Erlend Nuland Valen

• Øverby, Nina Cecilie; Medin, Anine Christine; Valen, Erlend Nuland; Salvesen, Lorentz; Vik, Frøydis Nordgård & Hillesund, Elisabet Rudjord (2026). Lessons learned from digital dietary interventions targeting the preconception population. Proceedings of the Nutrition Society. ISSN 0029-6651. doi: 10.1017/S0029665126102286. Full text in Research Archive
• Valen, Erlend Nuland; Wills, Andrew Keith; Medin, Anine Christine; Vik, Frøydis Nordgård; Engeset, Dagrun & Salvesen, Lorentz [Show all 8 contributors for this article] (2026). Effect of a digital dietary intervention on diet quality in young adults in Norway – The PREPARED randomised controlled trial. BMC Nutrition. 12. doi: 10.1186/s40795-026-01278-4. Full text in Research Archive Show summary

  Background Nutritional status and lifestyle during the preconception phase, the months and years before conception, may have substantial impact on the health of the next generation. Diet quality during these years has been a neglected in previous dietary assessments. Methods The PREPARED study is a digital intervention with a randomised controlled trial design with the aim to assess its effectiveness on diet quality and micronutrient adequacy. Individuals with a Norwegian identification number without biological children aged 20–35 were recruited using social media platforms. Data was collected digitally using a dietary screener which was recoded into a diet quality score (DQS) and a 24-hour recall recoded into binary variables to compare adherence to the average requirement defined by the Nordic Nutrition Recommendations 2023. The intervention group received access to a digital resource where all components were created using the Determinants of Nutrition and Eating framework (DONE), with new weekly content across 6 months. Results From the total sample of 1374, the follow-up sample consisted of 186 participants (13.5%) (Control: 99, Intervention: 87) on DQS, and 150 (10.9%) on micronutrient adequacy. The mean difference between intervention and control in total diet quality score was + 1.0 (IQR − 3.0, 4.9) (adjusted p = 0.63). The results showed no improvement in diet quality or change in proportion of participants reaching average requirements between the intervention and control group. Conclusions We found no evidence towards having a healthier diet in any of the groups at the end of the trial, and there were no differences in proportions reaching average requirement for selected micronutrients. The substantial loss to follow-up might have had a significant impact on the results. Improving or developing strategies for recruitment and keeping retention rates is an important area for future intervention studies.

• Øverby, Nina Cecilie; Ripatti, Katri Rakel; Valen, Erlend Nuland & Hillesund, Elisabet Rudjord (2025). Young adults’ experience with using a web based digital resource to promote healthy preconception diet. BMC Nutrition. 11. doi: 10.1186/s40795-025-01151-w. Full text in Research Archive Show summary

  Background The nutritional status of both women and men before conception impacts growth, development, and long-term health of future children. Evidence suggests that a substantial proportion of young adults lack adequate nutritional preparedness for future pregnancy. We have developed a digital resource, PREPARED, targeting young adults’ diet, nutrition literacy and dietary behavior that is presently being evaluated in a randomized controlled trial. The aim of the present study was to examine young adults´ thoughts and experiences following use of the e-learning resource. Methods We investigated whether the resource is perceived as useful by young adults (aged 20–35 years) and as practical support for obtaining a healthy diet. Nine young adults consented to participate and were given access to the resource for two months and were then interviewed using a semi-structured interview technique. Using a phenomenological approach the material was analysed by thematic analysis. Results Three main themes were identified: easier to make healthy choices , new justification for healthy eating , and further development . Access to recipes with simple and well-known ingredients and easy-to-read articles with a nuanced and positive focus were decisive factors for inspiration and motivation to change diet. Participants felt the resource saved time and appreciated its positive, informative approach. The emphasis on preconception nutrition was described as both enlightening and unfamiliar. Still, the resource has potential for improvements like navigation on the website, easier recipe portion estimation, and requests for more text to read. Conclusion According to young adults in this study, the PREPARED resource communicates clear and motivating messages about diet, health and the importance of nutritional preconception health for future parenthood. The resource was perceived as nuanced and trustworthy, which was highly valued. Our results inform future iterations of digital health tools or nutrition education programs for young adults.

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

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

• Valen, Erlend Larsen; Grasaas, Erik; Engeset, Dagrun; Salvesen, Lorentz; Skeie, Guri & Øverby, Nina Cecilie [Show all 7 contributors for this article] (2023). Myfood24 på norsk: et selvadministrert digitalt 24-timers kostintervju. Norsk tidsskrift for ernæring (NTFE). ISSN 1503-5034. 21(2), p. 13–22. doi: 10.18261/ntfe.21.2.3. Full text in Research Archive Show summary

  Innen ernæringsepidemiologien er vi i stor grad avhengige av å estimere inntak av mat og næringsstoffer basert på selvrapportering, til tross for at denne tilnærmingen er beheftet med målefeil. Graden av målefeil har betydning for analyser og tolkning av resultater, så metodene vi bruker bør være så valide som mulig. Å utvikle brukervennlige kostholdsmetoder som reduserer belastning for deltaker kan være et viktig bidrag til mer nøyaktig rapportering, samtidig som tids- og ressursbruken begrenses. Det digitale kostholdsverktøyet myfood24, opprinnelig utviklet ved Universitetet i Leeds, kan enten brukes som et selvadministrert 24-timers kostintervju, eller matdagbok. Verktøyet har de siste årene blitt oversatt og kulturelt tilpasset til flere land, både i og utenfor Europa, og har blitt validert i en rekke ulike aldersgrupper. I 2019 startet arbeidet med å lage en norsk versjon av myfood24. Det er allerede gjennomført en valideringsstudie av bilder av porsjonsstørrelser som inngår i den norske versjonen, og det planlegges å validere verktøyet ytterligere. Hensikten med denne artikkelen er å beskrive utviklingsarbeidet som er gjort. Målet er at norske myfood24 også skal kunne brukes av andre norske forskere, og med denne artikkelen ønsker vi å gjøre informasjon om verktøyet tilgjengelig.

• Valen, Erlend Nuland; Øverby, Nina Cecilie; Hardy-Johnson, Polly; Vik, Frøydis Nordgård; Salvesen, Lorentz & Omholt, Mona Linge [Show all 8 contributors for this article] (2023). Lessons learned from talking with adults about nutrition: A qualitative study in the PREPARED project. Maternal & Child Nutrition. ISSN 1740-8695. 20(S2). doi: 10.1111/mcn.13540. Full text in Research Archive Show summary

  Improving diet and dietary behaviour of men and women before pregnancy has thepotential to benefit both their current and long‐term health and the health of theirchildren. Little is known, however, about adults' perception of diet's role inprepregnancy health. This study aimed to explore the state of knowledge andawareness of preconception nutritional health in adults within the fertile age rangeand what they perceived could motivate healthy eating using the self‐determinationtheory as a theoretical framework. We analysed 33 short exploratory interviewswith men (n= 18) and women (n= 15) aged 18–45 years. Participants were grabsampled from three different public locations in the southern part of Norway.Interviews were audio‐recorded, transcribed verbatim in 2020 and analysed using athematic analysis with a semantic approach in 2022. The findings suggest that adultswithin the fertile age range are not intrinsically motivated to eat healthily, but whenthey do, it is because eating healthily often aligns with other goals consistent withtheir values, that is, getting fit or looking good. They possess some basic knowledgeof healthy behaviours during pregnancy but are generally unaware of the importanceof preconception health and nutrition. There is a need to increase awareness ofthe impact of preconception health on the health of this and future generations.Improved nutritional education on the significance of diet before conception mightfacilitate optimal conditions for conceiving and for pregnancy in the adult populationwithin fertile age range.

• Salvesen, Lorentz; Valen, Erlend Larsen; Wills, Andrew Keith; Hillesund, Elisabet Rudjord; Vik, Frøydis Nordgård & Engeset, Dagrun [Show all 8 contributors for this article] (2023). Developmental origins of health and disease knowledge is associated with diet quality in preconception young adult men and women. Journal of Developmental Origins of Health and Disease. ISSN 2040-1744. 15(5). doi: 10.1017/S2040174423000314. Full text in Research Archive Show summary

  The Developmental Origins of Health and Disease (DOHaD) approach supports that nutritional exposures in early life affect an individual’s later health and risk of disease. Dietary exposure during the preconception period may also influence individual, and inter- and transgenerational health and disease risk, in both men and women. This study aimed to describe knowledge of the DOHaD approach (DOHaDKNOWLEDGE) and diet quality in preconception young adults in Norway, to assess associations between DOHaDKNOWLEDGE and a Diet Quality Score (DQS), and to assess gender differences in those above. Data from 1362 preconception young adults was obtained from the PREPARED study baseline dataset. The sample had 88% women participants, a mean age of 27 years, 36% had overweight or obesity, and 77% had higher level of education. DOHaDKNOWLEDGE was assessed by the participants’ agreement to five statements using a Likert scale. Diet quality was assessed using aspects of diet quality and a DQS derived from a dietary screener. We found moderate level of both DOHaDKNOWLEDGE (12/20 points) and diet quality (DQS: 60/100 points), indicating potential for improvements. Specifically, the greatest potential for diet quality improvements were observed for sugary foods, red and processed meats, legumes, and unsalted nuts and seeds. Gender differences were observed for both DOHaDKNOWLEDGE and diet quality. DOHaDKNOWLEDGE was positively associated with DQS, adjusted for sociodemographic factors, with little evidence of an interaction effect by gender. This study indicates that knowledge of the DOHaD approach is positively associated with diet quality in preconception young men and women. Future studies should consider incorporating pregnancy intentions, relationship status, and health literacy.

• Øverby, Nina Cecilie; Medin, Anine Christine; Valen, Erlend Larsen; Salvesen, Lorentz; Wills, Andrew Keith & Engeset, Dagrun [Show all 8 contributors for this article] (2021). Effectiveness of a digital dietary intervention program targeting young adults before parenthood: protocol for the PREPARED randomised controlled trial. BMJ Open. 11(12). doi: 10.1136/bmjopen-2021-055116. Full text in Research Archive
• Hillesund, Elisabet Rudjord; Øverby, Nina Cecilie; Valen, Erlend Larsen & Engeset, Dagrun (2020). Alcohol consumption among students and its relationship with nutritional intake: a cross-sectional study. Public Health Nutrition (PHN). ISSN 1368-9800. 24(10), p. 2877–2888. doi: 10.1017/S1368980020004450. Full text in Research Archive
• Valen, Erlend Larsen; Engeset, Dagrun; Øverby, Nina Cecilie & Hillesund, Elisabet Rudjord (2020). StudentKost: a cross-sectional study assessing college students’ diets: reason for concern? Journal of Nutritional Science (JNS). 9. doi: 10.1017/jns.2020.33. Full text in Research Archive

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• Valand, Ida Ulrikke; Valen, Erlend Larsen & Salvesen, Lorentz (2023). Skills for life-podden, episode 4: Hæ, før barnet blir født? Prepared og preconception diet. [Internet]. Spotify, Google Podcasts, Apple Podcasts. Full text in Research Archive Show summary

  Doktorgradsstipendiatene Erlend Valen og Lorentz Salvesen presenterer forskningen sin, og vi snakker om hvordan kosthold før man blir foreldre påvirker det fremtidige barnets helse.

• Øverby, Nina Cecilie; Hillesund, Elisabet Rudjord; Helland, Sissel Heidi; Helle, Christine; Wills, Andrew Keith & Lamu, Admassu Nadew [Show all 23 contributors for this article] (2023). Evaluating the effectiveness and implementation of evidence-based early-life nutrition interventions in a community setting a hybrid type 1 non-randomized trial – the Nutrition Now project protocol. Frontiers in Endocrinology. 13. doi: 10.3389/fendo.2022.1071489. Full text in Research Archive Show summary

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

• Medin, Anine Christine; Valen, Erlend Nuland & Salvesen, Lorentz (2021). Photographs of foods - Experiences from adapting a British web-based dietary assessment tool (myfood24) for Norway. Full text in Research Archive

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