Elling Tufte Bere

• Bere, Elling Tufte; Christiansen, Solveig Tobie Glestad; Kamaleri, Yusman Bin; Ohm, Eyvind; Madsen, Christian & Røise, Olav [Show all 8 contributors for this article] (2026). Odds of sickness absence and disability pension after bicycle injuries: A Norwegian nationwide register study. Journal of Safety Research. ISSN 0022-4375. 99, p. 137–146. doi: 10.1016/j.jsr.2026.09.012. Full text in Research Archive Show summary

  Introduction: Increased bicycling is a key strategy for health and environmental goals, yet it may increase the number of cycling injuries, which is a risk factor for subsequent work disability. Low socioeconomic status (SES) is a known risk factor for both general traffic injuries and work disability, but less is known about social inequalities in long-term work disability following bicycle-specific accidents. This study assessed the risk of work disability among injured bicyclists and investigated associations with SES and injury severity. Method: We conducted a nationwide population-based case-control study, linking Norwegian Trauma Registry data (2015–2018) with administrative registries on welfare benefits and SES. The sample included 975 injured bicyclists (cases) aged 18–58 and 4,875 matched controls. Work disability, operationalized as receipt of sickness benefits, work assessment allowance, and disability pension, was assessed for four years post-injury. Injury severity was classified using the New Injury Severity Score (NISS). Results: Cases had significantly higher rates of work disability than controls. Four years post-accident, the odds of being on work assessment allowance or disability pension were more than doubled for cases (OR 2.44, 95% CI: 1.82–3.27). The odds increased markedly with injury severity (OR 7.40 for NISS ≥ 16). Bicycle injuries were more common among higher-income individuals (52% in the highest income quartile), in contrast to patterns observed for other road user groups. The relative increase in work disability associated with injury was stronger among high-income individuals (OR 3.32) than among low-income individuals (OR 1.26). Conclusions: Bicycle injuries substantially increased the odds of long-term work disability. Injured cyclists had a high socioeconomic profile, but injury severity was the strongest predictor of long-term work disability. Practical Applications: These findings indicate that assessment of the burden of cycling injuries should incorporate long-term functional and socioeconomic consequences.

• Sundfør, Hanne Beate; Stenling, Andreas; Bere, Elling Tufte; Fyhri, Aslak; Stavnsbo, Mette & Berntsen, Sveinung (2026). Exploring the relationship between e-cycling and additional moderate to vigorous intensity physical activity – A series of N-of-1 studies using accelerometer data. Journal of Cycling and Micromobility Research (JCMR). 9, p. 1–14. doi: 10.1016/j.jcmr.2026.100122. Full text in Research Archive Show summary

  Cycling and e-cycling are promoted as sustainable transport solutions with potential public health benefits. Whether cycling adds to total physical activity (PA) or replaces other activity remains a key question. This relationship is commonly framed by three hypotheses: Compensation (cycling replaces existing PA), Independence (cycling adds to PA), and Generalization (cycling increases PA in other domains). Although previous research generally suggests that active transport does not displace other PA, evidence remains limited due to cross-sectional designs and inadequate objective measures of cycling. This study examined whether (e-)cycling contributes to additional moderate-to-vigorous physical activity (MVPA) in daily life. Employees enrolled in an e-bike leasing programme at the University of Agder, Norway (n = 18) wore a thigh-mounted accelerometer (Fibion SENS®) for 52–85 consecutive days. Using an exploratory N-of-1 design, individual time-series analyses (i.e., dynamic regression modelling) assessed within-individual associations between cycling and MVPA within and across days. For most participants, e-cycling for work-related commuting was not associated with reductions in other MVPA, indicating no evidence of compensation. Only one participant showed partial compensation. Similar patterns were found for total cycling (electric and conventional): most showed no associations, while three displayed negative and two positive associations with additional MVPA. These findings align with the Independence hypothesis, suggesting that (e-)cycling adds to overall physical activity rather than displacing it, while also highlighting individual variation. By applying devise-based monitoring and within-person analyses in real-life settings, this study adds to the evidence base for cycling and e-cycling as health-promoting and sustainable mobility strategies.

• Sundfør, Hanne Beate; Berntsen, Sveinung; Bere, Elling Tufte & Fyhri, Aslak (2024). The effects of subsidising e-bikes on mode share and physical activity - A natural experiment. Journal of Transport and Health. ISSN 2214-1405. 35(March 2024), p. 1–13. doi: 10.1016/j.jth.2023.101752. Full text in Research Archive Show summary

  Introduction The promotion of increased cycling is a political goal in numerous countries due to its environmental and public health benefits. Initiatives to stimulate e-bike use, like subsidies, may be a relevant strategy. However, understanding of the effects of these subsidies remains limited. In the present study our aim was to investigate the short-term effects of subsidising e-bike purchases on mode share distribution, physical activity derived from daily travel, and overall levels of physical activity. Methods We used the 2020-subvention program in Oslo, Norway, as a natural experiment, employing a pre-post randomised group design. The trial group (N = 194) and control group (N = 2174) participated in a survey at two time points (in April and September 2021), which included a one-day travel diary and questions about physical activity over the previous week. Results Our findings revealed a significant 12.6 [7.2, 18.0] percentage point increase in bicycle mode share, followed by a decrease in the share of car and public transport usage of 10.1 [-15.9, −2.5] and 7.1 [-11.8, −2.4] percentage points. In terms of physical activity generated from daily travel, we observed a greater increase in e-cycling compared to the decrease in conventional cycling and walking, resulting in an overall rise in active transport. However, despite these findings, we did not detect a significant increase in overall physical activity resulting from this increased active mobility. Conclusion Initiatives such as subsidies for e-bikes may align with both environmental and public health goals, as the subvention led to an increase in the bicycle mode share and an overall rise in active transport. However, to assess the impact on overall physical activity, additional research utilising more precise measurements is needed.

• Zhou, Bin; Cesare, Mariachiara Di; Aguilar-Salinas, Carlos A; Ahmad, Nor Ani; Bovet, Pascal & Chen, Zhengming [Show all 51 contributors for this article] (2024). General and abdominal adiposity and hypertension in eight world regions: a pooled analysis of 837 population-based studies with 7·5 million participants. The Lancet. ISSN 0140-6736. 404(10455), p. 851–863. doi: 10.1016/S0140-6736(24)01405-3. Full text in Research Archive Show summary

  Background: Adiposity can be measured using BMI (which is based on weight and height) as well as indices of abdominal adiposity. We examined the association between BMI and waist-to-height ratio (WHtR) within and across populations of different world regions and quantified how well these two metrics discriminate between people with and without hypertension. Methods: We used data from studies carried out from 1990 to 2023 on BMI, WHtR and hypertension in people aged 20–64 years in representative samples of the general population in eight world regions. We graphically compared the regional distributions of BMI and WHtR, and calculated Pearson's correlation coefficients between BMI and WHtR within each region. We used mixed-effects linear regression to estimate the extent to which WHtR varies across regions at the same BMI. We graphically examined the prevalence of hypertension and the distribution of people who have hypertension both in relation to BMI and WHtR, and we assessed how closely BMI and WHtR discriminate between participants with and without hypertension using C-statistic and net reclassification improvement (NRI). Findings: The correlation between BMI and WHtR ranged from 0·76 to 0·89 within different regions. After adjusting for age and BMI, mean WHtR was highest in south Asia for both sexes, followed by Latin America and the Caribbean and the region of central Asia, Middle East and north Africa. Mean WHtR was lowest in central and eastern Europe for both sexes, in the high-income western region for women, and in Oceania for men. Conversely, to achieve an equivalent WHtR, the BMI of the population of south Asia would need to be, on average, 2·79 kg/m2 (95% CI 2·31–3·28) lower for women and 1·28 kg/m2 (1·02–1·54) lower for men than in the high-income western region. In every region, hypertension prevalence increased with both BMI and WHtR. Models with either of these two adiposity metrics had virtually identical C-statistics and NRIs for every region and sex, with C-statistics ranging from 0·72 to 0·81 and NRIs ranging from 0·34 to 0·57 in different region and sex combinations. When both BMI and WHtR were used, performance improved only slightly compared with using either adiposity measure alone. Interpretation: BMI can distinguish young and middle-aged adults with higher versus lower amounts of abdominal adiposity with moderate-to-high accuracy, and both BMI and WHtR distinguish people with or without hypertension. However, at the same BMI level, people in south Asia, Latin America and the Caribbean, and the region of central Asia, Middle East and north Africa, have higher WHtR than in the other regions. Funding: UK Medical Research Council and UK Research and Innovation (Innovate UK).

• Totland, Torunn Holm; Øvrebø, Bente; Brantsæter, Anne Lise; Holvik, Kristin; Bere, Elling Tufte & Torheim, Liv Elin [Show all 7 contributors for this article] (2024). Development and evaluation of an index assessing adherence to the Norwegian food-based dietary guidelines: the Norwegian Dietary Guideline Index (NDGI). BMC Nutrition. 10. doi: 10.1186/s40795-024-00900-7. Full text in Research Archive Show summary

  Background Monitoring adherence to the Norwegian food-based dietary guidelines (FBDGs) could provide valuable insight into current and future diet-related health risks. This study aimed to develop and evaluate an index measuring adherence to the Norwegian FBDGs to be used as a compact tool in nutrition surveillance suitable for inclusion in large public health surveys. Methods The Norwegian Dietary Guideline Index (NDGI) was designed to reflect adherence to the Norwegian FBDGs on a scale from 0–100, with a higher score indicating better adherence. Dietary intakes were assessed through 19 questions, reflecting 15 dietary components covered by the Norwegian FBDGs. The NDGI was applied and evaluated using nationally representative dietary data from the cross-sectional web-based Norwegian Public Health Survey which included 8,558 adults.​ Results The population-weighted NDGI score followed a nearly normal distribution with a mean of 65 (SD 11) and range 21–99. Mean scores varied with background factors known to be associated with adherence to a healthy diet; women scored higher than men (67 vs. 64) and the score increased with age, with higher educational attainment (high 69 vs. low 64) and with better self-perceived household economy (good 67 vs. restricted 62). The NDGI captured a variety of dietary patterns that contributed to a healthy diet consistent with the FBDGs. Conclusion The NDGI serve as a compact tool to assess and monitor adherence to the Norwegian FBDGs, to identify target groups for interventions, and to inform priorities in public health policies.​ The tool is flexible to adjustments and may be adaptable to use in other countries or settings with similar dietary guidelines.

• Stenqvist, Thomas Birkedal & Bere, Elling Tufte (2024). How traditional Norwegian outdoor activities are changing; a 10-year follow up in relation to sociodemographic factors. Frontiers in Sports and Active Living. 6. doi: 10.3389/fspor.2024.1355776. Full text in Research Archive Show summary

  Introduction: The study aims to evaluate the relationship between sociodemographic factors and changes in Norwegian outdoor activities between 2008 and 2018. Traditional outdoor activities, such as family trips in nature, the gathering of mushrooms and wild berries, and growing one's own plants to eat, are believed to have a positive impact on physical activity levels and health in general. Method: This study includes repeated cross-sectional surveys conducted in 38 randomly selected schools across two Norwegian counties. In 2008, 1,012 parents of 6th and 7th grade students from 27 schools completed a questionnaire. In 2018, 609 new parents from 25 schools participated. Variables were dichotomized. Descriptive analyses between groups were conducted using chi-square statistics. Binary logistic regression analyses were performed with the three outdoor activities as dependent variables, including year only (model 1), and then also gender, age (continuous), education (own and partners), and household income as independent variables (model 2). Results: Participation in weekly family trips in nature increased from 22% to 28% (p = 0.002), the OR for year 2018 vs. year 2008 was 1.51. Adjusted for sociodemographic factors, the OR remained stable and significant. Education was the only significant sociodemographic factor (OR = 1.60), indicating the odds of those with a higher education to be 60% higher to engage in weekly family trips in nature. Gathering of wild mushrooms and plants remained stable with time. Being female (OR = 1.44), age (OR = 1.049) and education (OR = 1.49) was related to gathering. An increase in growing plants to eat was observed with an increase from 42% to 51% (p < 0.001), OR = 1.33. However, it did not remain significant in model 2. Education was, in general, positively related to growing food (OR = 1.35). Conclusion: We observed a positive increase in family trips in nature over the period from 2008 to 2018. Furthermore, elder parents seem to be more involved in the long-rooted traditional Norwegian grow- and gather culture, and a social gradient is apparent as those with higher education do participate more often in traditional outdoor activities.

• Hovdenak, Ingrid Marie; Helleve, Arnfinn; Wolden, Ida Emilie & Bere, Elling Tufte (2024). Socioeconomic inequality in breakfast skipping among Norwegian adolescents. Nutrition Journal. 23, p. 1–8. doi: 10.1186/s12937-024-00998-2. Full text in Research Archive Show summary

  Background Skipping breakfast is associated with negative health-related and school-related outcomes. Breakfast is the most frequently skipped meal among adolescents. Thus, there is a need to explore the reasons for breakfast skipping across population subgroups to better inform policy makers. The purpose of this study was to present the prevalence of adolescents skipping breakfast on schooldays, analyse the reasons for skipping breakfast and assess associations between the prevalence of skipping breakfast and the reasons for skipping breakfast according to sociodemographic variables. Methods The data of a random sample of 10 000 upper secondary school students (aged 16–18 years) from Viken County, Norway, were collected. Students completed a questionnaire measuring breakfast skipping, reasons for skipping breakfast, and sociodemographic variables. Chi-square tests were used to assess differences between the independent groups (family affluence scale (FAS), parental education, and gender) and skipping breakfast and reasons for skipping breakfast. Results 22% of adolescents reported that they usually skipped breakfast on all schooldays. Skipping breakfast was more prevalent among females, older students, students with lower socioeconomic status and students in vocational education programmes. The difference in breakfast skipping between students with low and high FAS scores was 31% versus 16%, respectively. The most common self-reported reasons for skipping breakfast were time (59%) and not wanting to eat breakfast (48%). Furthermore, 9% reported health issues, and 3% reported economic constraints as a reason for skipping breakfast. Not wanting to eat breakfast was related to a higher FAS score, health issues were more common among girls, and economic constraints were more common among those with low socioeconomic status. Conclusions Skipping breakfast was common among Norwegian upper secondary school students. Lack of time and not wanting breakfast were clearly the most cited reasons for skipping breakfast. Health issues and economic constraints were also cited but were less common. The results showed diverging associations between different demographic characteristics and reasons for skipping breakfast. These results are important for developing effective programs to improve diet among adolescents.

• Ostojic, Sergej; Phelps, Nowell H.; Singleton, Rosie K.; Zhou, Bin; Heap, Rachel & Mishra, Anu [Show all 54 contributors for this article] (2024). Worldwide trends in the underweight and obesity from 1990 to 2022: a pooled analysis of 3,633 population-representative studies with 222 million school-aged children, adolescents, and adults. The Lancet. ISSN 0140-6736. 403(10431), p. 1027–1050. doi: 10.1016/S0140-6736(23)02750-2. Full text in Research Archive Show summary

  Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school-aged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity.

• Bere, Elling Tufte; Zinöcker, Marit; Berg, Siv Hilde & Dankel, Simon N (2024). NNR – subjektive meninger trumfer vitenskapelig evidens. [Kommentar]. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. Full text in Research Archive
• Juul, Filippa & Bere, Elling Tufte (2024). Ultra-processed foods – a scoping review for Nordic Nutrition Recommendations 2023. Food & Nutrition Research (FNR). ISSN 1654-6628. 68. doi: 10.29219/fnr.v68.10616. Full text in Research Archive
• Stavnsbo, Mette; Stenling, Andreas; Berntsen, Sveinung; Chinapaw, Mai J. M.; Hansen, Bjørge Hermann & Manios, Yannis [Show all 12 contributors for this article] (2023). Does an obesogenic family environment moderate the association between sports participation and body composition in children? The ENERGY project. Pediatric Obesity. ISSN 2047-6302. 18(7). doi: 10.1111/ijpo.13031. Full text in Research Archive Show summary

  BackgroundPrevious research on the association between sports participation and body composition has shown mixed findings. The family home is considered one of the most influential environments on childhood obesity. Thus, the association between sports participation and body composition in children may be influenced by an obesogenic home environment.ObjectivesTo investigate if an obesogenic family environment moderates the association between sports participation and body composition in children.MethodsA total of 3999 children (54% girls; 11.6 ± 0.7 years) and their parent(s) were included from the ENERGY project. A composite obesogenic family environment risk score was created from 10 questionnaire items. Height, weight (to calculate body mass index), and waist circumference were obtained by trained researchers and used as indicators of body composition.ResultsThe composite risk score significantly moderated the association between sports participation and both waist circumference and body mass index. In children from families with moderate and high obesogenic risk, organized sports participation was significantly associated with smaller waist circumference (moderate risk: −0.29, 95% CI −0.45 to −0.14; high risk: −0.46, 95% CI −0.66 to −0.25) and lower body mass index (moderate risk: −0.10, 95% CI −0.16 to −0.04; high risk: −0.14, 95% CI −0.22 to −0.06), but not in children with a low obesogenic family risk score.ConclusionsEnrolling children in sports activities from an early age can be important for healthy weight maintenance, especially among children from obesogenic family environments.

• Martnes, Jørgen Jerstad & Bere, Elling Tufte (2023). Physical activity when riding an electric-assisted bicycle with and without cargo. Frontiers in Sports and Active Living. 5. doi: 10.3389/fspor.2023.1179043. Full text in Research Archive Show summary

  Background: Regular physical activity provides several health benefits, and active transport is a convenient way to implement physical activity in everyday life. However, bikes’ lack of possibilities to carry cargo is a limitation. E-cargo bikes can help overcome barriers to cycling and increase levels of active transport while still providing the option to carry cargo such as groceries and children. As such, E-cargo bikes have a greater potential for being a substitute for cars, but relevance is not known as no study has assessed the energy expenditure and time used using E-cargo bikes with considerable cargo. Objectives: The aim of this study is to compare time spent riding and exercise intensity when (1) riding an electric-assisted bicycle with cargo (30 kg) and without cargo and (2) driving a car. Method: This study has a randomised crossover design. Eleven participants (six women) were recruited through convenience sampling. The participants traversed through a 4.5 km route with three different forms of transportation: an electricassisted bicycle (E-bike) with 30 kg cargo, an E-bike without cargo, and a car. Oxygen uptake was measured with a portable oxygen analyser (Metamax 3B), and time spent cycling was measured on site by the test leader using a stopwatch. Results: Riding an E-bike with cargo was slightly slower than riding an E-bike without cargo (11.8 vs. 11.1 min, p = 0.017) and driving a car (8.8 min, p = 0.002). There was no significant difference in exercise intensity between E-bikes with and without cargo but riding an E-bike with cargo entailed significantly higher exercise intensity compared to driving a car [4.9 metabolic equivalents of task (METs) vs. 1.4 METs, p ≤ 0.001]. Conclusions: E-biking with cargo was rather similar in time spent and exercise intensity to E-biking without cargo, and not much slower than driving a car. Using E-cargo bikes, therefore, appears a good alternative to driving a car when in need of carrying things such as grocery bags and children, resulting in increasing physical activity and, at the same time, decreasing greenhouse gas emissions.

• Øvrebø, Bente; Kjøllesdal, Marte Karoline Råberg; Stea, Tonje Holte; Wills, Andrew Keith; Bere, Elling Tufte & Magnus, Per Minor [Show all 8 contributors for this article] (2023). The influence of immigrant background and parental education on overweight and obesity in 8-year-old children in Norway. BMC Public Health. 23(1). doi: 10.1186/s12889-023-16571-1. Full text in Research Archive Show summary

  Background Little is known about the prevalence of overweight/obesity and socio-economic position (SEP) in children with immigrant background in Scandinavia. The purpose of this study is to examine the prevalence of overweight/obesity by immigrant background among children in Norway and to explore the role of SEP in explaining diferences in weight status. Methods Anthropometric data from 8,858 children (age 8.3 years) from the population-based Norwegian Childhood Growth Study were used. Information about immigrant background, country of origin, and parental education (used as an indicator of SEP) were provided by Statistics Norway. For children with immigrant background, regional background was determined based on country of origin. Prevalence ratios (PR) were estimated for overweight/obesity and weight-to-height-ratio (WHtR)≥0.5 by immigration and regional background, using generalized estimating equation log-binominal models adjusting for sex, age, survey year (model 1), residential area, population density (model 2) and parental education (model 3). Results Children with immigrant background had a higher prevalence of overweight/obesity and WHtR≥0.5 than non-immigrant background children. Adjusted for parental education, children with an immigrant background from Southern and Eastern Europe, Asia except South-Asia, and Africa had a higher prevalence of overweight/ obesity [PR: 1.37 (95% confdence interval (CI): 1.10–1.72), 1.28 (1.05–1.57), 1.47 (1.13–1.91), respectively] than children with a non-immigrant background. Children originating from Asia except South-Asia had a higher prevalence of WHtR≥0.5 (PR: 1.64, CI: 1.25–2.15) compared to non-immigrant background children. The adjustment for parental education did not substantially change the results. Conclusion Children with immigrant background had higher prevalence of overweight/obesity than non-immigrant background children. The diference varied according to region of origin but not substantially according to parental education. There is a need for culturally acceptable preventative measures targeting the parents of immigrant background children.

• Mishra, Anu; Zhou, Bin; Rodriguez-Martinez, Andrea; Bixby, Honor; Singleton, Rosie K. & Carrillo-Larco, Rodrigo M. [Show all 1,626 contributors for this article] (2023). Diminishing benefits of urban living for children and adolescents’ growth and development. Nature. ISSN 0028-0836. 615(7954), p. 874–883. doi: 10.1038/s41586-023-05772-8. Full text in Research Archive Show summary

  Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1,2,3,4,5,6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified.

• Halkjelsvik, Torleif & Bere, Elling Tufte (2023). The effect of free school fruit on academic performance: a nationwide quasi-experiment. Scientific Reports. 13(1), p. 1–11. doi: 10.1038/s41598-023-48095-4. Full text in Research Archive Show summary

  In past research, higher intake of fruit has been associated with better academic achievement. In Norway, the government required lower secondary schools to provide fruit to their pupils from 2007 to 2014. The present study assessed whether this policy improved academic performance. In addition to secondary schools, the policy covered schools with combined elementary and lower secondary education, but not ordinary elementary schools. This differentiation, in combination with administrative data on test scores before, during, and after the law was enforced, created a nationwide quasi-experiment. Population register data on parents’ sociodemographic characteristics allowed for targeted analyses on a subsample of boys with low sociodemographic status. In analyses of 5th grade tests, the free fruit policy coincided with a slight decline in test scores among eligible compared to non-eligible pupils in the subsample (B = − 0.18, 95%CI[− 0.35, − 0.01]) and entire population (B = − 0.14, 95%CI[− 0.24, − 0.05]). Exploratory analyses of exam data in 10th grade yielded similar results, and sensitivity tests either failed to detect any effect or demonstrated a negative tendency. In a Western country with low levels of food insecurity, a policy that required schools to provide free fruit to pupils did not appear to improve academic performance.

• Richardsen, Helene Kristin; Bere, Elling Tufte; Stea, Tonje Holte; Klepp, Knut Inge & Engeset, Dagrun (2023). Effect of Ending the Nationwide Free School Fruit Scheme on the Intake of Fruits, Vegetables, and Unhealthy Snacks in Norwegian School Children Aged 10–12 Years. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 20(3). doi: 10.3390/ijerph20032489. Full text in Research Archive Show summary

  The Norwegian authorities started a nationwide free school fruit program in 2007, implemented in all secondary schools (grades 8–10) and combined schools (grades 1–10) in Norway. The program ended in 2014. This study evaluates the effect of ending the nationwide free school fruit program on the consumption of fruit, vegetables, and unhealthy snacks among Norwegian sixth and seventh graders. The study sample consists of pupils at 18 schools that participated in all data collections in the Fruits and Vegetables Make the Marks project (FVMM), initiated in 2001, with new data collections in 2008 and 2018. Four of the schools were combined schools, therefore children in sixth and seventh grade at these schools received free fruit in 2008 (intervention schools), and fourteen schools did not (control schools). Between 2008 and 2018, pupils at the intervention schools ate a lower proportion of fruits and vegetables per school week, and the consumption of unhealthy snacks increased compared to the control schools. Completion of the free fruit program was not significantly different for boys and girls, or low and high parental education. The results indicate that the end of the free school fruit program resulted in less healthy eating habits among children.

• Bere, Elling Tufte & Dankel, Simon N (2023). Ja, hva kreves egentlig av kunnskap før man gir kostholdsråd? Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 143(13). doi: 10.4045/tidsskr.23.0586. Full text in Research Archive
• Vejrup, Kristine; Agnihotri, Neha; Bere, Elling Tufte; Schjølberg, Synnve; Leblanc, Marissa Erin & Hillesund, Elisabet Rudjord [Show all 7 contributors for this article] (2022). Adherence to a healthy and potentially sustainable Nordic diet is associated with child development in The Norwegian Mother, Father and Child Cohort Study (MoBa). Nutrition Journal. 21(1). doi: 10.1186/s12937-022-00799-5. Full text in Research Archive Show summary

  Background The rapid neurodevelopment that occurs during the first years of life hinges on adequate nutrition throughout fetal life and early childhood. Therefore, adhering to a dietary pattern based on healthy foods during pregnancy and the first years of life may be beneficial for future development. The aim of this paper was to investigate the relationship between adherence to a healthy and potentially sustainable Nordic diet during pregnancy and in early childhood and child development. Methods 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). In 83,800 mother-child pairs, maternal pregnancy diet and child diet at 6 months, 18 months and 3 years were scored according to adherence to the New Nordic Diet (NND). NND scores were calculated both as a total score and categorized into low, medium, or high adherence. Child communication and motor development skills were reported by parents at 6 months, 18 months, 3 and 5 years, using short forms of the Ages and Stages Questionnaire and the Child Development Inventory. Associations of NND adherence with child development were estimated with linear and logistic regression in crude and adjusted models. Results When examining the NND and child developmental scores as percentages of the total scores, we found positive associations between the NND scores (both maternal pregnancy diet and child diet) and higher scoring on child development (adjusted β^ s [95% confidence intervals] ranging from 0.007 [0.004, 0.009] to 0.045 [0.040, 0.050]). We further found that low and medium adherence to NND were associated with higher odds of later emerging developmental skills compared to high NND adherence at nearly all measured timepoints (odds ratios [95% CI] ranging from significant values 1.15 [1.03–1.29] to 1.79 [1.55, 2.06] in adjusted analyses). Conclusions Our findings support that adherence to a healthy and potentially sustainable diet early in life is important for child development every step of the way from pregnancy until age 5 years.

• Øvrebø, Bente; Stea, Tonje Holte; Bergh, Ingunn Holden; Bere, Elling Tufte; Suren, Pål & Magnus, Per Minor [Show all 8 contributors for this article] (2022). A nationwide school fruit and vegetable policy and childhood and adolescent overweight: A quasi-natural experimental study. PLoS Medicine. ISSN 1549-1277. 19(1). doi: 10.1371/journal.pmed.1003881. Full text in Research Archive Show summary

  Background School free fruit and vegetable (FFV) policies are used to promote healthy dietary habits and tackle obesity; however, our understanding of their effects on weight outcomes is limited. We assess the effect of a nationwide FFV policy on childhood and adolescent weight status and explore heterogeneity by sex and socioeconomic position. Methods and findings This study used a quasi-natural experimental design. Between 2007 and 2014, Norwegian combined schools (grades 1–10, age 6 to 16 years) were obligated to provide FFVs while elementary schools (grades 1–7) were not. We used 4 nationwide studies (n = 11,215 children) from the Norwegian Growth Cohort with longitudinal or cross-sectional anthropometric data up to age 8.5 and 13 years to capture variation in FFV exposure. Outcomes were body mass index standard deviation score (BMISDS), overweight and obesity (OW/OB), waist circumference (WC), and weight to height ratio (WtHR) at age 8.5 years, and BMISDS and OW/OB at age 13 years. Analyses included longitudinal models of the pre- and post-exposure trajectories to estimate the policy effect. The participation rate in each cohort was >80%, and in most analyses <4% were excluded due to missing data. Estimates were adjusted for region, population density, and parental education. In pooled models additionally adjusted for pre-exposure BMISDS, there was little evidence of any benefit or unintended consequence from 1–2.5 years of exposure to the FFV policy on BMISDS, OW/OB, WC, or WtHR in either sex. For example, boys exposed to the FFV policy had a 0.05 higher BMISDS (95% CI: −0.04, 0.14), a 1.20-fold higher odds of OW/OB (95% CI: 0.86, 1.66) and a 0.3 cm bigger WC (95% CI: −0.3, 0.8); while exposed girls had a 0.04 higher BMISDS (95% CI: −0.04, 0.13), a 1.03 fold higher odds of OW/OB (95% CI: 0.75, 1.39), and a 0-cm difference in WC (95% CI: −0.6, 0.6). There was evidence of heterogeneity in the policy effect estimates at 8.5 years across cohorts and socioeconomic position; however, these results were inconsistent with other comparisons. Analysis at age 13 years, after 4 years of policy exposure, also showed little evidence of an effect on BMISDS or OW/OB. The main limitations of this study are the potential for residual confounding and exposure misclassification, despite efforts to minimize their impact on conclusions. Conclusions In this study we observed little evidence that the Norwegian nationwide FFV policy had any notable beneficial effect or unintended consequence on weight status among Norwegian children and adolescents.

• Laxdal, Aron Gauti; Johansen, Bjørn Tore; Bere, Elling Tufte & Solstad, Bård Erlend (2022). Towards More Sustainable Sports: Analyzing the Travel Behavior of Adolescent Soccer Players in Southern Norway. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 19(15), p. 1–7. doi: 10.3390/ijerph19159373. Full text in Research Archive Show summary

  Mitigating climate change is a global challenge demanding effort from all sectors, and sports are no exception. While transportation is one of the key issues regarding sustainable sports, the methods by which children and adolescents get to practice have not received much attention. The objectives of this study were, therefore, to present how adolescents in Southern Norway travel to soccer practice and assess how the mode of transportation is related to sex, socioeconomic status, age, ethnicity, and distance from home to practice. Cross-sectional data were collected from 558 adolescent soccer players (398 boys and 190 girls) representing 30 different clubs from settlements of varying rurality. While most of the participants lived within cycling distance from the field of practice, the majority opted for passive modes of transportation (55% passive vs. 45% active). A logistic regression analysis found that traveling distance and age were associated with active transportation habits, while sex, ethnicity, and socioeconomic status were not. Further research is needed to examine the main barriers to active travel for this already active population, as active transport represents an opportunity for sports to become more sustainable.

• Riiser, Amund; Bere, Elling Tufte; Andersen, Lars Bo & Nordengen, Solveig (2022). E-cycling and health benefits: A systematic literature review with meta-analyses. Frontiers in Sports and Active Living. 4. doi: 10.3389/fspor.2022.1031004. Full text in Research Archive
• Bjørnarå, Helga Birgit; Berntsen, Sveinung; Velde, Saskia J. te; Fyhri, Aslak; Isaksen, Ketil & Deforche, Benedicte [Show all 9 contributors for this article] (2021). The impact of weather conditions on everyday cycling with different bike types in parents of young children participating in the CARTOBIKE randomized controlled trial. International Journal of Sustainable Transportation. ISSN 1556-8318. doi: 10.1080/15568318.2021.1999538. Full text in Research Archive Show summary

  Knowledge about how weather conditions affect travel behavior in different user groups and contexts is relevant for planners and policymakers to facilitate sustainable transportation systems. We aimed to assess the influence of day-to-day weather on cycling for transportation among parents of young children with access to different bike types (e-bike vs non e-bike) in a natural study setting over nine months. We hypothesized less impact of weather variability on cycling when using an e-bike compared with a non e-bike. A randomized, controlled trial was conducted in Southern Norway. The intervention group (n = 18) was in random order equipped with an e-bike with trailer for child transportation (n = 6), a cargo (longtail) bike (n = 6) and a traditional bike with trailer (n = 6), each for three months. These 18 participants reported cycling on 832 out of 3276 person-days (25%). We used dynamic structural equation modeling for intensive longitudinal data to examine the relations between daily weather conditions, bike type (e-bike vs traditional bike), and cycling (dichotomized daily at yes or no). Air temperature (positively) and wind speed (negatively) were both credible predictors of cycling, whereas the other predictors (precipitation in the morning (yes or no) and presence of snow (yes or no) were not. We added interaction terms between bike type and weather conditions, but none of the interaction terms had a credible effect on cycling. Thus, the relations between weather conditions and cycling were not moderated by bike type among parents of young children.

• Øvrebø, Bente; Bergh, Ingunn Holden; Stea, Tonje Holte; Bere, Elling; Surén, Pål & Magnus, Per Minor [Show all 8 contributors for this article] (2021). Overweight, obesity, and thinness among a nationally representative sample of Norwegian adolescents and changes from childhood: Associations with sex, region, and population density. PLOS ONE. 16(8). doi: 10.1371/journal.pone.0255699. Full text in Research Archive
• Bjørnarå, Helga Birgit; Westergren, Thomas; Sejersted, Ellen; Torstveit, Monica Klungland; Hansen, Bjørge Hermann & Berntsen, Sveinung [Show all 7 contributors for this article] (2021). Does organized sports participation in childhood and adolescence positively influence health? A review of reviews. Preventive Medicine Reports. 23. doi: 10.1016/j.pmedr.2021.101425. Full text in Research Archive
• Hillesund, Elisabet Rudjord; Sagedal, Linda R.; Bere, Elling & Øverby, Nina Cecilie (2021). Family meal participation is associated with dietary intake among 12-month-olds in Southern Norway. BMC Pediatrics. 21. doi: 10.1186/s12887-021-02591-6. Full text in Research Archive
• Agnihotri, Neha; Hillesund, Elisabet Rudjord; Bere, Elling Tufte; Wills, Andrew Keith; Brantsæter, Anne Lise & Øverby, Nina Cecilie (2021). Development and description of New Nordic Diet scores across infancy and childhood in the Norwegian Mother, Father and Child Cohort Study (MoBa). Maternal & Child Nutrition. ISSN 1740-8695. 17(3). doi: 10.1111/mcn.13150. Full text in Research Archive
• Bjørnarå, Helga Birgit; Westergren, Thomas; Fegran, Liv; Velde, Saskia J. te; Fyhri, Aslak & Deforche, Benedicte [Show all 9 contributors for this article] (2020). Cumbersome but desirable — Breaking the code of everyday cycling. PLOS ONE. 15(9), p. 1–20. doi: 10.1371/journal.pone.0239127. Full text in Research Archive Show summary

  Introduction Cycling for transport could integrate physical activity (PA) into daily routines and potentially increase total PA levels. However, for parents with young children, most factors affecting transport mode choice tend to facilitate car use. Greater insight is necessary into reasons for (not) using sustainable transport modes in parents with young children. Therefore, the objective of this study was to explore the experiences, including motives, perceptions, attitudes, and norms, of parents of young children by using an e-bike, a longtail bike, and a traditional bike for everyday travel to the workplace, kindergarten, and the grocery store during the autumn, winter, and spring, in nine months. Methods Semistructured focus group interviews were conducted with 18 parents of young children residing in southern Norway. Parents were recruited through Facebook announcements and direct contact with kindergartens, selected organisations, and companies in the Kristiansand municipality. Data were analysed by systematic text condensation by using NVivo V.11. Results Participants’ experiences were summarised by three main themes: ‘cycling is cumbersome’, ‘cycling reflects the desirable me’, and ‘breaking the cycling code’. Time use, planning, logistics, wet and cold weather, long distances, and no cycling habit were frequently mentioned barriers, and the most notable facilitator was the children’s attitude towards cycling. In general, children loved to cycle and preferred cycling to driving. Additionally, the freedom and independence of cycling were emphasised and valued. Conclusion In challenging weather conditions, parents of young children may experience cycling as cumbersome but desirable, and bike access could increase the feasibility of daily cycling.

• Mildestvedt, Thomas; Hovland, Olav Johannes; Berntsen, Sveinung; Bere, Elling Tufte & Fegran, Liv (2020). Getting physically active by e-bike: An active commuting intervention study. Physical Activity and Health (PAAH). 4(1), p. 120–129. doi: 10.5334/paah.63. Full text in Research Archive
• Oeckel, Veerle Van; Deforche, Benedicte; Ridgers, Nicola D.; Bere, Elling Tufte & Verloigne, Maïté (2020). Validity of Items Assessing Self-Reported Number of Breaks in Sitting Time among Children and Adolescents. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 17(18). doi: 10.3390/ijerph17186708. Full text in Research Archive
• Mildestvedt, Thomas; Hovland, Olav Johannes; Berntsen, Sveinung; Bere, Elling Tufte & Fegran, Liv (2020). Getting Physically Active by E-Bike : An Active Commuting Intervention Study. Physical Activity and Health (PAAH). 4(1), p. 120–129. doi: 10.5334/paah.63. Full text in Research Archive Show summary

  Introduction: Increased physical activity (PA) is a major component in promoting public health, and active commuting could make an important contribution. Using an electric bicycle (e-bike) is reported to be of at least moderate intensity PA and is an alternative to other modes of transport for commuting. We aimed to explore the experience of commuting by e-bike in an intervention study. Methods: Focus group interviews with 21 previously inactive participants from three cities in Norway, who were given access to an e-bike for commuting for three (N = 2) or eight months (N = 19). Participants cycled for 226 days on average. The interviews were analyzed using systematic text condensation. Results: The use of e-bikes and active commuting stimulated some participants to take on additional PA in their leisure time. Others preferred active commuting to be their daily PA. Participants’ experiences of commuting by e-bike were characterized by a motivational shift from external reasons for e-biking, such as pressure to get fit, to feelings of well-being, enjoyment and recognition of the health benefits. Conclusion: Commuting by e-bike was convenient and promoted good health. Promoting e-bikes could lead to long term changes among inactive people because positive experiences stimulate autonomous reasons for active commuting.

• Agnihotri, Neha; Øverby, Nina Cecilie; Bere, Elling Tufte; Wills, Andrew Keith; Brantsæter, Anne Lise & Hillesund, Elisabet Rudjord (2020). Childhood adherence to a potentially healthy and sustainable Nordic diet and later overweight: The Norwegian Mother, Father and Child Cohort Study (MoBa). Maternal & Child Nutrition. ISSN 1740-8695. 17(2). doi: 10.1111/mcn.13101. Full text in Research Archive
• Stea, Tonje Holte; Nordheim, Oda; Bere, Elling Tufte; Stornes, Per Gunnar & Eikemo, Terje Andreas (2020). Fruit and vegetable consumption in Europe according to gender, educational attainment and regional affiliation — A cross-sectional study in 21 European countries. PLOS ONE. 15(5). doi: 10.1371/journal.pone.0232521. Full text in Research Archive Show summary

  Objective The purpose of the present study was to examine fruit and vegetable consumption according to gender, educational attainment and regional affiliation in Europe. Design Cross-sectional study. Setting 21 European countries. Participants 37 672 adults participating in the 7th round of the European Social Survey. Main outcome measures Fruit and vegetable consumption was measured using two single frequency questions. Responses were dichotomized into low (<once a day) and high (≥once a day) consumption. The association between consumption of fruit and vegetables and gender, educational level, regional affiliation was examined using logistic regression analyses. Results Overall, females showed increased odds of consuming fruit (OR 1.71 (95%CI:1.62, 1.79) and vegetable (1.59 (1.51, 1.67)) compared to males and high educated participants showed increased odds of consuming fruit (1.53 (1.43, 1.63)) and vegetables (1.86 (1.74, 2.00)) compared to low educated participants. Our results also showed that participants living in Eastern Europe had the lowest odds of consuming fruit and vegetables, whereas participants from Southern- and Northern Europe had the highest odds of consuming fruit and vegetables, respectively. Results from interaction analyses confirmed the positive association between fruit and vegetable consumption and educational level, although for some European regions, decreased odds of fruit and vegetables was observed among medium educated participants compared to those with low education. Conclusions Overall, the present study showed that being female and having a high education were associated with increased consumption of fruit and vegetables. However, the direction and strength of these relationships depends on regional affiliations.

• Øvrebø, Bente; Halkjelsvik, Torleif Bjordal; Meisfjord, Jørgen Rajan; Bere, Elling Tufte & Hart, Rannveig Kaldager (2020). The effects of an abrupt increase in taxes on candy and soda in Norway: an observational study of retail sales. International Journal of Behavioral Nutrition and Physical Activity. 17, p. 1–9. doi: 10.1186/s12966-020-01017-3. Full text in Research Archive
• Bjørkkjær, Tormod & Bere, Elling Tufte (2019). Strategier i skolen for helsefremmende kosthold hos barn og unge. In Holthe, Asle; Aadland, Eli Kristin & Viig, Nina Grieg (Ed.), Mat og helse i grunnskolelærerutdanningene. Fagbokforlaget. ISSN 9788245032901. p. 129–142. Full text in Research Archive Show summary

  Den vitenskapelige antologien "Mat og helse i lærerutdanningene" har et tydelig profesjonsrettet perspektiv og dreier seg om lærerutdanningsfagets hva, hvordan og hvorfor. Bidragene i antologien presenterer ny forskning med en tydelig fagdidaktisk innretning innenfor følgende tematiske områder: danning og didaktiske praksiser i skolens matlandskap, helsefremmende kosthold, bærekraftige matvaner og forbruk og mat og måltider som identitets- og kulturuttrykk. Boken henvender seg til lærerutdannere og masterstudenter i lærerutdanningene.

• Bjørnarå, Helga Birgit; Berntsen, Sveinung; Velde, Saskia J. te; Fyhri, Aslak; Deforche, Benedicte & Andersen, Lars Bo [Show all 7 contributors for this article] (2019). From cars to bikes - the effect of an intervention providing access to different bike types: A randomized controlled trial. PLOS ONE. 14(7), p. 1–17. doi: 10.1371/journal.pone.0219304. Full text in Research Archive Show summary

  Introduction We aimed to investigate whether providing parents with children in kindergarten with access to different bicycle types could influence (i) travel behavior and cycling amount, and (ii) intrinsic motivation for cycling and psychological constructs related to car use. Methods A randomized, controlled trial was conducted in Southern Norway from September 2017 to June 2018. In total 36 parents were recruited and randomly drawn into an intervention (n = 18) or control group (n = 18). The intervention group was in random order equipped with an e-bike with trailer (n = 6), a cargo (longtail) bike (n = 6) and a traditional bike with trailer (n = 6). Results At follow-up, more participants from the intervention group (vs. the control group) were classified as cyclists to the workplace (n = 7 (38.9%) vs. n = 1 (5.9%), p = 0.04), but not to the kindergarten (n = 6 (33.3%) vs. n = 2 (11.8%), p = 0.23) or to the grocery store (n = 2 (11.1%) vs. n = 0 (0%), p = 0.49). A significant (p = ≤0.05) increase in cycling frequency (0.1 to 2.0 days/week) from baseline to follow-up was found in the intervention group for all destinations and seasons, except to the grocery store during winter (p = 0.16). A decrease in frequency of car driving (-0.2 to -1.7 days/week) was found to be apparent in terms of travelling to the workplace and the kindergarten for all seasons, yet not to the grocery store for any season (p = 0.15–0.49). The intervention group (vs. the control group) reported significantly higher “intrinsic regulation” for cycling (p = 0.01) at follow-up. Conclusion Access to different bike types for parents with children attending kindergarten resulted in overall increased cycling, decreased car use and higher intrinsic motivation for cycling. E-bikes obtained the greatest cycling amount in total, with the smallest sample variability. Hence, providing parents with children in kindergarten with access to e-bikes might result in increased and sustained cycling, also during the winter season.

• Jahre, Anette Botnmark; Bere, Elling Tufte; Nordengen, Solveig; Solbraa, Ane Kristiansen; Andersen, Lars Bo & Riiser, Amund [Show all 7 contributors for this article] (2019). Public employees in South-Western Norway using an e-bike or a regular bike for commuting – A cross-sectional comparison on sociodemographic factors, commuting frequency and commuting distance. Preventive Medicine Reports. 14. doi: 10.1016/j.pmedr.2019.100881. Full text in Research Archive Show summary

  Large-scale analyses on the travel behavior of e-bikes are scarce, and current knowledge regarding who the e-bike owners are is inconsistent. Also, commuters represent a relevant user group with an unexploited potential. Therefore, the purpose of the present study was to examine (i) associations between type of bike (e-bike vs. regular bike) with place of residence (county), sociodemographic variables (age, sex, educational level, income and ethnicity) and habitual physical activity level, and (ii) if public employees possessing an e-bike cycle more often and longer distances to work. A cross-sectional survey was conducted in 2017 among 1977 (5.2% of eligible subjects) public employees in Southern and Western Norway. Binary and multinomial logistic regression analyses were conducted. Respondents possessing an e-bike were less likely to perform high levels of leisure time physical activity (OR 0.56 (CI 0.39-0.82)), compared to those possessing a regular bike only. For those residing in Agder, the likelihood of possessing an e-bike (vs. regular bike) was almost 4 times higher (OR 3.98 (CI 2.53-6.26)), compared with participants residing in Sogn og Fjordane. Compared with those possessing a regular bike only, e-bike users cycled more frequently to work, both occasionally (OR 3.71 (CI 2.44-5.65)) and most of the time (OR 4.28 (CI 2.79-6.55)), and they had higher odds of cycling medium distances to the workplace (OR 1.74 (CI 1.04-2.90)). In conclusion, e-bike access could result in increased commuter cycling, both in terms of cycling frequency and cycling distance, which in turn could contribute to enhanced physical activity levels.

• Øvrebø, Bente; Stea, Tonje Holte; Velde, Saskia J. te; Bjelland, Mona; Klepp, Knut Inge & Bere, Elling Tufte (2019). A comprehensive multicomponent school-based educational intervention did not affect fruit and vegetable intake at the 14-year follow-up. Preventive Medicine. ISSN 0091-7435. 121, p. 79–85. doi: 10.1016/j.ypmed.2019.02.015. Full text in Research Archive Show summary

  The intake of fruit and vegetables is associated with beneficial health outcomes, and studies aimed at increasing fruit and vegetable intake lack long-term follow-up. The primary objective of this study was to evaluate the long-term (14-year) effects of a multicomponent school-based educational intervention targeted to increase fruit and vegetable intake in children. The secondary objective was to evaluate the potential synergistic effect between free school fruit and the educational program. A cluster randomized school-based intervention was initiated in 2001 in Norway, known as the Fruit and Vegetable Make the Marks study. In total, 38 schools were randomized; for the intervention (n = 18) and as control schools (n = 20). A subsample of the intervention schools (n = 9) were additionally given free school fruit, resulting in two intervention groups - one with and one without free fruit. Participants completed questionnaires in September 2001 (baseline, mean age 11.8), May 2002 (at the end of the intervention), May 2003, May 2005, September 2009 and throughout 2016 (mean age 26.5). Of 1950 participants, 982 (50.4%) completed the 14-year follow-up and were considered as the current study sample. Analysis yielded no 14-year effects of the educational program on fruit and vegetable intake. A synergistic effect between the educational program and free fruit was not observed either. Future studies might benefit from increased focus on more extensive parental involvement, increased home availability, and a longer intervention period. However, more long-term studies are needed to evaluate the effects of school-based interventions into adulthood.

• Hovdenak, Ingrid Marie; Stea, Tonje Holte; Twisk, Jos; Velde, Saskia J. te; Klepp, Knut Inge & Bere, Elling Tufte (2019). Tracking of fruit, vegetables and unhealthy snacks consumption from childhood to adulthood (15 year period): does exposure to a free school fruit programme modify the observed tracking? International Journal of Behavioral Nutrition and Physical Activity. 16(22). doi: 10.1186/s12966-019-0783-8. Full text in Research Archive Show summary

  Background The rationale for promoting increased consumption of fruit and vegetables (FV) at an early age is based on results from previous tracking-studies, indicating that dietary habits learned in childhood sustain into adulthood. Previous tracking studies have several limitations (e.g. low study sample, few repeated measurements and/or short a follow-up period). In addition, to our knowledge, no study has shown that a dietary intervention initiated in childhood affects tracking of dietary behaviour. The main objectives in this study were therefore to assess tracking of FV and unhealthy snacks in a large sample with multiple follow-up surveys over 15-years, and whether exposure to free school fruit for one school year modified tracking. Method The longitudinal cohort-study, Fruit and Vegetables Make the Marks, included 38 randomly drawn schools in Norway; nine intervention schools received free fruit (or vegetable) in the school year 2001/2002 and 29 schools severed as control. The baseline sample included 1950 subjects, and 16–92% participated at five follow-up surveys (2002–2016). FV consumption and unhealthy snacks were measured by FFQ. Mixed models were applied to estimate overall tracking coefficients, and to assess whether the intervention modified tracking ((from baseline, from follow-up one (while intervention was running) and from follow-up two (after end of intervention)). Results Overall tracking coefficients were 0.33 for fruit, 0.36 for vegetables and differed by sex for unhealthy snacks: 0.46 males and 0.39 for females (interaction p = 0.065). Most analyses showed no significant difference in tracking between the intervention group and control group. However, from follow-up one, tracking coefficients were different for unhealthy snacks, 0.46 vs. 0.38 (interaction p = 0.036), and from follow-up two for vegetables, 0.35 vs 0.48 (p = 0.036), in the intervention group and control group, respectively. Conclusion Our results indicate low to moderate tracking of FV and unhealthy snacks from childhood to adulthood. We found little evidence that the free fruit intervention modified tracking of fruit, vegetables or unhealthy snacks. More research is needed on if or how we can influence the tracking of fruit, vegetables and unhealthy snacks consumption to improve public health.

• Hovdenak, Ingrid Marie; Stea, Tonje Holte; Magnus, Per; Krokstad, Steinar; Samdal, Oddrun & Bere, Elling Tufte (2019). How to evaluate the effect of seven years of The Norwegian School Fruit Scheme (2007-14) on fruit, vegetables, snacks consumption and weight status- A natural experiment. Scandinavian Journal of Public Health. ISSN 1403-4948. 49, p. 347–357. doi: 10.1177/1403494819875923. Full text in Research Archive Show summary

  Aim: From August 2007 to June 2014, the Norwegian School Fruit Scheme (NSFS) legally established that all pupils in junior high and combined schools (275,000 pupils every year), but not those in primary schools (343,000 pupils every year), were entitled to a free piece of fruit or vegetable every school day. The NSFS is a natural experiment, unique in terms of scope and lengthiness. Such governmental efforts to improve the diet of the public are rarely evaluated. Thus, an evaluation of the comprehensive, well-designed NSFS is warranted. The aim was to describe how the NSFS can be evaluated using existing data sets. Methods: Four data sets have been identified for the evaluation of the NSFS: (a) the Nord-Trøndelag Health Study, (b) the Norwegian Mother and Child Cohort Study, (c) the Norwegian Child Growth Study/Growth in Teenagers and (d) Health Behaviour in School Aged Children. These comprehensive studies have collected cross-sectional or longitudinal data providing information about children’s dietary consumption and/or weight status, which can be utilised in the evaluation of the NSFS. Both short- and long-term effects of the NSFS related to dietary habits and weight status and the potential effect of moderators such as socio-economic status, sex, ethnicity and the age of children and adolescents can be studied. Conclusions: Worldwide, there is a lack of well-designed, long-term studies evaluating the impact of governmental efforts to improve public diet. The present study describes how the NSFS can be evaluated using data from four large data sets on eating habits and weight status.

• Hovdenak, Ingrid Marie; Bere, Elling Tufte & Stea, Tonje Holte (2019). Time trends (1995-2008) in dietary habits among adolescents in relation to The Norwegian School Fruit Scheme: The HUNT study. Nutrition Journal. 18(77). doi: 10.1186/s12937-019-0501-z. Full text in Research Archive
• Hillesund, Elisabet Rudjord; Seland, Siv; Bere, Elling; Sagedal, Linda Reme; Torstveit, Monica Klungland & Lohne-Seiler, Hilde [Show all 8 contributors for this article] (2018). Preeclampsia and gestational weight gain in the Norwegian Fit for Delivery trial. BMC Research Notes. 11(282). doi: 10.1186/s13104-018-3396-4. Full text in Research Archive
• Lobben, Stian Ellingsen; Malnes, Lena; Berntsen, Sveinung; Tjelta, Leif Inge; Bere, Elling Tufte & Kristoffersen, Morten [Show all 7 contributors for this article] (2018). Bicycle usage and cardiorespiratory fitness among inactive adults provided with electrically assisted bicycles. Acta Kinesiologiae Universitatis Tartuensis. ISSN 1406-9822. 24, p. 60–73. doi: 10.12697/akut.2018.24.05. Full text in Research Archive
• Stea, Tonje Holte; Tveter, Eline Tønnesson; Velde, Saskia J. te; Vik, Frøydis Nordgård; Klepp, Knut Inge & Bere, Elling Tufte (2018). The effect of an extra piece of fruit or vegetables at school on weight status in two generations - 14 years follow-up of the Fruit and Vegetables Makes the Marks study. PLOS ONE. 13:e0205498(10). doi: 10.1371/journal.pone.0205498. Full text in Research Archive Show summary

  Background: The obesity epidemic presents a major public health challenge, and a poor diet quality has been identified as one of the most important contributing factors. Whereas a sufficient fruit and vegetable consumption has been associated with several positive health outcomes, the long-term effect on overweight and obesity is unclear. Thus, the aims of this study were to investigate if one year with free school fruit had any effect on weight status 14 years later, and if it affected the birth weight of the participants’ children. Methods: In 2001, 10 -12-year old Norwegian children, received one year of free school fruit in the intervention study “Fruits and Vegetables Make the Marks” (FVMM) and in 2016, a total of 1081 participants of 2049 eligible responded to a follow-up survey. Multilevel logistic regression was used to investigate if one year of free school fruit was associated with weight status and with birthweight status of the offspring. The analyses were adjusted for gender, educational level, and the offspring analysis also for parents’ weight status, and the nested design (child/parent). Results: The odds ratios of being overweight (OR: 0.93, 95% CI: 0.70, 1.24) or having a child with high or low birth weight (OR: 0.52, 95% CI: 0.21, 1.30) in the intervention group compared to the control group were not statistically significant, 14 years after the intervention period. Conclusions: One year of free school fruit did not have an effect on weight status on the participants or birth weight of their offspring, 14 years after the intervention period. Although, results from the present study contribute to fill the knowledge gaps concerning long-term effects of public health efforts on weight status, more follow-up studies with larger samples are warranted.

• Bjørnarå, Helga Birgit; Torstveit, Monica Klungland & Bere, Elling Tufte (2018). Healthy and sustainable diet and physical activity: the rationale for and experiences from developing a combined summary score. Scandinavian Journal of Public Health. ISSN 1403-4948. p. 1–9. doi: 10.1177/1403494818785056. Full text in Research Archive
• Stea, Tonje Holte; Hovdenak, Ingrid Marie; Rønnestad, Jannike Berggren; Rennestraum, Kjersti Hovland; Vik, Frøydis Nordgård & Klepp, Knut Inge [Show all 7 contributors for this article] (2018). Effects of 1 y of free school fruit on intake of fruits, vegetables, and unhealthy snacks: 14 y later. American Journal of Clinical Nutrition. ISSN 0002-9165. 108. doi: 10.1093/ajcn/nqy243. Full text in Research Archive
• Skreden, Marianne; Hillesund, Elisabet Rudjord; Wills, Andrew K.; Brantsæter, Anne Lise; Bere, Elling & Øverby, Nina Cecilie (2018). Adherence to the New Nordic Diet during pregnancy and subsequent maternal weight development: A study conducted in the Norwegian Mother and Child Cohort Study (MoBa). British Journal of Nutrition. ISSN 0007-1145. 119(11), p. 1286–1294. doi: 10.1017/S0007114518000776. Full text in Research Archive
• Johannessen, Berit; Helland, Sissel Heidi; Øverby, Nina Cecilie; Fegran, Liv & Bere, Elling (2018). "A bumpy road": Kindergarten staff experiences of participation in an intervention to promote healthy diets in toddlers. Appetite. ISSN 0195-6663. 127, p. 37–43. doi: 10.1016/j.appet.2018.04.008. Full text in Research Archive
• Bolt-Evensen, Kathrine; Vik, Frøydis Nordgård; Stea, Tonje Holte; Klepp, Knut Inge & Bere, Elling (2018). Consumption of sugar-sweetened beverages and artificially sweetened beverages from childhood to adulthood in relation to socioeconomic status - 15 years follow-up in Norway. International Journal of Behavioral Nutrition and Physical Activity. 15:8, p. 1–9. doi: 10.1186/s12966-018-0646-8. Full text in Research Archive Show summary

  BACKGROUND: In Norway, social inequalities in health and health-related behaviors have been reported despite the well-developed welfare state. The objective of the present study was to analyze; (i) the development in frequency of consumption of sugar-sweetened beverages (SSB) and artificially sweetened beverages (ASB) from childhood to adulthood; (ii) socioeconomic inequalities in the consumption of SSB and ASB using different indicators of socioeconomic status (SES); (iii) time trends in potential disparities in SSB and ASB consumption among different socioeconomic groups to assess the development in socioeconomic inequality from childhood to adulthood. METHODS: This study uses data from the Fruits and Vegetables Make the Marks (FVMM) longitudinal cohort, including participants (n = 437) from 20 random schools from two Norwegian counties. Data from the first survey in 2001 (mean age 11.8) and follow-up surveys in 2005 (mean age 15.5) and 2016 (mean age 26.5) were used. Consumption of SSB and ASB were measured using a food frequency questionnaire, which the participants completed at school in 2001 and 2005, and online in 2016. Various indicators of SES were included; in 2001, parental education and income were measured, in 2005, participants' educational intentions in adolescence were measured, and in 2016, participants' own education and income were measured. The main analyses conducted were linear mixed effects analysis of the repeated measures. RESULTS: Between 2001 and 2016, a decrease in frequency of consumption of SSB (2.8 v 1.3 times/week; p = < 0.001) and an increase in frequency of consumption of ASB (1.1 v 1.6 times/week; p = 0.002) were observed. Participants with a higher educational level in adulthood and higher educational intentions in adolescence had a significantly lower frequency of consumption of SSB at all time points (2001, 2005 and 2016). No significant widening (or narrowing) of inequalities were observed from childhood to adulthood. CONCLUSIONS: A decrease in consumption of SSB and an increase in consumption of ASB from childhood to adulthood were found. Participants with high SES consumed in general less SSB (but not ASB), however, results varied depending on SES indicator used. The established inequalities persisted from childhood to adulthood.

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• Skjelbred, Siv-Elisabeth; Fyhri, Aslak; Ciccone, Alice; Pedersen, Cathrine & Bere, Elling Tufte (2026). Hvordan får vi flere barn til å gå og sykle til skolen? doi: https:/www.nifu.no/nifu-toi-seminar-11-februar-hvordan-far-vi-flere-barn-til-a-ga-og-sykle-til-skolen/. Full text in Research Archive Show summary

  Norge har som mål at 80 prosent av elevene skal gå eller sykle til skolen. I mange deler av landet er man imidlertid langt unna å nå målet. I PULSE-prosjektet samarbeider TØI, NIFU og Universitetet i Agder med to hovedformål: 1) Øke fysisk aktivitet blant ungdom gjennom aktiv reise 2) Undersøke rollen aktiv reise har for humør og skoleprestasjoner. I tillegg til funn fra prosjektet vil seminaret formidle praktiske erfaringer fra tiltak som er gjennomført i Norge, fra skoleorganiserte opplærings- og mestringsinitiativ til kampanjer og konkurranser. Hva skal til for å få flere barn i bevegelse før skoledagen starter – og hvilke effekter kan dette ha for læring, helse og trivsel? Det inviteres til seminar for å dele erfaringer, diskutere funn og sammen utvikle mer helhetlige løsninger for økt aktiv skoletransport. Seminaret vil også ha en workshop med formål å utvikle et helhetlig opplegg for mer aktiv mobilitet på skoleveien. Arbeidet tar sikte på løsninger som kan tilpasses lokale kontekstuelle forhold og fungere i samspill med skolens læreplaner og øvrige rammebetingelser.

• Kolby, Marit; Bere, Elling Tufte; Dankel, Simon N; Molin, Marianne; Kjellsby, Line Capjon & Iuell, Ragnhild Skari [Show all 8 contributors for this article] (2025). Tiden er overmoden for å oppdatere kostrådene. Forskersonen.no. doi: https:/www.forskersonen.no/debattinnlegg-kostrad-mat/tiden-er-overmoden-for-a-oppdatere-kostradene/2597844. Full text in Research Archive
• Bere, Elling Tufte (2025). Hvordan distanse til skolen potensielt kan påvirke fysisk aktivitet. Full text in Research Archive
• Bere, Elling Tufte; Nilsen, Vegard; Løkra, Sissel; Poppe, Line Marie; Medin, Anine Christine & Strand, Elin (2025). Hvordan etablere et samfunn som gjør det enkelt å spise sunt? Full text in Research Archive Show summary

  Skole og barnehager har en rolle for å utjevne forskjeller. Hvem har mest innflytelse på barn og unges kosthold? Er det mer kostbart å spise sunt? Hvilke grep kan barnehager og skoler bidra til sunnere mat?

• Bere, Elling Tufte (2024). De nye norske kostrådene sklir i kaviaren. Full text in Research Archive
• Bere, Elling Tufte (2024). Folk på UiA. Var skeptisk til el-sykkelens treningseffekt. Så kom forskningsresultatene. [Internet]. UiA.no. Full text in Research Archive
• Bere, Elling Tufte (2024). Hälsoprofessor: Elcykel slår cykel. Intervju om transport til jobb. [Journal]. Svenska dagbladet. Full text in Research Archive
• Bere, Elling Tufte (2024). Hva er det beste fremkomstmiddelet når man kobler tidsbruk med helsegevinst? [Journal]. aftenposten.no. Full text in Research Archive
• Bere, Elling Tufte (2024). Är evidens man sällan ser kring mat och hälsa. Intervju om ultraprosesert mat. [Journal]. Svenska dagbladet. Full text in Research Archive
• Bere, Elling Tufte (2024). Hva er det beste fremkomstmiddelet når man kobler tidsbruk med helsegevinst? [Journal]. Stavanger aftenblad. Full text in Research Archive
• Bere, Elling Tufte (2024). Kobles til overvekt og kreft, men advarslene ble skrotet: – Mer enn nok bevis. [Journal]. Nettavisen. Full text in Research Archive
• Bere, Elling Tufte (2024). Har gitt kostråd i 70 år – nå er 7 av 10 overvektige: Mener denne maten bør svartelistes. Intervju om ultraprosessert mat. [Journal]. Nettavisen. Full text in Research Archive
• Skalicka, Vera; Stavnsbo, Mette; Bere, Elling Tufte & Wichstrøm, Lars (2023). Socioeconomic, parental and child predictors of child sports participation from Age 6 to Age 14. A Random Intercept Cross-Lagged Panel Model. Full text in Research Archive
• Uldahl, Maria & Bere, Elling Tufte (2023). Lavinntektsfamilier i Norge må bruke en større andel av inntekten sin for å spise i tråd med kostrådene. Norsk tidsskrift for ernæring (NTFE). ISSN 1503-5034. doi: 10.18261/ntfe.21.1.5. Full text in Research Archive
• Dankel, Simon N; Molin, Marianne & Bere, Elling Tufte (2023). Ultraprosessert mat burde være et kostråd: JA. Norsk tidsskrift for ernæring (NTFE). ISSN 1503-5034. 21(3), p. 31–37. doi: 10.18261/ntfe.21.3.8. Full text in Research Archive Show summary

  Nøkkelpunkter • Det er konsistente, sterke sammenhenger mellom høyt inntak av UPF og en rekke livsstilssykdommer. • Det er uhelse igjen i UPF etter at sukker, salt, fett, fiber og andre kostholdsmønstre er justert bort. • Det at enkelte «sunne» matvarer har fått preg av industriell ultraprosessering bør pirre nysgjerrigheten og sette oss i føre-var modus, heller enn å avfeie UPF-klassifiseringen. • UPF er tydelig definert innenfor NOVA-klassifiseringen – NNR bruker mer utydelige begrep som «prosessert» eller «plantebasert». • Vi mener NNR-rapporten viser et reduksjonistisk syn på mat og helse – ordet evolusjon nevnes ikke ett eneste sted.

• Bere, Elling Tufte (2023). Do ultra-processed foods fit in a sustainable future? [Radio]. Nordic Foodology. Full text in Research Archive
• Bere, Elling Tufte (2023). Utkast til nye kostråd burde advart om sammenhengen mellom uhelse og ultra¬prosessert mat. Full text in Research Archive
• Bere, Elling Tufte (2023). Big effort needed on UK diet to fight ultra-processed food, say health experts. [Journal]. The Guardian. Full text in Research Archive
• Bere, Elling Tufte (2023). Nye kostråd; Kapittel om ultraprosessert mat. Full text in Research Archive
• Bere, Elling Tufte (2023). Sustainable physical activity. Full text in Research Archive
• Bere, Elling Tufte (2023). Kostrådene lider av nutrisjonisme. Full text in Research Archive
• Bere, Elling Tufte (2023). Halvparten av all maten vi spiser er ultraprosessert. Hvor farlig er det? [Journal]. DN. Full text in Research Archive
• Bere, Elling Tufte (2023). Ekspertgruppe bidro til nye kostråd. Nå kjenner flere av dem ikke igjen rådene: – Jeg vil ikke ha navnet mitt på dette. [Journal]. aftenposten.no. Full text in Research Archive
• Bere, Elling Tufte (2023). Intervju om ultraprosessert mat og kostråd. [Radio]. Nrk. Full text in Research Archive
• Pedersen, Ingeborg; Moe, Ellinor; Ihlebæk, Camilla; Nordbø, Emma Charlott Andersson; Amundsen, Guro Vollan & Bere, Elling Tufte [Show all 11 contributors for this article] (2023). Samskaping - er det egentlig mulig? Full text in Research Archive
• Zinöcker, Marit; Dankel, Simon Erling Nitter; Berg, Siv Hilde & Bere, Elling Tufte (2023). De nye kostrådene har metodiske mangler. doi: 10.4045/tidsskr.23.0758. Full text in Research Archive
• Øvrebø, Bente; Kjøllesdal, Marte Karoline Råberg; Stea, Tonje Holte; Wills, Andrew Keith; Bere, Elling Tufte & Suren, Pål [Show all 9 contributors for this article] (2022). Prevalence of overweight, obesity and central adiposity among children with immigrant background in Norway. Full text in Research Archive
• Blytt, Cornelia; Folkestad, Mia; Theofylaktopoulou, Despoina; Vildmyren, Iselin Thowsen; Kolve, Cathrine Solheim & Bere, Elling Tufte [Show all 8 contributors for this article] (2022). Students’ breakfast habits and socioeconomic status - A comparison of two high schools with a free breakfast meal. Full text in Research Archive
• Bere, Elling Tufte (2022). Evaluering av EMO. Forskningsprosjektet Samskaping av aktive møteplasser. Full text in Research Archive
• Bere, Elling Tufte (2022). FHI-rapport: Tilbud om enkel varm skolemat er gjennomførbart. [Journal]. aftenposten.no. Full text in Research Archive
• Ihlebæk, Camilla; Nordbø, Emma Charlott Andersson; Bere, Elling Tufte; Schipperijn, Jasper & Pawlowski, Charlotte (2022). Informasjonsfilm: Forskningsprosjektet "Samskaping av aktive møteplasser". Full text in Research Archive
• Bere, Elling Tufte (2022). Ny rapport om skolemat: Det er mulig å servere enkel varmmat, men fast ordning vil kreve ekstra personale. [Journal]. Forskning.no. Full text in Research Archive
• Bere, Elling Tufte (2022). Vær og (el)sykling. [TV]. Nrk. Full text in Research Archive
• Bere, Elling Tufte (2022). Skolemat og sosial ulikhet. [Radio]. Nrk. Full text in Research Archive
• Bere, Elling Tufte (2022). Du har en bratt bakke hjem fra jobb – hva gjør du? lokalavisen fedrelandsvennen. Full text in Research Archive
• Bere, Elling Tufte (2021). Dette betyr de nye aktivitetsrådene for deg. Full text in Research Archive
• Bere, Elling Tufte (2021). Dette betyr de nye aktivitetsrådene for deg. Full text in Research Archive
• Bere, Elling Tufte (2021). Dette betyr de nye aktivitetsrådene for deg. Full text in Research Archive
• Bere, Elling Tufte (2021). Dette betyr de nye aktivitetsrådene for deg. Full text in Research Archive
• Bere, Elling Tufte (2020). Elektrisk rå kraft. [Journal]. Hallingdølen. Full text in Research Archive
• Bere, Elling Tufte (2020). Du blir sprek av å spinne på et treningssenter, men sykler du til jobb er du også med på å redde verden KRONIKK: Mer trim og trening er ikke bare positivt. Det innebærer også økte klimagassutslipp. Full text in Research Archive
• Bere, Elling Tufte (2020). Folk strømmer til treningsløypene: – Jeg har aldri opplevd maken. [Journal]. https://www.fvn.no/sport/i/3JOAg0/folk-stroemmer-til-trening. Full text in Research Archive
• Bere, Elling Tufte (2020). Hjemmehygge gir godteri-boom: – Folk er helt gale. [TV]. https://www.nrk.no/sorlandet/mer-hjemmetid-gir-godteri-boom-. Full text in Research Archive
• Stenqvist, Thomas Birkedal & Bere, Elling Tufte (2020). How traditional Norwegian outdoor activities are changing; a 10 year follow up. ECSS Conference Proceedings. ISSN 2188-1154. Full text in Research Archive
• Bere, Elling Tufte (2020). – Ja! Landbruket har bruk for mange av dem. [Journal]. https://www.fvn.no/nyheter/lokalt/i/AdMagq/ja-landbruket-har. Full text in Research Archive
• Hillesund, Elisabet Rudjord; Valand, Ida Ulrikke; Bere, Elling Tufte; Vistad, Ingvild; Sagedal, Linda Reme & Øverby, Nina Cecilie (2019). Meals eaten with family in relation to dietary quality in 12-month-olds. A sub-study in the Norwegian Fit for Delivery study. Full text in Research Archive
• Hovdenak, Ingrid Marie; Bere, Elling Tufte & Stea, Tonje Holte (2019). Time trends (1995-2006) in dietary habits among Among adolescents in relation to the Norwegian School Fruit Scheme: The HUNT study. Full text in Research Archive
• Meltzer, Helle Margrete & Bere, Elling Tufte (2019). Kosthold og bærekraft. In Engeset, Dagrun; Torheim, Liv Elin & Øverby, Nina Cecilie (Ed.), Samfunnsernæring. Universitetsforlaget. ISSN 9788215030630. p. 222–229. Full text in Research Archive
• Bjørnarå, Helga Birgit; Berntsen, Sveinung; Velde, Saskia Te; Deforche, Benedicte; Fegran, Liv & Fyhri, Aslak [Show all 8 contributors for this article] (2019). E-bikes for family transportation: Project From Cars to Bikes. Full text in Research Archive
• Hovdenak, Ingrid Marie; Bere, Elling Tufte; Selstø, Annlaug & Helleve, Arnfinn (2023). Effekten av et gratis skolemåltid- en kunnskapsoppsummering. Folkehelseinstituttet. ISSN 9788284063515. Full text in Research Archive Show summary

  Innledning Gratis skolemat blir sett på som et tiltak som kan påvirke både helse og skolerelaterte utfallsmål. Hensikten med denne rapporten er å oppsummere hva forskningen sier om effekten av et gratis skolemåltid. Sentrale utfall er deltakelse ved skolemåltidet, vektstatus, kosthold, akademiske resultater, fravær samt sosial ulikhet. I tillegg til disse utfallsmålene vil vi beskrive skolemåltidet opp mot bærekraft. Metode Vi tok utgangspunkt i en nylig publisert oversiktsartikkel (Cohen, 2021), som oppsummerte effekten av gratis skolemåltid i høyinntektsland. Videre gjennomføre vi tre litteratursøk etter 1) systematiske litteraturstudier publisert de siste 10 årene, 2) nyere empiriske studier publisert i 2021 og 2022 (altså en oppdatering av Cohen), og 3) empiriske studier publisert i Norden (uten tidsavgrensning). Videre inkluderte vi relevante studier fra litteraturlisten til inkluderte studier. For å gi en rikere beskrivelse av hva den potensielle effekten av et skolemåltid kan være, eller andre relevante betraktninger rundt et skolemåltid, beskriver vi også grå litteratur som tidligere utredninger og evalueringer fra Norge. Dette ble gjort usystematisk, og må ses på som et tillegg til oppdraget, og ikke som en del av hovedoppdraget. Resultat En systematisk oversiktsartikkel, åtte empiriske studier publisert i 2021 og 2022 og 13 studier fra Norden, samt tre studier fra litteraturlister til de inkluderte studiene, var relevant og oppfylte inklusjonskriteriene. Videre beskriver vi i tillegg tre tidligere utredninger, en rapport og tre evalueringer. Oversiktsartikkelen viste at majoriteten av inkluderte studier rapporterte at gratis skolemåltid, særlig lunsj, var assosiert med økt deltakelse ved skolemåltider, bedre kosthold og forbedret matsikkerhet, og måltidet førte enten til ingen endring i vekt, eller mindre overvekt, blant elever. For frokost var resultatene sprikende. Generelt var resultatene fra den nordiske litteraturen sprikende og flere av studiene hadde lav kvalitet. Majoriteten av studiene fra Norden viste at et gratis skolemåltid (frokost eller lunsj) hadde en positiv effekt på noen kostutfall. Videre tyder resultatene på at et gratis skolemåltid kan bidra til å redusere sosiale forskjeller i kostholdet. Totalt tre nordiske studier undersøkte sammenhengen mellom gratis skolemåltid og vekt, hvorav en studie viste økt vekt og en annen viste økt midjemål, og en viste ingen endring som følge av et gratis skolemåltid. To nordiske studier undersøkte effekten av et gratis skolemåltid på akademiske prestasjoner, hvor ingen av disse viste tydelig positiv effekt. Ingen av de nordiske studiene fant en sammenheng mellom gratis skolemåltid og fravær (to studier), trivsel (to studier) eller skolemiljø (to studier). I henhold til bærekraft, var det bare en studie fra Danmark som undersøkte effekten av matsvinn. Resultatene viste at et varmt skolemåltid førte til mer matsvinn sammenlignet med medbragt matpakke. To studier som så på langtidseffekten av gratis skolemåltid, implementert i Norden på 1920-1940-tallet, viste at skolemåltidet førte til lengre skolegang og økt inntekt. Diskusjon En rekke studier undersøker effekten av et gratis skolemåltid, men denne har begrenset relevans for norske forhold. Det er generelt mangel på relevant forskning som undersøker effekten av et gratis skolemåltid. Resultatene av studiene som er overførbare til en norsk setting er sprikende. Konklusjon Den internasjonale forskningslitteraturen viser positive effekter av å tilby et gratis skolemåltid på flere utfallsmål, men resultatene er i mindre grad overførbare til en norsk kontekst. Det er mangel på robuste studier av effektene av å tilby et gratis skolemåltid i kontekster som den norske.

• Kolve, Cathrine Solheim; Helleve, Arnfinn & Bere, Elling Tufte (2022). Gratis skolemat i ungdomsskolen – nasjonal kartlegging av skolematordninger og utprøving av enkel modell med et varmt måltid. Folkehelseinstituttet. ISSN 9788284062624. Full text in Research Archive Show summary

  Innledning Gratis skolemat (det vil si et måltid uten elev- eller foreldrebetaling) blir av mange sett på som et tiltak som kan løse flere utfordringer i samfunnet relatert til kosthold, trivsel og læring, sosiale forskjeller og miljø. Selv om det i Norge er en tradisjon for å ta med mat hjemmefra er det flere elever som ikke har gode spisevaner på skoledager. Utfordringene med et gratis skolemåltid til alle skoleelever er blant annet betydelige kostnader knyttet til investeringer og drift. FHI ønsket å prøve ut om det er praktisk mulig å tilberede og tilby et varmt måltid ved ungdomsskoler ved bruk av eksisterende fasiliteter, samt å kartlegge omfanget av skolematordninger ved norske ungdomsskoler. I samarbeid med Geitmyra matkultursenter for barn og Unge Kokker ble det utviklet et konsept med enkel varmmat som kan lages i én gryte. Dette konseptet ble testet ut på fem ungdomsskoler, hvor elevene fikk tilbud om å spise et gratis varmt måltid over ti skoledager. Menyen bestod av havregrøt, fiskegryte, gulrotsuppe, grønnsakssuppe og chili-sin-carne. Geitmyra matkultursenter for barn og Unge Kokker bistod også skolene med planlegging og gjennomføring, og kokker var til stede de fem første av de ti utprøvningsdagene. Prosjektet hadde følgende problemstillinger: Delprosjekt 1 i) Hvilke skolematsordninger finnes i dag ved norske ungdomsskoler? Delprosjekt 2 ii) Er det mulig for ungdomsskoler å tilby et varmt skolemåltid innenfor dagens infrastruktur? iii) Hva syntes elever om å få servert et varmt skolemåltid, og i hvilken grad kan et slikt skolemåltid påvirke elevenes kosthold? Metode Kartleggingen over ulike skolematordninger ved landets ungdomsskoler ble gjennomført som en nettbasert spørreskjemaundersøkelse til alle skoler med ungdomstrinn (bruttoutvalg=985 skoler). Konseptet ble prøvd ut ved fem skoler (tre i Oslo og to i Trøndelag) for å sikre variasjon i skolenes beliggenhet, elevantall og elevsammensetning. Skolene testet ut konseptet med enkle varmretter i totalt ti dager. For å undersøke elevenes vaner og holdninger ble det gjennomført spørreskjemaundersøkelser blant 1043 elever før og under utprøvingen. Ved hver skole ble det også gjennomført to fokusgruppeintervju, et intervju med elever og et intervju med en gruppe lærere/rektor. I tillegg ble det gjort observasjoner ved alle skolene for å gi et innblikk i selve gjennomføringen. Resultater Nasjonal kartlegging (delprosjekt 1) Totalt besvarte 817 ungdomsskoler den nasjonale kartleggingen, noe som gav en svarprosent på 83%. Resultatene viste at 16% (n=133) av ungdomsskoler hadde en ordning med organisert skolemat. Blant skolene som hadde en skolematordning hadde 61% av disse en gratisordning. Totalt var det 6% av skolene som hadde et tilbud om et gratis måltid til alle elevene hver skoledag. De fleste serverte lunsj (54%), og det vanligste lunsjtilbudet var å servere kald mat (77%), men over halvparten (56%) hadde også tilbud om varmmat. Utprøving av varmmatmodell (delprosjekt 2) Prosjektet med utprøving av en varmmatmodell viste at det var mulig for ungdomsskolene å tilberede og servere et varmt måltid til elevene. Forutsetninger for å få det til var god planlegging, lokal tilpasning og en ansvarlig person som koordinerte prosjektet ved hver skole. Erfaringene fra prosjektet tilsier at tilbud om et varmt skolemåltid må ha en ansatt som er ansvarlig for opplegget og som har den nødvendige kunnskapen for å kunne lage mat til mange. I dette prosjektet var det en trygghet for de ansatte på skolene at det var til stede kokk fra Geitmyra matkultursenter for barn eller Unge kokker de første fem dagene. Elevene selv var positive til å få gratis mat, men det var en utfordring å få alle til å smake og spise opp maten. Blant de som besvarte spørreskjemaet (n=670) var det 33% av elevene som sa de likte maten dårligere enn det de vanligvis spiser til skolelunsj (nistepakke for de fleste). Det var flere som ikke smakte på rettene som ble servert. For eksempel var det 25% som ikke smakte på fiskegryten. Blant elevene som smakte på rettene, var det havregrynsgrøten og chilisin-carne elevene likte best, men det var ikke mer enn 54 og 51% som rapporterte at de likte disse rettene godt. Andelen som likte de forskjellige rettene, varierte stort mellom skolene. I fokusgruppene ga elevene uttrykk for at de ønsket mer variasjon og tilpassede retter. Sammenlignet med undersøkelsen før utprøvingen viste undersøkelsen som ble gjennomført mens konseptet ble testet ut forholdsvis små endringer i hva som ble spist på skolen. Det var en liten økning i andelen som spiste frokost og grønnsaker på skolen, og en liten reduksjon i andelen som spiste snacks og frukt på skolen. Diskusjon Den nasjonale kartleggingen viste at det er relativt få ungdomsskoler som hadde en ordning med gratis skolemat i Norge. Selv om resultatene fra pilotundersøkelsen viste at det er mulig å lage og servere et enkelt varmt måltid til elever på ungdomsskolen med dagens infrastruktur og personell, er det lite realistisk å etablere ordninger med skolemat uten dedikerte personalressurser med kompetanse og ekstra ressurser. Elevene som deltok i denne utprøvingen var i utgangspunktet positive til å få servert et gratis måltid hver dag, og flere likte rettene godt. Samtidig falt ikke rettene i smak hos alle. Mange elever lot også være å smake på maten som ble servert. For flere elever var det ukjente retter og smaker som ble servert. Det er en stor utfordring om mange ikke spiser maten. Det å lage sunne, matretter som skal tilfredsstille alle, og samtidig være innenfor et begrenset budsjett, er nok vanskelig. Resultatene fra studien viste at det ikke er sikkert at en skolematordning i ungdomsskolen nødvendigvis vil forbedre kostholdet blant ungdom i Norge i dag. Blant de elevene som smakte på rettene var det likevel en liten forbedring i hva de spiste. Elevene og skolepersonale hadde positive erfaringer med å innta måltidet sammen. Dette kan tyde på at deltakelsen i felles måltider kan ha en funksjon for det sosiale miljøet ved skolene. Konklusjon Omtrent hver sjette ungdomsskole hadde i 2020 en form for skolematordning, mens det bare ved 6% av skolene var et tilbud om gratis skolemat hver dag. Pilotundersøkelsen viste at det er mulig for ungdomsskoler å servere et varmt måltid til elever innenfor skolens infrastruktur, men at en permanent ordning vil kreve andre ressurser og personale med riktig kompetanse. Elevene selv gav uttrykk for at de ønsket seg gratis skolemat, men rettene som ble servert falt ikke helt i smak. Både elever og skolens personell opplevde selve måltidsituasjonen som positiv for det sosiale miljøet.

• Øvrebø, Bente; Bere, Elling Tufte & Stea, Tonje Holte (2022). Evaluations of school-based and fiscal efforts on diet-related behaviors and weight, emphasizing fruit, vegetables, candy, and soda. Universitetet i Agder. ISSN 9788284270647. Full text in Research Archive

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