BackgroundStrategies to optimize early-life nutrition provide an important opportunity for primary prevention of childhood obesity. Interventions that can be efficiently scaled-up to the magnitude needed for sustainable childhood obesity prevention are needed. The objective of this study was to evaluate the effects of an eHealth intervention on parental feeding practices and infant eating behaviors.MethodsThe Norwegian study Early Food for Future Health is a randomized controlled trial. Parents were recruited via social media and child health clinics during spring 2016 when their child was aged 3 to 5 months. In total 718 parents completed a web-based baseline questionnaire at child age 5.5 months. The intervention group had access to a webpage with monthly short video clips addressing specific infant feeding topics and age-appropriate baby food recipes from child age 6 to 12 months. The control group received routine care. The primary outcomes were child eating behaviors, dietary intake, mealtime routines and maternal feeding practices and feeding styles. The secondary outcomes were child anthropometry. This paper reports outcomes at child age 12 months.ResultsMore than 80% of the intervention group reported viewing all/most of the video clips addressing infant feeding topics and indicated that the films were well adapted to the child’s age and easy to understand. Children in the intervention group were served vegetables/fruits more frequently (p = 0.035) and had tasted a wider variety of vegetables (p = 0.015) compared to controls. They were also more likely to eat family breakfast (p = 0.035) and dinner (p = 0.011) and less likely to be playing or watching TV/tablet during meals (p = 0.009) compared to control-group children. We found no group differences for child anthropometry or maternal feeding practices.ConclusionsOur findings suggest that the eHealth intervention is an appropriate and feasible tool to propagate information on healthy infant feeding to Norwegian mothers. Our study also suggests that anticipatory guidance on early protective feeding practices by such a tool may increase young children’s daily vegetable/fruit intake and promote beneficial mealtime routines.Trial registrationISRCTN, ISRCTN13601567. Registered 29 February 2016, http://www.isrctn.com/ISRCTN13601567Electronic supplementary materialThe online version of this article (10.1186/s12966-018-0763-4) contains supplementary material, which is available to authorized users.

Objective: It is debated whether the intake of added sugar displaces micronutrientrich foods and dilutes the nutrient density of the diet, and whether there is a link between sugar and the increased rate of obesity. The objectives of this study were to examine the effect of added sugar on the intakes of energy, micronutrients, fruit and vegetables, and to examine the association between intake of added sugar and age, sex, body mass index, physical activity, inactivity and parents' education. Design: Participants recorded their food intake in pre-coded food diaries for 4 days and filled in a questionnaire about physical activity, watching television (TV)/using a personal computer (PC) and parents' education. Subjects: Three hundred and ninety-one 4-year-olds, 810 students in the 4th grade (9 years old) and 1005 in the 8th grade (13 years old) were included in the study. Results: The intakes of all nutrients, except a-tocopherol among 4-year-olds and vitamin C among 4-year-olds and 4th graders, decreased with increasing content of added sugar in the diet. Moreover, high consumers of added sugar had a 30-40% lower intake of fruit and vegetables than did low consumers. A negative association was observed between consumption of added sugar and body mass index among girls in the 8th grade (P ¼ 0.013), whereas a positive association was observed among 4-year-old boys (P ¼ 0.055). Associations between physical activity, hours spent watching TV/using a PC, parents' education and the energy intake from added sugar varied in the different age groups. Conclusions: This study showed a negative association between the intake of added sugar and intakes of micronutrients, fruit and vegetables. The negative association between sugar intake and intake of fruit and vegetables is important from a public health perspective, since one of the main health messages today is to increase current intake of fruit and vegetables.

Objective: To construct a diet score for assessing degree of adherence to a healthy and environmentally friendly New Nordic Diet (NND) and to investigate its association with adequacy of gestational weight gain and fetal growth in a large prospective birth cohort. Design: Main exposure was NND adherence, categorized as low, medium or high adherence. Main outcomes were adequacy of gestational weight gain, described as inadequate, optimal or excessive according to the 2009 Institute of Medicine guidelines, and fetal growth, categorized as being small, appropriate or large for gestational age. Associations of NND adherence with gestational weight gain and fetal growth were estimated with multinomial logistic regression in crude and adjusted models. Setting: Norway. Subjects: Women (n 66 597) from the Norwegian Mother and Child Cohort Study (MoBa). Results: Higher NND adherence implied higher energy and nutrient intakes, higher nutrient density and a healthier macronutrient distribution. Normal-weight women with high as compared with low NND adherence had lower adjusted odds of excessive gestational weight gain (OR = 0·93; 95 % CI 0·87, 0·99; P = 0·024). High as compared with low NND adherence was associated with reduced odds of the infant being born small for gestational age (OR = 0·92; 95 % CI 0·86, 0·99; P = 0·025) and with higher odds of the baby being born large for gestational age (OR = 1·07; 95 % CI 1·00, 1·15; P = 0·048). Conclusions: The NND score captures diet quality. Adherence to a regional diet including a large representation of fruits and vegetables, whole grains, potatoes, fish, game, milk and drinking water during pregnancy may facilitate optimal gestational weight gain in normal-weight women and improve fetal growth in general.

Of the participants, 86% had at least one, 45% at least two and 15% at least three CVD risk factors. Few patients were treated with statins and anti-hypertensive drugs.

Objective: To identify factors associated with exclusive breast-feeding and breastfeeding during the first year of life among Norwegian infants. Design: Data on breast-feeding practices were collected by a semi-quantitative FFQ. Setting: In 2006-2007 about 3000 infants were invited to participate in a populationbased prospective cohort study in Norway. Subjects: A total of 1490 mothers/infants participated at both 6 and 12 months of age. Results: Exclusive breast-feeding at 4 months was associated with parental education, parity and geographical region, while exclusive breast-feeding at 5?5 months was associated only with maternal age. At both ages, a negative association with exclusive breast-feeding was observed for maternal smoking. Breast-feeding at 6 months was associated with parental education, maternal age and marital status. Breast-feeding at 12 months was associated with maternal education, maternal age and number of children. At both ages, negative associations with breast-feeding were observed for maternal smoking and descending birth weight. At 12 months, a negative association was also observed for having day care by other than the parents. Conclusions: Even though Norway has an extensive and positive breast-feeding tradition and a maternal leave system that supports the possibility to breast-feed, factors like maternal education, maternal age and maternal smoking are strongly associated with duration of exclusive breast-feeding and breast-feeding. Research to better understand the reasons for inequalities in breast-feeding is needed to facilitate the development of more effective breast-feeding promotion strategies. This again may improve compliance with recommendations and reduce inequalities in infant feeding practices.Keywords Exclusive breast-feeding Breast-feeding Infant feeding practices Adequate nutrition during infancy and early childhood is essential to ensure growth, health and development of children to reach their full potential. Breast milk strongly contributes to good health and nutrition of infants. Apart from being an excellent nutritional source for the growing child, breast milk is associated with a reduced risk of many diseases in infants and mothers. A recent review by Duijts et al. (1) points out that a number of studies in industrialised countries suggest that breast-feeding protects infants against overall infections, gastrointestinal and respiratory tract infections. Moreover, Ip et al. (2) reported long-term benefits of breast-feeding for infants to be reduced risk of obesity and type 2 diabetes in later life, and long-term benefits for breast-feeding mothers to be reduced risk of breast and ovarian cancers.The initiation and duration of exclusive breast-feeding and breast-feeding are influenced by a number of factors. Although the factors that influence the initiation and duration of breast-feeding in developed countries have been broadly studied (3)(4)(5) , previous studies in these countries have rarely examined the factors associated with exclusive breast-feedi...

Objective: The goals of this study were to investigate whether children and adolescents can accurately estimate portion sizes of preweighed food by viewing photographs of food, and whether age influences the ability to estimate food portion sizes. Subjects: A total of 63 male and female volunteers aged 9-19 y participated in the study. Design: Each participant received a photographic booklet with photograph series of 13 food items. Participants over 10 y of age were asked to estimate portion sizes of food on 34 plates placed in front of them by comparing the different portions to corresponding photographs of food. Younger participants were asked to estimate portion sizes of food on 17 plates by comparing the portions to photographs. Results: Participants made 2019 comparisons between actual food portion sizes and photographs of food portion sizes. On average, 60% of the comparisons were made correctly. A photograph directly adjacent to the photograph depicting the correct portion size was chosen in 35% of the comparisons and 5% of the comparisons were made incorrectly. Portion sizes were estimated more accurately when the actual served portions of food had exactly the same appearance as the foods portrayed in the photographic booklet. No differences existed between children's and adolescents' abilities to estimate portion sizes using photographs. Conclusions: Large variability may exist in an individual's capability of choosing a photograph that correctly depicts food portion sizes, but the error at the group level is quite small. These data indicate that a photographic booklet of foods can be a useful tool for portion size estimates in these age groups.

Aim: The aim of the present study was to investigate the prevalence rate of overweight and obesity in a nationwide survey of fourth- and eighth-grade Norwegian schoolchildren, the changes in overweight rates among eighth graders from 1993 to 2000, and to investigate factors associated with overweight. Methods: Cross-sectional dietary surveys were conducted on nationally representative samples of eighth graders in 1993, and among fourth and eighth graders in 2000. Self-reported weight and height was available from 1,650 eighth graders in 1993, and from 664 fourth and 825 eighth graders in 2000. Data on dietary pattern, social class, and physical activity were also available. Results: In 2000 the prevalence of overweight and obesity among the fourth graders was 18.5% and 3.6%, respectively, and among the eighth graders 11.5% and 1.8%, respectively. A marked increase in overweight and obesity among Norwegian eighth graders from 1993 to 2000 was observed; the prevalence of overweight and obesity increased by 4 and 0.9 percentage points, respectively. Social class, time spent watching TV or in front of a computer, and breakfast frequency were associated with the odds of being overweight. An inverse relation between intake of sweets and overweight was observed. Validation studies demonstrated a high correlation between self-reported and measured height and weight in both age groups. Conclusion: The present study demonstrates a high prevalence of overweight and obesity among schoolchildren, especially among fourth graders in Norway. Moreover, the proportion of overweight and obese children has increased greatly among eighth graders during the last decade.

Aims/hypothesis We evaluated how well the diet of Norwegian children and adolescents with type 1 diabetes fulfils the Nordic and European dietary recommendations, focusing on parameters affecting prevention of atherosclerosis. We also compared the diet of this patient group with that of healthy same-age control subjects. Materials and methods A total of 177 children and adolescents with type 1 diabetes (9-10-year-olds, 12-13-year-olds) and 1,809 healthy same-age control subjects recorded their food intake for 4 days in precoded food diaries.Results In children and adolescents with type 1 diabetes the percentage of energy (E%) from fat (33-35 E%) and saturated fat (14-15 E%) was higher than recommended for that group. Furthermore their intake of fibre was lower (16-19 g/day) than current recommendations. There were no differences in energy intake between diabetic subjects and healthy control subjects. Percentage of energy from fat (mean difference: 3.4 E%, p<0.001) and saturated fat (mean difference: 1.0 E%, p<0.001) was significantly higher among diabetic subjects than control subjects. Intake of fruits and vegetables was low (210 g/day) compared with recommendations, both in the diabetic and control subjects. Conclusions/interpretation Diabetic children and adolescents had a high intake of energy from saturated fat and low intake of fibre, fruits and vegetables, which could increase the risk of development of atherosclerosis. This study supports the idea that nutritional guidance in the treatment of children and adolescents with type 1 diabetes should be more focused, especially with regard to intake of fibre, fruits and vegetables and to quality and quantity of fat intake.