Bakgrund Prevalensen hos barn med diabetes typ I och den samtidiga förekomsten av celiaki varierar i studier mellan 2,4-16,4 %. Celiaki och diabetes typ I kräver båda en noggrant kontrollerad kost. Det tycks finnas få studier som undersöker hur kombinationen av de två olika kosterna fungerar i praktiken. Syfte Att utforska hur föräldrar till barn med dubbeldiagnosen celiaki-diabetes upplever att kosten fungerar. Metod En kvalitativ metod användes i form av skrivna berättelser, insamlade via ett webbaserat formulär. Informanterna var 26 föräldrar till barn i åldrarna 3- 16 år med dubbeldiagnosen celiaki-diabetes. Berättelserna analyserades med kvalitativ innehållsanalys. Resultat Informanterna upplevde att det var svårare att få maten att fungera då de hade båda sjukdomarna att ta hänsyn till och att dubbeldiagnosen krävde ständig planering av måltider. Föräldrarna upplevde bristande kunskap i omgivningen, exempelvis hos personal inom skola och restaurang. Det fanns små möjligheter att spara tid och pengar och matutbudet var ofta begränsat, särskilt vad gäller produkter med lågt glykemiskt index. Upplevelser av att vara till besvär och ett bristande bemötande från omgivningen kunde förstärka känslan av att inte vara som alla andra. Slutsats Svårigheterna att lita på omgivningens kunskaper kring de två kostbehandlingarna försvårade följsamheten till kosten och begränsade barnens sociala liv. Upplevelserna av bristande bemötande och förståelse i omgivningen kunde förstärka känslan av att inte vara som alla andra och att vara till besvär. Därför finns ett behov av utbildning riktad till skol- och restaurangpersonal för ökad kunskap och förståelse. Mer material rörande matlagning anpassat till dubbeldiagnosen skulle också underlätta, både för barnens familjer och omgivningen. Den ständiga planeringen begränsade vardagen och föräldrarollen påverkades till att bli mer kontrollerande vilket skulle kunna försvåra för föräldrarna i att lotsa barnet till mer självständighet. Utbudet av glutenfria specialprodukter med lågt glykemiskt index var begränsat, framförallt vad gäller bröd. Därmed finns ett behov av en vidare produktutveckling. / Background The prevalence of both coeliac disease and diabetes type I in the pediatric population varies between 2.4-16.4 %. Both diseases demand a strictly controlled diet A limited number of studies are investigating the practical implementation of the two diets. Objective To investigate parent’s experiences of the diet, when having a child with both coeliac disease and diabetes type I. Method A qualitative method was used in form of narratives, collected through a web based form. The informants consisted of 26 parents, having a child of age 3-16 years, diagnosed with both coeliac disease and diabetes type I. Qualitative content analysis was used to analyze the narratives. Result Difficulties were experienced by the informants considering the practical implementation of the two diets. The double diagnosis demanded frequent planning. Lack of knowledge in the surroundings was experienced, for example in staff at school and restaurants. The possibilities of saving time and money were limited and there were limitations also in the food supply, especially gluten-free products with low glycemic index. Due to experience of inconvenience and negative treatment from their surroundings, the feelings of being different were enhanced. Conclusion Difficulties in trusting others knowledge regarding the diet lead to compliance issues and put restraint to the children’s social life. Perceptions of lack of treatment and understanding in the surroundings could enhance the feeling of not being like everyone else and being a nuisance. A need for education aimed at staff in schools and restaurants exists to increase knowledge and understanding. More materials regarding cooking with the double-diagnosis are desirable. Constant planning lead to limitations in the daily life and the parenting role became more controlling, which could create difficulties when guiding the child into independence. Also the supply of gluten-free products with low glycemic index is limited and need further development.

Syfte: Undersöka möjliga metoder till att finna matglädje vid ätstörningar samt undersöka hur användbara dessa metoder kan vara för människor med ätstörningar både i och utanför behandling. Bakgrund: Ätstörningar är ett växande folkhälsoproblem och ett område där det krävs mer uppmärksamhet och forskning för att öka förståelsen och kunskapen av ätstörningar, samt även för att kunna öka förebyggandet och behandling av dessa sjukdomar. Denna uppsats inriktar sig på ätstörningar och matglädje. Det är oerhört viktigt att hitta glädjen för mat när man har en ätstörning för att kunna nå ett friskare liv och ett friskare tänkesätt kring mat och sin egen kropp. Denna uppsats har undersökt möjliga metoder som kan användas för att hjälpa människor med ätstörningar att finna matglädje. En studie har genomförts på Capio Anorexi Center i Malmö som fokuserade på hur personalen arbetar för att hjälpa patienter att finna glädje för mat under behandling, samt hur de arbetar för att förmedla mat på ett positivt sätt för sina patienter. Metod: Litteraturstudier genomfördes både innan och efter undersökningen på Capio Anorexi Center. Undersökningen bestod av kvalitativa halvstrukturerade intervjuer med två av personalen på Capio Anorexi Center, samt med en dietist och en anonym person som har lidit av ätstörningar och gått i behandling. Tre av intervjuerna genomfördes med ljudinspelning och en intervju genomfördes via mejl. Varje intervju varade i cirka 45 minuter. Intervjuerna sammanställdes genom att först skriva av de inspelade intervjuerna och sedan kategorisades svaren för varje intervju till relevanta områden. Därefter analyserades och jämfördes detta med litteratur som böcker, rapporter, vetenskapliga artiklar samt elektroniska källor som var relaterade till matglädje och ätstörningar. Resultat: Elva metoder har undersökts och presenterats i denna uppsats som kan vara användbara till att finna matglädje både i och utanför behandling för de som behöver stöd: att våga, pedagogiska måltider, att äta regelbundet, varierat och planera måltider, att tillaga och servera aptitliga och lockande måltider, mindfulness och mindfulness eating, måltidsmiljö och måltidens sociala betydelse, nutritionsbehandling, saperemetoden, att äta lugnt och avslappnat, måltidsundervisning via en video- och ljuduppspelning vid måltider samt att stänga ute myter, bantning och skönhetsideal. Slutsats: Elva möjliga metoder som kan vara användbara till att finna matglädje har funnits. Detta genom förstudier med litteratur, en undersökning på Capio Anorexi Center och intervjuer, samt genom en analys och jämförelser mellan intervjuerna och litteratur som relaterade till ätstörningar och matglädje. Dessa metoder kan vara möjliga att använda för att kunna återfå ett friskare tankesätt kring mat och måltider samt för att kunna finna glädje för mat. Att finna matglädjen vid ätstörningar är ett steg mot ett friskare liv, dock för att kunna bli helt frisk från en ätstörning krävs det att dessa metoder kombineras med andra olika terapiformer, då det är viktigt att även arbeta med bland annat självkänsla och självförtroende, samt eventuellt andra svåra problem och symtom. / Background: Eating disorders are a growing public health concern which requires more attention and research to increase the understanding and prevention of eating disorders. This paper focuses on eating disorders and its relation to the joy of food. It is very important to find joy for food when suffering from an eating disorder to achieve a healthier life and healthier thinking around food and the body. This paper has examined possible methods that can be used for treating people with eating disorders to enjoy food. The study was conducted at Capio Anorexia Center in Malmö, a daycare clinic for eating disorders, and the study was focused on how the staff works to help patients find joy for food during treatment, and how they work to express food in a positive way to their patients. Methods: Literature studies were carried out before and after the study at Capio Anorexia Center. Qualitative half structured interviews were also carried out with two of the staff at Capio Anorexia Center, and with a dietitian and an anonymous person who has suffered from an eating disorder and received treatment. Three of the interviews were conducted with sound recording and the other one was conducted via email. Each interview lasted about 45 minutes. The interviews were compiled by first writing of the recorded interviews and then the answers for each interview were categorized to relevant fields. An analysis and comparison of these interviews to various literatures like books, reports, scientific papers and internet sources related to enjoying food and eating disorders were also carried out. Results: Eleven methods were found that may be useful to find joy for food both in treatment and outside of treatment for those who need support: daring, educational meals, eating regularly, varied and plan meals, cook and serve appealing meals, mindfulness and mindfulness eating, eating environment and social importance when eating, nutritional therapy, the “sapere-method”, eating slow and relaxed, the use of vodcast during meals and to keep out myths, dieting and beauty ideals. Conclusions: Eleven possible methods that may be useful to find joy for food have been found. This by preliminary studies with literature, a study at Capio Anorexia Center and interviews, and also by analyzing and comparing the interviews with literature related to eating disorders and enjoying food. The eleven methods described may be useful when regaining joy for food and a healthier thinking when it comes to food and meal situations. An important step in recovering from an eating disorder is to find pleasure when eating; therefore these methods can be possible tools to help people with eating disorders to find the joy for food. However, to reach a healthy life free from an eating disorder these methods described in this paper has to be combined with a variety of other therapies, because it is also important to work with self-esteem, self-confidence, and other symptoms and problems of the eating disorder.

SAMMANFATTNING Bakgrund Forskning inom området mat och hälsa har en lång tradition. Däremot finns lite forskning om den praktiska dagliga verksamheten för dietister. Dietister är nöjda med sitt arbete men det finns ett flertal faktorer som gör dem frustrerade såsom t ex tidsbrist. Dietisters verksamhet bygger på konceptet mat och hälsa. Folkhälsa har diskuterats mycket senaste åren då välfärdsjukdomar är ett växande problem. För att förbättra folkhälsan har Fysisk aktivitet på Recept (FaR®) tagits fram, vilket kan skrivas ut av all legitimerad sjukvårdspersonal, inkluderat dietister. Tidigare studier har undersökt hur implementeringen av FaR® har fungerat. I dessa studier har inga dietister medverkat utan enbart annan vårdpersonal. Resultatet har varit att vårdpersonalen har haft en positiv inställning till FaR® men det prioriteras lågt i ett kort perspektiv pga. tidsbrist och bristande rutiner. Arbetssituationen hos vårdgivare har visat sig vara oacceptabel på många sätt enligt tidigare studier. Syfte Att studera dietisters arbetssituation utifrån idén att införa ett nytt arbetsinstrument (FaR®) i den dagliga dietistverksamheten. Metod Individuella kvalitativa intervjuer genomfördes med en frågeguide för att skapa struktur i intervjuerna. Därutöver var intervjun flexibel. Intervjuerna spelades in och transkriberades. Därefter lades de in i en kvalitativ datamatris för vidare analys. Material Fem dietister inom primärvården från Stockholmsområdet intervjuades. De var mellan 30 och 45 år och hade arbetat mellan 3 och 14 år som dietister. Resultat Intressanta teman såsom dietisters åsikter om hälsa, syn på FaR®, deras arbetssituation samt tvetydiga inställning till arbetet resulterade studien i. Diskussion Dietisterna skulle gärna jobba med helhetsaspekten på hälsa där det både finns rum för kost och fysisk aktivitet. I nuläget krävs dock prioriteringar till fördel för kosten, för att leverera en bra kvalitet på patientbehandlingarna. Vilka faktorer som påverkar arbetstillfredsställelse analyserades i en teorimodell. Vissa starka, positiva faktorer kan väga upp andra negativa, missgynnande faktorer så att tillfredsställelsen av arbetssituationen ändå upplevs bra. Konklusion Denna undersökning har fått agera katalysator för att belysa dietisters arbetssituation. Skulle mer tid och resurser läggas på dietister inom sjukvård och hälsovård skulle möjligtvis FaR® användas i större utsträckning. / ABSTRACT Background Research of food and health has been explored for centuries. However little is known about the practical daily work situation among dietitians. Dietitians are mostly satisfied with their work but they also feel frustrated over the fact that they have time limitations. The dietitians work is a mix of food and health. During the last years the public health has been debated because of the rising problems with metabolic diseases. To enhance the public health, a new kind of prescription has been developed, called Physical activity on Prescription (PaP). All authorized medical personnel, including dietitians, have been given the right to prescribe it. The implementation of PaP has previously been studied. No dietitians were represented in these studies but other medical personnel were. They had a positive attitude to PaP but in a short perspective they have given it a low priority because of lack of time and routines. In many ways the work situation among health care providers is unacceptable, according to previous studies. Objective To study the work situation among dietitians with PaP as an illustrating factor. Methods Individualized qualitative interviews were conducted with the assistance of a question sheet to create a structural interview result. To investigate further, the interview was also flexible. The interview was recorded and then transcribed. The transcribed material was then put into a qualitative data matrix for analysis. Subjects/Settings Five dietitians from the primary care in Stockholm were interviewed. They were 30 to 45 years old and have worked as dietitians for 3 to 14 years. Results The study has resulted in many interesting themes such as dietitians view on health and on PaP, their work situation and their ambiguous feelings towards their work. Discussion The dietitians in this study would like to have more time to work with both nutrition and physical activity but for now they are forced to set their priorities to nutrition to deliver a good quality to their patients. Work satisfaction was analyzed in a theory model to determine which factors were the most important. Strong and positive factors showed to compensate for the more negative and disfavorable factors. The result was that the dietitians felt satisfied with their work situation even though there were some unfavorable factors involved. Conclusions This study became a way to discover and highlight the work situation among dietitians. If more time and money would be invested in health care, dietitians would have an opportunity to possibly use PaP in a greater extent.

The aim of this study has been to investigate students’ understanding of fractions when they occur in the practical subject home economics. In order to investigate this, the learning study method was used. Learning study can be understood as a method to gain deeper understanding of what is learnt by students during a lesson to increase learning outcome. The variation theory framework has been utilized to analyze the results of this study. The object of learning was chosen to be addition of fractions bigger than one half when they appear in home economics. The results indicate that in order for the learners to experience the object of learning it requires that they discern some critical aspects; to distinguish between quarters and four parts, the relationship between the part and the whole in fractions, varied presentations of the same fraction along with an understanding of the meaning of the concept to double.   Moreover the students have carried out a math test which tested the students’ theoretical understanding of fractions to see whether they can transfer the knowledge from one learning context to another. The result evinces that most of the learners show a good understanding of fractions in a theoretical context as well as a practical. The learning study has increased the students learning according to the object of learning

Background Sweden has experienced a unique epidemic of celiac disease (CD) in children younger than 2 years of age. The epidemic was partly explained by changes over time in infant feeding and indicated a multifactorial aetiology. In CD, a strict lifelong gluten-free diet (GFD) is crucial for health but noncompliance is often reported among adolescents. Knowledge is limited regarding their own perspectives and experiences of managing the disease and adhering to GFD. Objectives To analyse the incidence of CD in epidemic and post epidemic birth cohorts, and explore and understand how adolescents with CD perceive and manage their everyday lives in relation to the GFD. Methods A population-based incidence register of CD in children covering the entire nation from 1998 to 2003, and part of the country back to 1973. ESPGHAN diagnostic criteria for CD and NUTS classification of regions were used. Incidence rates for each year of diagnosis, age group, gender and region, and cumulative incidence by age for each birth cohort were calculated. Ten focus groups were conducted with 47 CD adolescents aged 15-18 years. Transcribed interviews were analysed to illustrate and explain adolescents’ own perspectives concerning life with a GFD, and to search for recurrent stigma-related themes across the groups. Results A considerable gap in the cumulative incidence of CD at comparable ages was demonstrated between birth cohorts of the epidemic and post-epidemic periods. The gap persisted during pre-school years, although it decreased somewhat with age. During the final years of follow-up there was again a gradual increase in incidence rate among children younger than 2 years of age. The childhood populations in ‘West Sweden’ and ‘Småland and the islands’ had a significantly higher incidence rate compared to ‘North Middle Sweden’ and ‘Stockholm’. CD adolescents described an awareness of being different from others produced by meal appearance and the poor availability of gluten-free (GF) food. Eating in public had the effect of making an invisible condition visible and thereby creating a context for felt or enacted stigma. Maintaining invisibility avoided the negative consequences of stigma. The probability of compliance with the GFD was compromised by insufficient knowledge of significant others, problems with the availability and sensory acceptance of GF food, insufficient social support and their perceived dietary deviance. Three different approaches to the GFD emerged: compliers, occasional non-compliers, and non-compliers. Conclusions The difference in CD risk between birth cohorts at comparable ages may suggest an opportunity for primary prevention. Based on post-epidemic incidence trends, the Swedish epidemic might not have been as unique as previously thought, even though its magnitude was striking. The regional variation in CD risk supports multifactorial aetiology. Continued efforts are warranted to define factors besides gluten exposure that modulate CD risk. CD adolescents experience various dilemmas related to the GFD. It can produce stigma experiences in adolescence, and dietary compliance (or lack of) can be understood in terms of dealing with GFD concealment and disclosure. The increase in CD prevalence over time and unmet needs in young celiacs require resources to attain adequate levels of dietetic provision, regulated subsidies for covering additional costs for GF food, evidence-based practice, and increased general CD awareness for optimum clinical outcomes.

Healthy dietary changes would be beneficial for society, as the economic burden of diet-related diseases is massive, and for the individual, who would reduce their risk of ill health. However, it is not easy to change dietary habits. Therefore, the aim of this thesis was to better understand dietary change, focusing on the barriers to and facilitators of healthy dietary change by i) examining changes in food choices when dietary change is imposed by a medical diagnosis, ii) examining experiences related to dietary change and its sustainability after participation in a study where healthy dietary changes were required, and iii) examining diet cost in relation to healthiness of the diet. Methods Eighty children aged 13 who were diagnosed with celiac disease (CD) by a screening study reported their food intake in a food frequency questionnaire before and 1,5 years after commencing a gluten-free diet. Changes in food intake and the healthiness of the diet were examined, controlling for societal changes through the use of an age- and sex-matched control group. Diet healthiness was assessed using the National Food Administration’s (NFA) food index and the Diet Quality Index-Swedish Nutritional Recommendations. Qualitative interviews were conducted with 14 individuals who participated in an intervention study five years earlier where they had been randomly selected to adhere to a Mediterranean-like diet for three months. Analyses of the transcribed interviews focused on their experiences of barriers to and facilitators of dietary change and its sustainability. The costs related to healthy diets were examined by comparing consumer food prices with dietary intake data collected in two separate studies. The first study collected dietary intake data through a diet history interview with participants who had been randomized to either a Mediterranean-like diet or to continue their normal diet. The second study collected dietary intake data from 4-, 8-, and 11-year-old children by means of food diaries and was conducted by the NFA. Diet healthiness was assessed using the Healthy Eating Index 2005. Results The screened CD group made relatively few changes to their diets. They decreased their intake of certain gluten-containing products, including pizza, chicken nuggets, fish sticks, and pastries. There were no changes in the healthiness of their diet. The narratives of the individuals changing their diets showed that social relationships were the main barrier to sustainability. Social relationships within the household were especially troublesome, and various coping strategies were required on an everyday basis. Dietary change also increased the burden of food work (e.g., planning, shopping, cooking), which was another major barrier to dietary change. Comparisons between consumer costs of healthy and less healthy diets showed that those consuming the healthier diets also had consumed more expensive diets. Conclusion More barriers to healthy dietary changes were found than facilitators of these transitions. For instance, the impact of social relationships on sustainability of dietary change was found to be high, indicating the importance of participation of other household members when dietary changes are implemented. The higher cost of the healthier diets may be another barrier for healthy dietary changes, especially for those with limited resources. Even though it is possible to eat healthily at a lower cost, such a diet would likely require both cooking skills and time, thus making the task more difficult. However, the finding that children diagnosed with CD only made minor changes in their consumption of, for instance, bread and pasta, indicates that one way of increasing the healthiness of a diet is to substitute healthier alternatives within the same food group for less healthy food items.

The purpose of this study is to examine what pupils in the ninth grade eats for lunch and also whether there is any connection between their lunch habits and perceived ability to concentrate and fatigue. A further aim was to study pupils' experience of dining environment in schools.The study is based on a quantitative method with questionnaires. The study was implemented on four schools in elementary school in themunicipalityofKristianstadand Tanum. Our results demonstrate, in accordance with several previous studies conducted in the same age group, that it is about half of the pupils who eats school lunch every day and that the majority are eating school lunch 3-5 days a week. Furthermore, our study shows that the pupils who rarely eat vegetables in school feel tired and distracted to a greater extent than the group of pupils who eat vegetables almost daily. Our result also shows that the group of pupils who eat the main course 3-5 days a week feel both tired and distracted to a greater extent than the group of students who eat the main course more rarely. In accordance with previous studies our study shows that differences exist between boys and girls regarding food that is eaten instead of school lunch. Food containing empty calories is the most popular kind, it causes glucose levels to get out of balance which makes students tired and distracted.The result of our study shows that most pupils claim that they often feel tired and distracted during the school day. Hunger affects the individual's emotions, motivation and cognition (Lennernäs, 2011), which can be linked to the fact that only 6 % of pupils feel that they are getting satisfied every day after eating the school lunch. There are also many pupils who choose not to eat anything else those days they choose to skip the school lunch. Nevertheless, the majority of pupils are still happy with the environment in the school dining room and it is barely half the pupils who want bigger influence on what is served for school lunch.

Sammanfattning Bakgrund: Våra matvanor grundläggs tidigt i livet. Med tanke på det rådande hälsoläget i Sverige och världen behöver långvarigt preventiva insatser sättas in i tidig ålder för att bekämpa utvecklingen av fetma. Salut-satsningen är ett exempel på en preventiv insats som syftar till att främja hälsa hos barn och ungdomar. Syfte: Att undersöka hur förstagångsmödrar upplever och uppfattar den information om hälsosamma matvanor som mödrahälsovården (MHV), barnavårdscentralen (BVC) och folktandvården ger inom Salut-satsningen. Metod: Kvalitativa semistrukturerade telefonintervjuer utfördes med 18 strategiskt utvalda förstagångsmödrar vars barn var i åldern ett till ett och ett halvt år. Data analyserades enligt Graneheims kvalitativa innehållsanalys. Mödrarna ingår i Västerbottens Salut-satsning och bor inom upptagningsområdet för Västerbottens läns landsting. Resultat: De flesta mödrar fick information om utrymmesmat, måltidsordning samt frukt och grönsaker. Informationen som vissa av mödrarna fått upplevdes för generell. Något mödrarna saknade från samtalen var mer individanpassad information samt att den skulle vara djupare. Den information som gavs varierade beroende på vilken hälsocentral mödrarna besökt. De hade inställningen att hela familjen bör äta hälsosamt samt att man som förälder bör vara en bra förebild. Många hade inställningen att de hade goda matvanor sedan tidigare och att förändring ej var nödvändig. Slutsats: Informationen om frukt och grönsaker är det budskap som framförallt gått fram till mödrarna, vilket motiverat dem till att göra förändringar i familjens matvanor. Mödrarna upplevde att informationen var för generell och att de saknar bakgrund till råden. En återkommande inställning bland mödrarna var att de redan ansåg sig ha goda matvanor och därför inte behövde ta åt sig av råden.

Bakgrund: Tidigare studier visar att faktorer som exempelvis rökning och låg utbildningsnivå har samband med ett lägre frukt- och grönsaksintag. För att öka frukt- och grönsakskonsumtionen är det värdefullt att identifiera grupper med lågt intag. Syfte: Syftet med studien var att undersöka hur frukt- och grönsaksintaget såg ut hos vuxna samt om livsstilsfaktorer och sociala faktorer kan ha samband med frukt- och grönsaksintaget. Metod: En enkätstudie genomfördes i Umeå och Örnsköldsvik där 275 vuxna i ett bekvämlighetsurval tillfrågades att delta. Efter externt bortfall och efter exklusion av ofullständigt ifyllda enkäter ingick totalt 101 deltagare i studien. Enkäten bestod av 20 frågor, varav 19 slutna. Data bearbetades och analyserades i SPSS 17.0 med chi-2 test, signifikansnivån sattes till p<0,05. Resultat: Majoriteten av respondenterna hade ett rapporterat intag lägre än rekommendationen (74 %). Av respondenterna hade 40 individer ett lågt frukt- och grönsaksintag (<3ggr/dag), 19 individer hade ett medelhögt intag (3ggr/dag) och 42 individer hade ett högt intag (>3ggr/dag). En signifikant större andel av respondenterna med högt frukt- och grönsaksintag fanns i grupperna med hög utbildningsnivå, hög fysisk aktivitet, lågt alkoholintag, icke rökare, kunskap om Livsmedelsverkets kostråd om 500 gram frukt och grönsaker per dag samt de som ansåg att detta kostråd var viktigt. Slutsats: Resultaten från denna studie tyder på att ytterligare insatser för att främja ett högre frukt- och grönsaksintag behövs, framförallt i de grupper som tenderar att ha lägst intag. Livsstilen kan ha större påverkan på frukt- och grönsaksintaget än enskilda faktorer. Sambandet mellan utbildningsnivå och frukt- och grönsaksintag gör att det blir viktigt att identifiera vilka yrkesgrupper som representerar lägre utbildningsnivåer för att se var fler insatser behövs. / Background: Earlier studies have shown associations between factors such as smoking and low education level and a lower fruit and vegetable intake. To increase fruit and vegetable consumption it is important to identify groups with low intake. Objective: The aim of this study was to investigate the intake of fruit and vegetables among adults and if lifestyle and social factors may be associated with this intake. Method: A study was conducted in Umeå and Örnsköldsvik where convenience samples of 275 adults were asked to participate. After external loss and after exclusion of incomplete questionnaires there were a total of 101 participants in the study. The survey was based on 20 questions, of which 19 were closed. The data was processed and analyzed in SPSS 17.0 with chi-square tests, the level of significance was set to p<0,05. Results: The majority of respondents reported an intake below the recommendation (74%). Of all respondents, 40 participants had low fruit and vegetable intake (<3times/day), 19 had moderate intake (3 times/day) and 42 respondents had high intake (>3 times/day). A significant higher proportion of respondents with high fruit and vegetable intake where found in the groups with high level of education, high physical activity, low alcohol intake, non- smoking, awareness of the National Food Agency´s dietary advice about 500 gram fruit and vegetables per day and the opinion that this advice was important. Conclusion: The results from this survey suggest that further efforts to promote a higher fruit and vegetable intake are needed, especially in the groups who tend to have the lowest intake. Lifestyle may have a greater impact on fruit and vegetable intake than single factors alone. The association between level of education and fruit and vegetable intake makes it important to identify professions who represent a lower education level to see where more effort is needed.

BAKGRUND Modifierad Atkins Diet (MAD) och ketogenkost är kostbehandlingar som ordineras till barn med svårbehandlad epilepsi. Andra patientgrupper som behandlas med dessa dieter är patienter med glukostransportprotein typ 1-brist. Kostbehandlingarna är kolhydratfattiga och fettrika. I Sverige finns fyra sjukhus som arbetar med MAD och ketogenkost. I dagsläget saknas studier som beskriver hur behandlingarna upplevs av berörda familjer. SYFTE Syftet med studien var att utforska hur föräldrar till barn som behandlas med MAD eller ketogenkost upplever kostbehandlingen. METOD Kvalitativa intervjuer baserade på en halvstrukturerad frågeguide har genomförts. Fem familjer från olika delar av landet deltog i studien. Intervjuerna spelades in med mp3-spelare för att sedan transkriberas ordagrant. Samtalen analyserades genom kvalitativ innehållsanalys. RESULTAT Föräldrarna berättade om en rädsla och oro inför behandlingsstarten och att introduktionsperioden som familjerna erbjöds inför kostbehandlingen visade sig vara mycket viktig för kommande behandlingsprocess. Föräldrarna upplevde det svårt att tillaga en varierad kost och att det var viktigt med adekvata hjälpmedel och regelbunden vårdkontakt för att kunna tillämpa kostbehandlingen i vardagslivet. Deras behov av stöd förändrades under behandlingsprocessen. Genomgående var att informanterna upplevde att de sociala aktiviteterna anpassades efter kostbehandlingen. Föräldrarna upplevde det som viktigt att ha kontakt med andra familjer i liknade situation. Trots att föräldrarna upplevde flera olika praktiska och sociala problem ansåg de ändå att det positiva, som var kopplat till behandlingens resultat övervägde. En förälder uttryckte sig med orden ”Vi fick tillbaka vårt barn”- vilket återspeglar många föräldrars åsikt om behandlingen. SLUTSATS MAD och ketogenkost kräver mycket tid och kunskap för berörda familjer och påverkar deras vardag både praktiska och socialt. Med stöd från vård, barnomsorg, familj och vänner upplevde föräldrarna att det var lättare att upprätthålla behandlingen. Det finns också ett behov av att få prata med andra föräldrar och familjer som är liknande situationer. / BACKGROUND Modified Atkins Diet (MAD) and Ketogenic Diet are treatments prescribed to children suffering from refractory epilepsy. Patients with glucose transporter protein type 1 deficiency are also commonly treated with these diets, which are low in carbohydrates and high in fat. In Sweden, there are four hospitals implementing these treatments, but there is currently not sufficient information on how they are affecting the families. OBJECTIVE The purpose of this study was to explore how parents of children treated with MAD or Ketogenic Diet experience the treatment. METHOD Qualitative interviews based on a semi-structured topic guide was conducted. Five families from different parts of Sweden participated in this study. The interviews were recorded with an mp3 device and transcribed verbatim. Qualitative content analysis was used for data analysis. RESULT The parents disclosed anxiety before the start of the treatment and they acknowledged that the first week of introduction, which they, were offered before the start, proved to be essential for the rest of the treatment process. The families found it difficult to cook a balanced meal according to the dietary requriements, and also that it was important to have adequate resources and routine contact with health services to be able to apply the treatment to daily life. Their need for support changed during the treatment process. The informants believed their social activities were accommodated due to treatment. The parents felt the need to be in contact with other families in a similar situation. One parent expressed him-/herself with the words “We got our child back”, which reflects many parents view, regarding the treatment. CONCLUSION MAD and Ketogenic Diet require a lot of time and knowledge and affect practical and social aspects in daily living. With the support of health care, child care, family and friends, the parents felt it was easier to maintain treatment. The informants also shed light on the necessity of being in contact with other parents and families in similar situations.