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Forsum, Elisabet
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Delisle Nystrom, C., Forsum, E., Henriksson, H., Trolle-Lagerros, Y., Larsson, C., Maddison, R., . . . Löf, M. (2016). A Mobile Phone Based Method to Assess Energy and Food Intake in Young Children: A Validation Study against the Doubly Labelled Water Method and 24 h Dietary Recalls. Nutrients, 8(1), 50
Open this publication in new window or tab >>A Mobile Phone Based Method to Assess Energy and Food Intake in Young Children: A Validation Study against the Doubly Labelled Water Method and 24 h Dietary Recalls
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2016 (English)In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 8, no 1, p. 50-Article in journal (Refereed) Published
Abstract [en]

Mobile phones are becoming important instruments for assessing diet and energy intake. We developed the Tool for Energy Balance in Children (TECH), which uses a mobile phone to assess energy and food intake in pre-school children. The aims of this study were: (a) to compare energy intake (EI) using TECH with total energy expenditure (TEE) measured via doubly labelled water (DLW); and (b) to compare intakes of fruits, vegetables, fruit juice, sweetened beverages, candy, ice cream, and bakery products using TECH with intakes acquired by 24 h dietary recalls. Participants were 39 healthy, Swedish children (5.5 +/- 0.5 years) within the ongoing Mobile-based Intervention Intended to Stop Obesity in Preschoolers (MINISTOP) obesity prevention trial. Energy and food intakes were assessed during four days using TECH and 24 h telephone dietary recalls. Mean EI (TECH) was not statistically different from TEE (DLW) (5820 +/- 820 kJ/24 h and 6040 +/- 680kJ/24 h, respectively). No significant differences in the average food intakes using TECH and 24 h dietary recalls were found. All food intakes were correlated between TECH and the 24 h dietary recalls (r = 0.665-0.896, p < 0.001). In conclusion, TECH accurately estimated the average intakes of energy and selected foods and thus has the potential to be a useful tool for dietary studies in pre-school children, for example obesity prevention trials.

Place, publisher, year, edition, pages
MDPI AG, 2016
Keywords
mobile phones; energy intake; food intake; total energy expenditure; child; DLW; 24 h dietary recall
National Category
Clinical Medicine Basic Medicine
Identifiers
urn:nbn:se:liu:diva-128982 (URN)10.3390/nu8010050 (DOI)000374589300048 ()26784226 (PubMedID)
Note

Funding Agencies|Swedish Research Council [2012-2883]; Swedish Research Council for Health, Working Life and Welfare [2012-0906]; Bo and Vera Axson Johnsons Foundation; Karolinska Institutet

Available from: 2016-06-09 Created: 2016-06-07 Last updated: 2019-06-28
Forsum, E., Olhager, E. & Törnqvist, C. (2016). An Evaluation of the Pea Pod System for Assessing Body Composition of Moderately Premature Infants. Nutrients, 8(4), 238
Open this publication in new window or tab >>An Evaluation of the Pea Pod System for Assessing Body Composition of Moderately Premature Infants
2016 (English)In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 8, no 4, p. 238-Article in journal (Refereed) Published
Abstract [en]

(1) Background: Assessing the quality of growth in premature infants is important in order to be able to provide them with optimal nutrition. The Pea Pod device, based on air displacement plethysmography, is able to assess body composition of infants. However, this method has not been sufficiently evaluated in premature infants; (2) Methods: In 14 infants in an age range of 3-7 days, born after 32-35 completed weeks of gestation, body weight, body volume, fat-free mass density (predicted by the Pea Pod software), and total body water (isotope dilution) were assessed. Reference estimates of fat-free mass density and body composition were obtained using a three-component model; (3) Results: Fat-free mass density values, predicted using Pea Pod, were biased but not significantly (p > 0.05) different from reference estimates. Body fat (%), assessed using Pea Pod, was not significantly different from reference estimates. The biological variability of fat-free mass density was 0.55% of the average value (1.0627 g/mL); (4) Conclusion: The results indicate that the Pea Pod system is accurate for groups of newborn, moderately premature infants. However, more studies where this system is used for premature infants are needed, and we provide suggestions regarding how to develop this area.

Place, publisher, year, edition, pages
MDPI AG, 2016
Keywords
body composition; fat-free mass density; isotope dilution; Pea Pod; premature infants; three-component model
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-128968 (URN)10.3390/nu8040238 (DOI)000374590200060 ()27110820 (PubMedID)
Note

Funding Agencies|Medical Research Council of Southeast Sweden; County Council of Ostergotland

Available from: 2016-06-09 Created: 2016-06-07 Last updated: 2018-03-27
Lachat, C., Hawwash, D., Ocke, M. C., Berg, C., Forsum, E., Hornell, A., . . . Huybrechts, I. (2016). Strengthening the Reporting of Observational Studies in Epidemiology-Nutritional Epidemiology (STROBE-nut): An Extension of the STROBE Statement. PLoS Medicine, 13(6), e1002036
Open this publication in new window or tab >>Strengthening the Reporting of Observational Studies in Epidemiology-Nutritional Epidemiology (STROBE-nut): An Extension of the STROBE Statement
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2016 (English)In: PLoS Medicine, ISSN 1549-1277, E-ISSN 1549-1676, Vol. 13, no 6, p. e1002036-Article, review/survey (Refereed) Published
Abstract [en]

Background Concerns have been raised about the quality of reporting in nutritional epidemiology. Research reporting guidelines such as the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement can improve quality of reporting in observational studies. Herein, we propose recommendations for reporting nutritional epidemiology and dietary assessment research by extending the STROBE statement into Strengthening the Reporting of Observational Studies in Epidemiology-Nutritional Epidemiology (STROBE-nut). Methods and Findings Recommendations for the reporting of nutritional epidemiology and dietary assessment research were developed following a systematic and consultative process, coordinated by a multidisciplinary group of 21 experts. Consensus on reporting guidelines was reached through a three-round Delphi consultation process with 53 external experts. In total, 24 recommendations for nutritional epidemiology were added to the STROBE checklist. Conclusion When used appropriately, reporting guidelines for nutritional epidemiology can contribute to improve reporting of observational studies with a focus on diet and health.

Place, publisher, year, edition, pages
PUBLIC LIBRARY SCIENCE, 2016
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:liu:diva-130294 (URN)10.1371/journal.pmed.1002036 (DOI)000379128200007 ()27270749 (PubMedID)
Available from: 2016-07-31 Created: 2016-07-28 Last updated: 2019-02-01
Henriksson, H., Bonn, E. S., Bergström, A., Bälter, K., Bälter, O., Delisle, C., . . . Löf, M. (2015). A New Mobile Phone-Based Tool for Assessing Energy and Certain Food Intakes in Young Children: A Validation Study. JMIR mhealth and uhealth, 3(2), Article ID e38.
Open this publication in new window or tab >>A New Mobile Phone-Based Tool for Assessing Energy and Certain Food Intakes in Young Children: A Validation Study
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2015 (English)In: JMIR mhealth and uhealth, E-ISSN 2291-5222, Vol. 3, no 2, article id e38Article in journal (Refereed) Published
Abstract [en]

Background: Childhood obesity is an increasing health problem globally. Obesity may be established already at pre-school age. Further research in this area requires accurate and easy-to-use methods for assessing the intake of energy and foods. Traditional methods have limited accuracy, and place large demands on the study participants and researchers. Mobile phones offer possibilities for methodological advancements in this area since they are readily available, enable instant digitalization of collected data, and also contain a camera to photograph pre- and post-meal food items. We have recently developed a new tool for assessing energy and food intake in children using mobile phones called the Tool for Energy Balance in Children (TECH). Objective: The main aims of our study are to (1) compare energy intake by means of TECH with total energy expenditure (TEE) measured using a criterion method, the doubly labeled water (DLW) method, and (2) to compare intakes of fruits and berries, vegetables, juice, and sweetened beverages assessed by means of TECH with intakes obtained using a Web-based food frequency questionnaire (KidMeal-Q) in 3 year olds. Methods: In this study, 30 Swedish 3 year olds were included. Energy intake using TECH was compared to TEE measured using the DLW method. Intakes of vegetables, fruits and berries, juice, as well as sweetened beverages were assessed using TECH and compared to the corresponding intakes assessed using KidMeal-Q. Wilcoxon matched pairs test, Spearman rank order correlations, and the Bland-Altman procedure were applied. Results: The mean energy intake, assessed by TECH, was 5400 kJ/24h (SD 1500). This value was not significantly different (P=.23) from TEE (5070 kJ/24h, SD 600). However, the limits of agreement (2 standard deviations) in the Bland-Altman plot for energy intake estimated using TECH compared to TEE were wide (2990 kJ/24h), and TECH overestimated high and underestimated low energy intakes. The Bland-Altman plots for foods showed similar patterns. The mean intakes of vegetables, fruits and berries, juice, and sweetened beverages estimated using TECH were not significantly different from the corresponding intakes estimated using KidMeal-Q. Moderate but statistically significant correlations (ρ=.42-.46, P=.01-.02) between TECH and KidMeal-Q were observed for intakes of vegetables, fruits and berries, and juice, but not for sweetened beverages. Conclusion: We found that one day of recordings using TECH was not able to accurately estimate intakes of energy or certain foods in 3 year old children.

Place, publisher, year, edition, pages
JMIR publications, 2015
Keywords
Cell phone, digital camera, food intake, energy intake, child, DLW, FFQ
National Category
Clinical Science Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-117419 (URN)10.2196/mhealth.3670 (DOI)25910494 (PubMedID)
Available from: 2015-04-27 Created: 2015-04-27 Last updated: 2019-06-28Bibliographically approved
Delisle, C., Sandin, S., Forsum, E., Henriksson, H., Trolle-Lagerros, Y., Larsson, C., . . . Löf, M. (2015). A web- and mobile phone-based intervention to prevent obesity in 4-year-olds (MINISTOP): a population-based randomized controlled trial. BMC Public Health, 15(95)
Open this publication in new window or tab >>A web- and mobile phone-based intervention to prevent obesity in 4-year-olds (MINISTOP): a population-based randomized controlled trial
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2015 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, no 95Article in journal (Refereed) Published
Abstract [en]

Background: Childhood obesity is an increasing health problem globally. Overweight and obesity may be established as early as 2-5 years of age, highlighting the need for evidence-based effective prevention and treatment programs early in life. In adults, mobile phone based interventions for weight management (mHealth) have demonstrated positive effects on body mass, however, their use in child populations has yet to be examined. The aim of this paper is to report the study design and methodology of the MINSTOP (Mobile-based Intervention Intended to Stop Obesity in Preschoolers) trial. Methods/Design: A two-arm, parallel design randomized controlled trial in 300 healthy Swedish 4-year-olds is conducted. After baseline measures, parents are allocated to either an intervention-or control group. The 6-month mHealth intervention consists of a web-based application (the MINSTOP app) to help parents promote healthy eating and physical activity in children. MINISTOP is based on the Social Cognitive Theory and involves the delivery of a comprehensive, personalized program of information and text messages based on existing guidelines for a healthy diet and active lifestyle in pre-school children. Parents also register physical activity and intakes of candy, soft drinks, vegetables as well as fruits of their child and receive feedback through the application. Primary outcomes include body fatness and energy intake, while secondary outcomes are time spent in sedentary, moderate, and vigorous physical activity, physical fitness and intakes of fruits and vegetables, snacks, soft drinks and candy. Food and energy intake (Tool for Energy balance in Children, TECH), body fatness (pediatric option for BodPod), physical activity (Actigraph wGT3x-BT) and physical fitness (the PREFIT battery of five fitness tests) are measured at baseline, after the intervention (six months after baseline) and at follow-up (12 months after baseline). Discussion: This novel study will evaluate the effectiveness of a mHealth program for mitigating gain in body fatness among 4-year-old children. If the intervention proves effective it has great potential to be implemented in child-health care to counteract childhood overweight and obesity.

Place, publisher, year, edition, pages
BioMed Central, 2015
Keywords
Childhood obesity; Randomized controlled trial; Mobile phones; Body composition
National Category
Clinical Medicine Basic Medicine
Identifiers
urn:nbn:se:liu:diva-115821 (URN)10.1186/s12889-015-1444-8 (DOI)000349745800001 ()25778151 (PubMedID)
Note

Funding Agencies|Swedish Research Council; Swedish Research Council for Health, Working life and Welfare; Karolinska Institute; Bo and Vera Ax:son Johnssons foundation; Spanish Ministry of Economy and Competitiveness [RYC-2010-05957, RYC-2011-09011]

Available from: 2015-03-20 Created: 2015-03-20 Last updated: 2019-06-28
Henriksson, H., Eriksson, B., Forsum, E., Flinke Carlsson, E. & Löf, M. (2015). Development of body composition and its relationship with physical activity: A longitudinal study of Swedish children until 4·5 years of age.
Open this publication in new window or tab >>Development of body composition and its relationship with physical activity: A longitudinal study of Swedish children until 4·5 years of age
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2015 (English)Manuscript (preprint) (Other academic)
Abstract [en]

In order to develop strategies to prevent early childhood obesity more knowledge about longitudinal body composition development is needed. Previous studies have shown that there is a negative relationship between the physical activity level (PAL) and total body fat (TBF) in children. The aims of this study were: 1) To describe the longitudinal development of body composition from 1 week to 4·5 years of age. 2) To study the relationships between measures of body composition and PAL at 3 years of age. 3) To compare the relationships between body composition measures and PAL at 3 years of age to the corresponding relationships at 1·5 years of age. Body composition was measured using air-displacement plethysmography at 1 week, 12 weeks and at 4·5 years of age. At 1·5 and 3 years body composition and PAL were assessed using the doubly labelled water method and indirect calorimetry. The results showed that TBF% and fat mass index (FMI) were higher than corresponding reference values, during infancy and childhood. We found a relationship between TBF% and PAL at 3 years of age but this was explained by a relationship between PAL and fat-free mass index (FFMI). The corresponding relationship at 1·5 years of age could not be explained by a relationship between PAL and FFMI. In conclusion, the children in this study had higher body fatness compared to the corresponding reference values. This may indicate an identification of a secular trend in body composition development which is characterized by a high body fatness. Our findings also suggest that body fatness might counteract physical activity at 1·5 years of age when the capacity to perform physical activity is limited, however this result was not observed at 3 years of age when such a capacity has been developed.

Keywords
Body composition, energy expenditure, physical activity, children, doubly labelled water
National Category
Clinical Science Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-117418 (URN)
Available from: 2015-04-27 Created: 2015-04-27 Last updated: 2019-06-28Bibliographically approved
Henriksson, P., Eriksson, B., Forsum, E. & Löf, M. (2015). Gestational weight gain according to Institute of Medicine recommendations in relation to infant size and body composition.. Pediatric Obesity, 10(5), 388-394
Open this publication in new window or tab >>Gestational weight gain according to Institute of Medicine recommendations in relation to infant size and body composition.
2015 (English)In: Pediatric Obesity, ISSN 2047-6302, E-ISSN 2047-6310, Vol. 10, no 5, p. 388-394Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Intrauterine life may be a critical period for programming childhood obesity; however, there is insufficient knowledge concerning how gestational weight gain (GWG) affects infant fat mass (FM) and fat-free mass (FFM).

OBJECTIVES: The aim of this study was to investigate relationships between GWG according to Institute of Medicine (IOM) recommendations and infant size, FM and FFM. We also investigated if the associations were different for normal-weight and overweight/obese women.

METHODS: This study included 312 healthy Swedish mother-infant pairs. Infant body composition at 1 week of age was assessed using air-displacement plethysmography. Maternal GWG was defined as below, within or above the 2009 IOM recommendations. Multiple regression analyses were used.

RESULTS: Compared with women whose weight gain was within IOM recommendations, women with weight gain below the recommendations had infants that were shorter (-0.7 cm, P = 0.008) when adjusting for confounders. Normal-weight women exceeding IOM recommendations had infants with higher FM (+58 g, P = 0.008) compared with normal-weight women who gained within the recommendations. No corresponding association was observed for overweight/obese women.

CONCLUSIONS: Inadequate GWG was associated with shorter infants, while excessive GWG was associated with greater infant FM for women who were of normal weight before pregnancy.

Place, publisher, year, edition, pages
John Wiley & Sons, 2015
National Category
Other Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-115298 (URN)10.1111/ijpo.276 (DOI)000364584300011 ()25521831 (PubMedID)
Note

Funding agencies: Swedish Research Council [15402]; Swedish Research Council Formas [222-2006-614, 222-2008-1332]; AFA Insurance; Medical Faculty at Linkoping University; County Council of Ostergotland

Available from: 2015-03-12 Created: 2015-03-12 Last updated: 2019-06-28Bibliographically approved
Henriksson, P., Lof, M. & Forsum, E. (2015). Glucose Homeostasis Variables in Pregnancy versus Maternal and Infant Body Composition. Nutrients, 7(7), 5615-5627
Open this publication in new window or tab >>Glucose Homeostasis Variables in Pregnancy versus Maternal and Infant Body Composition
2015 (English)In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 7, no 7, p. 5615-5627Article in journal (Refereed) Published
Abstract [en]

Intrauterine factors influence infant size and body composition but the mechanisms involved are to a large extent unknown. We studied relationships between the body composition of pregnant women and variables related to their glucose homeostasis, i.e., glucose, HOMA-IR (homeostasis model assessment-insulin resistance), hemoglobin A(1c) and IGFBP-1 (insulin-like growth factor binding protein-1), and related these variables to the body composition of their infants. Body composition of 209 women in gestational week 32 and of their healthy, singleton and full-term one-week-old infants was measured using air displacement plethysmography. Glucose homeostasis variables were assessed in gestational week 32. HOMA-IR was positively related to fat mass index and fat mass (r(2) = 0.32, p less than 0.001) of the women. Maternal glucose and HOMA-IR values were positively (p 0.006) associated, while IGFBP-1was negatively (p = 0.001) associated, with infant fat mass. HOMA-IR was positively associated with fat mass of daughters (p less than 0.001), but not of sons (p = 0.65) (Sex-interaction: p = 0.042). In conclusion, glucose homeostasis variables of pregnant women are related to their own body composition and to that of their infants. The results suggest that a previously identified relationship between fat mass of mothers and daughters is mediated by maternal insulin resistance.

Place, publisher, year, edition, pages
MDPI, 2015
Keywords
body composition; infant; insulin resistance; pregnancy; sex difference
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-121143 (URN)10.3390/nu7075243 (DOI)000359349800033 ()26184296 (PubMedID)
Note

Funding Agencies|Swedish Research Council [15402]; Swedish Research Council Formas [2008-1332, 2006-614]; Medical Faculty, Linkoping University; County Council of Ostergotland

Available from: 2015-09-08 Created: 2015-09-08 Last updated: 2019-06-28
Henriksson, P., Löf, M. & Forsum, E. (2015). Glucose, insulin, and the insulin-like growth factor binding protein 1 in the circulation of pregnant women in relation to their own body composition and to that of their infants.
Open this publication in new window or tab >>Glucose, insulin, and the insulin-like growth factor binding protein 1 in the circulation of pregnant women in relation to their own body composition and to that of their infants
2015 (English)Manuscript (preprint) (Other academic)
Abstract [en]

Aim: Intrauterine factors influence infant size and body composition but the mechanisms involved are incompletely known. We studied relationships between the body composition of pregnant women and variables related to their glucose homeostasis, i.e. glucose, insulin, HOMA-IR (homeostasis model assessment-insulin resistance), haemoglobin A1c and IGFBP-1 (insulin-like growth factor binding protein 1), in their circulation and related these variables to the body composition of their infants.

Methods: Body composition of 209 women in gestational week 32 and of their healthy, singleton and full-term one-week-old infants was measured using air displacement plethysmography. Glucose homeostasis variables were assessed in gestational week 32.

Results: Insulin/HOMA-IR were positively related to body mass index, fat mass index and fat mass (r2=0.32-0.36, P<0.001) of the women. Their glucose, insulin and HOMA-IR values were positively (P≤0.009) associated, while IGFBP-1was negatively (P=0.001) associated, with infant fat mass. Insulin and HOMA-IR were positively associated with fat mass of daughters (P<0.001), but not of sons (P≥0.65) (Sex-interaction: P≤ 0.042).

Conclusion: Glucose homeostasis variables of pregnant women are related to their own body composition and to that of their infants. The results suggested that a previously identified relationship between fat mass of mothers and daughters is mediated by insulin resistance.

Keywords
Body composition, infant, insulin resistance, mother, sex difference
National Category
Public Health, Global Health, Social Medicine and Epidemiology Clinical Science
Identifiers
urn:nbn:se:liu:diva-117431 (URN)
Available from: 2015-04-27 Created: 2015-04-27 Last updated: 2019-06-28Bibliographically approved
Henriksson, P., Löf, M. & Forsum, E. (2015). Parental fat-free mass is related to the fat-free mass of infants and maternal fat mass is related to the fat mass of infant girls. Acta Paediatrica, 104(5), 491-497
Open this publication in new window or tab >>Parental fat-free mass is related to the fat-free mass of infants and maternal fat mass is related to the fat mass of infant girls
2015 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 104, no 5, p. 491-497Article in journal (Refereed) Published
Abstract [en]

Aim: Existing studies suggest that weight and body composition of parents influence the size and body composition of their offspring, but are often inconclusive and conducted by means of inappropriate body composition methodology. Our aim was to study infant size and body composition variables in relation to body composition variables of their mothers and fathers in a well-nourished population using an accurate methodology.

Methods: Between 2008 and 2011, we used air displacement plethysmography to measure the body composition of 209 parent–infant units. Parents were measured when women were in gestational week 32. Their healthy, singleton, full-term infants were measured at 1 week.

Results: Infant fat-free mass in grams was positively related (p ≤ 0.007) to the fat-free mass in kilograms of the mothers (15.6 g/kg) and the fathers (9.1 g/kg). Furthermore, the fat mass of the daughters, but not of the sons, was positively related to the fat mass of the mothers (5.8 g/kg, p = 0.007).

Conclusion: This study found associations between the fat-free mass of parents and infants and an association between the fat mass of mothers and their infant girls. These findings may help to understand early life factors behind overweight and obesity.

Place, publisher, year, edition, pages
John Wiley & Sons, 2015
Keywords
Body composition, Father, Infant, Mother, Sex difference
National Category
Public Health, Global Health, Social Medicine and Epidemiology Clinical Science
Identifiers
urn:nbn:se:liu:diva-117430 (URN)10.1111/apa.12939 (DOI)000353643400023 ()25645821 (PubMedID)
Available from: 2015-04-27 Created: 2015-04-27 Last updated: 2019-06-28Bibliographically approved
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