Increasing fibre intake in the UK: lessons from the Danish Whole Grain Partnership.

Diets deficient in fibre are reported globally. The associated health risks of insufficient dietary fibre are sufficiently grave to necessitate large-scale interventions to increase population intake levels. The Danish Whole Grain Partnership (DWP) is a public-private enterprise model that successfully augmented whole-grain intake in the Danish population. The potential transferability of the DWP model to Slovenia, Romania and Bosnia-Herzegovina has recently been explored. Here, we outline the feasibility of adopting the approach in the UK. Drawing on the collaborative experience of DWP partners, academics from the Healthy Soil, Healthy Food, Healthy People (H3) project and food industry representatives (Food and Drink Federation), this article examines the transferability of the DWP approach to increase whole grain and/or fibre intake in the UK. Specific consideration is given to the UK's political, regulatory and socio-economic context. We note key political, regulatory, social and cultural challenges to transferring the success of DWP to the UK, highlighting the particular challenge of increasing fibre consumption among low socio-economic status groups - which were also most resistant to interventions in Denmark. Wholesale transfer of the DWP model to the UK is considered unlikely given the absence of the key 'success factors' present in Denmark. However, the DWP provides a template against which a UK-centric approach can be developed. In the absence of a clear regulatory context for whole grain in the UK, fibre should be prioritised and public-private partnerships supported to increase the availability and acceptability of fibre-rich foods.

Various ways towards animal product limiting - Practical and social engagements in initial phase of dietary change.

Reducing one's consumption of foods containing animal products, or avoiding such foods altogether, has become part of everyday life for many people in the Western world. People's motivations for such "animal product limiting" are well-established, but the ways in which individuals enact and experience dietary change in the initial phase are not well understood. Nor is it clear whether, and how, these people present their dietary changes to others. Through the analysis of interviews with 28 people residing in Denmark who had recently (<9 months) embarked on flexitarian, pescetarian, vegetarian or vegan diets, this paper explores how people, in the initial phase of trying to consume fewer, or no, foods with animal products, (i) engage in the practicalities of daily food activities and (ii) communicate their experiences with, and opinions about, the dietary changes they are making in interpersonal interactions. The findings reveal two very different ways of organising the daily food activities: Foodism and Convenience. They also disclose three different ways of communicating in interpersonal interactions: Ethical advocacy, Plant food demonstration and Anonymisation of diet. The paper offers insights into the variation in practices underlying animal product limiting. It suggests that the plant food sector should cater for people relying on convenient food practices as well as those engaged in more advanced ("foodie") practices. Further, in discussing interpersonal communication in the light of community-based social marketing, we argue that the findings highlight how animal product limiters, in everyday social life, may be able to encourage more people to embark on animal product limiting.

Is time-restricted eating a robust eating regimen during periods of disruptions in daily life? A qualitative study of perspectives of people with overweight during COVID-19.

BACKGROUND: Time-restricted eating (TRE) has been suggested as a feasible dietary strategy in individuals with overweight. Disruptions in daily life e.g., severe illness can affect engagement in lifestyle interventions to obtain healthier body weight. This study examined if and how the engagement with TRE among people with overweight was affected by the Danish COVID-19 lockdowns as an example of disruptions in daily life. METHODS: Fifteen participants with overweight enrolled in a TRE intervention, i.e. restricting all eating and drinking except water to the same daily ten-hour window, were interviewed about their experiences and engagement with TRE during COVID-19 lockdowns. Interviews were semi-structured and conducted by phone or face-to-face with safe social distancing. Data analysis was grounded in a reflexive thematic analysis approach. RESULTS: Daily life rhythms were disrupted by lockdowns by preventing participants from performing ordinary daily activities such as going to work, socialising, eating out or exercising. For some, this challenged their TRE engagement, while most were able to undertake the TRE eating window but reported increased snacking and consumption of take-away food within their eating window. For all, exercise habits became unhealthier. The negative impact on TRE engagement primarily occurred during daytime, as social distancing made it easier to engage with TRE during evenings. CONCLUSIONS: This study showed that even people highly motivated to obtain healthier lifestyles practices struggled to maintain engagement with healthy behaviours, whereas sticking to the TRE window was manageable during COVID-19. TRE as a weight loss strategy was challenged which calls for more attention to supporting people in daily life to obtain healthier practices, also in case of periods of other disruptions such as divorce, serious illness etc.

What happens after a weight loss intervention? A qualitative study of drivers and challenges of maintaining time-restricted eating among people with overweight at high risk of type 2 diabetes.

Time-restricted eating (TRE)1 has been conceptualised as a strategy for achieving weight loss and improving metabolic health, but limited knowledge exists about how people can maintain TRE in daily life. This study examined how TRE was maintainable in daily life after a three-month intervention (the RESET study) in which participants were encouraged to consume all food and beverages except water within a 10-h daily window. Specifically, we examined TRE maintenance patterns across participants, including drivers and challenges for maintenance success. A qualitative longitudinal study was conducted, and twenty participants with overweight at high risk of type 2 diabetes were interviewed using a semi-structured interview guide at the end of the intervention and after a three-month follow-up period. Data were analysed longitudinally in two steps inspired by a pattern-oriented longitudinal analysis approach. Seven participants maintained a strict 10-h window, ten maintained an adjusted TRE regimen (e.g., taking days off), and three did not attempt maintenance. Maintenance drivers included consistent daily rhythms and regular meal patterns, subjective experiences (e.g., feeling healthier), making flexible adjustments to the TRE regimen, family support and avoiding feelings of guilt. Maintenance challenges included social evening events, inconsistent daily rhythms and eating patterns, preoccupation with losing weight, lack of family support and self-blame. TRE was manageable for most participants; however, personalised support for adjusting TRE to daily life is needed to ensure long-term maintenance. Future studies should explore the effectiveness of a personalised TRE concept to determine the usefulness of TRE in real-life settings.

Watching, keeping and squeezing time to lose weight: Implications of time-restricted eating in daily life.

Time-restricted eating (TRE) is a novel intervention that allows eating and drinking within a certain time window and has shown positive effects on body weight in few studies. Weight loss strategies that easily can be integrated into daily life are needed, but knowledge about how TRE affects daily life is lacking. This study examined how individuals having overweight or obesity at high risk of type 2 diabetes performed TRE in daily life, with a focus on how the timing of eating changed the organisation and rhythms of daily activities. Semi-structured interviews were conducted with participants enrolled in a randomised controlled trial studying the effect of a 12-week TRE intervention focusing on a self-selected daily 10-h window between 6 AM and 8 PM. Seventeen participants from the intervention group were interviewed at baseline and end of intervention, and data were analysed using a thematic analysis approach. Participants found TRE simple and appealing due to the unrestricted dietary intake. In general, participants did not change their food preferences and continued to eat three main daily meals. However, participants had to increase their awareness of the time of day, reshuffle ordinary daily activities and plan their intake more carefully. Two participants reported fully adherence every day, whereas all other participants reported one to several episodes of intake outside their window during the 12 weeks. Social evening activities and collective rhythms were largest barriers. Our findings suggest that TRE interventions would benefit from a broader perspective on daily life and an expanded view on families and friends as joint units of intervention. TRE interventions should consider individuals' daily rhythms and help them develop practical solutions to integrating new eating practices.

Linking socioeconomic disadvantage to healthiness of food practices: Can a practice-theoretical perspective sharpen everyday life analysis?

Food is one of the key themes in public health policy and debates over inequalities in health. In this article, we argue that more research is needed to understand how socioeconomic disadvantage is translated into low degrees of healthiness. We suggest that everyday life analysis may be sharpened by way of drawing upon a practice-theoretical perspective on the mundane processes involved in this translation. We base our suggestion on a small review of three strands in the literature on social inequality, food and health, namely public health research, lifestyle analysis and everyday life studies, and we take our analytical starting point in the latter. In the article, we argue that a practice-theoretical perspective may enable research in social disadvantage and healthiness of food that describes and interprets variants in the conditioned agency, which cuts cross the multiplicity of different practices that make-up people's daily lives. Finally, we suggest that a stronger focus on social interaction and social hierarchy would adapt a practice-theoretical perspective further to empirical analysis in the field of food, health and socioeconomic disadvantage.

Predictors of weight loss after bariatric surgery-a cross-disciplinary approach combining physiological, social, and psychological measures.

BACKGROUND: Bariatric surgery leads to a substantial weight loss (WL), however, a subset of patients undergoing surgery fails to achieve adequate WL. The reason for the individual variation in WL remains unexplained. Using an exploratory cross-disciplinary approach, we aimed to identify preoperative and early postoperative factors explaining the variation in WL after bariatric surgery. METHODS: Sixty-one subjects were recruited. Eighteen subjects did not receive surgery and three subjects dropped out, leaving a total sample of 40 subjects. Physiological, social, and psychological data were collected before and 6 months after surgery. All variables were analyzed in combination using a least absolute shrinkage and selection operator (LASSO) regression to explain the variation in WL 18 months after Roux-en-Y gastric bypass (n = 30) and sleeve gastrectomy (n = 10). RESULTS: Mean WL was 31% (range: 10-52%). The following preoperative factors predicted 59% of the variation in WL: type of surgery (14%), diabetes status (12%), economic resources (9%), sex (7%), binge eating disorder (7%), degree of depression (5%), household type (3%), and physical activity (1%). Including information on early responses after surgery increased the ability to predict WL to 78% and was explained by early WL (47%), changes in energy density of food consumed from a buffet meal (9%), changes in glicentin (5%), degree of depression (5%), sex (5%), type of surgery (2%), economic resources (2%), and changes in drive for thinness (1%). CONCLUSIONS: Using a cross-disciplinary approach, a substantial part of the individual variation in WL was explained by a combination of basic patient characteristics, psychological profile, and social conditions as well as physiological, psychological and behavioral responses to surgery. These results suggest that patient characteristics collected in a cross-disciplinary approach may help determine predictors for less successful WL after bariatric surgery. If verified in larger cohorts this may form the basis for individualized postoperative support to optimize WL outcome.

The consequences of unemployment on diet composition and purchase behaviour: a longitudinal study from Denmark.

OBJECTIVE: To explore and describe quantitatively the effect over time of unemployment on food purchase behaviour and diet composition. DESIGN: Longitudinal data from 2008-2012, with monthly food purchase data aligned with register data on unemployment measured as a dichotomous indicator as well as a trend accounting for the duration. SETTING: A household panel which registers daily food purchases combined with detailed nutritional information and registration of the duration of unemployment at individual level. The structure of the data set facilitates the detection of effects or associations between duration of unemployment and diet composition, purchase behaviour in terms of food expenditure, and share of food purchased on offer and in discounters while controlling for important confounding factors. SUBJECTS: Danish households of working age (n 3440) adjusted to household equivalents. We use fixed-effects econometric methods to control for unobserved heterogeneity. RESULTS: In the short run, unemployment led to substitution in favour of discount stores and increases in food expenditure and in consumption of saturated fat, total fat and protein due to increased consumption of animal-based foods. In the medium run food expenditure declined together with consumption of fresh animal-based foods and saturated fat, total fat and protein. In the even longer run these nutrients were substituted by carbohydrates and added sugar. CONCLUSIONS: Unemployment has a substantial influence on diet composition, but effects vary with duration of the unemployment period, which may have potential health implications. This ought to be taken into consideration in evaluations of existing reforms and in future reforms of welfare systems.

Being targeted as a "severely overweight pregnant woman" -A qualitative interview study.

BACKGROUND: Pregnant women with a body mass index (BMI) ≥ 30 kg/m2 have been targeted in health-care systems in many western countries as a high-risk group. However, we have limited knowledge of the long-term significance of this prenatal care policy. OBJECTIVE: To investigate accounts women give of their experiences of being targeted as severely overweight during pregnancy when they look back at the intervention 4-5 years later. DESIGN: Interpretive analysis based on 21 semi-structured interviews conducted 4-5 years after the pregnancy with Danish mothers categorized as having a pre-pregnancy BMI ≥ 30. FINDINGS: In the women's retrospective accounts three phases were identified and separated: (i) Being identified as a "severely overweight pregnant woman." The women differed over whether they accepted this categorization, but all believed that an approach based on weight was acceptable. (ii) Encounters with health-care professionals. The women differed here: some reported no negative experiences; others reported experiences of prejudice and silence. (iii) Reflections on long-term outcomes. Most women reported that the interventions during their pregnancies did not lead to any lasting lifestyle change. The women disagreed over whether, in principle, pregnancy was a suitable time to be targeted. DISCUSSION AND CONCLUSION: Our study illustrates the importance of critically considering whether pregnancy is a suitable window of opportunity for obesity prevention, and shows that women's experiences should be examined in relation to each phase of intervention. More interdisciplinary studies are needed to map potential benefits and other consequences over the short- and long-term.

Food insecurity in Denmark-socio-demographic determinants and associations with eating- and health-related variables.

Background: Food insecurity and its consequences have not received much attention in the Nordic, social-democratic welfare states. This study reports the prevalence of low and very low food security in Denmark, identifies its socio-demographic determinants and examines its associations with eating-related and health-related outcomes. Methods: A cross-sectional survey with a mixed-mode response format (telephone interviewing or Internet). A disproportional stratified random sampling design was employed (N = 1877). Main measure was the 6-item gradient food security construct adapted from the US. Results: Prevalence of low and very low food security was 6.0% (95% CI:5.4-8.5%) and 2.4% (95% CI:1.3-3.3%), respectively. Prevalence was highest in households with disposable income below OECD's poverty threshold, households receiving benefits or disability pensions, and single-parent households. After socio-demographic adjustment, adults from low/very low food secure households had a higher probability of eating an unhealthy diet (women: adj.RR 2.82 P < 0.001; men: adj.RR 2.15 P < 0.01). Adults from low/very low food secure households had lower life satisfaction (women: adj.RR 0.49, P < 0.05; men: adj.RR 0.09 P < 0.001) and higher risk of psychological distress (women: adj.RR 2.42 P < 0.05; men: adj.RR 8.95 P < 0.001). Obesity was more prevalent in low/very low food secure women (RR 2.44 P < 0.05), but not after socio-demographic adjustment. Conclusion: Food insecurity in Denmark is associated with adverse factors such as unhealthy diet, obesity, life satisfaction, and psychological distress. It is important to widen food insecurity research to non-liberal welfare states since low/very low food security is negatively associated with unhealthy eating and other health indicators, even in a social-democratic welfare state.

Optimistic and pessimistic self-assessment of own diets is associated with age, self-rated health and weight status in Danish adults.

The aim of this study was to analyse concordance between Danish adults' recorded diet quality and their own assessment of the healthiness and to examine socio-demographic, health and behavioural characteristics associated with an optimistic or pessimistic self-assessment. Data were derived from The Danish National Survey of Diet and Physical Activity 2011-2013 and included a random sample of 3014 adults (18-75 y). Diet quality was evaluated on the basis of seven-day pre-coded food diaries and categorised 'unhealthy', 'somewhat healthy' and 'healthy'. Self-assessment of the healthiness of own diets was registered via personal interviews and categorised healthy enough 'to a high degree', 'to some degree' or 'not at all/only partly'. Highly and somewhat optimistic self-assessment, respectively, were defined as assessing own diets as healthy enough to a high degree or to some degree while having unhealthy diets. Highly and somewhat pessimistic self-assessment, respectively, were defined as assessing own diets as not healthy enough or healthy enough to some degree while having healthy diets. Multiple logistic regression models were used to examine characteristics associated with optimistic and pessimistic self-assessments, respectively. Among individuals with unhealthy diets, 13% were highly optimistic and 42% somewhat optimistic about the healthiness of their diets. Among individuals with healthy diets, 14% were highly pessimistic and 51% somewhat pessimistic about the healthiness of their diets. Highly optimistic self-assessment was associated with increasing age, excellent self-rated health, normal weight and a moderate activity level. Highly pessimistic self-assessment was associated with decreasing age, good self-rated health and being obese. The findings indicate that people seem to use personal health characteristics as important references when assessing the healthiness of their diets.

Changing tastes: learning hunger and fullness after gastric bypass surgery.

Gastric bypass surgery is a specific medical technology that alters the body in ways that force patients to fundamentally change their eating habits. When patients enrol for surgery, they enter a learning process, encountering new and at times contested ways of sensing their bodies, tasting, and experiencing hunger and fullness. In this paper, we explore how patients begin to eat again after gastric bypass surgery. The empirical data used here are drawn from a Danish fieldwork study of individuals undergoing obesity surgery. The material presented shows how the patients used instructions on how to eat. We explore the ways in which diverse new experiences and practices of hunger and fullness are part of the process of undergoing surgery for severe obesity. New sensory experiences lead to uncertainty; as a result, patients practice what we term mimetic eating, which reflects a 'sensory displacement' and hence a rupture in the person's sense of self and social relations. We suggest that eating should be conceptualised as a practice that extends beyond the boundaries of our bodies and into diverse realms of relations and practices, and that changing the way we eat also changes the fundamentally embodied experience of who we are.

Experiences From a Web- and App-Based Workplace Health Promotion Intervention Among Employees in the Social and Health Care Sector Based on Use-Data and Qualitative Interviews.

BACKGROUND: An increasing number of Web- and app-based tools for health promotion are being developed at the moment. The ambition is generally to reach out to a larger part of the population and to help users improve their lifestyle and develop healthier habits, and thereby improve their health status. However, the positive effects are generally modest. To understand why the effects are modest, further investigation into the participants' experiences and the social aspects of using Web- and app-based health promotion tools is needed. OBJECTIVE: The objectives of this study were to investigate the motivation behind taking part in and using a Web- and app-based health promotion tool (SoSu-life) at the workplace and to explore the participants' experiences with using the tool. METHODS: Qualitative interviews with 26 participants who participated in a 38-week randomized controlled trial of a workplace Web- and app-based tool for health promotion were conducted. Data were supplemented with tracking the frequency of use. The basic features of the tool investigated in the trial were self-reporting of diet and exercise, personalized feedback, suggestions for activities and programs, practical tips and tricks, and a series of social features designed to support and build interactions among the participants at the workplace. RESULTS: The respondents reported typically one of the two reasons for signing up to participate in the study: either a personal wish to attain some health benefits or the more social reason that participants did not want to miss out on the social interaction with colleagues. Peer pressure from colleagues had made some participants to sign up even though they did not believe they had an unhealthy behavior. Of the total of 355 participants in the intervention group, 203 (57.2%) left the intervention before it ended. Of the remaining participants, most did not use the tool after the competition at the end of the initial 16-week period. The actual number of active users of the tool throughout the whole intervention period was low; however, the participants reported that lifestyle habits became a topic of conversation. CONCLUSIONS: A tool that addresses group interactions at workplaces appears to initiate peer pressure, which helped recruitment for participation. However, active participation was low. A social change was indicated, allowing for more interaction among colleagues around healthy lifestyle issues. Future and more long-term studies are needed to determine whether such social changes could lead to sustained improvements of health.

Working with a fractional object: enactments of appetite in interdisciplinary work in anthropology and biomedicine.

This paper explores the productive tensions occurring in an interdisciplinary research project on weight loss after obesity surgery. The study was a bio-medical/anthropological collaboration investigating to what extent eating patterns, the subjective experience of hunger and physiological mechanisms are involved in appetite regulation that might determine good or poor response to the surgery. Linking biomedical and anthropological categories and definitions of central concepts about the body turned out to be a major challenge in the collaborative analysis. Notably, the conception of what constitutes 'appetite' was a key concern, as each discipline has its particular definition and operationalization of the term. In response, a material-semiotic approach was chosen which allowed for a reconceptualization of appetite as a 'fractional object', engaged in multiple relations and enacted differently in each instance. This perspective produced creative contrasts and offered alternative explorations of both scientific knowledge production and anthropological practices. The paper thereby explores the interfaces between anthropology and medical science by attending to the challenges and opportunities that result from destabilising an assumed fixed and well-defined concept associated with the body.

"I feel good and I am not overweight" - A qualitative study of considerations underlying lay people's self-assessments of unhealthy diets.

It has been suggested that optimistic self-assessments of unhealthy diets constitute a barrier to the promotion of healthier eating practices. In order to discuss possible reasons for such optimistic assessments, knowledge about the considerations underlying self-assessments of unhealthy diets is needed. The aim of this qualitative study is to explore this issue by comparing considerations underlying the assessments of people who overestimate the healthiness of their unhealthy diets with those of people who express more realistic assessments. Interviewees were recruited among those respondents to the Danish National Survey of Diet and Physical Activity 2011-2013, who had been accorded a low diet index score. A thematic analysis of qualitative interviews is undertaken (N = 16). When interviewees are asked to assess the healthiness of their diets, they draw upon their nutritional knowledge and their perceptions of healthy eating practices. However, these considerations tend to be overruled by more decisive criteria. Thus, diets are assessed as being not exactly healthy, but nevertheless healthy enough - so long as interviewees feel good. Moreover, a personal history of weight status and weight concerns emerge as decisive criteria in self-assessments. Those who experience problems in these areas tend to be realistic about the unhealthy character of their diets, while optimistic assessments appear to be linked to tendencies to perceive oneself as not being overweight, not having experienced weight gain or loss, or not being concerned about weight. This study concludes that decisive criteria in lay people's self-assessments of unhealthy diets - with regard to feeling and looking good - differ markedly from the criteria employed in food-based dietary guidelines. These broader criteria of assessment should be recognized by professionals engaged in planning health promotion strategies with reference to dietary health.

Changes in the social context and conduct of eating in four Nordic countries between 1997 and 2012.

How have eating patterns changed in modern life? In public and academic debate concern has been expressed that the social function of eating may be challenged by de-structuration and the dissolution of traditions. We analyzed changes in the social context and conduct of eating in four Nordic countries over the period 1997-2012. We focused on three interlinked processes often claimed to be distinctive of modern eating: delocalization of eating from private households to commercial settings, individualization in the form of more eating alone, and informalization, implying more casual codes of conduct. We based the analysis on data from two surveys conducted in Denmark, Finland, Norway and Sweden in 1997 and 2012. The surveys reported in detail one day of eating in representative samples of adult populations in the four countries (N = 4823 and N = 8242). We compared data regarding where, with whom, and for how long people ate, and whether parallel activities took place while eating. While Nordic people's primary location for eating remained the home and the workplace, the practices of eating in haste, and while watching television increased and using tablets, computers and smartphones while eating was frequent in 2012. Propensity to eat alone increased slightly in Denmark and Norway, and decreased slightly in Sweden. While such practices vary with socio-economic background, regression analysis showed several changes were common across the Nordic populations. However, the new practice of using tablets, computers, and smartphones while eating was strongly associated with young age. Further, each of the practices appeared to be related to different types of meal. We conclude that while the changes in the social organization of eating were not dramatic, signs of individualization and informalization could be detected.

Use and Preference of Advice on Small Children's Food: Differences Between Parents From Ethnic Minority, Ethnic Majority, and Mixed Households.

The authors analyzed the influence of acculturation on parental attitudes to, and use of, different sources of health advice about young children's food in Denmark. Using combined ethnic position of the children's parents as a proxy for household acculturation, the authors conducted a postal survey of 2,511 households with young children (6 months to 3.5 years) occupying ethnic minority, ethnic majority, or ethnic mixed position. The analysis showed that the use of advice differed in the 3 groups. Households with ethnic minority status were more likely to use the child's grandparents, general practitioners, and hospital staff as information sources, while households with ethnic majority status were more likely to use mothers' peer groups and written material. In all types of household municipal public health nurses were relied on as a source of advice on young children's food, but households with ethnic minority status were more likely to find the advice obtained in this way incompatible with their family eating habits. Although existing dietary health communication strategies delivered by public health nurses appear to work well in all household types, parents from minority households seem to experience dilemmas. These may be related to their cultural and generational status at the time of receiving the advice. Adjustments to current communication strategies on young children's food are suggested.

Ethnicity and children's diets: the practices and perceptions of mothers in two minority ethnic groups in Denmark.

This study explores concerns and dilemmas connected with diet, health and child-feeding in families with ethnic minority background. The aim is to contribute to better targeting of dietary advice to ethnic minority parents in Denmark. Four focus group interviews were carried out with mothers of children between 4 months and 2 and a half years who were descendants of Turkish or Pakistani immigrants. The focus groups investigated: (1) everyday feeding practices; (2) values and concerns behind food choice; (3) social and cultural norms influencing feeding and eating practices; (4) experienced dilemmas in dietary change; and (5) sources of nutritional advice. Public health authorities in Denmark tend to link diet-related health problems among ethnic minority populations with their ethnic identity, dichotomising ethnic and Danish dietary habits. This may overlook values and concerns other than those related to ethnicity that are sometimes more important in determining food habits. The present study found that child-feeding practices were shaped by two main aims: (1) securing and improving child health; and (2) ensuring multi-cultural eating competence in children. The results confirm that ethnic distinctions do matter in the concerns and dilemmas mothers experience when feeding their children, but they also challenge the health authorities' reliance on dichotomies in promoting health among immigrant families. The participants' ethnic self-identification through food practices did not refer primarily to the birthplaces of their parents. Rather, it was context dependent and directed simultaneously towards majority and minority culture.

Food shopping and weight concern. Balancing consumer and body normality.

The desire to achieve a normal, culturally acceptable body is often seen as the main driver of food-consumption practices adopted by individuals who are concerned about their body weight. In social research into weight management self-control is therefore often a central theme. Turning the focus towards practices and values related to food shopping, this study adds to our understanding of central features in perceptions of normality among people with weight concerns. In a qualitative study 25 people who participated in a dietary intervention trial in Denmark were interviewed and five people were observed. The study shows that the aim of achieving a normal body does not eclipse the importance of enacting values linked to ideas of the 'normal consumer'. Using empirical examples, the study illuminates how consumer freedom is attained in ways that are both complementary to, and in conflict with, practices and experiences of controlling food intake. The paper suggests that freedom and control are composite and complementary ideals of normality for people with weight concerns. On the basis of this insight, the authors discuss the contribution the paper makes to existing studies of weight management and food consumption.

Opportunities for healthier child feeding. Does ethnic position matter? - self-reported evaluation of family diet and impediments to change among parents with majority and minority status in Denmark.

Health inequality between ethnic groups is expressed in differences in the prevalence of diet related diseases. The aim of the study was to investigate and compare barriers toward eating healthier among ethnic majority and minority parents in Denmark. A postal survey was carried out among 2511 parents with either Danish or non-western ethnic minority descendant background, investigating barriers on cultural, structural, social, individual, and practical levels. The results showed that compared with parents of Danish origin, ethnic minority parents were more likely to evaluate their own diets negatively (OR 3.0, CI 1.7-5.3), and to evaluate their children's diets negatively (OR 4.6, CI 2.5-8.4). In addition, ethnic minority parents to a higher degree experienced barriers to eating healthier than Danish parents did. Most salient was ethnic minority parents' expression of a lack of control over their own food intake and the food given to their children in everyday life. Such a lack of control was identified on practical, social, structural and individual levels. Young age of the parents was found to explain some of the differences between ethnic groups. It is concluded that dietary interventions directed at parents of small children should address not only cultural background but also barriers operating on practical, social, structural, and individual levels, as some of these influence ethnic minorities and the majority population differently. Further exploration of the importance of young age and the interplay between structural and cultural factors in the lives of ethnic minority families is needed.