Reporting accuracy of population dietary sodium intake using duplicate 24 h dietary recalls and a salt questionnaire.

High dietary Na intake is associated with multiple health risks, making accurate assessment of population dietary Na intake critical. In the present study, reporting accuracy of dietary Na intake was evaluated by 24 h urinary Na excretion using the EPIC-Soft 24 h dietary recall (24-HDR). Participants from a subsample of the European Food Consumption Validation study (n 365; countries: Belgium, Norway and Czech Republic), aged 45-65 years, completed two 24 h urine collections and two 24-HDR. Reporting accuracy was calculated as the ratio of reported Na intake to that estimated from the urinary biomarker. A questionnaire on salt use was completed in order to assess the discretionary use of table and cooking salt. The reporting accuracy of dietary Na intake was assessed using two scenarios: (1) a salt adjustment procedure using data from the salt questionnaire; (2) without salt adjustment. Overall, reporting accuracy improved when data from the salt questionnaire were included. The mean reporting accuracy was 0·67 (95 % CI 0·62, 0·72), 0·73 (95 % CI 0·68, 0·79) and 0·79 (95 % CI 0·74, 0·85) for Belgium, Norway and Czech Republic, respectively. Reporting accuracy decreased with increasing BMI among male subjects in all the three countries. For women from Belgium and Norway, reporting accuracy was highest among those classified as obese (BMI ≥ 30 kg/m2: 0·73, 95 % CI 0·67, 0·81 and 0·81, 95 % CI 0·77, 0·86, respectively). The findings from the present study showed considerable underestimation of dietary Na intake assessed using two 24-HDR. The questionnaire-based salt adjustment procedure improved reporting accuracy by 7-13 %. Further development of both the questionnaire and EPIC-Soft databases (e.g. inclusion of a facet to describe salt content) is necessary to estimate population dietary Na intakes accurately.

Concentrations of phthalates and bisphenol A in Norwegian foods and beverages and estimated dietary exposure in adults.

Phthalates and bisphenol A (BPA) are ubiquitous in our environment. These chemicals have been characterized as endocrine disruptors that can cause functional impairment of development and reproduction. Processed and packaged foods are among the major sources of human exposure to these chemicals. No previous report showing the levels of these chemicals in food items purchased in Norway is available. The aim of the present study was to determine the concentration of ten different phthalates and BPA in foods and beverages purchased on the Norwegian market and estimate the daily dietary exposure in the Norwegian adult population. Commonly consumed foods and beverages in Norway were purchased in a grocery store and analysed using gas- and liquid chromatography coupled with mass spectrometry. Daily dietary exposures to these chemicals in the Norwegian adult population were estimated using the latest National dietary survey, Norkost 3 (2010-2011). This study showed that phthalates and BPA are found in all foods and beverages that are common to consume in Norway. The detection frequency of phthalates in the food items varied from 11% for dicyclohexyl phthalate (DCHP) to 84% for di-iso-nonyl phthalate (DiNP), one of the substitutes for bis(2-ethylhexyl) phthalate (DEHP). BPA was found in 54% of the food items analysed. Among the different phthalates, the highest concentrations were found for DEHP and DiNP in the food items. Estimated dietary exposures were also equally high and dominated by DEHP and DiNP (400-500 ng/kg body weight (bw)/day), followed by di-iso-butyl phthalate (DiBP), di-n-butyl phthalate (DnBP), di-n-octyl phthalate (DnOP) and di-iso-decyl phthalate (DiDP) (30-40 ng/kg bw/day). Dimethyl phthalate (DMP), diethylphthalate (DEP) and DCHP had the lowest concentrations and the exposures were around 10-20 ng/kg bw/day. Estimated dietary exposure to BPA was 5 ng/kg bw/day. In general, levels of phthalates and BPA in foods and beverages from the Norwegian market are comparable to other countries worldwide. Grain and meat products were the major contributors of exposure to these chemicals in the Norwegian adult population. The estimated dietary exposures to these chemicals were considerably lower than their respective tolerable daily intake (TDI) values established by the European Food Safety Authority (EFSA).

Consumer involvement in dietary guideline development: opinions from European stakeholders.

OBJECTIVE: The involvement of consumers in the development of dietary guidelines has been promoted by national and international bodies. Yet, few best practice guidelines have been established to assist with such involvement. DESIGN: Qualitative semi-structured interviews explored stakeholders' beliefs about consumer involvement in dietary guideline development. SETTING: Interviews were conducted in six European countries: the Czech Republic, Germany, Norway, Serbia, Spain and the UK. SUBJECTS: Seventy-seven stakeholders were interviewed. Stakeholders were grouped as government, scientific advisory body, professional and academic, industry or non-government organisations. Response rate ranged from 45 % to 95 %. RESULTS: Thematic analysis was conducted with the assistance of NVivo qualitative software. Analysis identified two main themes: (i) type of consumer involvement and (ii) pros and cons of consumer involvement. Direct consumer involvement (e.g. consumer organisations) in the decision-making process was discussed as a facilitator to guideline communication towards the end of the process. Indirect consumer involvement (e.g. consumer research data) was considered at both the beginning and the end of the process. Cons to consumer involvement included the effect of vested interests on objectivity; consumer disinterest; and complications in terms of time, finance and technical understanding. Pros related to increased credibility and trust in the process. CONCLUSIONS: Stakeholders acknowledged benefits to consumer involvement during the development of dietary guidelines, but remained unclear on the advantage of direct contributions to the scientific content of guidelines. In the absence of established best practice, clarity on the type and reasons for consumer involvement would benefit all actors.

Evaluation of a short food frequency questionnaire used among Norwegian children.

OBJECTIVE: The aim of this study was to evaluate a short food frequency questionnaire (FFQ) against a four-day precoded food diary (PFD) with regard to frequency of food intake among Norwegian 9- and 13-year-olds. SUBJECTS AND DESIGN: A total of 733 9-year-olds and 904 13-year-olds completed first a short FFQ and one to two weeks later a four-day PFD. The short FFQ included questions about 23 food items, including different drinks, fruits, vegetables, bread, fish, pizza, sweets, chocolate and savoury snacks. The PFD covered the whole diet. RESULTS: When comparing mean intake from the PFD with comparable food items in the FFQ, all food items showed that increasing intake measured with the PFD corresponded with increasing intake with the short FFQ. However, participants reported a significantly higher frequency of intake for most foods with the short FFQ compared with PFD, except for soft drinks with sugar and sweets. The median Spearman correlation coefficient between the two methods was 0.36 among the 9-year-olds and 0.32 among the 13-year-olds. Often eaten foods such as fruits and vegetables had higher correlations than seldom eaten foods such as pizza and potato chips. The median correlation coefficients for drinks alone were higher (r=0.47) for both age groups. CONCLUSIONS: Results indicate that the short FFQ was able to identify high and low consumers of food intake and had a moderate capability to rank individuals according to food intake. Drinks, fruits and vegetables had better correlations with the PFD than infrequently eaten food items.

Overweight and obesity among Norwegian schoolchildren: changes from 1993 to 2000.

AIM: The aim of the present study was to investigate the prevalence rate of overweight and obesity in a nationwide survey of fourth- and eighth-grade Norwegian schoolchildren, the changes in overweight rates among eighth graders from 1993 to 2000, and to investigate factors associated with overweight. METHODS: Cross-sectional dietary surveys were conducted on nationally representative samples of eighth graders in 1993, and among fourth and eighth graders in 2000. Self-reported weight and height was available from 1,650 eighth graders in 1993, and from 664 fourth and 825 eighth graders in 2000. Data on dietary pattern, social class, and physical activity were also available. RESULTS: In 2000 the prevalence of overweight and obesity among the fourth graders was 18.5% and 3.6%, respectively, and among the eighth graders 11.5% and 1.8%, respectively. A marked increase in overweight and obesity among Norwegian eighth graders from 1993 to 2000 was observed; the prevalence of overweight and obesity increased by 4 and 0.9 percentage points, respectively. Social class, time spent watching TV or in front of a computer, and breakfast frequency were associated with the odds of being overweight. An inverse relation between intake of sweets and overweight was observed. Validation studies demonstrated a high correlation between self-reported and measured height and weight in both age groups. CONCLUSION: The present study demonstrates a high prevalence of overweight and obesity among schoolchildren, especially among fourth graders in Norway. Moreover, the proportion of overweight and obese children has increased greatly among eighth graders during the last decade.

[Intake of fruit and vegetables among Norwegian children and adolescents]. / Hvor mye frukt og grønt spiser norske barn og ungdommer?

BACKGROUND: We present a survey of the intake of fruit and vegetables among Norwegian children and adolescents and examine the association between fruit and vegetable intake and intake of macronutrients and micronutrients. MATERIAL AND METHODS: In 2000 and 2001, a nationwide dietary survey using four-days records was conducted among four-year-olds and students in the fourth and eighth grades (UNGKOST-2000). RESULTS: The average intake of fruit and vegetables was nearly 250 gram per day, increasing with age. The percentages of children eating more than 500 gram fruit and vegetables per day were 5% among the four-year-olds, 7% among fourth-graders, and 11% among eighth-graders. A positive association was observed between intake of fruit and vegetables and intake of fibre and all micronutrients, while a negative association was found between fruit and vegetable intake and percentage of energy coming from added sugar and saturated fatty acids. INTERPRETATION: The study shows that children and adolescents have less than half the recommended intake of fruit and vegetables. Furthermore, higher intake of fruit and vegetables is associated with higher dietary quality.