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Additional file 1: Table S1. Original and modified categories of frequency of fish intake in the Tromsø Study. Table S2. Modifications of the frailtyphenotype in the Tromsø7 Study (2015–2016). Table S3. Characteristics of tracking sample in Tromsø4 and Tromsø6 (n=3229). Table S4. Odds ratios (ORs) and 95% confidence intervals (CIs) for fish intake and 8-year follow-up pre-frailty after exclusion of baseline frailty (n = 3219)a. Table S5. Characteristics of participants in Tromsø6 by Tromsø7 participation status (n = 6837)a. Table S6. Odds ratios (ORs) and 95% confidence intervals (CIs) for baseline fish intake and pre-frailty with inverse probability weightsa (n = 6183)b. Table S7. Characteristics of participants in Tromsø6 with complete and incomplete data on fish intake (n = 5750)a. Table S8. Odds ratios (ORs) and 95% confidence intervals (CIs) for patterns of fish intake and pre-frailty using multiple imputation (MI)a (n = 5750)b. Table S9. Onset of physical frailty characteristics in Tromsø7 (n = 4350)a. Table S10. Frailty prevalence in Tromsø7 stratified by age (n = 4350)a.

BACKGROUND: Protein intake is suggested as an important dietary factor in the prevention of frailty, however, the infuence of lifelong intake remains unclear. OBJECTIVES: The present study investigated the relationship between daily protein intake and patterns of protein intake over 21 years and the risk of pre-frailty/frailty. DESIGN: Prospective cohort study. SETTING: The population-based Tromsø Study in Tromsø municipality, Norway. PARTICIPANTS: In total, 1,906 women and 1,820 men aged >45 years in 1994 who participated in both Tromsø4 (1994–95) and Tromsø7 (2015–16). MEASUREMENTS: Frailty status in Tromsø7 was measured according to Fried’s phenotype, classifying participants as “robust” (frailty components present: 0), “pre-frail” (1–2) or “frail” (>3). Daily intake of protein was estimated from self-reported habitual dietary intake using food frequency questionnaires and assessed as grams per kilogram bodyweight (g/kg BW) and per megajoule energy intake (g/MJ). The protein–frailty association was assessed via longitudinal and crosssectional multivariable logistic regression analyses. RESULTS: The prevalence of pre-frailty and frailty in this study was 27% and 1.0%, respectively. Longitudinal analysis showed that the odds of pre-frailty/frailty decreased by 57% (odds ratio (OR) = 0.43, 95% confdence interval (CI) = 0.31;0.58, pCONCLUSIONS: Intake of protein in g/kg BW both in mid-life and later in life was inversely associated with pre-frailty/frailty in older adults. This emphasizes the importance of an adequate protein intake to facilitate healthy ageing in Norwegian older adults.

© The Authors 2019, Objective: To evaluate daily eating frequency (main meals and snacks) in relation to weight status in children aged 3–9 years, representative of the Portuguese population. Design: Cross-sectional study. Dietary intake was estimated as the mean of two non-consecutive days of food diaries, followed by face-to-face interviews. Weight and height were measured by trained observers. Eating occasions (EO) were defined by the children’s caregiver; an EO was considered separate if the time of consumption was different from other EO and it provided at least 209 kJ (50 kcal). Main meals defined as ‘breakfast’, ‘lunch’ and ‘dinner’ could be selected only once per day. The remaining EO were considered snacks. The association between eating frequency and overweight/obesity was evaluated through logistic regressions weighted for the population distribution. Setting: National Food, Nutrition and Physical Activity Survey of the Portuguese population, 2015–2016. Participants: Portuguese children aged 3–9 years with complete dietary data and anthropometric measurements (n 517). Results: Overall, the number of daily EO ranged from 3·5 to 11, and on average children had 5·7 daily EO. After adjustment for child’s sex, age and total energy intake, and considering only plausible energy intake reporters, having < 3 snacks/d was positively associated with being overweight/obese (OR = 1·98; 95 % CI 1·00, 3·90), compared with having ≥ 3 snacks/d. Conclusions: Lower daily frequency of EO was associated with increased odds of being overweight or obese in children. A higher eating frequency, maintaining the same energy intake, seems to contribute to a healthy body weight in children., This study had institutional support from the General Directorate of Health (DGS), the Regional Health Administration Departments, the Central Administration of the Health System (ACSS) and the European Food Safety Authority (CFT/EFSA/DCM/2012/01-C03). The researchers acknowledge all these institutions and persons involved in all phases of the IAN-AF 2015–2016, as well as the participants. Financial support: The IAN-AF 2015–2016 received funding from the EEA Grants Program, Public Health Initiatives (grant number PT06-000088SI3). The EEA Grant Program had no role in the design, analysis or writing of this article.

Additional file 4. CDQI score calculation. Detailed description of the CDQI score components and calculations

Additional file 1: Figure S1. Estimated marginal means of the BRA-study, showing vegetables served in the kindergarten departments (n = 34) at baseline and follow-up 1, in relation to what degree the intervention components (posters, supplementary material and 1-day inspirational course) were perceived useful by the kindergarten staff. (Black box) Baseline data, (Orange dotted box) Follow-up 1 data.

Additional file 8. Supplementary table. Relative risk for ADHD diagnosis for one SD increase in PDQI, UPFI and CDQI score

Additional file 1. The Impact of a Community-Oriented Problem-Based Learning Curriculum Reform on the Quality of Primary Care Delivered by Gradua

Additional file 9. Supplementary figure. Relative AME (%) change in ADHD symptom score for one SD increase in PDQI, UPFI and CDQI score, stratified by child sex and maternal ADHD symptoms (0–3, higher score equaling more symptoms)

Additional file 2. PDQI score calculation. Detailed description of the PDQI score components and calculations

Additional file 5. Supplementary figure. Visualization of covariate selection for maternal diet quality during pregnancy as exposure via a Directed Acyclic Graph

Additional file 10. Supplementary figure. Relative risk for ADHD diagnosis for one SD increase in PDQI, UPFI and CDQI score, stratified by child sex and maternal ADHD symptoms (0–3, higher score equaling more symptoms)

Additional file 7. Supplementary table. Absolute AME and corresponding relative AME change in ADHD symptoms for one SD increase in PDQI, UPFI and CDQI score

Additional file 2: Supplementary file 2. Interview guide patients.

Additional file 3. Supplementary Table. Foods and beverages from group 4 in the NOVA classification included in the Ultra-Processed Food Index (UPFI)

Additional file 6. Supplementary figure. Visualization of covariate selection for child diet quality at 3 years as exposure via a Directed Acyclic Graph.

Additional file 1: Supplementary file 1. Interview guide nurses.

The TIDieR (Template for Intervention Description and Replication) Checklist. (DOCX 32 kb)

The BRA-study intervention description according to the TIDieR checklist. (DOCX 27 kb)

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