Includes bibliographical references / Aim: The aim of this study was to determine the adequacy of the dietary intake of pregnant women attending Bishop Lavis MOU, in the Tygerberg area of Cape Town. Methods: One hundred and fifty-two women between 12 and 20 weeks' gestational age participating in the Main PASS study were recruited. They completed three interviewer-administered 24-hour dietary recall assessments on three different days, each approximately two weeks apart. Dietary reference values for adequate nutritional intake during pregnancy and the South African food based dietary guidelines and NARs and MAR were used to assess the nutritional adequacy. Anthropometric and socio-demographic information was also collected. Results: The results indicate that just over a quarter of the sample were classified as teenage pregnancies. The majority had between grades eight and ten, and had a monthly household income between R500 and R5000. With a mean energy intake of 10 168.4kJ, majority (79.5%) of the study sample did not meet the energy DRI. Close to half (42.8 %) of the study sample did not meet the DRI for protein intake. All participants met the carbohydrate EAR, and many exceeded the recommended fat intake. The intake of sugar and saturated fats exceeded recommendations with sugar contributing to almost half of the total energy from carbohydrates. The intakes of vitamin A, D and E, pantothenate, biotin, folate, calcium, iron, magnesium, potassium, and manganese fell below the recommendations. Sugar was the most commonly consumed food item, followed by potato, chicken, milk, and white bread. Apples were the most commonly consumed fruit. When compared to the FBDG, the study sample consumed double the recommended portions of starch, half the recommended daily fruit and vegetables, and half the recommended legumes. Conclusion: The high intake of refined carbohydrates, especially sugar, and the high intake of foods high in saturated fats needs to be addressed. Micronutrient intake is generally poor, especially with nutrients that are vital to proper growth and development of the foetus. Education on appropriate dietary changes, as well as suggestions to make implementation of such changes affordable would be invaluable, and may contribute towards decreasing the incidence of adverse pregnancy outcomes.

Sammanfattning Bakgrund I vårt dagliga arbete på våra skolor har vi sett att elever många gånger är orkeslösa. Vi människor behöver mat för att överleva och behålla en god hälsa, men maten har också en rad sociala,psykologiska och känslomässiga betydelser. Mellanmål är viktiga för barn och unga då de kommer att hjälpa till att bidra med en stor del av dagens totala närings- och energiintag. Det är därför av störstavikt att mellanmål alltid är näringsrika. Energin hos barn och unga behöver fördelas på flera måltideroch en bra måltidsordning för barn och unga är vanligtvis frukost, mellanmål, lunch, mellanmål,middag och många gånger ett till mellanmål. Syfte Syftet med studien var att förstå ungdomars perspektiv på mellanmål samt faktorer sompåverkat detta. Metod Kvalitativa semistrukturerade individuella intervjuer genomfördes med 8 olika elever på tvåskolor i Mellansverige. Intervjuerna spelades in och analyserades med kvalitativ innehållsanalys. Resultat Eleverna ansåg att mellanmålet var viktigt för energipåfyllning, prestation och framförallt förträning. Vi såg även att elever som hade fysiska aktiviteter på fritiden la mer vikt vid mellanmåletsuppbyggnad och innehåll än de som inte hade några aktiviteter. De flesta elever åt inte mellanmål iskolan utan oftast intogs mellanmål efter träning eller på fritiden. Det framkom även att vuxnapåverkade mellanmålsvanorna hos eleverna genom att uppmuntra eller inte uppmuntra dem till att konsumera mellanmål. Tidsbrist verkar också vara en påverkande faktor när det kommer till valet avmellanmål då många av eleverna föredrog mellanmål som var snabba och enkla. En del av eleverna föredrog mer näringsrika mellanmål före träning, medan andra valde mellanmål baserat påtillgänglighet och smak. En del av eleverna ansåg att mellanmål var viktigt för att orka fokusera helaskoldagen och för att undvika trötthet och hunger. Slutsats Ungdomar vet att de behöver fylla på med mat och således också äta mellanmål för att bibehålla energinivåerna under en dag, men det visade sig vara tydligt att det var långt ifrån alla som gjorde det. Fysiskt aktiva ungdomar åt ofta för att få energi innan och även fylla på med energi eftersina träningspass, andra åt för att få energi för att kunna prestera och orka mer i skolan och en del ungdomar åt som ett tidsfördriv och/eller för att stilla ett sug. Vi kunde också tydligt se att uppmuntran var avgörande för mellanmålets vara eller icke vara. Slutsatsen vi drar är att fysisk aktivitet, uppmuntran och ännu mer utbildning, kommer vara tre viktiga nycklar i arbetet för att få ungdomar att äta mer näringsriktiga mellanmål

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In recent decades the number of children with overweight has increased worldwide. To understand the mechanisms behind this development, knowledge regarding metabolism and physiology in relation to the nutritional situation in early life is of importance. In particular, information about body composition development during early childhood is relevant. This thesis presents three studies in this area. In the pregnancy study serum samples, collected from 23 women before, during and after pregnancy, were analysed for serum levels of leptin, adiponectin and resistin and used to assess insulin resistance (HOMA-IR) in relation to the total body fat (TBF) content of the women. TBF (%) and leptin were significantly correlated with HOMA-IR before and during pregnancy. When HOMA-IR was regressed on TBF (%) the slope of the regression line was 0.111 in gestational week 32 and significantly (p<0.05) higher than the value before pregnancy, 0.046, indicating that healthy pregnancy enhances the relationship between body fatness and insulin resistance. In the HF-study hydration of fat-free mass (hydration factor, HF) was assessed in 12 newborns using the doubly labelled water (DLW) method and air displacement plethysmography (PeaPod). HF was 80.9% with a low biological variability (0.81% of average HF). In the longitudinal study the body density of 108 healthy fullterm infants (53 girls, 55 boys) was measured at one and 12 weeks of age using PeaPod. Body composition was calculated using two models (Fomon’s and Butte’s). BMI values for the mothers of the infants were assessed before pregnancy. Body composition and total energy expenditure using the DLW-method were assessed in 20 of these children at the age of 1.5 years, when their sleeping metabolic rate was measured using indirect calorimetry and their resting energy metabolism was calculated using prediction equations. Butte´s model gave significantly (p<0.05) lower values for TBF than Fomon´s model, and invalid results for five newborns. Using Fomon´s model, at one week of age girls contained 13.4 ± 3.7 % and boys contained 12.5 ± 4.0 % TBF. The corresponding figures at 12 weeks were 26.3 ± 4.2 % and 26.4 ± 5.1 %. The mothers’ BMI values before pregnancy were correlated with the body weight but not with the TBF (g,%) or fat-free mass (g) of their infants at one week of age. At 1.5 years of age girls (n=9) contained 28.0±2.8 % and boys (n=11) 28.3±3.7 % TBF. Between one and 12 weeks of age all infants increased their TBF content, while 13 children increased and seven children decreased their TBF content between the ages of 12 weeks and 1.5 years. The results demonstrated that predicting rather than measuring resting energy metabolism involves a risk for spurious correlations between TBF and physical activity level. The level of physical activity (x), was negatively correlated with [TBF (%) at 1.5 years minus TBF (%) at 12 weeks] (y), r=-0.52, p=0.02. In conclusion, the results suggest that the body fat content of a woman has a stimulating effect on the growth, rather than on the fat retention, of her foetus. They also show that the Fomon model is the best available model when calculating the body composition of infants from body density. Finally, the results indicate that physical activity at the age of 1.5 years is important regarding the rate at which the high level of body fat, typical of infancy, decreases in early childhood. / Övervikt och fetma bland barn har under senare år blivit allt vanligare i många delar av världen. Studier av nutrition, metabolism och fysiologi under graviditet och de tidiga barnaåren är av vikt för att förstå vilka faktorer som ligger bakom denna utveckling. Speciellt viktigt är att studera hur kroppssammansättningen förändras tidigt i livet. Den här avhandlingen innehåller tre studier som berör detta ämnesområde. I en studie på gravida analyserades serumprover, insamlade från 23 kvinnor innan, under och efter deras graviditet, med avseende på halter av leptin, adiponektin och resistin. Via serumproverna fastställdes också kvinnornas insulinresistens (HOMA-IR). Dessa resultat relaterades sedan till mängden kroppsfett hos dessa kvinnor. Mängden kroppsfett (%) och leptin visade, före och under graviditet, en signifikant korrelation med HOMA-IR. En regressionsanalys av HOMA-IR (y) och % kroppsfett (x) i graviditetsvecka 32 gav ett k-värde (lutning) på 0,111, vilket i jämförelse med motsvarande k-värde före graviditet 0,046 var signifikant högre (p<0.05). Detta resultat visar att hos friska kvinnor potentierar graviditeten sambandet mellan kroppsfett och insulinresistens. I en studie av hydreringsgrad i fettfri kroppsvikt (HF) fastställdes HF i 12 nyfödda med hjälp av dubbelmärkt vatten och helkroppsplethysmografi (PeaPod). HF uppmättes till 80,9% med en låg biologisk variation (0,81 % av genomsnittlig HF). I en longitudinell studie mättes kroppsdensiteten med PeaPod hos 108 friska fullgångna spädbarn (53 flickor, 55 pojkar) när de var en respektive tolv veckor gamla. Deras kroppssammansättning beräknades med två olika modeller (Fomons och Buttes). Uppgift om mödrarnas pregravida BMI samlades in. Vid 1,5 års ålder mättes kroppssammansättning och total energiomsättning hos 20 av de 108 barnen. Vid detta tillfälle mättes även viloomsättningen med indirekt kalorimetri under sömn. Viloomsättningen predikterades även med en formel. Buttes modell gav signifikant (p<0.05) lägre nivå av kroppsfett (%) jämfört med Fomons modell och i fem fall erhölls inga resultat alls. Beräkningar med Fomons modell visade att vid en veckas ålder innehöll flickorna 13.4 ± 3.7 % och pojkarna 12.5 ± 4.0 % kroppsfett. Motsvarande värden vid 12 veckors ålder var 26.3 ± 4.2 % och 26.4 ± 5.1 %. Mödrarnas BMI innan graviditet korrelerade med kroppsvikt men inte med kroppsfett (g,%) eller fettfri vikt (g) hos deras barn vid en veckas ålder. Vid 1,5 års ålder innehöll flickorna (n=9) 28.0±2.8 % och pojkarna (n=11) 28.3±3.7 % kroppsfett. Mellan en och 12 veckors ålder ökade alla barnen sin kroppsfetthalt. Mellan 12 veckor och 1,5 år ökade kroppsfetthalten hos 13 barn medan den minskade hos 7. Resultat visar att predikterad viloomsättning ökar risken för att få en falsk korrelation mellan kroppsfetthalt och fysisk aktivitetsnivå jämfört med om man använder uppmätt viloomsättning. Den fysiska aktivitetsnivån vid 1,5 års ålder (x), var negativt korrelerad till förändring i kroppsfetthalt [kroppsfett (%) vid 1.5 år minus kroppsfett (%) vid 12 veckor] (y), r=-0.52, p=0.02. Sammanfattningsvis tyder resultaten på att kvinnors kroppsfetthalt har en stimulerande effekt på fostrets på totala tillväxt men inte på dess retention av kroppsfett. Dessutom visar resultaten att Fomons modell är den bästa tillgängliga när det gäller att beräkna kroppssammansättningen hos spädbarn från kroppsdensitet. Slutligen tyder resultaten på att den fysiska aktivitetsnivån vid 1,5 års ålder har betydelse för hur fort den höga kroppsfetthalten, som är typisk för spädbarnsperioden, sjunker under tidig barndom.

Epidemiological data suggest that populations with higher serum/ tissue levels of carotenoids have a lower risk of coronary heart disease (CHD), possibly due to the antioxidant capacity. Lycopene, a carotenoid mainly found in tomatoes, has been suggested to have the greatest antioxidant capacity of the carotenoids found in fruits and vegetables. Carotenoids are fat-soluble compounds and their absorption from the diet into the body may depend on the amount of dietary fat ingested. For years there has been debate about what energy source should replace the saturated fat in the diet, to give the optimum serum lipid profile to reduce CHD risk. Studies have compared monounsaturated fat rich diets with high carbohydrate, low fat diets and have found that both diets decrease serum cholesterol and low-density lipoprotein (LDL) cholesterol levels. Results for high-density lipoprotein (HDL) cholesterol and triglycerides have been inconsistent. However, it is of interest to study the effects of different diets on lipid oxidation, as this may also influence CHD risk. Studies have investigated the effect of different amounts of total fat on the serum levels of carotenoids especially beta-carotene and lutein, but to our knowledge no study has looked at the effect of different amounts of fats on the serum lycopene levels, and whether this could subsequently affect the oxidation of LDL in vitro. XIV Two separate randomised crossover dietary intervention studies were conducted; one in healthy men and the other in healthy women aged 20 to 70 years. The aim was to compare the effects of monounsaturated fat rich (MUFA) diet (38% of energy from fat) and high carbohydrate low fat (HCLF) diet (15% energy from fat) with controlled lycopene content, on serum lycopene levels. Main sources of lycopene in the diets were canned tomatoes and tomato soup for the study in women (lycopene content -15.9 mg/day) and tomato paste and tomato soup for the study in men (lycopene content - 20.2 mg/day). Serum lipids and lipoproteins levels and in vitro oxidation of LDL particles were also measured. Compared to the baseline levels there was a significant increase in the serum trans lycopene and total lycopene levels after MUFA diet for the study in women. Comparing the levels at the end of the two diets no difference was observed. In the study in men serum trans, cis and total lycopene levels increased after the MUFA and HCLF diet periods. There was no significant difference in trans; cis and total lycopene levels at the end of two diets. Thus, high levels of monounsaturated fat in the diet do not appear to increase lycopene absorption and serum levels compared to very low fat diet. There was however a better serum lipid profile after MUFA diet compared to HCLF diet. Lag phase for the in vitro oxidation of LDL particles was also longer on the MUFA diet. The lack of difference in antioxidant levels would indicate that this was due to the different fatty acid component of the diet.

ABSTRACT   Background Irritable bowel syndrome is the most common functional gastrointestinal disease affecting an average of 5-10% of the population. IBS cannot be cured, but proper treatment can alleviate the symptoms. FODMAP diet has proven to be the most effective treatment, which means reducing the intake of foods that the intestine has difficulty to digest. Objective The study aims at investigating IBS patients' experiences of following FODMAP dietary treatment. Method Six individual qualitative interviews were conducted with patients at a clinic in a suburb north of Stockholm. The purpose of the interviews was to get a person's view of their experiences with FODMAP dietary treatment. The interviews were recorded electronically and then verbally transcribed. The transcripts were then analyzed according to Granheim and Lundman's content analysis. Results Individuals who suffer from IBS have various kinds of constraints, their symptoms hindered their everyday lives and their social life, which affected relationships with relatives negatively. Those who did not get enough support from their close relatives experienced loneliness and found the FODMAP treatment more difficult to follow. FODMAP treatment required drastic dietary changes and symptoms were obtained when wrong food was consumed and it made that treatment felted difficult sometimes. Planning and purchasing were experienced as time consuming and complicated. The participants mentioned that they felt a sense of uncertainty for trying new foods, which meant that the diet often became monotonous.Conclusion It was clear that this patient group is in need of support from several different directions. With frequent healthcare contact, patients would gain increased knowledge about their illness. This would contribute to reduced risk of recurrent symptoms and the compliance of treatment would be increased. More support would help patients find tools to simplify their everyday lives. Healthcare professionals could also be able to provide adequate education for relatives, which would increase understanding of the disease and its treatment.

Investigate how a loss of appetite in the elderly population can be prevented och cocounteracted, based on factors that cause reduced appetite in elderly. Litterature study and a minor review of Hudiksvalls municipalities activities regarding diet for the elderly. Interview with the nutritionist in charge. Physiological changes in combination with patological causes, cause a decrease in appetite. Adaptions according to the elderly persons prerequsitites are required to stimulate appetite and reduce the risk of weight loss.

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Bakgrund: Menstruell hälsa är en viktig del för flickor, kvinnors och livmoderbärares livskvalitet och något som bör vara en del i arbetet för jämställdhet. Livsmedelsval och kostinterventioner har visat sig ha påverkan på menscykelns uttryck och individers upplevelse av premenstruella symtom.  Syfte: Syftet med denna studie är att undersöka om det finns associationer mellan olika typer av livsmedelsval samt andra livsstilsfaktorer och graden av upplevda premenstruella symtom. Metod: Kvantitativ webenkät. Enkätsvar insamlades från menstruerande personer mellan 15–40 år genom rekrytering via inlägg i Facebookgrupper och planscher på Umeå universitetscampus under den 13–21 september 2023. Sammanlagt analyserades 105 enkätsvar. Grad av symtom för symtomgrupper och dysmenorré analyserades mot intagsgrupper av livsmedel (”inget”, ”lågt” och ”högt”) för att undersöka om skillnader fanns. De statistiska metoder som användes var Kruskal-Wallis test och Wilcoxon rangsummetest för att se mellan vilka grupper skillnad fanns. Resultat: Grupper med högt intag av ”Energidricka”, ”Vego-mejerier”, ”Vego-kött”, ”Söta snacks”, ”Kaffe” och ”Mejerier” hade högre grad av symtom i en eller flera av symtomgrupperna. Individer med högre intag av ”Fet fisk” och ”Vitt kött” hade lägre grad av dysmenorré. Slutsats: Resultatet av denna studie indikerar att livsmedelsval och människors upplevelser av deras menscykler och symtom berörs av varandra. Dock kan inte dessa resultat tolkas som att vissa livsmedelsval orsakar högre eller lägre symtomgrad. Resultaten från denna studie är i linje med vissa tidigare studier samt ger ytterligare bekräftelse att fler observationsstudier och interventionsstudier behövs för att komma fram till potentialen som livsmedelsval och kosthållning kan ha på flickor, kvinnor och livmoderbärares upplevda symtom vilket i sin tur kan påverka deras livskvalitet. Hur och i vilken utsträckning kostförändringar skulle kunna användas som behandlingsalternativ för premenstruella symtom är till stor del outforskat och en möjlighet för dietister att utöka sitt arbetsområde. / Background: Menstrual health is a crucial aspect of the quality of life for girls, women and individuals with a uterus and should be a part of the work for gender equality. Food choices and dietary interventions have been shown to influence the expression of the menstrual cycle and individuals’ experience of premenstrual symptoms. Objective: The aim of this study is to investigate potential associations between different types of food choices and other lifestyle factors with the degree of perceived premenstrual symptoms. Method: A quantitative online survey was conducted. Survey responses were collected from menstruating individuals aged 15 to 40 years through recruitment via posts in Facebook groups and posters placed on the Umeå University campus between September 13 and September 21, 2023. In total, 105 survey responses were analyzed. The severity of symptoms in different symptom groups and dysmenorrhea were analyzed in relation to categories of food intake (“none”, “low”, and “high”) to explore differences and potential correlations. The analytical techniques utilized included the Kruskal-Wallis test and the Wilcoxon rank-sum test. Results: Higher consumption of “Energy drinks”, “Plant-based dairy”, “Plant-based meat”, “Sweet snacks”, “Coffee”, and “Dairy” was associated with a higher degree of symptoms in one or more symptom groups. Individuals with higher consumption of “Fatty fish” and “White meat” experienced a lower degree of dysmenorrhea.Conclusion: The results of this study suggest a strong interconnection between food choicesand individuals’ experiences of their menstrual cycles and symptoms. However, it is important to emphasize that these findings do not imply causation between food choices and symptom severity. This study’s findings are consistent with some prior research and provide additional support for the necessity of further observational and intervention studies to uncover the potential impact of food choices and nutrition on the perceived symptoms of girls, women, and individuals with a uterus, which in turn can influence their overall quality of life. How and to what extent to which dietary modifications could be employed as a treatment option for premenstrual symptoms remains largely unexplored, presenting an opportunity for dietitians to expand their professional scope of practice.