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Before parenthood

Emerging evidence indicates that the nutritional status of parents at conception, and even before, influences the lifelong physical and mental health of their future children. Worldwide action is called for in translating this knowledge into public health benefits.

The PRIFORSK Lifecourse Nutrition has research projects validating dietary assessment methods for young adults, research assessing diet in this group, research identifying the associations between preconception diet and their own and coming children’s health, and intervention research on how to improve diet in the preconception phase. 

PRECONDIET

  • Funding: University of Agder
  • Project leader: Nina Øverby
  • Project group: Elisabet Hillesund, Frøydis Vik, Wendy Van Lippevelde, Andrew Wills

In Precondiet we use existing unique Norwegian health surveys linked with birth registry data to explore adolescent and pre-pregnancy diet in relation to maternal and child health outcomes. Dietary data from Young-HUNT at adolescent age have been explored.

Our first results from this study are out. In Young-HUNT1, there was evidence of associations between dietary choices, meal patterns, and neonatal outcomes. These findings were similar in the pooled analyses but were attenuated to the point of non-significance in the smaller Young-HUNT3 cohort.

Overall, energy-dense food products were associated with a small detrimental impact on some neonatal outcomes, whereas healthier food choices appeared protective. Our study suggests that there are causal links between consumption of healthy and unhealthy food and meal patterns in adolescence with neonatal outcomes for offspring some years later. The effects seen are small and will require even larger studies with more state-of-the-art dietary assessment to estimate these robustly.

A second paper estimating the associations of adolescent dietary patterns and meal habits with hypertensive disorders of pregnancy (HDP) and preterm birth are under consideration for publication.

PREPARED

  • Project leader: Nina Øverby, co-PI Elisabet Hillesund
  • PhD: Erlend Valen, Lorentz Salvesen
  • Project group: Frøydis Vik, Anine Medin, Dagrun Engeset, Andrew Wills
  • Funding: University of Agder and PRC Lifecourse Nutrition
  • Contact person: Nina Cecilie Øverby.
  • Project duration: August 2021 - August 2041

In the project PREPARED, we are exploring causal relationships between preconception diet and health in the next generation.

We have developed a theory and evidence-based digital intervention aiming to improve prospective parents’ preconception diet and promote health in the next generation. Results from the user involvement that informed the development of this study where young adults were interviewed, are published. These showed that adults within the fertile age range are not intrinsically motivated to eat healthily, but when they do, it is because eating healthily often aligns with other goals consistent with their values, that is, getting fit or looking good. They possess some basic knowledge of healthy behaviours during pregnancy but are generally unaware of the importance of preconception health and nutrition https://pubmed.ncbi.nlm.nih.gov/37277971/ 

From autumn 2021 to spring 2022 we recruited participants to this study. More than 1000 young adults are participating and have been randomized to either the intervention or control group. Dietary data were collected at baseline, post-intervention, and we will follow these participants until they become parents. To evaluate the effect of the intervention on subsequent pregnancy and child health, data will be linked with birth registry data.

Digital interventions have the advantage of being cheap and having exceptional reach into populations previously hard to engage in research. This also provides the potential to address social inequalities in health. Effects of the intervention on the primary outcome: diet quality, will be evaluated in 2024.

PREPARED will expand and generate new knowledge on the importance of preconception diet for health in the next generation, and provide a health-promoting tool that can be applied both nationally and internationally. PREPARED may give Norway a chance to participate in the forefront of this cutting-edge area of research.

The first baseline results from this project, dietary quality and DOHaD-knowledge will be available early 2024.

Skills for life

  • Funding: University of Agder
  • Project start: October 2018 (ongoing)
  • Project leader: Elisabet R. Hillesund
  • PhD Candidate: Ida Ulrikke Valand
  • Project group: Nina Øverby, Charlotte Kiland, Tormod Bjørkkjær, Frøydis Vik.

Skills for Life is an educational project targeting undergraduate students aiming to promote knowledge, skills and competencies needed for their immediate and long-term health and well-being. Young adults are literally carriers of the next generation, and investments into the health of young adults have been shown to positively impact health prospects of future children.

A diet literacy course has been developed in cocreation with the target group. Focus group discussions (FGDs) were conducted in groups of students during fall 2019 to identify enhancers and barriers to healthy eating, and their thoughts on the relevance of a diet-related life skills course and asked for advice on course content. Results from this is published here: https://pubmed.ncbi.nlm.nih.gov/35389990/. When presented to the idea of a dietary life skills course as a university course, the students were mostly positive regarding its relevance and utility, however both motivators and barriers for attending were put forward. Some mentioned potential academic course benefits, such as enhanced CV, and a few mentioned potential societal benefits such as a healthy population and sustainable food consumption. Several motivators for attending the course were launched, such as increased knowledge and cooking skills, having dinner and expanded network. The students wanted to learn about food, nutrients and health, and how to cook simple, affordable, healthy and sustainable meals. Potential barriers for attending were mostly related to practicalities, such as potential lack of alignment with ordinary study programme or too demanding lectures.

Based on these findings a preliminary course plan was developed and subsequently discussed and modified with inputs from a group of students from the original FGDs. The course is being delivered autumn 2023, and a group of 30 students from different faculties are taking part. The course is being evaluated both quantitatively and qualitatively, and results will be published spring/autumn 2024. The ultimate aim of this project is to establish an ECT-yielding university course to be offered to students every year or semester along with other relevant life skills courses.

Studentkost

  • Project leaders: Nina Øverby, Elisabet Hillesund, Anine Medin.
  • Project group: Erlend Larsen Valen.

College students constitute a significant proportion of the young adult population in Norway. They are in their reproductive years, which is of interest regarding diet and preconception health.

In 2019 we enrolled 622 students aged 18-40 years. The students completed a food frequency questionnaire, including questions of supplement use, over the past 4 weeks. Intake of fruits, vegetables, oily fish, and whole grain was lower than recommended, as were mean intake of folate, iron, and iodine. Our main findings are that students have a somewhat suboptimal diet compared to the Norwegian dietary guidelines. Male students had generally lower diet quality than females. Compared to the Nordic Nutrition Recommendations (NNR), we also saw a relatively high probability of inadequate intake of several micronutrients and a very high probability for some micronutrients in a significant portion of the sample. Our findings encourage further investigation into young adults' diet. https://pubmed.ncbi.nlm.nih.gov/32983424/ 

Since excessive alcohol consumption during reproductive years may impact the integrity of developing eggs and sperm, potentially affecting the life-long health of future children, we wanted to explore alcohol consumption among students. Further, knowing that inadequate diets could aggravate the preconception effects of alcohol, we explored whether weekly alcohol intake is associated with energy and nutrient intake and adequacy of micronutrient intake among students. More than 80 % reported having consumed alcoholic beverages the past 4 weeks. One-third of men and 13 % of women exceeded the upper recommended limit of 14 UK alcohol units/week. An inverse association between increasing alcohol intake and energy-adjusted micronutrient intake was evident for thiamine, phosphate, Fe, Zn and Se in men, and for vitamin A, β-carotene, vitamin E and C, thiamine, vitamin B6, folate, P, Mg, K, Fe, Zn and Cu in women.

In 2020 we performed a new cross-sectional study among first year university students. Results are not yet published.

Veggiskills

Principal Investigator (PI): Anine C. Medin (Associate Professor, University of Agder)
Funding:  University of Agder
Project Start: 1 April 2021 (ongoing)

Background

Today’s dietary habits are major contributors to the global burden of disease and irreversible environmental damage. The EAT-Lancet Commission Report (2019) proposed a universal shift to plant-based diets with limited meat and dairy intake as a solution. However, not all plant-based diets are sustainable, as some may lack essential nutrients.

About the project

The VeggiSkills project aims to enhance understanding of youth aged 16–24 and their ability to adopt and adhere to healthy, sustainable plant-based diets. Insights from the project can guide targeted interventions to promote dietary changes that reduce disease burden and environmental harm.

Aims and objectives

The project evaluates dietary habits, nutritional quality, health outcomes, and food literacy among youth following various diets, ranging from vegan to omnivorous. Specific objectives include:

  1. Assessing dietary intake, nutritional status, and body composition
  2. Investigating food and nutrition literacy
  3. Identifying factors that facilitate or hinder adherence to plant-based diets and their impact on healthy eating practices

Design and methods

VeggiSkills Norway is a mixed-methods, cross-sectional study combining quantitative and qualitative approaches. From September 2021 to March 2022, 165 youth in Southern Norway, practicing diverse diets (vegan, lacto-ovo vegetarian, pescatarian, flexitarian, omnivorous), were recruited using convenience and snowball sampling.

Quantitative assessments included:

  • Dietary intake
  • Biomarkers for nutritional status
  • Antropometrics including body composition
  • Food and nutrition literacy

Qualitative assessments:
A subsample of 24 participants completed in-depth interviews.

Organisation

The project runs from 2021 to 2025. The research team includes A.C. Medin (PI), Associate Professor W. Van Daele (University of Agder), Professor C. Larsson (University of Gothenburg), Dr. C. Margerisson (Deakin University), PhD students Synne Groufh-Jacobsen and Isabelle Mulkerrins (University of Gothenburg), and Dr. D. Aune (Imperial College London), alongside several master’s students.

Synne Groufh-Jacobsen lead the practical implementation of the study as part of her PhD. She is supervised by Medin, Van Daele, and Larsson.

Collaborations

As an extension of the described project, a collaboration has been established with researchers in Sweden and Australia. Funding has already been secured for VeggiSkills-Sweden, which is currently being carried out in Sweden (Gothenburg) led by Professor Christel Larsson. Read more about the VeggiSkills-Sweden project.

Funding

The project is supported by the University Board of the University of Agder as part of a strategic initiative linked to the UN Sustainable Development Goals, with additional funding from the Faculty of Health and Sports Sciences at the University of Agder.

 

Published May 16, 2024 - Last modified Jan. 6, 2025