Christine Helle

• Osorio, Natalie Garzon; Vik, Frøydis Nordgård; Hillesund, Elisabet Rudjord; Helland, Sissel Heidi; Love, Penelope & Abel, Marianne Hope [Show all 12 contributors for this article] (2026). A Formative Evaluation of Parental Perceptions Related to Acceptability, Appropriateness, Feasibility, and Reported Use of an e-Learning Resource Targeting Diet in the First 1000 Days: Survey Study. JMIR Formative Research. 10, p. 1–13. doi: 10.2196/84277. Full text in Research Archive Show summary

  Background In October 2022, the Nutrition Now (NN) e-learning resource was implemented within Maternal and Child Healthcare centers and Early Childhood Education and Care centers of a southern Norwegian municipality. The e-learning resource targets expectant parents, parents of children aged 0‐2 years, and Early Childhood Education and Care staff, aiming to promote healthy dietary behaviors during the first 1000 days of life. Objective This study aimed to explore parental perceptions related to the acceptability, appropriateness, feasibility, and reported use of the NN e-learning resource among parents. Methods From October 2022 to May 2023, expecting parents and parents of children aged 0‐2 years were recruited from 2 Norwegian municipalities, one intervention group receiving access to the NN e-learning resource, and one control. Participants in the intervention group received a web-based follow-up questionnaire 7 months after gaining access to the NN e-learning resource. Data were analyzed using descriptive statistics. Results Of the 179 participants in the NN study intervention group, 48 completed the web-based follow-up questionnaire administered 7 months after enrollment. Parents rated the e-learning resource positively on items assessing whether they liked and appreciated the resource, perceived it as an appropriate source of information, and found it doable and easy to use. Most respondents reported visiting the resource (38/48, 79%), although only 21% (10/48) reported frequent visits. Less than half of the participants answering the web-based follow-up questionnaire reported having watched the theme films (20/48, 42%), the recipe films (17/48, 35%), or making food using recipes provided in the e-learning resource (20/48, 42%). Conclusions Parents rated the NN e-learning resource positively but reported limited use. These findings point to the need for strategies that enhance engagement with self-guided digital interventions among expectant parents and parents of young children. Future efforts should focus on identifying how to maximize potential adoption of the e-learning resource and evaluate its impact to promote healthy dietary behaviors during the first 1000 days of life.

• Øverby, Nina Cecilie; Hillesund, Elisabet Rudjord & Helle, Christine (2026). Associations Between Aspects of Diet and Internalizing and Externalizing Behaviors in Children Aged 4 Years. Nutrients. 18(9). doi: 10.3390/nu18091461. Full text in Research Archive Show summary

  Background/objectives: Mental health challenges are increasing worldwide. Identifying preventable factors for such challenges is important and will have the greatest impact if identified in young children. In this study we aimed to explore the association between aspects of diet and child mental health at the age of 4 years. Methods: This is a secondary analysis of data from the Early Food for Future health study in Norway, a randomized controlled trial aiming to improve diet at ages 6–12 months. Cross-sectional data from 363 children aged 4 years and their mothers are used. Diet was assessed using food frequency questions. Five food scores were developed: vegetables, fruits, fruit and vegetables, sweet/salty snack score, and soft drink score. The Child Behavioral Checklist (CBCL) was used to assess internalizing and externalizing behaviors. Crude and multivariable linear regression models are presented. Results: We found that frequency of consumption of vegetables and total frequency of consumption of fruit and vegetables in 4-year-old children were inversely associated with internalizing behavior (β −0.207, 95% CI: 0.351, −0.063), while frequency of consumption of sweet and salty snacks was positively associated (β 1.807, 95% CI: 0.276, 3.337) with externalizing behavior and frequency of consumption of fruit and vegetables was inversely associated (β −0.188, 95% −0.336, −0.041). All were independent of maternal education, measures of financial difficulties and maternal mental health. Conclusion: An inverse association was observed between child frequency of consumption of fruit and vegetables and internalizing and externalizing behaviors, whereas frequency of consumption of sweet/salty snacks was positively associated with externalizing behavior. A varied and healthy diet early in life may promote child mental health, with potential large returns for society. Given the observational nature of the data, causal inference is limited and intervention studies are needed.

• Hunter, Kylie E; Nguyen, David; Libesman, Sol; Williams, Jonathan G; Aberoumand, Mason & Aagerup, Jannik [Show all 72 contributors for this article] (2025). Parent-focused behavioural interventions for the prevention of early childhood obesity (TOPCHILD): a systematic review and individual participant data meta-analysis. The Lancet. ISSN 0140-6736. 406(10509), p. 1235–1254. doi: 10.1016/s0140-6736(25)01144-4. Full text in Research Archive Show summary

  Background Childhood obesity is a global public health issue, which has prompted governments to invest in prevention programmes. We aimed to investigate the effectiveness of parent-focused early childhood obesity prevention interventions globally. Methods We did a systematic review and individual participant data meta-analysis. We searched databases and trial registries (MEDLINE, Embase, CENTRAL, CINAHL, PsycInfo, ClinicalTrials.gov, and WHO International Clinical Trials Registry Platform) from inception until Sept 30, 2024, for randomised controlled trials commencing before 12 months of age examining parent-focused behavioural interventions to prevent obesity in children, compared With usual care, no intervention, or attention control. Individual participant data were checked, harmonised, and assessed for integrity and risk of bias. We excluded trials that were quasi-randomised, investigated pregnancy-only interventions, or did not collect any child weight-related outcomes. The primary outcome was BMI Z score at age 24 months (±6 months). We did an intention-to-treat, two-stage, random effects meta-analysis to examine effects overall and for prespecified subgroups. We assessed certainty of evidence using Grading of Recommendations Assessment, Development, and Evaluation. This study is registered with PROSPERO, CRD42020177408. Findings Of 19 990 identified records, 47 (0·24%) trials were completed and eligible. Of these, 18 (38%) assessed Our primary outcome, BMI Z score. We obtained individual participant data for 17 (94%; n=9128) of these 18 trials (n=9383), representing 97% of eligible participants. Of these 9128 participants, 4549 (50%) were boys, 4415 (48%) were girls, and 164 (2%) had unknown sex. We found no evidence of an effect of interventions on BMI Z score at age 24 months (±6 months; mean difference –0·01 [95% CI –0·08 to 0·05]; high certainty evidence, τ²=0·01; n=6505; 2623 missing). Findings were robust to prespecified sensitivity analyses (eg, different analysis methods and missing data), and we found no evidence of differential intervention effects for prespecified subgroups including priority populations and trial-level factors. Interpretation These findings indicate that examined parent-focused behavioural interventions are insufficient to prevent obesity at age 24 months (±6 months). This evidence highlights a need to re-think childhood obesity prevention approaches.

• Lian, Henrik; Øverby, Nina Cecilie; Vik, Frøydis Nordgård; Medin, Anine Christine; Osorio, Natalie Garzon & Helle, Christine [Show all 12 contributors for this article] (2025). Implementation strategies: lessons learned during an e-learning intervention to improve dietary behaviors and feeding practices in early childhood education and care. BMC Nutrition. 11(1). doi: 10.1186/s40795-024-00990-3. Full text in Research Archive Show summary

  Background Early Childhood Education and Care (ECEC) centers play an important role in fostering healthy dietary habits. The Nutrition Now project focusing on improving dietary habits during the first 1000 days of life. Central to the project is the implementation of an e-learning resource aimed at promoting feeding practices among staff and healthy dietary behaviours for children aged 0–3 years in ECEC. Implementing new interventions often presents challenges. This study explores ECEC staff views and experiences with selected strategies for implementing an e-learning resource in ECEC centers in a municipality in Southern Norway. Methods The study is a part of the Nutrition Now study, a hybrid type 1 non-randomized controlled trial. The implementation process followed the Dynamic Integrated Evaluation Model (DIEM). Implementation strategies were selected from the Expert Recommendations for Implementing Change (ERIC) project and included identify and prepare champions, conduct educational meetings, distribute educational materials, create a learning collaborative, and remind clinicians. ECEC teachers from participating ECEC centers in the intervention municipality were recruited as champions. Brief (5–7 min minutes), semi-structured phone interviews, covering key points, were conducted with the champions 8 times, evenly distributed over six months. The interviews were analysed using qualitative thematic analysis. Results In total, 29 of the invited ECEC centers (53%) participated, and 260 brief interviews (88%) were conducted with champions (n=37). An evaluation of the feedback from the champions suggests that the five selected implementation strategies were acceptable. Five main themes were developed by qualitative analysis: 1) Being a champion resembles what I already do. 2) Educational meetings are fine but take time. I prefer when peers share experiences. 3) Newsletters were helpful and reminded me, but I do not always have enough time to read. 4) Evaluations have increased my awareness, and we do them informally and formally. 5) The regular phone calls reminded me I could receive support and express my opinion Conclusion This study’s findings suggest that several implementation strategies are acceptable for stakeholders in an ECEC e-learning healthy eating intervention. However, time constraints among champions may hinder deep engagement. These results provide valuable insights into how the selected implementation strategies may function in practice and how they are perceived and experienced by the ECECs staff. Trial registration Trial registration on June 6, 2022: ISRCTN10694967.

• Johnson, Brittany J; Chadwick, Paul M; Pryde, Samantha; Seidler, Ana Lena; Hunter, Kylie E & Aberoumand, Mason [Show all 69 contributors for this article] (2025). Behavioural components and delivery features of early childhood obesity prevention interventions: intervention coding of studies in the TOPCHILD Collaboration systematic review. International Journal of Behavioral Nutrition and Physical Activity. 22(1). doi: 10.1186/s12966-025-01708-9. Full text in Research Archive Show summary

  Background Early childhood obesity prevention interventions that aim to change parent/caregiver practices related to infant (milk) feeding, food provision and parent feeding, movement (including activity, sedentary behaviour) and/ or sleep health (i.e. target parental behaviour domains) are diverse and heterogeneously reported. We aimed to 1) systematically characterise the target behaviours, delivery features, and Behaviour Change Techniques (BCTs) used in interventions in the international Transforming Obesity Prevention for CHILDren (TOPCHILD) Collaboration, and 2) explore similarities and differences in BCTs used in interventions by target behaviour domains. Methods Annual systematic searches were performed in MEDLINE, Embase, Cochrane (CENTRAL), CINAHL, PsycINFO, and two clinical trial registries, from inception to February 2023. Trialists from eligible randomised controlled trials of parent-focused, behavioural early obesity prevention interventions shared unpublished intervention materials. Standardised approaches were used to code target behaviours, delivery features and BCTs in both published and unpublished intervention materials. Validation meetings confirmed coding with trialists. Narrative syntheses were performed. Results Thirty-two trials reporting 37 active intervention arms were included. Interventions targeted a range of behaviours. The most frequent combination was targeting all parental behaviour domains (infant [milk] feeding, food provision and parent feeding, movement, sleep health; n[intervention arms]=15/37). Delivery features varied considerably. Most interventions were delivered by a health professional (n=26/36), included facilitator training (n=31/36), and were interactive (n=28/36). Overall, 49 of 93 unique BCTs were coded to at least one target behav‑ iour domain. The most frequently coded BCTs were: Instruction on how to perform a behaviour (n[intervention arms, separated by domain]=102), Behavioural practice and rehearsal (n=85), Information about health consequences (n=85), Social support (unspecified) (n=84), and Credible source (n=77). Similar BCTs were often used for each target behaviour domain. Conclusions Our study provides the most comprehensive description of the behaviour change content of complex interventions targeting early childhood obesity prevention available to date. Our analysis revealed that interventions targeted multiple behaviour domains, with significant variation in delivery features. Despite the diverse range of BCTs coded, five BCTs were consistently identified across domains, though certain BCTs were more prevalent in specific domains. These findings can be used to examine effectiveness of components and inform intervention development and evaluation in future trials. Trial registration PROSPERO registration no. CRD42020177408=84), and Credible source (n=77). Similar BCTs were often used for each target behaviour domain.

• Brandtzæg, Marthe; Danielsen, Kjersti Karoline; Øverby, Nina Cecilie; Helle, Christine; Wills, Andrew Keith & Sveaas, Silje Halvorsen (2025). Higher Physical Activity Level is Associated With Increased Well-being and Better Mental Health in Women up to 4 Years Postpartum: A Cohort Study. Journal of Physical Activity and Health. ISSN 1543-3080. 22(1), p. 1409–1417. doi: 10.1123/jpah.2024-0654. Full text in Research Archive Show summary

  Background: Many women reduce physical activity (PA) level during pregnancy, which may contribute to increased risk of mental health challenges. The aim was to describe changes in PA levels in women over a 4-year postpartum period and to investigate associations between PA level and mental health. Methods: Seven hundred fifteen Norwegian women recruited from child health centers and social media completed web questionnaires. PA was measured 5, 12, 24, and 48 months postpartum as frequency per week (>30 min short of breath/sweating): <1/week, 1 to 2/week, and ≥3/week. Mental health was measured 5, 12, and 24 months postpartum and included psychological distress, self-efficacy, joy/anger, and depression. Change in PA levels was analyzed with Friedman test using longitudinal data, and associations were analyzed with multiple linear/logistic regression using cross sectional data. Results: In the 207 women completing all PA measurements, the levels showed a consistent pattern throughout the period. On a group level, there was a decrease in PA frequency from 5 to 12 months (P < .001) and an increase from 12 to 24 months (P = .024). Higher PA levels were associated with increased joy (β = 0.17; 95% CI, 0.04–0.31; P = .012) and self-efficacy (β = 0.25; 95% CI, 0.12–0.39; P < .001) 5 months postpartum and reduced depression symptoms (β = −0.16; 95% CI, −0.30 to −0.01; P = .036) and risk of psychological distress (odds ratio = 0.27; 95% CI, 0.09–0.79; P = .017) 12 months postpartum. Conclusion: Most of the women had a low PA level postpartum, and the levels showed a consistent pattern throughout the period. The findings indicated that higher levels of PA were associated with better mental health in postpartum women.

• Medin, Anine Christine; Vik, Frøydis Nordgård; Helle, Christine; Helland, Sissel Heidi; Wills, Andrew Keith & Osorio, Natalie Garzon [Show all 22 contributors for this article] (2024). Scaling up evidence-based digital early life nutrition interventions in a county setting: an implementation trial – protocol for Phase 2 of the Nutrition Now project. Frontiers in Public Health. 11. doi: 10.3389/fpubh.2023.1326787. Full text in Research Archive Show summary

  Background: Few effective health interventions transition from smaller efficacy or effectiveness studies to real-world implementation at scale, representing a gap between evidence and practice. Recognising this, we have developed Nutrition Now – a tailored digital resource building on four efficacious dietary interventions, aiming to improve nutrition in the important first 1,000 days of life. Nutrition Now targets and guides expectant parents and parents of 0–2 year olds, serves as a reliable source of evidence-based information for midwives and public health nurses at maternal and child healthcare (MCH) centres, and offers pedagogical tools for early childhood education and care (ECEC) staff. The aim of this study is to implement Nutrition Now at scale and evaluate the impact of different sets of multifaceted implementation strategies on implementation outcomes. Methods: A quasi-experimental design with three study arms will be used, providing either low, medium or high implementation support, when rolled out in 50 municipalities in 2 counties in Norway. Nutrition Now will be implemented in MCH and ECEC settings and made available to expectant parents and parents of 0–2 year olds through social media and MCH. The implementation support builds on strategies described in the Expert Recommendations for Implementing Change (ERIC) implementation framework and is informed by dialogues with stakeholders. Impact of the different degree of implementation support will be assessed by examining reach, adoption, fidelity, and sustainability using usage data generated from the Nutrition Now resource, publicly available municipal data and qualitative interviews with MCH and ECEC staff. Discussion: Nutrition Now Phase 2 will break new ground by scaling up successively delivered and complementary dietary interventions in the first 1,000 days of life in a real-life context. The project also seeks to identify what level of implementation support is most effective when implementing digital, scalable, evidence-based early-life nutrition interventions in community settings. The project will inform implementation research and provide knowledge about effective implementation strategies to be used in a national scale-up of Nutrition Now. Trial registration: The study is registered prospectively (submitted 14/06/2022, registration date: 19/06/2022) in the International Standard Randomised Controlled Trial Number registry (ISRCTN): reg. Number: ISRCTN10694967, https://doi.org/10.1186/ISRCTN10694967.

• Helle, Christine; Hillesund, Elisabet Rudjord & Øverby, Nina Cecilie (2024). Exploring Public Health Nurses’ Thoughts, Needs and Expectations for the Development and Usability of an Online Parenting Resource on Early Nutrition Delivered through Primary Care: A Qualitative Study. Nutrients. 16(17), p. 1–17. doi: 10.3390/nu16172861. Full text in Research Archive
• Osorio, Natalie Garzon; Vik, Frøydis Nordgård; Helle, Christine; Hillesund, Elisabet Rudjord; Øverby, Nina Cecilie & Helland, Sissel Heidi [Show all 15 contributors for this article] (2024). Implementing an early-life nutrition intervention through primary healthcare: staff perspectives. BMC Health Services Research. 24(1). doi: 10.1186/s12913-024-11582-z. Full text in Research Archive Show summary

  Background: Nutrition interventions targeting early childhood can be cost-effective and may provide lifelong, intergenerational benefits. From October 2022 to April 2023 the Nutrition Now (NN) e-learning resource was implemented within Early Childhood Education and Care centres and the Maternal and Child Healthcare Centre (MCHC) in a southern Norwegian municipality. As part of the NN project, the present study aims to explore the MCHC staff’s experiences with implementing the NN resource, to gain insights into measures important to scale up digital early-life nutrition interventions. Methods: Three group interviews were conducted among public health nurses and midwives alongside one individual interview with the department leader of a MCHC in May 2023. An inductive thematic analysis, as described by Braun and Clarke, was conducted to generate the key themes and subthemes regarding the implementation process of NN within the MCHC. Results: Three main themes were generated: [1] Important resource but not always utilized; [2] Parents are interested but had issues with access; and [3] Staff and stakeholder buy-in and commitment needed from the start. Overall, the staff viewed the NN resource as a potential tool for promoting diet-related topics and believed it could support the guidance they were already providing parents. However, few staff members fully familiarized themselves with the resource. While staff perceived parents as positive when informed about NN, they believed issues such as access challenges, competing platforms, and time constraints reduced parental engagement. Lastly, staff suggested improvements for NN’s implementation, including enhanced training, better planning, assigning champions, and lowering the threshold for access. Conclusion: The findings of this study suggest that the real-world implementation of digital evidence-based health behaviour interventions is feasible but would be enhanced by employing strategies focusing on engagement and utilization.

• Helle, Christine; Hillesund, Elisabet Rudjord & Øverby, Nina Cecilie (2023). A qualitative study of public health nurses' perspectives and experiences on nutritional guidance for parents of infants and toddlers. Maternal & Child Nutrition. ISSN 1740-8695. 20(S2). doi: 10.1111/mcn.13546. Full text in Research Archive Show summary

  In Norway, public health nurses (PHNs) are responsible for giving parents nutritional knowledge, but limited research describes how they perceive this task. This study explores PHNs' perceptions and experiences on nutritional guidance for parents of infants and toddlers. Semistructured interviews with six PHNs were conducted and transcribed verbatim. Data were subjected to thematic analysis. Five main themes were identified: (1) Dietary guidance for parents is central to the work; (2) PHNs perceive they have parents' trust, and parents are in general open to nutrition counselling; (3) food and meals must be seen in light of the family context; (4) The dialogue must be adapted to the individual family; and (5) PHNs have expertise on nutrition; however, updating knowledge is difficult. Nutritional guidance was perceived by PHNs as a core activity. They felt that they had parents' trust, and that parents were particularly open to nutritional guidance during the first 2 years. Counselling was generally well received, but conversations on overweight were perceived as difficult. PHNs strove to tailor their guidance to individual needs. However, providing guidance on a wide range of issues in different families and cultures could be challenging. They acknowledged a need for updating knowledge but the offer of courses was sparse. Our findings suggest a discrepancy between how nutrition is prioritized in the education of PHNs and what they encounter in clinical practice. In the future, this should be given more attention given the PHNs' unique position to promote healthy eating and long-term health.

• Vejrup, Kristine; Hillesund, Elisabet Rudjord; Agnihotri, Neha; Helle, Christine & Øverby, Nina Cecilie (2023). Diet in Early Life Is Related to Child Mental Health and Personality at 8 Years: Findings from the Norwegian Mother, Father and Child Cohort Study (MoBa). Nutrients. 15(1). doi: 10.3390/nu15010243. Full text in Research Archive Show summary

  There is rising concern about population mental health. Personality and mental health traits manifest early. Sufficient nutrition is fundamental to early development. However, little is known about early life dietary impact on later mental health. The aim of this study was to investigate associations of exposure to a healthy and sustainable antenatal and early childhood diet with personality traits and symptoms of depression and anxiety measured at 8 years of age. This study is based on the Norwegian Mother, Father and Child Cohort Study (MoBa) and uses data from the Medical Birth Registry of Norway (MBRN) including 40,566 participants. Mental health measures and personality traits were assessed at 8 years. Dietary data from pregnancy, child age 6 and 18 months and 3 and 7 years were used. With few exceptions, inverse associations were observed between healthier diet at all time points and depression and anxiety symptom scores at age 8. We found positive associations between diet scores at almost all time points and extraversion, benevolence, conscientiousness and imagination. Inverse associations were observed between diet scores and neuroticism. Combined, these findings underpin a probable impact of both maternal pregnancy diet and early childhood diet on several aspects of child mental health.

• Helle, Christine; Hillesund, Elisabet Rudjord & Øverby, Nina Cecilie (2023). Maternal mental health is associated with children's frequency of family meals at 12 and 24 months of age. Maternal & Child Nutrition. ISSN 1740-8695. doi: 10.1111/mcn.13552. Full text in Research Archive Show summary

  Diet during the child's first years is important for growth and development. In toddlerhood, higher diet quality is reported among children eating meals together with family. Although previous literature has documented several associations between maternal mental health and early child feeding practices, less is known about the relationship between maternal mental health and child frequency of shared family meals. This study explores associations between maternal symptoms of anxiety and depression, measured by The Hopkins Symptoms Checklist (SCL-8), and toddler participation in family meals. We used cross-sectional data from the Norwegian study Early Food for Future Health, in which participants responded to questionnaires at child age 12 (n = 455) and 24 months (n = 295). Logistic regression was used to explore associations between maternal mental health and child having regular (≥5 per week) or irregular (<5 per week) family meals (breakfast and dinner), adjusting for relevant child and maternal confounding variables. Children of mothers with higher scores of anxiety and depression had higher odds of Irregular family meals at both timepoints; (OR: 2.067, p = 0.015) and (OR: 2.444, p = 0.023). This is one of few studies exploring associations between maternal mental health and child frequency of shared family meals in early childhood, a period where the foundation for life-long health is shaped. Given the high prevalence of mental ailments and disorders, these findings are important and may inform future public health interventions. Further exploration of this relation is needed, including longitudinal research to test predictive associations and qualitative studies to increase insight and understanding.

• Helle, Christine; Hillesund, Elisabet Rudjord & Øverby, Nina Cecilie (2022). Associations between infant and maternal characteristics measured at child age 5 months and maternal feeding styles and practices up to child age two years. PLOS ONE. 17(1). doi: 10.1371/journal.pone.0261222. Full text in Research Archive
• Helle, Christine; Hillesund, Elisabet Rudjord; Wills, Andrew Keith & Øverby, Nina Cecilie (2019). Evaluation of an eHealth intervention aiming to promote healthy food habits from infancy -the Norwegian randomized controlled trial Early Food for Future Health. International Journal of Behavioral Nutrition and Physical Activity. 16(1), p. 1–16. doi: 10.1186/s12966-018-0763-4. Full text in Research Archive Show summary

  Strategies to optimize early-life nutrition provide an important opportunity for primary prevention of childhood obesity. Interventions that can be efficiently scaled-up to the magnitude needed for sustainable childhood obesity prevention are needed. The objective of this study was to evaluate the effects of an eHealth intervention on parental feeding practices and infant eating behaviors.

• Helle, Christine; Hillesund, Elisabet Rudjord; Wills, Andrew Keith & Øverby, Nina Cecilie (2019). Examining the effects of an eHealth intervention from infant age 6 to 12 months on child eating behaviors and maternal feeding practices one year after cessation: The Norwegian randomized controlled trial Early Food for Future Health. PLOS ONE. 14(8), p. 1–19. doi: 10.1371/journal.pone.0220437. Full text in Research Archive Show summary

  The Norwegian randomized controlled trial Early Food for Future Health provided parental anticipatory guidance on early protective feeding practices from child age 6 to 12 months through an eHealth intervention. Previously published outcomes at child age 12 months indicated that the eHealth intervention increased daily vegetable/fruit intake and promoted more beneficial mealtime routines. The objective of the current paper is to evaluate the effects of the intervention at child age 24 months, one year after cessation.

• Helle, Christine; Hillesund, Elisabet Rudjord & Øverby, Nina Cecilie (2018). Timing of complementary feeding and associations with maternal and infant characteristics: A Norwegian cross-sectional study. PLOS ONE. 13(6). doi: 10.1371/journal.pone.0199455. Full text in Research Archive Show summary

  Norwegian Health authorities recommend solid food to be introduced between child age 4–6 months, depending on both the mother´s and infant’s needs. The aim of this paper is to describe timing of complementary feeding in a current sample of Norwegian mother/infant-dyads and explore potential associations between timing of introduction to solid foods and a wide range of maternal and infant characteristics known from previous literature to influence early feeding interactions. The paper is based on data from the Norwegian randomized controlled trial Early Food for Future Health. In 2016, a total of 715 mothers completed a web-based questionnaire at child age 5.5 months. We found that 5% of the infants were introduced to solid food before 4 months of age, while 14% were not introduced to solid food at 5.5 months of age. Introduction of solid food before 4 months of age was associated with the infant not being exclusive breastfed the first month, receiving only formula milk at 3 months, the mother being younger, not married/cohabitant, smoking, less educated and having more economic difficulties. Not being introduced to solid food at 5.5 months was associated with the infant being a girl, being exclusive breastfed the first month, receiving only breastmilk at 3 months, the mother being older, married and having 3 or more children. This study shows that there are still clear socioeconomic differences regarding timing of complementary feeding in Norway. Infants of younger, less educated and smoking mothers are at higher risk of not being fed in compliance with the official infant feeding ecommendations. Our findings emphasize the importance of targeting socioeconomically disadvantaged mothers for support on healthy feeding practices focusing on the infant‘s needs to prevent early onset of social inequalities in health.

• Bjørset, Vilde Kristin; Helle, Christine; Hillesund, Elisabet Rudjord & Øverby, Nina Cecilie (2018). Socio-economic status and maternal BMI are associated with duration of breast-feeding of Norwegian infants. Public Health Nutrition (PHN). ISSN 1368-9800. 21(8), p. 1465–1473. doi: 10.1017/S1368980017003925. Full text in Research Archive
• Helle, Christine; Hillesund, Elisabet Rudjord; Omholt, Mona Linge & Øverby, Nina Cecilie (2017). Early food for future health: a randomized controlled trial evaluating the effect of an eHealth intervention aiming to promote healthy food habits from early childhood. BMC Public Health. 17(1). doi: 10.1186/s12889-017-4731-8. Full text in Research Archive Show summary

  Childhood overweight and obesity is a global public health challenge. Primary prevention initiatives targeting parents have been called for to encourage a positive feeding environment and healthy eating habits that may lay a good foundation for future health. At the same time, there is a need for interventions which combine accessibility and scalability with cost effectiveness. Today’s parents are extensive Internet-users, but only a few randomized controlled trials have investigated the use of Internet to promote healthy eating habits in early childhood. In Early Food for Future Health we have developed and will evaluate an Internet-based tool for parents of children between 6 and 12 months, aiming to increase knowledge about infant nutrition and foster protective feeding behavior.

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• Humberseth, Kathrine; Helle, Christine & Øverby, Nina Cecilie (2026). Ny forskning på norske barn: – Sammenheng mellom kosthold og adferdsvansker. [Internet]. Aftenposten.no. Full text in Research Archive Show summary

  Forskere mener at det fireåringer spiser, kan henge sammen med hvordan de har det psykisk.

• Heslien, Kaia Elisabeth Paulsen; Helland, Sissel Heidi & Helle, Christine (2025). Sammen rundt bordet i barnehagen. Full text in Research Archive
• Wehus, Walter Norman; Øverby, Nina Cecilie & Helle, Christine (2025). Slik gikk det da forskerne prøvde tidlig innsats mot overvekt hos barn. [Internet]. Forskning.no. doi: https:/www.forskning.no/barn-fedme-foreldre/slik-gikk-det-da-forskerne-provde-tidlig-innsats-mot-overvekt-hos-barn/2560003. Full text in Research Archive Show summary

  – Vi må tenke nytt, sier forsker.

• Kristiansen, Nina & Helle, Christine (2025). Er du veldig kresen? Da kan du ha en spise­forstyrrelse. [Internet]. Forskning.no. doi: https:/www.forskning.no/mat-sykdommer/er-du-veldig-kresen-da-kan-du-ha-en-spiseforstyrrelse/2569969. Full text in Research Archive Show summary

  SPØR EN FORSKER: For de kresne er sosiale lag plagsomt. Det kan være enklest å holde seg hjemme.

• Helle, Christine (2025). Matnyttig - hva er det og hva har vi funnet ut av? Om Matnyttigs foreldredel. Full text in Research Archive
• Helle, Christine (2025). Er det sammenheng mellom ernæring og psykisk helse hos barn og ungdom? Full text in Research Archive
• Øverby, Nina Cecilie; Helle, Christine & Wee, Emilie (2025). Fødselsdepresjon hos mor kan gjøre at barn overspiser. [Internet]. Forskning.no. Full text in Research Archive
• Øverby, Nina Cecilie; Helle, Christine & Helland, Sissel Heidi (2024). Forskerfokus: Den lange veien mot (noe) Matnyttig. Full text in Research Archive
• Helle, Christine & Øverby, Nina Cecilie (2024). Hvordan fremme gode spisevaner blant barn gjennom helsestasjonen. Christine Helle og Nina Cecilie Øverby fra UIA presenterer Matnyttig –forskningsprosjekt som skal fremme god ernæring tidlig i livet. Full text in Research Archive
• Bergstrøm, Ida Irene & Helle, Christine (2024). Det er genene som gjør barnet ditt kresent, ikke din innsats på kjøkkenet. [Internet]. Forskning.no. Full text in Research Archive
• Øverby, Nina Cecilie; Helle, Christine & Humberset, Kathrine (2023). Forskere fant sterk sammen­heng mellom kosthold og barns person­lighet: – Viser seg å være enda klarere enn vi tidli­gere har trodd. [Journal]. Varden; varden.no. Full text in Research Archive
• Øverby, Nina Cecilie; Helle, Christine & Humberset, Kathrine (2023). Godt kosthold kan gi mer robust personlighet. [Journal]. Aftenposten. Full text in Research Archive
• Øverby, Nina Cecilie; Helle, Christine & Humberset, Kathrine (2023). Forskere fant sammenheng mellom kosthold og barns personlighet: – Viser seg å være enda klarere enn vi tidligere har trodd. [Journal]. Aftenposten.no/foreldreliv. Full text in Research Archive
• Øverby, Nina Cecilie; Helle, Christine & Wehus, Walter Norman (2023). Slik påvirker kostholdet personligheten din. [Internet]. Forskning.no. Full text in Research Archive
• Øverby, Nina Cecilie; Helle, Christine & Humberset, Kathrine (2023). Forskere fant sammenheng mellom kosthold og barns personlighet: – Viser seg å være enda klarere enn vi tidligere har trodd. [Journal]. Fædrelandsvennen; fvn.no. Full text in Research Archive
• Øverby, Nina Cecilie; Helle, Christine & Humberset, Kathrine (2023). Forskere fant sammenheng mellom kosthold og barns personlighet: – Viser seg å være enda klarere enn vi tidligere har trodd. [Journal]. Romsdals Budstikke; rbnett.no. Full text in Research Archive
• Øverby, Nina Cecilie; Helle, Christine & Humberset, Kathrine (2023). Forskere fant sammenheng mellom kosthold og barns personlighet: – Viser seg å være enda klarere enn vi tidligere har trodd. [Journal]. Bergens Tidene; bt.no. Full text in Research Archive
• Øverby, Nina Cecilie; Helle, Christine & Humberset, Kathrine (2023). Forskere fant sammenheng mellom kosthold og barns personlighet: – Viser seg å være enda klarere enn vi tidligere har trodd. [Journal]. iTromsø; iTromsø.no. Full text in Research Archive
• Øverby, Nina Cecilie; Helle, Christine & Humberset, Kathrine (2023). Forskere fant sammenheng mellom kosthold og barns personlighet: – Viser seg å være enda klarere enn vi tidligere har trodd. [Journal]. Sunnmørsposten; smp.no. Full text in Research Archive
• Helle, Christine & Hillesund, Elisabet Rudjord (2023). Matnyttig: presentasjon av status, foreløpige resultater og veien videre. Full text in Research Archive
• Helle, Christine & Hillesund, Elisabet Rudjord (2023). Matnyttig; orientering om status og veien videre. Full text in Research Archive
• Øverby, Nina Cecilie & Helle, Christine (2023). Er det sammenhenger mellom kosthold tidlig i livet og senere pykisk helse og personlighet? Full text in Research Archive
• Øverby, Nina Cecilie & Helle, Christine (2023). Sammenhenger mellom kosthold tidlig i livet, psykisk helse og personlighet. Full text in Research Archive
• Stiansen, Yngve; Øverby, Nina Cecilie & Helle, Christine (2023). Barne-kosthold påvirker psyken. [Radio]. NRK Sørlandssendinga. Full text in Research Archive
• Helle, Christine; Hillesund, Elisabet Rudjord & Øverby, Nina Cecilie (2023). Public health nurses' wishes, needs and expectations for the development and use of a new online resource on early nutrition – A qualitative study in the Nutrition Now project. Full text in Research Archive
• Øverby, Nina Cecilie; Helle, Christine & Baksaas, Jenny Marie (2023). Kan barns kosthold påvirke personligheten deres? [Internet]. Psykologisk.no. Full text in Research Archive
• Øverby, Nina Cecilie; Hillesund, Elisabet Rudjord; Helland, Sissel Heidi; Helle, Christine; Wills, Andrew Keith & Lamu, Admassu Nadew [Show all 23 contributors for this article] (2023). Evaluating the effectiveness and implementation of evidence-based early-life nutrition interventions in a community setting a hybrid type 1 non-randomized trial – the Nutrition Now project protocol. Frontiers in Endocrinology. 13. doi: 10.3389/fendo.2022.1071489. Full text in Research Archive Show summary

  Disappointingly few efficacious health interventions are successfully scaled up and implemented in real world settings. This represents an evidence-to-practice gap, with loss of opportunity to improve practice. Aiming to improve nutrition in the first 1000 days of life, we have combined four efficacious dietary interventions into a single adapted digital resource (Nutrition Now) for implementation in a Norwegian community setting. Nutrition Now targets pregnant women and parents of 0–2-year-olds with messages focusing on healthy dietary behaviours. Early childhood education and care (ECEC) staff are provided with pedagogical tools addressing healthy food exposure and child food acceptance. Objectives: a) evaluate the effectiveness of provision of the Nutrition Now resource on child diet and diet-related outcomes, with special attention to the influence of socio-economic position, b) gather information on the effectiveness of the implementation process to inform forthcoming scale-up and c) perform trial- and model-based economic evaluations. This is a hybrid type 1 implementation study, focusing on evaluation of effectiveness. A quasi-experimental design with pre- and post-tests, where one municipality gets access to the resource (n~800), while a matched non-equivalent control municipality (n~800) does not, will be used. Effectiveness will be assessed by examining e.g., diet outcomes, developmental outcomes, and feeding practices. The resource will be implemented in ECEC settings and made available to pregnant women and parents through the Norwegian system of maternal and child health (MCH) care. The implementation process includes iterative adjustments and implementation strategies from the implementation framework Expert Recommendations for Implementing Change (ERIC) informed by dialogues with stakeholders. Implementation outcomes (e.g., acceptability and adoption) will be assessed through questionnaires and interviews with parents, ECEC and MCH staff, with particular attention to ethnic diverse groups. Both within-trial and modelling-based economic evaluation will be performed. Nutrition Now will bridge the existing evidence-to-practice gap through rigorous scientific effectiveness evaluation of municipal scale up and inform subsequent county scale up. The study is the first to implement efficacious nutrition interventions in early life with potential for health improvement using technology to maximise the reach and impact of both parental and MCH dietary guidance and ECEC practice.

• Helle, Christine & Hillesund, Elisabet Rudjord (2022). Matnyttig; Å fremme gode matvaner og god matomsorg i de første leveårene. Full text in Research Archive
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• Helle, Christine & Hillesund, Elisabet Rudjord (2022). Matnyttig: Om å fremme gode matvaner og god matomsorg i de første leveårene. Full text in Research Archive
• Rutter, Harry; Medin, Anine Christine; Vik, Frøydis Nordgård; Øverby, Nina Cecilie; Helland, Sissel Heidi & Helle, Christine (2022). What are the factors that influence children’s diet? A mapping session for local stakeholders in Arendal. Full text in Research Archive
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• Wehus, Walter Norman & Helle, Christine (2019). Foreldre som fekk opplæring på nett serverte barna meir frukt og grønsaker. [Internet]. Forskning.no. doi: https:/www.forskning.no/barn-og-ungdom-mat-og-helse-partner/foreldre-som-fekk-opplaering-pa-nett-serverte-barna-meir-frukt-og-gronsaker/1327836. Full text in Research Archive
• Helle, Christine; Hillesund, Elisabet Rudjord & Øverby, Nina Cecilie (2019). Examining the effects of an eHealth intervention from infant age 6 to 12 months on child eating behaviors and maternal feeding practices one year after cessation: The Norwegian randomized controlled trial Early Food for Future Health. Full text in Research Archive
• Helle, Christine (2019). Early Food for Future Health - a digital intervention to assist in transitioning infants from nursing to solid food. Full text in Research Archive
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• Helle, Christine (2019). The official opening of Priority Research Centre on Lifecourse Nutrition; summary and closing words. Full text in Research Archive
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• Helle, Christine; Hillesund, Elisabet Rudjord; Omholt, Mona Linge & Øverby, Nina Cecilie (2016). Early Food for Future Health - an E-health intervention aiming to promote healthy food habits from early childhood. Full text in Research Archive
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• Rosenvinge, Morten & Helle, Christine (2016). Smaken av noe nytt. [Internet]. Universitetet i Agder, Innaskjærs. Full text in Research Archive
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• Helle, Christine (2016). Nyskaping og samskaping med DDU-midler. [Internet]. Universitet i Agder; beta.uia. Full text in Research Archive
• Øverby, Nina Cecilie; Skreden, Marianne; Helle, Christine & Hillesund, Elisabet Rudjord (2015). Mat, barn og mulighetsvinduet. Full text in Research Archive
• Helle, Christine; Øverby, Nina Cecilie & Hillesund, Elisabet Rudjord (2019). Early Food for Future Health. A randomized controlled trial evaluating the effects of an eHealth intervention aiming to promote healthy food habits from early childhood. Universitetet i Agder. ISSN 9788271179366. Full text in Research Archive Show summary

  The World Health Organization (WHO) has defined obesity as one of today's greatest threats to public health. In Norway, 15-20 % of children aged 8-9 years are either overweight or obese. A substantial literature now relates early infant nutrition to development of later non-communicable diseases (NCD) like overweight and obesity. The early feeding environment is critical for establishing eating habits that may influence weight development and healthy growth in the long term. Since parents are gate-keepers of food and contribute to the child’s eating in numerous ways, primary prevention initiatives targeting parents have been called for to facilitate development of healthy eating habits. Barriers to fos tering healthy eating habits in children include parental feeding practices that prevent the child from using hunger and satiety signals to initiate and stop eating. This may undermine the innate capacity to self-regulate energy intake which develops during infancy. Other influential early feeding practices are repeated exposures to unfamiliar foods in order to develop a broader range of taste preferences, and parental strategies to improve dietary variety facilitating infant acceptance for healthy foods. In 2014, when the current study was planned, only a few randomized controlled trials had investigated methods of primary prevention of obesity commencing during infancy, the largest being the Australian NOURISH study. NOURISH targeted responsive early feeding practices through educational group sessions in first-time Australian parents. Responsive feeding is characterized by caregiver guidance and recognition of the child’s cues of hunger and satiety. During the last years, several randomized controlled trials focusing on responsive parenting and feeding have shown a positive impact on child eating outcomes, child growth and child feeding practices. However, in these trials the interventions were delivered using traditional approaches like home-visits or face-to-face group settings, which is expensive and hence potentially cost-prohibitive at the level necessary for a national primary preventive public health strategy. Today, the Internet has become increasingly important for parents as a place to seek support and information about parenthood and children’s health and well-being. Yet, so far only very few studies have evaluated the effectiveness of web-based interventions targeted at feeding practices and eating behaviors during infancy.

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