Validation of a semi-quantitative food-frequency questionnaire used among 12-month-old Norwegian infants.

OBJECTIVE: To assess the validity of a semi-quantitative food-frequency questionnaire (SFFQ) used in a large nation-wide dietary survey among 12-month-old Norwegian infants. METHODS: The SFFQ was administered to the parents about 1 week before the infants turned 12-month-old. The participants filled in the SFFQ and 1-2 weeks later they kept weighed food records for a total of 7 days. Both methods were completed for 64 infants. RESULTS: The SFFQ overestimated energy intake with 25% and gave significantly higher estimates of all nutrients compared with the records, except for calcium. Much of the difference between the methods disappeared when nutrient density was compared. Spearman correlation coefficients between pairwise measurements of nutrient intakes from the food records and the SFFQ ranged from 0.18 for vitamin D to 0.72 for polyunsaturated fatty acid intake (median r=0.50). On average 38% of the infants were classified in the same quartile with the two methods, and 3% in the opposite quartile. The correlations for food items varied from 0.28 for sweetened drinks to 0.83 for commercial porridge (median r=0.62). CONCLUSION: This study indicated that the SFFQ overestimates average absolute nutrient intakes. However, the questionnaire gave better estimates for average nutrient densities than for absolute nutrient intakes. The capability of the questionnaire to rank infants according to intake of nutrients and food items was moderate, but at the same level as others have observed with food-frequency questionnaires.

Infant feeding practices and associated factors in the first six months of life: the Norwegian infant nutrition survey.

AIM: To describe and evaluate infant feeding practices during the first 6 mo of life in relation to recommendations, and to study infant feeding practices in relation to maternal and infant characteristics. METHODS: Data from 2383 Norwegian infants aged 6 mo were collected by a self-administered semi-quantitative food-frequency questionnaire measuring feeding practices at 6 mo and feeding practices retrospectively at < or = 5.5 mo of age. RESULTS: Only 1% of the infants had never been breastfed. The proportion of breastfed infants was 96% at 1 mo, 85% at 4 mo and 80% at 6 mo. The proportion of exclusively breastfed infants was 90% at 1 mo, 44% at 4 mo and 7% at 6 mo. Twenty-one percent of the infants were introduced to solid foods before the age of 4 mo. For exclusive breastfeeding at 4 mo, breastfeeding at 6 mo and timely introduction of solid foods (not before 4 mo) significant positive trends were found for maternal age, education and degree of urbanization. Negative associations were found for maternal smoking. Furthermore, exclusive breastfeeding at 4 mo was associated with infant gender and marital status, and the odds of breastfeeding at 6 mo significantly decreased with decreasing infant birthweight. Finally, both the odds of exclusive breastfeeding at 4 mo and of breastfeeding at 6 mo increased with increasing numbers of children. CONCLUSION: These results indicate that a majority of Norwegian infants are fed in accordance with infant feeding recommendations during their first 6mo of life. However, the duration of exclusive breastfeeding is shorter than recommended. Infant feeding practices are significantly associated with maternal and infant characteristics.

Knowledge and attitudes of folate, and use of dietary supplements among women of reproductive age in Norway 1998.

BACKGROUND: Authorities in many countries, including Norway from March 1998, recommend that women consume supplemental folate before and early in pregnancy to prevent neural tube defects. The aim of this survey was to establish Norwegian baseline data on knowledge, use and attitudes of folate and dietary supplements before implementing national campaigns on folate and pregnancy. METHOD: A telephone survey was carried out in late 1998 among 1,146 Norwegian women of reproductive age. The women were recruited from a nationally representative stratified random sample. RESULTS: Among the women aged 18-45 years, 50.4% had heard about folate, 32.9% knew about its role in pregnancy and 9.5% that it may prevent a malformation. Only 4.0% of the women knew that the critical period for folate supplementation to prevent a neural tube defect is before and early in pregnancy. The strongest determinants of knowledge were closeness to a pregnancy and educational level. Dietary supplements were used daily or almost daily by 53.3% of the women. The most commonly used types were multivitamin supplements and cod liver oil while only 0.9% of the women reported current use of supplemental folate. The women were also asked about use of folate and dietary supplements before or early in their last pregnancy: 44.3% reported that they had used a dietary supplement and 2.4% had used folate. Among the few women who had been pregnant within the last year of the interview, 10.3% reported use of a folate supplement. Overall, 56.0% of the women stated that they would use a folate supplement in a future pregnancy and 66.7% that they wanted more information about folate. CONCLUSIONS: Although about half of Norwegian women had heard about folate in 1998, just below 10% knew that it could prevent a malformation. Use of folate supplements was low in 1998, but more than half of the women stated that they would use folate supplements in a future pregnancy.

[Folate and health--new knowledge and new recommendation]. / Folat og helse--ny kunnskap og nye anbefalinger.

The dietary intake of folate in Norway is not optimal with regard to minimizing the risk of birth defects (especially neural-tube defects), and poSsibly also cardiovascular diseases and other diseases. The National Nutrition Council has therefore initiated a project to evaluate the status of folate in Norway and to recommend actions for necessary improvement. A protective effect of folic acid supplements on neural-tube defects has been found in observational studies and clinical trials. The effects of folate on cardiovascular diseases and cancer are less certain. The estimated average intake of folate from foods in Norway is lower than the recommended 300 micrograms per day for adult women and men, and remarkably lower than the 400 micrograms per day recommended for pregnant and lactating women. Thus, with the aim of minimizing the risk for neural-tube defects, the National Nutrition Council now recommends that all women who are planning pregnancy or who are likely to become pregnant have an intake of at least 400 micrograms folate per day. Because it may be difficult to achieve this through diet alone, and because an additional risk-lowering effect of folic acid supplementation has been shown, a folic acid supplement of 400 micrograms per day is recommended for this group. The supplement should be taken one month before conception and during the first two months of pregnancy. Fortification of foods with folate is not recommended because some groups may then exceed the recommended upper intake level.

Food intake and patterns of feeding of Norwegian infants.

Norway has formed a policy on infant feeding, expressed as dietary allowances and guidelines concerning food intake. In a longitudinal and prospective study of health and development during infancy, the feeding patterns of 217 Norwegian infants were followed in order to evaluate the policy. The findings indicated that prevailing guidelines were largely followed by the parents. Forty-five per cent still got breastmilk at 6 months. Solid foods were usually introduced around 4-5 months, iron-enriched porridge being commonly used. At 10 months 91 per cent were given bread. The nutrient intakes at 10 months were mainly in accordance with the recommendations. The quality of the diet seemed to diminish somewhat when sandwiches replaced porridge. More emphasis should be put upon toddlers' diet in counselling the parents.