Search

Water is essential for survival, but one in three individuals worldwide (2.2 billion people) lacks access to safe drinking water. Water intake requirements largely reflect water turnover (WT), the water used by the body each day. We investigated the determinants of human WT in 5604 people from the ages of 8 days to 96 years from 23 countries using isotope-tracking ( 2 H) methods. Age, body size, and composition were significantly associated with WT, as were physical activity, athletic status, pregnancy, socioeconomic status, and environmental characteristics (latitude, altitude, air temperature, and humidity). People who lived in countries with a low human development index (HDI) had higher WT than people in high-HDI countries. On the basis of this extensive dataset, we provide equations to predict human WT in relation to anthropometric, economic, and environmental factors.

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.

Source at https://vkm.no/. In 2006, VKM published “A comprehensive assessment of fish and other seafood in the Norwegian diet”. The assessment supported the recommendation from Norwegian Health authorities to eat more fish both for dinner and on sandwiches. In an update of the assessment in 2014 VKM concluded that “the benefits from fish consumption clearly outweigh the negligible risk presented by current levels of contaminants and other undesirable substances in fish”. Because of new knowledge available, the Norwegian Food Safety Authority requested a new benefit and risk assessment of fish in the Norwegian diet in 2019. In the assignment, they asked VKM to answer the following questions: Which health consequences will it have for the Norwegian population if they: Continue with the same fish consumption levels as of today Increase the consumption of fish to match the recommendations given by the Norwegian Directorate of Health

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 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)

In 2019, the Nordic network on dietary surveys compared results regarding 24 h recalls, if the method was used in a systematic Nordic set up. A standardized central food list for 7 days was entered into national nutrients calculation systems and the intakes of individual food groups and nutrients on each day and as a daily average of the 7 days were compared. Results were presented at an online workshop on November 20th, 2020. In addition to the country specific presentations of the analysis, each country also gave a presentation on the latest national dietary survey. Despite standardized input, there were many differences in the results. The presentations on national dietary surveys showed differences and similarities of conducting dietary surveys and elucidated a lot of the common challenges researchers face. Many topics could be further elucidated on future network meetings.

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.

Request from the Norwegian Food Safety Authority: Following a report from the National Nutrition Council calling for actions to secure adequate iodine intake in the population, the Norwegian Food Safety Authority requested the Norwegian Scientific Committee for Food and Environment (VKM) to conduct a benefit- and risk assessment of iodization of household salt and industrialised salt in bread. VKM addressed the request: VKM appointed a project group consisting of members of the Panel on Nutrition, Dietetic Products, Novel Food and Allergy and Panel on Contaminants to answer the request. The Panel on Nutrition, Dietetic Products, Novel Food and Allergy has reviewed and revised drafts prepared by the project group and finally approved the benefit- and risk assessment This benefit and risk assessment is based on 1) established knowledge about health consequences from severe iodine deficiency, 2) systematic literature review of the evidence for health consequences of mild to moderate iodine deficiency, 3) literature review of studies on adverse health effects from excessive iodine intakes to re-evaluate existing tolerable upper intake levels (ULs), 4) evaluation of estimated iodine intake levels in different population groups in Norway compared to established dietary reference values, specifically estimated average requirement (EAR) and UL, and finally 5) an estimation of the effect of different scenarios of increasing iodization levels in household salt and salt in bread on iodine intake levels in different population groups compared to the established dietary reference values EAR and UL. For the purpose of this benefit and risk assessment of iodization in household salt and salt in bread, risk may be understood as risk of adverse health effects related to too high or too low iodine intakes. Benefit may be understood as reduction or avoidance of adverse health effects related to too high or too low iodine intakes. For iodine, this is a challenging maneuver, as the gap between too low and too high intakes is narrow. The project group conducted two systematic literature reviews. One was performed to evaluate the evidence for the impact of mild- to moderate iodine deficiency on neurodevelopment, thyroid function and birth outcomes, the other to evaluate the evidence for adverse health effects from excessive iodine intake to possibly re-evaluate the existing tolerable upper intake levels. Current evidence for adverse health effects of iodine deficiency: Severe iodine deficiency resulting in hypothyroidism during foetal life, infancy, or early childhood may lead to permanent intellectual disability. Severe maternal iodine deficiency in pregnancy may also result in miscarriages, preterm delivery, stillbirth, and congenital abnormalities. These effects are due to low levels of thyroid hormones affecting the developing tissues. The health effects of severe iodine deficiency are well established, but for mild to moderate deficiency the effects are less known. After screening of more than 15 000 titles and abstracts and quality assessment of 131 full text scientific papers, 36 publications were included for the grading of evidence for consequences of mild to moderate iodine deficiency. We used the criteria proposed by the World Cancer Research Fund for grading of evidence. Based on our systematic literature review, the evidence for adverse effects from mild to moderate iodine deficiency and neurodevelopment was judged to meet the criteria for limited suggestive. Limited suggestive means that the evidence is too limited to permit a probable or convincing causal judgement but shows a generally consistent direction of effect. It was further concluded that there is limited (no conclusion) evidence to support that mild to moderate iodine deficiency causes thyroid dysfunction or has negative effects on birth outcomes. Limited (no conclusion) means that the evidence is so limited that no firm conclusion can be made. Established reference values for iodine requirement: Several competent bodies have established dietary reference values for iodine. We have based this benefit and risk assessment on estimated average requirements (abbreviated EAR or AR) from the Nordic Nutrition Recommendations (2012) for adults, and from the Institute of Medicine (2001) for adolescents and children. Estimated average requirement is an iodine intake that is estimated to meet the requirement of half the healthy individuals in the population. The iodine intake is considered to be adequate if 97.5% of a population has a habitual intake above the estimated average requirement. Re-evaluation of tolerable upper intake levels: As the evidence for health effects of excessive iodine intakes is far less comprehensive than for iodine deficiency, we did not aim at evaluating the literature for excess intakes with the same weight of evidence tools as for deficiency. We have only evaluated whether recent literature is in line with the existing tolerable upper intake levels or if it supports that tolerable upper intake levels should be changed. Generally, UL is the maximum level of total chronic daily intake judged to be unlikely to pose a risk of adverse health effects, and in the case of iodine the UL for adults is the maximum daily intake where changes in TSH are unlikely to occur (SCF, 2002). After screening more than 2500 titles and abstracts, five studies fulfilled the inclusion criteria and were found relevant and included for evaluation of existing ULs. The existing ULs from the Scientific Committee on Food from 2001 is maintained. However, according to findings in new studies, the lowest-observed-adverse-effect levels (LOAEL) for excessive iodine intake may be lower than previously assumed, and the uncertainty factor inherent in the established ULs is reduced from three to 1.3 for adults. The findings also indicate a reduced LOAEL for the existing ULs in children. Changes in thyroid stimulating hormone (TSH) without changes in thyroid hormones (T3 or T4), that is subclinical hypothyroidism, are observed in one randomised controlled dose-response study and four cross-sectional studies in children at iodine intakes close to the ULs. Subclinical hypothyroidism is not considered to be harmful, but may progress into overt hypothyroidism. Iodine intake in Norwegian population groups and implications of salt iodization: Iodine intakes in adults are higher in men than in women and increase with increasing age for both sexes. Women of childbearing age and 13-year-old girls have the lowest estimated iodine intakes. 26% of the women of childbearing age have intakes below the estimated average requirement of 100 µg/day, and 38% of the 13-year-old girls have intakes below the estimated average requirement of 73 µg/day. The estimated iodine intakes in the 5th percentile of women of childbearing age and 13-year-olds is 70 and 38 µg/day, respectively. All adults and 13-, 9- and 4- year-olds have individual intakes below the tolerable upper intake levels. The estimates for 2-year-olds show that 9% have intakes below the estimated average requirement, and 8% have intakes above the tolerable upper intake level. The estimated iodine intake in the 95th percentile is 215 µg/day, slightly above the tolerable upper intake level of 200 µg/day. The estimates for non-breastfed 1-year-olds show that 8% have intakes below the estimated average requirement, and 18% have intakes above the tolerable upper intake level. The estimated iodine intake in the 95th percentile for this group is 259 µg/day. We present 12 scenario tables combining three scenarios (household salt alone, salt in bread alone and both household salt and salt in bread) with four iodization levels (15, 20, 25 and 50 mg iodine per kg salt). The percentages of the population groups with intakes above the estimated average requirement increases with increasing iodization levels, but so does the percentages with intakes above tolerable upper intake levels for some groups of the population. The scenarios that seem to elevate iodine intakes in women of childbearing age and 13-yearolds up to adequate intakes, are iodization up to 15 or 20 mg iodine per kg salt, including iodization of salt in bread. Above these iodization levels, no increased benefit would be expected in women of childbearing age and 13-year-olds. For 1- and 2-year-olds all scenarios lead to an increase in the proportion of toddlers with estimated intakes above the tolerable upper intake level. Benefit- and risk characterisation of iodization of household salt and industrialised salt in bread: Low estimated iodine intakes in adolescents (13-year-olds) and women of childbearing age (18-45 years) cannot be sufficiently corrected by the proposed increased iodization levels of salt and/or bread without imposing high iodine intakes in 1- and 2-year-old children. VKM assumes that the women of childbearing age and 13-year-olds will benefit from increased iodization levels in salt and bread. This will also benefit other groups that, for various reasons, have few iodine-rich sources in their diet, e.g., people who do not eat lean fish or consume milk or other dairy products. The risk imposed on the youngest age groups is a higher proportion of the 1- and 2-year-olds with iodine intakes above the tolerable upper intake level. Based on the scientific evidence and the data presented in this benefit and risk assessment it cannot be concluded that a specific iodization level benefits all age and gender groups without posing increased risk of harm to others or that the benefits in one population group outweighs the risks in others, or that the benefits in one group outweigh the risks in others. It should be noted that recommendations for nutrients are set to secure adequate growth, development, maintenance of health, and to reduce the risk of chronic illnesses. Thus, iodine intakes below EAR or above UL will decrease the possibilities of achieving the beneficial effects of adequate intake. Current iodine intake in certain population groups is worryingly low, and trend studies indicate that consumption of milk and dairy products in Norway, the most significant iodine sources in the diet, is declining, especially among young women. Several studies show that especially adolescents and women of childbearing age have insufficient iodine intakes, which may leave some at risk of severe iodine deficiency. There are, however, to our knowledge, no data on the prevalence of severe iodine deficiency in Norway. In other words, we do not know how many, if any, there are who have clinical consequences of inadequate iodine intakes. The scenarios that seem to elevate iodine intakes in women of childbearing age and 13-year olds (the groups at highest risk of low intakes) to adequate levels are iodization up to 15 or 20 mg iodine per kg salt, including iodization of salt in bread. Above these iodization levels, no increased benefit would be expected in women of childbearing age and 13-year-olds whereas several population groups will be at risk of exceeding UL, especially in 1- and 2-year-olds. The WHO recommends salt as a vehicle for correcting iodine deficiency in a population, followed by a close monitoring of the iodization program.

Småbarnskost 3 er den tredje landsomfattende kartleggingen av kostholdet blant 2-åringer i Norge. I februar 2019 ble 3000 mødre til barn født i februar 2017 invitert til å fylle ut et spørreskjema om kostholdet til barnet ved 2 års alder. Spørreskjemaet var tilgjengelig både som et elektronisk spørreskjema og et papirspørreskjema. Deltakelsesprosenten i Småbarnskost 3 var 47 %. Mødrenes gjennomsnittsalder var 33 år og de fleste mødrene (67 %) hadde høyere utdanning. Da barnet var 2 år hadde de fleste mødrene (63 %) inntektsgivende arbeid på heltid og de fleste barna (94 %) gikk i barnehage. Resultatene fra Småbarnskost 3 viser en rekke positive trekk ved kostholdet til 2-åringer. Barna hadde et kosthold som i stor grad var i tråd med anbefalingene og inkluderte grovt brød, grøt og andre kornvarer, frukt, bær og grønnsaker, kjøtt og fisk, yoghurt og melk. Inntaket av næringsstoffer var også i stor grad i tråd med anbefalingene, med unntak av inntaket av mettet fett som i gjennomsnitt lå over anbefalt nivå og inntaket av jern som lå under anbefalt nivå for jenter. Tilskudd av vitamin D var nødvendig for å komme på nivå med anbefalt inntak av vitamin D. De viktigste resultatene fra undersøkelsen er summert opp i punktene under: • I andre leveår var andelen som ble ammet 34 % ved 13 måneders alder, 24 % ved 15 måneder, 16 % ved 18 måneder og 8 % ved 2 års alder. • 79 % av barna fikk grøt og gjennomsnittlig inntak av grøt var 87 g/dag. Hjemmelaget grøt ble gitt til 68 % og industrifremstilt grøt ble gitt til 29 % av barna. • Tilnærmet alle barna fikk brød, og gjennomsnittlig inntak var 113 g/dag. Grovt brød og ekstra grovt brød var de mest brukte brødtypene. De mest brukte påleggstypene var hvitost/smøreost og leverpostei. • Tilnærmet alle barna fikk grønnsaker og frukt og bær daglig eller ukentlig. Totalt gjennomsnittlig inntak av grønnsaker var 80 g/dag, og det var gulrot og tomat som var mest spist. Gjennomsnittlig inntak av frukt og bær var 181 g/dag, hvorav frisk frukt utgjorde 109 g/dag, mens industrifremstilte fruktmoser bidro med 35 gram frukt og bær per dag. • Gjennomsnittlig inntak av potet var 16 g/dag. • Gjennomsnittlig inntak av fisk og fiskeprodukter var 33 g/dag. Inntaket av kjøtt og kjøttprodukter var 35 g/dag. Rødt kjøtt utgjorde 83 % og hvitt kjøtt utgjorde 17 % av det totale kjøttinntaket. • Gjennomsnittlig inntak av kumelk som drikke var i underkant av 3 dl/dag. De fleste drakk lettmelk med 1 % fett (60 %) og lettmelk med 0,5 % fett (tilsatt vitamin D)(46 %). • De fleste barna (92 %) fikk yoghurt daglig eller ukentlig. Gjennomsnittlig inntak var 102 g/dag, og det meste av inntaket var fruktyoghurt. • Alle barna fikk vann, og gjennomsnittlig inntak var i underkant av 5 dl/dag. • 53 % av barna fikk juice daglig eller ukentlig, og gjennomsnittsinntaket var 29 g/dag. • 48 % av barna fikk søte drikker som saft, brus og nektar med sukker, og gjennomsnittlig inntak var i underkant av en halv desiliter per dag (40 g/dag). • 54 % av barna fikk vitamin D-tilskudd eller annet kosttilskudd, hvorav 30 % fikk tran og 16 % fikk vitamin D-dråper. • Gjennomsnittlig inntak av vitaminer og mineraler var på nivå med eller høyere enn anbefalt, med unntak av jern, som var litt under anbefalingen for jenter. Tran/vitamin D-dråper eller annet tilskudd med vitamin D var nødvendig for å komme på nivå med anbefalt daglig inntak av vitamin D. • Inntaket av vitamin A var over anbefalt daglig inntak, og den viktigste kilden var leverpostei. • Kosttilskudd (tran og vitamin D-dråper) var den viktigste kilden til vitamin D. Matvaregruppen smør, margarin og olje bidro også vesentlig til vitamin D. • De viktigste kildene til jern var brød, grøt og kjøtt/kjøttprodukter. • De viktigste kildene til jod var matvaregruppene melk og yoghurt og fisk og fiskeprodukter. • Gjennomsnittlig andel energi fra de ulike energigivende næringsstoffene (karbohydrat, protein og fett) var innenfor anbefalingene, med unntak av mettet fett som bidro med 12,8 energiprosent (E%) og dermed lå over anbefalt inntak (< 10 E%). 85 % av barna fikk mer mettet fett i kosten enn anbefalt. Hovedkildene til mettet fett var matvaregruppene smør, margarin og olje, melk og yoghurt, ost og kjøtt/kjøttprodukter. • Gjennomsnittlig andel energi fra tilsatt sukker var på 4,6 E% og innenfor anbefalingen (< 10 E%). 4 % av barna hadde et inntak ≥ 10 E%. Hovedkildene til tilsatt sukker var søte drikker og yoghurt. • Det var ingen store forskjeller i inntak av matvarer og næringsstoffer mellom gutter og jenter, men gutter hadde et høyere inntak av enkelte matvarer som for eksempel grøt og brød og et noe høyere inntak av enkelte næringsstoffer som for eksempel karbohydrat og jern. Sammenligningen av resultatene fra Småbarnskost 3 (2019) med resultatene fra den forrige landsomfattende kostholdsundersøkelsen blant 2 år gamle barn (Småbarnskost 2, 2007) tyder på at det har det skjedd flere endringer i kostholdet til 2-åringer i løpet av denne 12-årsperioden. Selv om samme metode (matvarefrekvensspørreskjema) ble benyttet i de to undersøkelsene, må endringene over tid vurderes med forbehold siden spørreskjemaet har blitt noe endret, samt at svarprosenten var lavere i Småbarnskost 3 sammenlignet med Småbarnskost 2 (47 % i 2019 vs. 56 % i 2007). Siden forrige undersøkelse har andelen barn som blir ammet i andre leveår økt. Det har vært en reduksjon i inntak av søte drikker (40 g/dag i 2019 vs. 60 g/dag i 2007), og en økning i inntak av vann (475 g/dag i 2019 vs. 307 g/dag i 2007). Inntaket av grønnsaker har økt (71 g/dag i 2019 vs. 54 g/dag i 2007), samtidig som inntaket av potet har gått ned (13 g/dag i 2019 vs. 26 g/dag i 2007). Totalt inntak av frukt og bær har økt (181 g/dag i 2019 vs. 152 g/dag i 2007), men inntaket av frisk frukt har gått ned, samtidig som inntaket av fruktmoser, og da særlig industrifremstilte fruktmoser, har økt. Inntaket av grøt har økt (87 g/dag i 2019 vs. 58 g/dag i 2007), og da særlig inntaket av hjemmelaget grøt, samtidig som inntaket av brød har blitt noe redusert (113 g/dag i 2019 vs. 131 g/dag i 2007). Selv om det totale inntaket av brød har gått ned, er inntaket av grovt brød høyere i 2019 sammenlignet med 2007. Inntaket av yoghurt har også økt siden 2007 (102 g/dag i 2019 vs. 71 g/dag i 2007). Inntaket av kumelk som drikke har blitt noe redusert (286 g/dag i 2019 vs. 309 g/dag i 2007), og da særlig inntaket av lettmelk med 1 % fett, samtidig som inntaket av lettmelk med vitamin D har økt siden 2007. Det har også vært en økning i andel brukere av helmelk og smør/Bremykt siden forrige undersøkelse i 2007. Gjennomsnittlig andel energi fra tilsatt sukker var lavere i 2019 (4,6 E%) sammenlignet med i 2007 (6,7 E%), og andelen som var innenfor anbefalingen for tilsatt sukker (< 10 E%) var høyere (96 % i 2019 vs. 84 % i 2007). Inntaket av mettet fett blant 2 år gamle barn synes ikke å ha endret seg siden 2007. Flere av barna fikk vitamin D-dråper i 2019 (16 %) sammenlignet med i 2007 (4 %), samtidig som andelen som fikk tran har blitt noe redusert, fra 38 % i 2007 til 30 % i 2019. Det var også en vesentlig reduksjon i andel som svarte at de unngikk å gi enkelte matvarer til barnet fordi de var redd barnet kunne reagere med allergi/intoleranse (15 % i 2019 vs. 27 % i 2007), og denne reduksjonen kunne tilskrives en vesentlig reduksjon i andelen som svarte at de unngikk å gi nøtter til barnet.

publishedVersion

We study the algebraic combinatorics of monomial degenerations of Plücker forms which is governed by matching fields in the sense of Sturmfels and Zelevinsky. We provide a necessary condition for a matching field to yield a SAGBI basis of the Plücker algebra for 3-planes in n-space. When the ideal associated to the matching field is quadratically generated this condition is both necessary and sufficient. Finally, we describe a family of matching fields, called 2-block diagonal, whose ideals are quadratically generated. These matching fields produce a new family of toric degenerations of Gr(3,n).Background: Disease-related malnutrition is a challenge among hospitalized patients. Despite guidelines and recommendations for prevention and treatment, the condition continues to be prevalent. The MyFood system is a recently developed decision support system to prevent and treat disease-related malnutrition. Objective: To investigate the possible implementation of the MyFood system in clinical practice, the aims of the study were (1) to identify current practice, routines, barriers, and facilitators of nutritional care; (2) to identify potential barriers and facilitators for the use of MyFood; and (3) to identify the key aspects of an implementation plan. Methods: A qualitative study was performed among nurses, physicians, registered dietitians, and middle managers in 2 departments in a university hospital in Norway. Focus group discussions and semistructured interviews were used to collect data. The Consolidated Framework for Implementation Research (CFIR) was used to create the interview guide and analyze the results. The transcripts were analyzed using a thematic analysis. Results: A total of 27 health care professionals participated in the interviews and focus groups, including nurses (n=20), physicians (n=2), registered dietitians (n=2), and middle managers (n=3). The data were analyzed within 22 of the 39 CFIR constructs. Using the 5 CFIR domains as themes, we obtained the following results: (1) Intervention characteristics: MyFood was perceived to have a relative advantage of being more trustworthy, systematic, and motivational and providing increased awareness of nutritional treatment compared with the current practice. Its lack of communication with the existing digital systems was perceived as a potential barrier; (2) Outer settings: patients from different cultural backgrounds with language barriers and of older age were potential barriers for the use of the MyFood system; (3) Inner settings: no culture for specific routines or systems related to nutritional care existed in the departments. However, tension for change regarding screening for malnutrition risk, monitoring and nutritional treatment was highlighted in all categories of interviewees; (4) Characteristics of the individuals: positive attitudes toward MyFood were present among the majority of the interviewees, and they expressed self-efficacy toward the perceived use of MyFood; (5) Process: providing sufficient information to everyone in the department was highlighted as key to the success of the implementation. The involvement of opinion leaders, implementation leaders, and champions was also suggested for the implementation plan. Conclusions: This study identified several challenges in the nutritional care of hospitalized patients at risk of malnutrition and deviations from recommendations and guidelines. The MyFood system was perceived as being more precise, trustworthy, and motivational than the current practice. However, several potential barriers were identified. The assessment of the current situation and the identification of perceived barriers and facilitators will be used in planning an implementation and effect study, including the creation of an implementation plan.

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

The Norwegian Scientific Committee for Food and Environment (Vitenskapskomiteen for mat og miljø, VKM) has, at the request of the Norwegian Food Safety Authority (Mattilsynet, NFSA), evaluated the intake of fluoride in the diet, together with intake of fluoride from dental hygiene and caries prevention products. VKM has also evaluated suggested maximum limits for fluoride in food supplements at 0.5, 1, 5 and 7 mg/day in relation to established tolerable upper intake levels (ULs). The former maximum limit for fluoride of 0.5 mg/day in food supplements was repealed 30 May 2017. Fluorine is a gaseous halogen which occurs naturally only in anionic form as fluoride (F- ). Fluorides are ubiquitous in air, water and the lithosphere. Fluoride is found naturally in all water sources. The highest levels are found in groundwater. Surface water usually has lower concentrations of fluoride than groundwater, most often under 0.5 mg/L. Major dietary fluoride sources are water and tea. An important non-dietary source is dental hygiene products such as toothpaste and tablets for caries prevention. There is no fluoridation of drinking water or salt in Norway. Fluoride is not an essential nutrient. Caries is not a fluoride deficiency disease. However, because of the beneficial effects for caries prevention, an adequate intake (AI) of 0.05 mg per kg body weight per day has been set for fluoride by the European Food Safety Authority (EFSA). Readily soluble fluorides (sodium- and potassium fluoride) are rapidly and almost completely absorbed by passive diffusion in the stomach and the small intestine. Absorption is influenced by acidity and concomitant food intake. Absorbed fluoride is rapidly distributed in blood plasma, but is retained only in calcified tissues, that are bones and teeth. Consequently, 99% of the total fluoride content of the body is found in bone and teeth. Absorbed fluoride which is not deposited in calcified tissues is excreted almost exclusively via the kidneys. Whereas skeletal bone and dentine accumulate fluoride throughout life, enamel of teeth incorporate fluoride only at the time of tooth formation. Fluoride substitutes for hydroxyl groups in the apatite, increasing the resistance to caries. In permanent teeth enamel maturation is completed at the age of seven to eight years, except in the third molars. Posteruptive fluoride uptake by enamel occurs only in the outer layer and depends on local oral fluoride levels. A linear relationship between fluoride exposure and caries resistance has been demonstrated. Over the years, the view has shifted from systemic fluoride being most effective for caries prevention to local oral exposure being most important. Acute toxic effects may be provoked by fluoride, and deaths have been reported after intake of very large doses from fluoride tablets. The main adverse outcomes from intake of excess doses of fluoride over time, are enamel fluorosis in children up to eight years of age, and bone fluorosis in older children and adults. Dental fluorosis causing mottled teeth is largely a cosmetic effect, whereas bone fluorosis causes stiff joints and a greater tendency to fractures. Tolerable upper intake levels (UL) for fluoride have been set by the American Institute of Medicine (IOM) and by the European Food Safety Authority (EFSA). In this report, we relate estimated fluoride intakes to the upper level set by EFSA. Intakes of the main dietary fluoride sources, water and tea, in different age groups were obtained from Norwegian dietary surveys. High fluoride intakes were estimated by applying the 95 percentile of fluoride concentrations in water obtained from 2001 fluoride analyses from Norwegian waterworks in the period between 2010 and 2018 and in tea obtained from a Polish study to the daily volume consumed. Fluoride intakes from recommended use of dental hygiene and caries prevention products were then added, plus a small fixed value for undescribed sources. The estimated 95 percentile fluoride exposure calculated this way was compared to the upper level, and scenarios with additional fluoride supplementation of 0.5, 1, 5 or 7 mg/day were developed. The estimated 95-percentile of fluoride exposure from water, tea and dental hygiene products alone (before fluoride from the suggested food supplement doses at 0.5, 1, and 7 mg/day were added) was found to exceed the upper level for 2-year old children and for adults. VKM concludes that all the suggested food supplement doses considered will cause the tolerable upper intake level to be exceeded in all age groups, except for the supplement doses of 0.5 in 9- and 13-year olds and 1 mg/day in 9 year olds. VKM emphasises that the current assessment of maximum limits for fluoride in food supplements is merely based on published reports concerning upper levels from the IOM (USA, 2001), Scientific Committee on Food (EU, 2003), Expert Group on Vitamins and Minerals (UK, 2003) and Nordic Nutrition Recommendations (Nordic Countries, 2012). VKM has not conducted any review of the literature for the current opinion, as this was outside the scope of the terms of reference from the NFSA.