Apples are rich in polyphenols and pectin, two potentially bioactive constituents; however, these constituents segregate differently during processing into juice products and clear juice is free of pectin and other cell wall components. We conclude that the fibre component is necessary for the cholesterol-lowering effect of apples in healthy humans and that clear apple juice may not be a suitable surrogate for the whole fruit in nutritional recommendations.
Objective: To assess the relative validity and reproducibility of the semiquantitative FFQ (SFFQ) applied in the evaluation of a community intervention study, SoL-Bornholm, for estimating food intakes. Design: The reference measure was a 4 d estimated food record. The SFFQ was completed two times separated by a 1-month period in order to test reproducibility. Setting: The Capital Region and the Regional Municipality of Bornholm, Denmark. Subjects: A total of fifty-four children aged 3-9 years were enrolled in the study. Results: In terms of validity, the SFFQ generally overestimated intakes compared with the food records, especially for vegetables. For most intakes, the mean difference increased with increasing intake. Gross misclassification was on average higher for energy and nutrients (17 %) than for foods (8 %). Spearman correlation coefficients were significant for twelve out of fourteen intakes, ranging from 0·29 to 0·63 for foods and from 0·12 to 0·48 for energy and nutrients. Comparing the repeated SFFQ administrations, the intakes of the first SFFQ were slightly higher than those of the second SFFQ. Gross misclassification was low for most intakes; on average 6 % for foods and 8 % for energy and nutrients. Intra-class correlations were significant for all intakes, ranging from 0·30 to 0·82 for foods and from 0·46 to 0·81 for energy and nutrients. Conclusions: The results indicate that the SFFQ gives reproducible estimates. The relative validity of the SFFQ was low to moderate for most intakes but comparable to other studies among children.
BackgroundResearch shows that obesity prevention has to start early. Targeting interventions towards subgroups of individuals who are predisposed, but yet normal weight, may prove more effective in preventing overweight than interventions towards unselected normal weight subsets. Finally, interventions focused on other factors than diet and activity are lacking. The objectives were to perform a randomized, controlled intervention aiming at preventing overweight in children aged 2–6 years, who are yet normal weight, but have high predisposition for future overweight, and to intervene not only by improving diet and physical activity, but also reduce stress and improve sleep quality and quantity.Methods/DesignBased on information from the Danish National Birth Registry and administrative birth forms, children were selected based on having either a high birth weight, a mother who was overweight prior to pregnancy, or a familial low socioeconomic status. Selected children (n = 5,902) were randomized into three groups; an intervention group, a shadow control group followed in registers exclusively, and a control group examined at the beginning and at the end of the intervention. Approximately 21% agreed to participate. Children who presented as overweight prior to the intervention were excluded from this study (n = 92). In the intervention group, 271 children were included, and in the control group 272 were included. Information obtained from the shadow control group is on-going, but it is estimated that 394 children will be included. The intervention took place over on average 1½ year between 2009 and 2011, and consisted of optional individual guidance in optimizing diet and physical activity habits, reducing chronic stress and stressful events and improving sleep quality and quantity. The intervention also included participation in cooking classes and play arrangements. Information on dietary intake, meal habits, physical activity, sleep habits, and overall stress level was obtained by 4–7 day questionnaire diaries and objective measurements.DiscussionIf the Healthy Start project is effective in preventing excessive weight gain, it will provide valuable information on new determinants of obesity which should be considered in future interventions, and on new strategies to prevent development of overweight and obesity at an early age.Trial registrationClinicalTrials.gov, ID NCT01583335.
A quasi-experimental study was designed to promote novel plant-based dishes using the nudging strategy 'dish of the day' among older consumers in Denmark, France, Italy and the United Kingdom. Participants were presented with three dish options: veggie balls, meatballs and fish cakes. In the intervention situation, participants were informed that the 'dish of the day' was the novel plant-based 'veggie balls'. Thereafter, participants were asked to choose one of three dishes to intake and then fill a questionnaire. No statistically significant difference in dish choice was found between the control group and intervention group in the four countries. Males were less likely to choose the plant-based dish when compared with the females. Participants from the United Kingdom and Denmark were more likely to choose the plant-based dish when compared with participants from France. High scores of security dimension from the Human Value Scale was negatively associated with choice of plant-based dish, while high scores of the sensory dimension from Food Choice Questionnaire and high scores of the universalism dimension from Human Values Scale were positively related to the choice of the plant-based dish. The 'dish of the day' nudging approach did not influence older people's plant-based dish choice. Gender, country, and dimensions of sensory, universalism and security were critical factors influencing an older people's plant-based food choice.
Project SoL was implemented over a period of four years from 2012–2015 with the aim to promote healthy eating and physical activity among families with children aged 3–8 years, living in selected communities in two Danish municipalities. This was done by applying the supersetting approach to implement complex multi-component interventions in a participatory, coordinated, and integrated manner in childcare centres, schools, and supermarkets in three local communities, as well as in local media during a 19-month period in the Regional Municipality of Bornholm, which served as the intervention site. The matching municipality of Odsherred served as a control site based on its similarity to Bornholm regarding several socio-demographic and health indicators. The present paper describes the design of Project SoL as well as the processes of developing and implementing its complex interventions. Moreover, the theoretical and conceptual framework of the project is described together with its organisational structure, concrete activities, and sustainability measures. The paper discusses some of the key lessons learned related to participatory development and the implementation of a multi-component intervention. The paper concludes that coordinated and integrated health promotion activities that are implemented together with multiple stakeholders and across multiple settings in the local community are much more powerful than individual activities carried out in single settings. The supersetting approach was a useful conceptual framework for developing and implementing a complex multi-component health promotion intervention and for fostering ownership and sustainability of the intervention in the local community. The research and evaluation approach of the project is described in a separate paper (Part 2).
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