention programmes targeting pre-school children and their families in primary...

Background/objectives: Short-term studies have suggested beneficial effects of a Palaeolithic-type diet (PD) on body weight and metabolic balance. We now report the long-term effects of a PD on anthropometric measurements and metabolic balance in obese postmenopausal women, in comparison with a diet according to the Nordic Nutrition Recommendation...

First, to evaluate the ability of a short dietary questionnaire (SDQ) to estimate energy intake (EI) on group and individual levels compared with total energy expenditure (TEE) measured by the doubly labelled water method. Second, to compare the SDQ's performance in estimating energy, nutrient and food intakes with a sixty-six-item FFQ used in larg...

Syftet med denna rapport var att systematiskt sammanstalla den vetenskapliga litteraturen om rad om mat till, eller faktiskt intag av mat hos personer med fetma. Följande slutsatser begränsas till samband mellan mat och vikt, sjuklighet samt dodlighet hos personer med fetma (definierat som BMI≥30 kg/m2 eller midjeomfang ≥102 cm eller ≥88 cm for man...

Previous studies have focused on weight maintenance following weight loss, i.e. secondary weight maintenance (SWM). The long-term results of SWM have been rather modest and it has been suggested that preventing initial weight gain, i.e. primary weight maintenance (PWM), may be more successful. Therefore, developing a prevention strategy focused on...

Objectives: Ectopic fat accumulation in liver and skeletal muscle may be an essential link between abdominal obesity, insulin resistance and increased risk of cardiovascular disease after menopause. We hypothesized that a diet containing a relatively high content of protein and unsaturated fat [mainly monounsaturated fatty acids (MUFAs)] but limit...

More knowledge about improving dietary intake in secondary preventive actions against childhood overweight and obesity is needed. The objective was to evaluate the impact of a 2-year intervention on energy, macronutrient and food intake of overweight and obese children participating in a randomised controlled trial. Children (8–12 years old) living...

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...

Objective. To evaluate the effect of a family-based intervention on anthropometric and metabolic markers in overweight and obese children. Methods. Overweight or obese 8–12 years olds (n = 93) were randomized into intervention or control groups. The intervention group participated in a program aiming for lifestyle changes regarding food habits and...

Abstract The aim was to examine the effect on physical activity of a 2-year family-based lifestyle intervention among overweight and obese Swedish children 8–12 years of age; 105 children were randomized to either intervention or control group. The intervention group was offered a 2-year lifestyle programme. Physical activity was measured using Sen...

To evaluate associations between anthropometrics and metabolic variables as well as cardiovascular risk factors among children. Subjects were recruited from a cohort of 274 healthy children in Umeå, Sweden. Anthropometric measures, blood pressure and venous blood samples were collected at age 10 years and simultaneously from parents. Altogether 144...

To assess energy and nutrient intakes and physical activity of adolescents in urban Cameroon according to sex and socio-economic status (SES). Cross-sectional study with adolescents randomly selected from schools in low-, middle- and high-SES areas. Weight and height were measured and information about food intake and physical activity was obtained...

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 1...

Overweight and obesity are considerable public health problems internationally as well as in Sweden. The long-term results of obesity treatment are modest as reported by other studies. The importance of extending the focus to not only comprise obesity treatment but also prevention of weight gain is therefore being emphasized. However, despite the s...

The purpose of this study was to examine the ability of the SenseWear Pro2 Armband (SWA) to accurately assess energy expenditure in free-living overweight or obese children during a 2-wk period by comparison with energy expenditure measured using the doubly labeled water (DLW) method. A second aim was to examine which software version, Innerview Pr...

Estimating energy intake (EI) of a child by using a diet history interview (DHI) method may be a challenge because of difficulty for the child to remember what has been eaten as well as to report portion sizes. The aim of this research was to validate reported EI from a DHI in children classified as overweight or obese by comparing the reported EI...

The aim of this study was to identify sources of nutrients in diets of young Swedish vegans and omnivores. Three months of dietary intakes were investigated by diet history interviews. Volunteers were recruited through advertising and visits to schools in the city of Umeå, Sweden. Thirty vegans, 15 female and 15 male, aged 17.5+/-1.0 years, were co...

In a town in northern Sweden, 3.3% of the 15-year-old adolescents were vegans in 1996. This study describes the process of becoming a vegan among adolescents and interprets the informants' descriptions by constructing categories, which later on were related to relevant theories. Group interviews were conducted with three vegans and in-depth intervi...

To compare the lifestyle-related characteristics of low-meat consumer and omnivore adolescents in Sweden and Norway. A total of 2041 students (578 from Umeå, Sweden; 504 from Stockholm, Sweden; and 959 from Bergen, Norway), with a mean age of 15.5 years, completed a questionnaire. Information was collected about physical characteristics, and health...

Adolescents sometimes become vegetarian for ethical rather than health reasons. This may result in health problems caused by lack of interest in and knowledge of nutrition. We compared the dietary intake and nutritional status of young Swedish vegans and omnivores. The dietary intakes of 30 vegans (15 males and 15 females; mean age: 17.5 +/- 1.0 y)...

Background: Adolescents sometimes become vegetarian for ethical rather than health reasons. This may result in health problems caused by lack of interest in and knowledge of nutrition. Objective: We compared the dietary intake and nutritional status of young Swedish vegans and omnivores. Design: The dietary intakes of 30 vegans (15 males and 15 fem...

It is difficult to obtain accurate reports of dietary intake; therefore, reported dietary intakes must be validated. Researchers need low-cost methods of estimating energy expenditure to validate reports of energy intake in groups with different lifestyles and eating habits. We sought to validate the reported energy expenditure and energy and prote...

To determine the prevalence of vegetarianism and compare food habits among vegetarian and omnivorous adolescents in Sweden and Norway. Cross-sectional study by questionnaire in Sweden and Norway to gather information about food habits. The municipalities of Umeå and Stockholm in Sweden, and Bergen in Norway. In total 2041 ninth-grade students (578...

A study was performed by surveying 124 Swedish upper secondary schools via telephone interviews. Those responsible for the school meals reported the number of students having different kinds of vegetarian food. Vegetarian food was defined as lacto-ovo-fish- vegetarian, lacto-ovo-vegetarian and vegan food (strict vegetarian food). The results showed...