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  • 1.
    Delisle, Christine
    et al.
    Karolinska Institute, Sweden.
    Sandin, Sven
    Karolinska Institute, Sweden.
    Forsum, Elisabet
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Henriksson, Hanna
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Institute, Sweden.
    Trolle-Lagerros, Ylva
    Karolinska Institute, Sweden.
    Larsson, Christel
    University of Gothenburg, Sweden.
    Maddison, Ralph
    University of Auckland, New Zealand.
    Ortega, Francisco B.
    University of Granada, Spain.
    Ruiz, Jonatan R.
    University of Granada, Spain.
    Silfvernagel, Kristin
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Health and Developmental Care, Center for Public Health.
    Löf, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Karolinska Institute, Sweden.
    A web- and mobile phone-based intervention to prevent obesity in 4-year-olds (MINISTOP): a population-based randomized controlled trial2015In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, no 95Article in journal (Refereed)
    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.

  • 2.
    Delisle Nystrom, Christine
    et al.
    Novum, Sweden.
    Forsum, Elisabet
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Henriksson, Hanna
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Trolle-Lagerros, Ylva
    Karolinska Institute, Sweden.
    Larsson, Christel
    University of Gothenburg, Sweden.
    Maddison, Ralph
    University of Auckland, New Zealand.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Health and Developmental Care, Center for Public Health.
    Löf, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Novum, Sweden.
    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 Recalls2016In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 8, no 1, p. 50-Article in journal (Refereed)
    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.

  • 3.
    Eriksson, Britt
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Nutrition . Linköping University, Faculty of Health Sciences.
    Olsson, Hanna
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Löf, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Nutrition . Linköping University, Faculty of Health Sciences.
    Hannestad, Ulf
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Forsum, Elisabet
    Linköping University, Department of Clinical and Experimental Medicine, Nutrition . Linköping University, Faculty of Health Sciences.
    Body composition and energy expenditure in response to physical activity in 1.5-year-old children studied by means of the doubly labeled water methodManuscript (preprint) (Other academic)
    Abstract [en]

    During recent decades the prevalence of overweight and obesity in childhood has increased and studies of the mechanisms involved are motivated. Previous research has shown a correlation between total body fat (TBF) (%) and physical activity level (PAL) but the assessment of PAL has often involved a risk for spurious correlations. Thus we compared PAL calculated using basal metabolic rate (BMR) predicted from equations, based on body weight (PALBMR) and associated with a risk for spurious correlations, with PAL calculated using sleeping metabolic rate (SMR) assessed using indirect calorimetry (PALSMR) in 20 healthy children aged 1.5 years. Total energy expenditure and body fatness were assessed using the doubly labelled water method. Body fatness of these children was also assessed at one week and three months of age. PALBMR was significantly (r=-0.48, p=0.03) correlated with TBF (%) while PALSMR was not. Furthermore, the increase in body fatness between three months and 1.5 years was significantly (r=-0.52, p=0.02) correlated with PALSMR at the age of 1.5 years. Our results indicate complex relationships between body fatness and physical activity in early life. When conducting studies in this area, resting energy metabolism should be measured rather than predicted using equations based on body weight.

  • 4.
    Forsum, Elisabet
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Flinke Carlsson, Eva
    Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping.
    Henriksson, Hanna
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Henriksson, Pontus
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Löf, Marie
    Karolinska Institutet, Stockholm, Sweden .
    BMI kan inte säkert identifiera 4-åringar med hög kroppsfetthalt2013In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 110, no 36Article in journal (Other academic)
  • 5.
    Forsum, Elisabet
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Flinke Carlsson, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Henriksson, Hanna
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Henriksson, Pontus
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Löf, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Department of Biosciences and Nutrition, Karolinska Institute, Huddinge, Sweden.
    Total body fat content versus BMI in 4-year-old healthy Swedish children.2013In: Journal of Obesity, ISSN 2090-0708, E-ISSN 2090-0716, Vol. 2013, article id 206715Article in journal (Refereed)
    Abstract [en]

    Childhood overweight and obesity, a worldwide problem, is generally identified using BMI (body mass index). However, this application of BMI has been little investigated in children below 5 years of age due to a lack of appropriate methods to assess body composition. Therefore, we used air displacement plethysmography (ADP) to study 4.4-year old boys and girls since this method is accurate in young children if they accept the requirements of the measurement. The purpose was to analyze the relationship between BMI and body fat in these children. Body composition was assessed in 76 (43 boys, 33 girls) of the 84 children brought to the measurement session. Boys and girls contained 25.2 ± 4.7 and 26.8 ± 4.0% body fat, respectively. BMI-based cut-offs for overweight could not effectively identify children with a high body fat content. There was a significant (P < 0.001) but weak (r = 0.39) correlation between BMI and body fat (%). In conclusion, requirements associated with a successful assessment of body composition by means of ADP were accepted by most 4-year-olds. Furthermore, BMI-based cut-offs for overweight did not effectively identify children with a high body fatness and BMI explained only a small proportion of the variation in body fat (%) in this age group.

  • 6.
    Forsum, Elisabet
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Löf, Marie
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences. Karolinska Institutet, Stockholm, Sweden .
    Henriksson, Hanna
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Evaluations of Actiheart, IDEEA and RT3 monitors for estimating activity energy expenditure in  free-living women2013In: Journal of Nutritional Science, ISSN 2048-6790, E-ISSN 2048-6790, Vol. 2, no e31Article in journal (Refereed)
    Abstract [en]

    Activity energy expenditure (AEE) during free-living conditions can be assessed using devices based on different principles. To make proper comparisons of different devices' capacities to assess AEE, they should be evaluated in the same population. Thus, in the present study we evaluated, in the same group of subjects, the ability of three devices to assess AEE in groups and individuals during free-living conditions. In twenty women, AEE was assessed using RT3 (three-axial accelerometry) (AEERT3), Actiheart (a combination of heart rate and accelerometry) (AEEActi) and IDEEA (a multi-accelerometer system) (AEEIDEEA). Reference AEE (AEEref) was assessed using the doubly labelled water method and indirect calorimetry. Average AEEActi was 5760 kJ per 24 h and not significantly different from AEEref (5020 kJ per 24 h). On average, AEERT3 and AEEIDEEA were 2010 and 1750 kJ per 24 h lower than AEEref, respectively (P < 0·001). The limits of agreement (± 2 sd) were 2940 (Actiheart), 1820 (RT3) and 2650 (IDEEA) kJ per 24 h. The variance for AEERT3 was lower than for AEEActi (P = 0·006). The RT3 classified 60 % of the women in the correct activity category while the corresponding value for IDEEA and Actiheart was 30 %. In conclusion, the Actiheart may be useful for groups and the RT3 for individuals while the IDEEA requires further development. The results are likely to be relevant for a large proportion of Western women of reproductive age and demonstrate that the procedure selected to assess physical activity can greatly influence the possibilities to uncover important aspects regarding interactions between physical activity, diet and health.

  • 7.
    Henriksson, Hanna
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Development of body composition and its relationship with physical activity in healthy Swedish children: A longitudinal study until 4.5 years of age including evaluation of methods to assess physical activity and energy intake2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Childhood obesity according to the World Health Organization is one of the most serious public health challenges of the 21st century. The proportion of childhood obesity is high both globally and in Sweden. This is of great concern since obese children tend to stay obese in adulthood. In order to develop strategies to prevent early childhood obesity more knowledge is needed regarding factors explaining why children become overweight and obese. Preventive strategies require accurate and easy-to-use methods to assess physical activity in response to energy expenditure as well as energy intake in young children, but such methods are largely lacking or have shown limited accuracy. The aims of this thesis were: 1) to describe the longitudinal development of body composition from 1 week to 4.5 years of age; 2) to study relationships between measures of body composition and the physical activity level (PAL) at 1.5 and 3 years of age; 3) to evaluate if heart rate recording and movement registration using Actiheart can capture variations in total energy expenditure (TEE) and activity energy expenditure (AEE) at 1.5 and 3 years; 4) to evaluate the potential of a 7-day activity diary to assess PAL at 1.5 and 3 years of age; 5) to evaluate a new tool (TECH) using mobile phones for assessing energy intake at 3 years of age.

    Healthy children were investigated at 1 and 12 weeks (n=44), at 1.5 (n=44), 3 (n=33) and 4.5 (n=26) years of age. Body composition was measured using air-displacement plethysmography at 1 and 12 weeks and at 4.5 years of age. At 1.5 and 3 years, body composition, TEE, PAL and AEE were assessed using the doubly labelled water method and indirect calorimetry. Heart rate and movements were recorded using Actiheart (four days) and physical activities were registered using the 7-day diary. Energy intake was assessed using TECH during one complete 24-hour period.

    Average percentage of total body fat (TBF) and average fat mass index (FMI) were higher (+3 to +81 %), while fat-free mass index (FFMI) was slightly lower (-2 to -9 %), in children in the study from 12 weeks until 4.5 years of age when compared to corresponding reference values. A relationship between TBF% and PAL was found both at 1.5 and 3 years of age. At 3 years, but not at 1.5 years, this could be explained by a relationship between PAL and FFMI. Actiheart recordings explained a significant but small fraction (8%) of the variation in free-living TEE at 1.5 and 3 years, and in AEE (6 %) at 3 years, above that explained by body composition variables. At 1.5 and 3 years of age, PAL estimated by means of the activity diary using metabolic equivalent (MET) values by Ainsworth et al. was not significantly different from reference PAL, but the accuracy for individuals was low. Average energy intake assessed by TECH was not significantly different from TEE. However, the accuracy for individuals was poor.

    The results of this thesis suggest that 1) The higher body fatness of the children in the study compared to the corresponding reference values may indicate the presence of a secular trend in body composition development characterized by a high body fatness. 2) Body fatness might counteract physical activity at 1.5 years of age when the capacity to perform physical activity is limited, but not at 3 years of age when such a capacity has been developed. 3) Actiheart recordings explained a significant but small fraction of the variation in TEE at 1.5 and 3 years, and in AEE at 3 years of age, above that explained by body composition variables. 4) The activity diary and TECH produced mean values in agreement with reference PAL and TEE, respectively, but the accuracy for individual children was low.

    In conclusion, the results of this thesis suggest the presence of a secular trend in body composition development in healthy Swedish children, from infancy up to 4.5 years of age, which is characterized by a high body fatness. Methods to assess physical activity and energy intake at 1.5 and 3 years of age provided some promising results on a group level, although further research is needed to increase the accuracy of these methods in individual children.

    List of papers
    1. Body-composition development during early childhood and energy expenditure in response to physical activity in 1.5-y-old children
    Open this publication in new window or tab >>Body-composition development during early childhood and energy expenditure in response to physical activity in 1.5-y-old children
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    2012 (English)In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 96, no 3, p. 567-573Article in journal (Refereed) Published
    Abstract [en]

    Background: The prevalence of childhood overweight and obesity has increased recently, but the mechanisms involved are incompletely known. Previous research has shown a correlation between the percentage of total body fat (TBF) and physical activity level (PAL). However, the PAL values used may involve a risk of spurious correlations because they are often based on predicted rather than measured estimates of resting energy metabolism. less thanbrgreater than less thanbrgreater thanObjectives: We studied the development of body composition during early childhood and the relation between the percentage of TBF and PAL on the basis of the measured resting energy metabolism. less thanbrgreater than less thanbrgreater thanDesign: Body composition was previously measured in 108 children when they were 1 and 12 wk old. When 44 of these children (21 girls and 23 boys) were 1.5 y old, their total energy expenditure and TBF were assessed by using the doubly labeled water method. Resting energy metabolism, which was assessed by using indirect calorimetry, was used to calculate PAL. less thanbrgreater than less thanbrgreater thanResults: Significant correlations were shown for TBF (r = 0.32, P = 0.035) and fat-free mass (r = 0.34, P = 0.025) between values (kg) assessed at 12 wk and 1.5 y of age. For TBF (kg) a significant interaction (P = 0.035) indicated a possible sex difference. PAL at 1.5 y was negatively correlated with the percentage of TBF (r = -0.40, P = 0.0076) and the increase in the percentage of TBF between 12 wk and 1.5 y (r = 0.38, P = 0.0105). less thanbrgreater than less thanbrgreater thanConclusions: The results indicate that body fatness and physical activity interact during early childhood and thereby influence obesity risk. Our results are based on a small sample, but nevertheless, they motivate additional studies in boys compared with girls regarding the development of body composition during early life.

    Place, publisher, year, edition, pages
    American Society for Nutrition, 2012
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-84341 (URN)10.3945/ajcn.111.022020 (DOI)000307863800016 ()
    Note

    Funding Agencies|Swedish Research Council|15402|AFA Insurance||Medical Faculty, Linkoping University||County Council of Ostergotland||Crown Princess Lovisa Foundation||

    Available from: 2012-10-05 Created: 2012-10-05 Last updated: 2019-06-28
    2. 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
    3. Evaluation of Actiheart and a 7d activity diary for estimating free-living total and activity energy expenditure using criterion methods in 1 center dot 5- and 3-year-old children
    Open this publication in new window or tab >>Evaluation of Actiheart and a 7d activity diary for estimating free-living total and activity energy expenditure using criterion methods in 1 center dot 5- and 3-year-old children
    2014 (English)In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 111, no 10, p. 1830-1840Article in journal (Refereed) Published
    Abstract [en]

    Accurate and easy-to-use methods to assess free-living energy expenditure in response to physical activity in young children are scarce. In the present study, we evaluated the capacity of (1) 4d recordings obtained using the Actiheart (mean heart rate (mHR) and mean activity counts (mAC)) to provide assessments of total energy expenditure (TEE) and activity energy expenditure (AEE) and (2) a 7d activity diary to provide assessments of physical activity levels (PAL) using three sets of metabolic equivalent (MET) values (PAL(Torun), PAL(Adolph) and PAL(Ainsworth)) in forty-four and thirty-one healthy Swedish children aged 1 center dot 5 and 3 years, respectively. Reference TEE, PAL(ref) and AEE were measured using criterion methods, i.e. the doubly labelled water method and indirect calorimetry. At 1 center dot 5 years of age, mHR explained 8% (P=0 center dot 006) of the variation in TEE above that explained by fat mass and fat-free mass. At 3 years of age, mHR and mAC explained 8 (P=0 center dot 004) and 6 (P=0 center dot 03)% of the variation in TEE and AEE, respectively, above that explained by fat mass and fat-free mass. At 1 center dot 5 and 3 years of age, average PAL(Ainsworth) values were 1 center dot 44 and 1 center dot 59, respectively, and not significantly different from PAL(ref) values (1 center dot 39 and 1 center dot 61, respectively). By contrast, average PAL(Torun) (1 center dot 5 and 3 years) and PAL(Adolph) (3 years) values were lower (Pless than0 center dot 05) than the corresponding PAL(ref) values. In conclusion, at both ages, Actiheart recordings explained a small but significant fraction of free-living energy expenditure above that explained by body composition variables, and our activity diary produced mean PAL values in agreement with reference values when using MET values published by Ainsworth.

    Place, publisher, year, edition, pages
    Cambridge University Press (CUP), 2014
    Keywords
    Heart rate recording; Activity diary; Doubly labelled water; Accelerometer
    National Category
    Clinical Medicine
    Identifiers
    urn:nbn:se:liu:diva-106669 (URN)10.1017/S0007114513004406 (DOI)000334172400012 ()
    Available from: 2014-05-21 Created: 2014-05-19 Last updated: 2019-06-28
    4. A New Mobile Phone-Based Tool for Assessing Energy and Certain Food Intakes in Young Children: A Validation Study
    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
  • 8.
    Henriksson, Hanna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Bonn, E. Stephanie
    Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden.
    Bergström, Anna
    Karolinska Institutet, Institute of Enviromental Medicine, Stockholm, Sweden.
    Bälter, Katarina
    Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden.
    Bälter, Olle
    Royal Institute of Technology, School of Computer Science and Communication, Stockholm, Sweden.
    Delisle, Christine
    Karolinska Institutet, Department of Biosciences and Nutrition, Huddinge, Sweden.
    Forsum, Elisabet
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Löf, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Karolinska Institutet, Department of Biosciences and Nutrition, Huddinge, Sweden.
    A New Mobile Phone-Based Tool for Assessing Energy and Certain Food Intakes in Young Children: A Validation Study2015In: JMIR mhealth and uhealth, E-ISSN 2291-5222, Vol. 3, no 2, article id e38Article in journal (Refereed)
    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.

  • 9.
    Henriksson, Hanna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.
    Eriksson, Britt
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Forsum, Elisabet
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Flinke Carlsson, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Löf, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Development of body composition and its relationship with physical activity: A longitudinal study of Swedish children until 4·5 years of age2015Manuscript (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.

  • 10.
    Henriksson, Hanna
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. PROmoting FITness and Health through physical activity research group (PROFITH), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.
    Henriksson, Pontus
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Department of Biosciences and Nutrition, Karolinska Institutet, NOVUM, Huddinge, Sweden.
    Tynelius, Per
    Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden.
    Ortega, Francisco B
    PROmoting FITness and Health through physical activity research group (PROFITH), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain; Department of Biosciences and Nutrition, Karolinska Institutet, NOVUM, Huddinge, Sweden.
    Muscular weakness in adolescence is associated with disability 30 years later: a population-based cohort study of 1.2 million men2018In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, p. 1-11Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate the associations of muscular strength in adolescence with later disability pension (DP), across different body mass index (BMI) categories and in combination with aerobic fitness.

    METHOD: This prospective cohort study consisted of males aged 16-19 years, recruited from the Swedish military conscription register between 1969 and 1994. A total of 1 212 503 adolescents met all the inclusion criteria and were therefore included in the analyses. Knee extension, handgrip and elbow flexion strength and aerobic fitness (bicycle ergometer test) were measured during conscription. Causes of DP were retrieved from the Social Insurance Office between years 1971 and 2012 (average follow-up time: 29.6 years).

    RESULTS: Knee extension strength in adolescence was inversely associated with men's risk of obtaining DP due to all causes (HR 1.40, 95% CI 1.36 to 1.44 for lowest vs highest strength quintile). Thus, muscular weakness was associated with DP. The risk associated with low muscular strength differed between specific causes of DP and the strongest associations were found for psychiatric, nervous system and other causes (HRs between 1.47 and 1.90 for lowest vs highest quintile). Being strong was associated with lower DP risk across BMI categories and being unfit, weak and obese was associated with the highest DP risk (HR 3.70, 95% CI 2.99 to 4.58).

    CONCLUSION: There was a strong association between muscular weakness and disability. A combination of muscular weakness and low aerobic fitness was an especially important risk factor for disability. This adds weight to call for muscular strength and fitness enhancing exercise for adolescents in all BMI categories.

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