Search

While primary and lower secondary school students in Norway have a relatively healthy diet, there are some weaknesses. Not all students eat breakfast at home/school or lunch at school. The school is an important arena for universal food and meal efforts targeting all students, which is important for their learning in the short and long term. Through a narrative/traditional review, this article investigates the research question: What impact do food and meals have on learning in primary and lower secondary schools? We focus on how food and meals affect concentration, school performance/results and social learning. Systematic reviews show that breakfast is important for short-term concentration and school results. Likewise, school lunch is associated with improved dietary quality, school attendance and academic achievement. School meals also impact social learning, e.g. eating routines, communication/friendship and broader societal issues of identity and connection to the community. Possibilities for promoting these outcomes in the Norwegian school system are presented, focusing on current curricula and policy documents. There is potential to strengthen the focus on food and meals, as well as the connection between food and learning in schools.

Over the course of 1st to 10th grade, every school student will consume nearly 2,000 lunches, and how schools plan this meal can be of great importance to the students. This chapter addresses various factors related to planning and providing the daily lunch meal in Norwegian school with the research question: Which promotive and inhibitive framework factors influence the implementation of school lunch in Norwegian primary and lower secondary school? Physical factors such as kitchen equipment, kitchens and dining rooms are important for the success of food and meals in school, depending on the type of school meal provision plan. Resource factors, such as staffing, and organizational factors are also important, as well as pedagogical and student factors. This chapter discusses promotive and inhibitive framework factors for the implementation of school lunches at Norwegian primary and lower secondary schools, primarily via the national professional guidelines for food and meals in schools. Today’s practice is also reviewed, and knowledge gaps as well as opportunities for new thinking and practical examples from the Norwegian context are presented.

Feeding practices in early childhood education and care (ECEC) settings are important for the development of healthy eating habits early in life. However, there is limited research on feeding practices among ECEC staff working with infants and toddlers, and how these practices relate to staff education. This study assessed the feeding practices, level of food neophobia, and participation in shared meals among ECEC staff, and examined whether there were differences in feeding practices related to education and shared meals. Furthermore, we explored the association between food neophobia levels among ECEC staff and their respective feeding practices in ECEC. In total, 130 ECEC teachers and other staff from two Norwegian ECEC trials completed a questionnaire about feeding practices and level of food neophobia. Our results showed that ECEC staff commonly used modelling and encouraging balance and variety feeding practices, but used food as a reward and emotion regulation less often. These practices differed by staff educational level, favoring highly educated staff. We found that more than half of ECEC staff ate lunch together with the children every day, and those who did so used positive feeding practices (encouraging balance and variety and modelling) more than those who did not eat with children; however, they also used restriction for health more often. Higher scores on food neophobia were associated with less use of emotion regulation and restriction for health when adjusted for relevant variables. In conclusion, our results show there is potential to improve feeding practices in ECEC, especially focusing on ECEC staff with low education. Suggested ways forward are updating guidelines to cover feeding practices and working on implementing these guidelines.

Exposure to varied foods in early life is important for short- and long-term health and development. Strategically introducing toddlers to new vegetables is not a common practice in Norwegian kindergartens. Therefore, we developed, conducted, and evaluated a web-based cluster randomised kindergarten intervention, Pre-schoolers’ Food Courage 2.0. The purpose of the current qualitative study was to explore kindergarten teachers' experience of implementing this intervention and what they thought facilitated the positive impact of the intervention reported in the quantitative evaluation. Ten individual telephonic interviews with kindergarten teachers who took part in the intervention study were conducted using a semi-structured interview guide. Data were transcribed verbatim and subjected to thematic analysis. Five main themes were identified: 1) One-year-olds love food and renewal of the menus was inspiring; 2) One-year-olds are surprisingly willing to try and accept novel foods; 3) Novel food at meals stimulate social interaction; and 4) The Sapere method is a fun and explorative activity for 1-year-olds. These four themes were the features perceived as the effective elements of the intervention by the kindergarten teachers. The fifth main theme was: 5) Sustained impact on kindergarten teachers’ practices and beliefs. The kindergarten teachers found the intervention easy to implement, and they were surprised by the foods 1-year-olds like and how the intervention increased their food acceptance. This age window of opportunity seems to be underused in kindergartens. By using the strategies described in the intervention, kindergarten staff effectively took advantage of this opportunity and consequently, child and kindergarten staff behaviour in relation to food was enhanced. Interventions targeting healthy feeding practices may potentially have a long-term public health impact by increasing food variety and vegetable intake in toddlers. Trial registration ISRCTN98064772.

Background It studies on the factors that affect the stability of fatty acid profiles from human blood specimens are generally performed by evaluating the effect of a single factor on an individual fatty acid and excluding a considerable amount of data from the total fatty acid profiles. Methods The stability of fatty acids from plasma, serum and red blood cells (RBC) was evaluated in terms of time, temperature, antioxidant and thawing. The fatty acids were methylated and analyzed by gas chromatography. The large volume of data is evaluated simultaneously and automatically by observing an Excel-based colour scale that indicates whether the fatty acid profiles have changed significantly as a result of the storage time (0–52 weeks), temperature (− 20 °C/− 80 °C), butylated hydroxytoluene (BHT) antioxidant (presence/absence) or thawing (single/multiple). Results Fatty acids from plasma were stable at both temperatures (− 20 °C/− 80 °C) regardless of BHT. Fatty acids from serum without BHT degrades faster at − 80 °C than − 20 °C and fatty acids from RBC without BHT degrades faster at − 20 °C than − 80 °C. Addition of BHT inhibits this effect in serum and RBC. Multiple thawing of RBC without BHT demonstrated that polyunsaturated fatty acids were generally more susceptible for changes at − 80 °C than at − 20 °C while BHT prevents partially this effect. Conclusions This study draws attention to the importance of pre-analytical considerations when storing blood samples in biobanks and the need of careful judgments when analyzing fatty acids profiles.

This article discusses social aspects of school lunches in Norway. How do 11‐year‐old students experience and perceive their packed lunches and lunch breaks and to what extent is the lunch break a space for children's sociality or an area for teachers’ governmentality? The study is based on 25 focus group discussions and drawing and writing assignments with 165 participants. A large proportion of the students expressed that they appreciated their packed lunches because they could decide for themselves what and how much to eat. Additionally, shortage of time and disturbance and noise in the classroom could ruin a good meal. The main issue that the students raised in relation to our question of sociality was with whom they could sit and eat their packed lunches. This finding underlines the importance of considering the emotional dimensions of eating and that commensal eating is not dependent on sharing the same food. The children experienced that the lunch break was governed by an adult agenda in which they had limited opportunities to create their own spaces.

Although a wide variety of articles on quantification of eicosanoids by using internal standards are published every year, little has been done on how much internal standard should be added. This article demonstrates that the application of experimental design enables estimating the interaction eicosanoid/internal standard and to select confidently an optimal amount of internal standard and a response factor (RF) for the analysis of eicosanoids in a high number of samples, where the amount of sample is limited and the unknown levels of eicosanoids are spanned in a wide range of concentrations. The results revealed that the interaction eicosanoid/internal standard is an important factor that affects the validity of the RF and subsequently the accuracy of the analysis.

Background Omega-3 (n-3) polyunsaturated fatty acids (PUFAs) have modulating effects in several chronic inflammatory conditions. The aim of the present study was to test whether prior short-term dietary supplementation with n-3 (fish or seal oil) or n-6 (soy oil) PUFA rich oils would protect the development of dextran sulfate sodium (DSS)-induced colitis in rats. Methods Forty-eight male Wistar rats were divided into 6 groups: no intervention, sham, DSS, seal oil + DSS, fish oil + DSS and soy oil + DSS. Following 7 days of acclimatisation, 1 mL oil (seal, fish or soy) or distilled water (sham) was administered by gavage day 8 to 14. Colitis was induced by 5% DSS in drinking water from day 15 to 21. Rats were sacrificed on day 23. Histological colitis (crypt and inflammation) scores, faecal granulocyte marker protein (GMP) and quantitative fatty acid composition in red blood cells were measured. Results Pretreatment with fish or seal oils did not significantly influence DSS induced inflammation. In fact, all the oils tended to exacerbate the inflammation. Soy oil increased the mean crypt score ( P < 0.04), but not the inflammation score or GMP. The ratio of n-6 to n-3 fatty acids (FAs) was 11 to 1 and 10 to 1 in standard diet and in red blood cells of control rats, respectively. Following administration of DSS, the ratio fell in all treatment groups ( P < 0.001). The lowest ratios were seen in the groups receiving DSS + fish or seal oils (around 6 to 1). Conclusion Short-term pretreatment with fish or seal oils did not protect against subsequent induction of colitis by DSS in this rat model. Whether the high ratio of n-6 to n-3 FAs in the standard diet concealed effects of n-3 FA supplementation should be further investigated.

Background: Rheumatic joint pain is a common extra-intestinal complication of inflammatory bowel disease (IBD). Because the high ratio of n-6 to n-3 fatty acids (FAs) of the Western diet might promote rheumatic disorders, we sought to compare the effects of short-term duodenal administration of n-3-rich seal oil and n-6-rich soy oil on IBD-related joint pain. Methods: Nineteen patients with IBD-related joint pain were included in the study; 9 had Crohn disease and 10 had ulcerative colitis. Ten millilitres seal oil (n = 10) or soy oil (n = 9) was self-administered through a nasoduodenal feeding tube 3 times daily for 10 days. Results: Compared with soy oil treatment, seal oil significantly reduced the duration of morning stiffness (P = 0.024), number of tender joints (P = 0.035), intensity of pain (P = 0.025) and the doctor’s scoring of rheumatic disease activity (P = 0.025) at the end of the 10-day treatment period. Analysis of the effects as area under the curve (area between the curve and baseline, zero) for the entire period from start of treatment until 6 months’ post-treatment suggested a long-lasting beneficial effect of seal oil administration on joint pain, whereas soy oil tended (not significantly) to aggravate the condition. Consistently, the serum ratios of n-6 to n-3 FAs (P 0.01) and arachidonic acid to eicosapentaenoic acid (P 0.01) were reduced after treatment with seal oil. Conclusion: The results suggest distinctive, differential prolonged effects on IBD-related joint pain of short-term duodenal administration of n-3-rich seal oil (significant improvement) and n-6-rich soy oil (tendency to exacerbation).

Background Brief intervention programs are clinically beneficial, and cost efficient treatments for low back pain, when offered at 8-12 weeks, compared with treatment as usual. However, about 30% of the patients do not return to work. The European Guidelines for treatment of chronic low back pain recommends Cognitive Behavioral Therapy (CBT), but conclude that further research is needed to evaluate the effectiveness of CBT for chronic low back pain. Methods/Design The aim of the multicenter CINS trial (Cognitive Interventions and Nutritional Supplements) is to compare the effectiveness of 4 different interventions; Brief Intervention, Brief Intervention and CBT, Brief Intervention and nutritional supplements of seal oil, and Brief Intervention and nutritional supplements of soy oil. All participants will be randomly assigned to the interventions. The nutritional supplements will be tested in a double blind design. 400 patients will be recruited from a population of chronic low back pain patients that have been sick listed for 2-10 months. Four outpatient clinics, located in different parts of Norway, will participate in recruitment and treatment of the patients. The Brief Intervention is a one session cognitive, clinical examination program based on a non-injury model, where return to normal activity and work is the main goal, and is followed by two booster sessions. The CBT is a tailored treatment involving 7 sessions, following a detailed manual. The nutritional supplements consist of a dosage of 10 grams of either soy or seal oil (capsules) per day for 3 months, administered in a double blind design. All patients will be followed up with questionnaires after 3, 6 and 12 months, while sick leave data will be collected up to at least 24 months after randomization. The primary outcome of the study is sick leave and will be based on register data from the National Insurance Administration. Secondary outcomes include self-reported data on disability, pain, and psychological variables. Conclusions To our knowledge, the CINS trial will be the largest, randomized trial of psychological and nutritional interventions for chronic low back pain patients to date. It will provide important information regarding the effectiveness of CBT and seal oil for chronic low back pain patients. Trial Registration http://www.clinicaltrials.gov, with registration number NCT00463970.

Background Seafood intake is associated with beneficial effects for human health. Seafood provides a number of nutrients beyond the traditionally known long chain marine n-3 fatty acids EPA, DPA and DHA, such as protein, vitamin D, iodine, selenium and vitamin B12. Valid assessment of dietary seafood and n-3 supplement intakes are becoming increasingly crucial when giving recommendations to populations as seafood consumption is regarded as an important part of a healthy and balanced diet. Methods The aim was to validate a short FFQ developed for assessment of dietary intake of seafood and n-3 supplements using the biomarkers marine n-3 fatty acids in erythrocytes and 25(OH)D in serum. Results Fifty-three healthy Norwegians aged 30-64 years with a mean BMI of 25 kg/m2 were compliant with the study protocol. 70% reported eating seafood for dinner one to two times per week, and 45% reported to eat seafood as spread, in salads or as snack meal three to five times or more per week. The FFQ correlated significantly with both the levels of marine n-3 fatty acids (r = 0.73, p < 0.0001) and with 25(OH)D (r = 0.37, p < 0.01). Mean level of marine n-3 and of 25(OH)D were 232 ± 65 μg/g erythrocytes and 73 ± 33 nmol/L serum, respectively. Conclusion The present short FFQ predicted strongly the levels of marine n-3 fatty acids in erythrocytes, and predicted fairly good the level of serum 25(OH)D and may therefore be a valid method for assessment of seafood and n-3 supplements intake among adults.

Kine Gregersen1,2, Ragna A Lind1, Jørgen Valeur1,3, Tormod Bjørkkjær2, Arnold Berstad1,3, Gülen Arslan Lied1,31Institute of Medicine, University of Bergen, Bergen, Norway; 2National Institute of Nutrition and Seafood Research (NIFES), Bergen, Norway; 3Section for Gastroenterology, Department of Medicine, Haukeland University Hospital, Bergen, NorwayAbstract: Short-term duodenal administration of n-3 polyunsaturated fatty acid (PUFA)-rich seal oil may improve gastrointestinal complaints in patients with subjective food hypersensitivity, as well as joint pain in patients with inflammatory bowel disease (IBD). The aim of the present explorative pilot study was to investigate whether 10-day open treatment with seal oil, 10 mL self-administrated via a nasoduodenal tube 3 times daily, could also benefit nongastrointestinal complaints and quality of life (QoL) in patients with subjective food hypersensitivity. Twenty-six patients with subjective food hypersensitivity, of whom 25 had irritable bowel syndrome (IBS), were included in the present study. Before and after treatment and 1 month posttreatment, patients filled in the Ulcer Esophagitis Subjective Symptoms Scale (UESS) and the Gastrointestinal Symptom Rating Scale (GSRS) for gastrointestinal symptoms and subjective health complaints (SHC) inventory for nongastrointestinal symptoms in addition to short form of the Nepean dyspepsia index (SF-NDI) for evaluation of QoL. Compared with baseline, gastrointestinal, as well as nongastrointestinal, complaints and QoL improved significantly, both at end of treatment and 1 month posttreatment. The consistent improvements following seal oil administration warrant further placebo-controlled trials for confirmation of effect.Keywords: food hypersensitivity, irritable bowel syndrome, subjective health complaints, quality of life, seal oil, n-3 polyunsaturated fatty acids

Compared with soy oil, 10 days treatment with seal oil (SO), 10mLx3 daily, self-administrated through a nasoduodenal feeding tube, relieves joint pain in patients with inflammatory bowel disease (IBD). This randomized, controlled, double blind pilot trial compares SO and whale oil (WO) administered similarly by duodenal tube, for 10 days in 18 patients with IBD-related joint pain (n=9 per group). Other long chain n-3 polyunsaturated fatty acids were prohibited 7-days prior to and during study. Significant changes from baseline to study end were observed in both groups: reduced plasma arachidonic acid to eicosapentaenoic acid ratio and prostaglandin E(2) (PGE(2)) levels (tendency in WO group), decreased IBD-related joint pain and IBD-disease activity, and improved quality of life. These changes were not significantly different between SO and WO groups. Inhibition of cyclooxygenase is consistent with amelioration of IBD-related joint pain, but, as active control was used, effects need confirmation.

In the Norwegian governmental guidelines for food and nutrition, an increased intake of fish and other seafood is particularly recommended. Fish is a good source of many important nutrients, such as proteins, very long-chain omega 3 fatty acids, vitamin D, vitamin B12, selenium and iodine. The beneficial effect on health by including fish has been documented in several studies. Increasing interest in the health gains obtained by regular fish intake has put emphasis on the need for documentation of both nutrients and contaminants in fish and seafood, with a balanced risk assessment. In this paper, some of the positive health effects of fish in the diet are elucidated.

Background A high dietary intake of n-6 compared to n-3 fatty acids (FAs) may promote the production of pro-inflammatory eicosanoids and cytokines. In two recent studies, short-term (10-day) duodenal administration of n-3 polyunsaturated fatty acid rich seal oil ameliorated joint pain in patients with inflammatory bowel disease (IBD). Using unpublished data from these two studies we here investigated whether normalisation of the n-6 to n-3 FA ratio in blood and tissues by seal oil administration was associated with improved health related quality of life (HRQOL) as assessed by the generic short-form 36 (SF-36) questionnaire. Results In the first pilot study, baseline n-6 to n-3 FA ratio in rectal mucosal biopsies from 10 patients with IBD (9 of those had joint pain) was significantly increased compared with that in 10 control patients without IBD or joint pain. Following seal oil administration, the n-6 to n-3 FA ratio of the IBD-patients was significantly lowered to the level seen in untreated controls. In the subsequent, randomized controlled study (n = 19), seal oil administration reduced the n-6 to n-3 FA ratio in blood similarly and also the SF-36 assessed bodily pain, while n-6 FA rich soy oil administration had no such effect. Conclusion In these two separate studies, short-term duodenal administration of seal oil normalised the n-6 to n-3 FA ratio in rectal mucosa and improved the bodily pain dimension of HRQOL of patients with IBD-related joint pain. The possibility of a causal relationship between n-6 to n-3 FA ratio in rectal mucosa and bodily pain in IBD-patients warrants further investigations.

Background Food hypersensitivity is a prevalent condition with poorly characterized underlying mechanisms. In the present pilot study we investigated effects of seal oil and soy oil on meal-induced symptoms and gastric accommodation in patients with subjective food hypersensitivity (FH). Single dose experiment: On three consecutive days, 10 mL of seal oil, soy oil, or saline were randomly administered into the duodenum of 10 patients with subjective FH and 10 healthy volunteers through a nasoduodenal feeding tube 10-20 minutes before the ingestion of a test meal. Short-term treatment study: 24 patients with subjective FH were randomly allocated to 10 days’ treatment with either 10 mL of seal or soy oil, self-administrated through an indwelling nasoduodenal feeding tube, 3 times daily. In both experiments meal-induced abdominal symptoms and gastric accommodation were measured by visual analogue scales and external ultrasound respectively. Results Symptoms and gastric accommodation were not significantly influenced by single doses of seal or soy oil. When given daily for 10 days, seal oil, but not soy oil, reduced total symptom scores significantly ( P = 0.03). The symptomatic improvement was not associated with improvements in gastric accommodation. Conclusion Daily administration of seal oil may benefit patients with subjective FH. The beneficial effect of seal oil in patients with subjective FH can not be ascribed to improved gastric accommodation.