Nina Cecilie Øverby

• Wesseltoft-Rao, Nima; Hillesund, Elisabet Rudjord; Øverby, Nina Cecilie; Olsen-Bergem, Heming & Vejrup, Kristine (2026). Health literacy, dietary behavior and body mass index in male and female Norwegian conscripts. A cross-sectional study. Journal of Public Health Research. ISSN 2279-9028. 15(3), p. 1–9. doi: 10.1177/22799036261461038. Full text in Research Archive Show summary

  Objectives Health literacy (HL) is an important determinant of health behaviors, including diet. In military populations, optimal nutrition is critical for physical performance, readiness, and long-term health. In Norway, first-time military service provides a unique opportunity to influence young conscripts’ health habits. This study investigates the relationship between HL and dietary patterns, body mass index (BMI), and meal adherence among Norwegian conscripts, with an emphasis on potential sex differences. Study Design A cross-sectional study. Methods This cross-sectional study included Norwegian conscripts completing first-time military service. HL was measured using the validated HLS-Q12 instrument. Dietary behaviors, meal patterns, and BMI were assessed using self-reported questionnaire data. A digital questionnaire was sent to Norwegian conscripts completing their first-time military service in 2022 (n=9,991). A total of 2,225 conscripts consented to participate in the study. The survey assessed dietary habits across different military settings, self-reported diet quality, and HL using the HLS-Q12 tool. BMI was calculated from self-reported height and weight. Statistical analyses included chi-square tests and Pearson correlation to explore associations between HL, diet, and BMI. Results Significant associations were observed between HL and several dietary variables; however, most associations were weak in magnitude. Higher HL was associated with more regular meal patterns and better self-reported diet quality. Additionally, differences between sexes were observed, but effect sizes were generally small. More than half of conscripts had an adequate HL, with males scoring significantly higher than females. Conscripts with adequate HL were more likely to rate their diet as good, follow meal recommendations, and maintain a normal BMI. However, no significant association between HL and BMI was found in the total population; differences appeared in sex-stratified analyses, among female conscripts. Independently of HL, unhealthy snacking and high-sugar drink consumption were more common during field training, whereas conscripts with inadequate HL (iHL) reporting higher sugary snack intake at home. Adequate HL was weakly but significantly correlated with higher self-reported diet quality, more frequent adherence to regular meals, and lower sugary snack consumption. This could mean that HL was associated with self-reported dietary intentions but not outcomes like BMI. Conclusions HL may be associated with dietary behaviors among conscripts. However, given the weak associations and study limitations, the findings should be interpreted with caution. Although more than half of the conscripts had adequate HL, iHL was prevalent among Norwegian conscripts. Poorer self-reported diet quality and lower adherence to regular meal patterns is associated with iHL, particularly during field training. No significant associations was found between HL and BMI. The findings suggest a need for tailored education to improve HL and behavior change, to promote healthier dietary habits during military service.

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

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

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

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

• 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.

• Medin, Anine C.; Polspoel, Maaike E. M.; Vejrup, Kristine; Strömmer, Sofia T.; Barker, Mary Elizabeth & Øverby, Nina Cecilie (2025). “I bought it, but I still don’t know what it is”: international students dealing with a new food culture in Norway − A qualitative study. International Journal of Qualitative Studies on Health and Well-being. ISSN 1748-2623. 20(1). doi: 10.1080/17482631.2025.2595849. Full text in Research Archive
• 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; Hillesund, Elisabet Rudjord & Øverby, Nina Cecilie (2025). Samfunnsrettet ernæringsarbeid. Norsk tidsskrift for ernæring (NTFE). ISSN 1503-5034. 23(3), p. 181–190. doi: 10.18261/ntfe.23.3.7. Full text in Research Archive Show summary

  Samfunnsernæring har som mål å fremme og opprettholde ernæringsrelatert helse og livskvalitet i befolkningsgrupper gjennom målrettet innsats og kunnskapsbaserte valg i samfunnet. Dette fagfeltet er en sentral del av både folkehelse og ernæringsvitenskap. Konsensus omkring fagfeltets definisjoner kom først på 1990-tallet, selv om fagfeltet ikke er nytt. Samfunnsernæring er både en vitenskap og praksis. Samfunnsrettet ernæringsarbeid er den praktisk anvendte delen av feltet samfunnsernæring. Det retter seg mot hele befolkningen eller befolkningsgrupper, på arenaer der mennesker lever sine liv. Samfunnsrettet ernæringsarbeid er komplekst og omfatter både akademisk og analytisk arbeid og arbeid ute i lokalsamfunnet. Å kartlegge, endre og evaluere påvirkningsfaktorer som påvirker befolkningens matvalg, kosthold og spisevaner, og dermed også deres helse og livskvalitet, er sentralt i arbeidet. Samfunnsrettet ernæringsarbeid foregår globalt og nasjonalt. I offentlig sektor i Norge er både stat, fylkene og kommuner involvert i arbeidet med føringer i folkehelseloven. Frivillige organisasjoner og privat sektor driver også med samfunnsrettet ernæringsarbeid. Sentrale kjennetegn er at arbeidet rettes mot grupper, helsefremming og forebygging, samt utjevning av sosial ulikhet i helse og kosthold. Iverksetting av tiltak er en viktig del av samfunnsrettet ernæringsarbeid. Eksempelvis kan dette være forbud mot markedsføring av usunn mat rettet mot barn, tiltak som påvirker matmiljøet og tilgjengelighet av frukt og grønnsaker, som gratis skolefruktordning, eller pedagogiske tiltak som fremmer et sunt kosthold. Det er behov for fagpersoner med solid kompetanse innen både folkehelse og ernæring for å styrke det samfunnsrettet ernæringsarbeidet i Norge.

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

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

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

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

• Valand, Ida Ulrikke; Bjørkkjær, Tormod; Kiland, Charlotte; Hillesund, Elisabet Rudjord; Vik, Frøydis Nordgård & Øverby, Nina Cecilie (2025). Feasibility of a dietary life skills course aimed at fostering cooking skills and a healthy diet among university students. Pilot and Feasibility Studies. 11. doi: 10.1186/s40814-025-01680-y. Full text in Research Archive Show summary

  Background The transition from living at home to independent university life has been associated with deteriorated health outcomes, and many university students lack cooking skills. Life skills education promotes skills essential to mastering everyday challenges such as planning and preparing healthy meals. We developed a dietary life skills course to foster cooking skills and a healthy diet among university students. This paper describes the feasibility testing of this Skills for Life course.

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

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

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

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

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

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

• Wills, Andrew Keith; Hillesund, Elisabet Rudjord; Lippevelde, Wendy Van; Barker, Mary Elizabeth; Vik, Frøydis Nordgård & Øverby, Nina Cecilie (2024). Preconception diet in adolescence and its association with hypertensive disorders of pregnancy and preterm birth. Results from The HUNT study. British Journal of Nutrition. ISSN 0007-1145. p. 1–8. doi: 10.1017/S0007114524000746. Full text in Research Archive
• Helle, Christine; Hillesund, Elisabet Rudjord & Øverby, Nina Cecilie (2024). Exploring Public Health Nurses’ Thoughts, Needs and Expectations for the Development and Usability of an Online Parenting Resource on Early Nutrition Delivered through Primary Care: A Qualitative Study. Nutrients. 16(17), p. 1–17. doi: 10.3390/nu16172861. Full text in Research Archive
• Hillesund, Elisabet Rudjord; Sagedal, Linda Reme & Øverby, Nina Cecilie (2024). Early-life family meal participation and anthropometric measures at 4 years of age. Journal of Developmental Origins of Health and Disease. ISSN 2040-1744. 15, p. 1–9. doi: 10.1017/S2040174424000217. Full text in Research Archive
• Osorio, Natalie Garzon; Vik, Frøydis Nordgård; Helle, Christine; Hillesund, Elisabet Rudjord; Øverby, Nina Cecilie & Helland, Sissel Heidi [Show all 15 contributors for this article] (2024). Implementing an early-life nutrition intervention through primary healthcare: staff perspectives. BMC Health Services Research. 24(1). doi: 10.1186/s12913-024-11582-z. Full text in Research Archive Show summary

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

• Helland, Sissel Heidi; Vejrup, Kristine & Øverby, Nina Cecilie (2024). I’m not sure whether I will implement it”: exploring barriers and facilitators to implementing a digital “healthy eating” resource in early education and care settings - teachers’ perspectives. BMC Public Health. 24. doi: 10.1186/s12889-024-19014-7. Full text in Research Archive
• Helland, Sissel Heidi; Bjørkkjær, Tormod; Vejrup, Kristine & Øverby, Nina Cecilie (2024). Enhancing core components for a digital “healthy eating” resource in early childhood and care settings: staff’s perceptions and needs. BMC Public Health. 24(1), p. 1–12. doi: 10.1186/s12889-024-20456-2. Full text in Research Archive Show summary

  Background In response to the growing need for effective programmes to promote healthy eating habits among children in real-world settings, we conducted a qualitative study. Our aim was to explore the content-related needs of early childhood education and care (ECEC) staff regarding the core components of an upcoming digital “healthy eating” resource. This resource, designed for real-world implementation through the Nutrition Now project, seeks to enhance children’s nutrition and health within ECEC settings. Methods Twelve individual semi-structured interviews with ECEC staff in a Norwegian municipality were conducted. Subsequently, we conducted two focus group discussions, involving five participants, to encourage reflection on the preliminary findings from the individual interviews. Qualitative thematic analysis was conducted using Nvivo software. Data from the interviews and focus groups were transcribed verbatim and analysed thematically to identify and summarise staff’s subjective experiences and reasoning. Results Six themes were identified for the development of the upcoming digital “healthy eating” resource: (1) A comprehensive recipe bank, and menu suggestions, (2) Tips for easy and quick cooking, simple hygiene and allergy management, (3) Age-appropriate food learning ideas, (4) Strategies for mealtime learning and engagement, (5) Alignment with the national ECEC curriculum, and (6) Parent-friendly access and content. Conclusions This research provides valuable guidance and informs the adaptation of an expert-led digital “healthy eating” intervention to better suit ECEC staff and the ECEC context, consequently enhancing its feasibility and effectiveness.

• Salvesen, Lorentz; Wills, Andrew Keith; Øverby, Nina Cecilie; Engeset, Dagrun & Medin, Anine Christine (2023). Relative validity of a non-quantitative 33-item dietary screener with a semi-quantitative food frequency questionnaire among young adults. Journal of Nutritional Science (JNS). 12, p. 1–13. doi: 10.1017/jns.2023.57. Full text in Research Archive Show summary

  The objective of the study was to assess the concordance and ranking ability of a non-quantitative 33-item dietary screener developed to assess the diet of young adults in Norway, ‘MyFoodMonth 1.1’, compared to a semi-quantitative food frequency questionnaire (FFQ). Data were collected in a cross-sectional dietary survey evaluating the diets of students at the University of Agder, in southern Norway. The students were asked to complete both a dietary screener and an FFQ. Data collection was carried out from September to December 2020. Participants were first-year university students aged ≥18 years familiar with Scandinavian language. Almost half of the eligible sample (n 344) was excluded due to not completing the FFQ, compared to 1⋅7 % not completing the dietary screener, resulting in 172 (66 % female) participants with a median age of 21 years. For most items of the dietary screener (n 27/33, 82 %), all aspects of diet quality and components of the Diet Quality Score showed moderate-to-strong concordance with the FFQ evaluated using Kendall's tau-b analyses (t > 0⋅31), supported by visual inspection of box and whisker plots and descriptive ranking ability in a cross-tabulation. There was little evidence to suggest that concordance was dependent on sex. The concordance and ranking ability of ‘MyFoodMonth 1.1’ is considered satisfactory compared to a semi-quantitative FFQ. This rapid dietary assessment instrument presents a valuable addition to traditional instruments and a possible solution to recruit hard-to-reach parts of the population.

• Øverby, Nina Cecilie; Hillesund, Elisabet Rudjord; Medin, Anine Christine; Vik, Frøydis Nordgård & Ostojic, Sergej (2023). Nutrition in a lifecourse perspective: From molecular aspects to public health approaches. Maternal & Child Nutrition. ISSN 1740-8695. 20(S2). doi: 10.1111/mcn.13582. Full text in Research Archive
• Ostojic, Sergej; Hillesund, Elisabet Rudjord; Øverby, Nina Cecilie; Vik, Frøydis Nordgård & Medin, Anine Christine (2023). Individual nutrients and serum klotho levels in adults aged 40–79 years. Food Science & Nutrition. 11(6), p. 3279–3286. doi: 10.1002/fsn3.3310. Full text in Research Archive Show summary

  Several dietary factors (including adherence to the Mediterranean diet or higher nut intake) seem to positively affect circulating antiaging Klotho protein levels; yet, a description of possible relationships between individual nutrients and Klotho activity has not been evaluated. We analyzed the association of dietary intake of individual macro- and micronutrients and nonnutritive food components with circulating Klotho levels in a sample of 40- to 79-year-old US adults. Data from the 2015–2016 National Health and Nutrition Examination Survey were analyzed. Nutrient/food component intakes were calculated in relation to total energy intake using the nutrient density method, and available pristine serum samples were analyzed for serum Klotho concentrations. The final study sample consisted of 2637 participants (mean age 59.0 ± 10.7 years; 52% women). Higher Klotho concentrations were found with higher intake of carbohydrates (p < .001), total sugars (p < .001), dietary fibers (p < .001), vitamin D (p = .05), total folates (p = .015), and copper (p = .018). The results of the regression analysis with a crude model showed significant associations among five nutrients/food components (carbohydrates, alcohol, total sugars, dietary fibers, and niacin) and soluble Klotho levels across the sample. After adjusting the models for age and gender, the nutrient/food component–Klotho association remained significant for carbohydrates, total sugars, and alcohol (p < .05). Dietary exposure to individual nutrients and nonnutritive food components appears to be associated with Klotho activity; however, additional research is needed to investigate the relationship between cause and effect in diet composition–Klotho interplay.

• 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.

• Prescott, Susan L.; D'Adamo, Christopher R; Holton, Kathleen; Ortiz, Selena; Øverby, Nina Cecilie & Logan, Alan C (2023). Beyond Plants: The Ultra-Processing of Global Diets Is Harming the Health of People, Places, and Planet. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 20(15). doi: 10.3390/ijerph20156461. Full text in Research Archive Show summary

  Global food systems are a central issue for personal and planetary health in the Anthropocene. One aspect of major concern is the dramatic global spread of ultra-processed convenience foods in the last 75 years, which is linked with the rising human burden of disease and growing sustainability and environmental health challenges. However, there are also calls to radically transform global food systems, from animal to plant-derived protein sources, which may have unintended consequences. Commercial entities have moved toward this “great plant transition” with vigor. Whether motivated by profit or genuine environmental concern, this effort has facilitated the emergence of novel ultra-processed “plant-based” commercial products devoid of nutrients and fiber, and sometimes inclusive of high sugar, industrial fats, and synthetic additives. These and other ingredients combined into “plant-based” foods are often assumed to be healthy and lower in calorie content. However, the available evidence indicates that many of these products can potentially compromise health at all scales—of people, places, and planet. In this viewpoint, we summarize and reflect on the evidence and discussions presented at the Nova Network planetary health meeting on the “Future of Food”, which had a particular focus on the encroachment of ultra-processed foods into the global food supply, including the plant-sourced animal protein alternatives (and the collective of ingredients therein) that are finding their way into global fast-food chains. We contend that while there has been much uncritical media attention given to the environmental impact of protein and macronutrient sources—meat vs. novel soy/pea protein burgers, etc.—the impact of the heavy industrial processing on both human and environmental health is significant but often overlooked, including effects on cognition and mental health. This calls for a more nuanced discourse that considers these complexities and refocuses priorities and value systems towards mutualistic solutions, with co-benefits for individuals, local communities, and global ecology.

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

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

• 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.

• Sonestedt, Emily & Øverby, Nina Cecilie (2023). Carbohydrates – a scoping review for Nordic Nutrition Recommendations 2023. Food & Nutrition Research (FNR). ISSN 1654-6628. 67. doi: 10.29219/fnr.v67.10226. Full text in Research Archive Show summary

  Background: Dietary carbohydrates are a major source of energy in the Nordic and Baltic countries. The health effects of different types of carbohydrates vary and there is a need to update the evidence regarding specific carbohydrates and their effects on health-related outcomes. Objective: The aim of this scoping review was to describe the evidence for the role of total carbohydrates (fiber excluded), glycemic index (GI) or glycemic load (GL) and added or free sugars for health-related outcomes as a basis for setting and updating dietary reference values for the Nordic Nutrition Recommendation (NNR) 2023. Method: We included evidence from several qualified systematic reviews (the World Cancer Research Fund, the European Food Safety Authority, the World Health Organization, the United States Dietary Guidelines Advisory Committee, the United Kingdom Scientific Advisory Committee on Nutrition) identified by the NNR project in line with the protocol description. Results: There is limited evidence that total carbohydrate intake (fiber excluded) outside of the current recommended range of 45–60% of energy is associated with health-related outcomes. There were no consistent benefits on clinical outcomes when changing the GI of a diet. High intake of dietary sugars is well known to be associated with dental caries. There was evidence from randomized control trials on surrogate disease endpoints, for a positive and causal relationship between the intake of added and free sugars and risk of some chronic metabolic diseases with moderate level of certainty for obesity and dyslipidaemia. The level of certainty was high for an association between high intake of sugar-sweetened beverages and risk of several chronic metabolic diseases. Conclusion: While there is limited evidence that total carbohydrates and GI and GL of the diet are related to health outcomes, the evidence suggests that high intakes of added and free sugars are related to detrimental health effects. In addition, with increasing intake of added and free sugars, there is less room for healthy foods and micronutrients, which is especially important for those with low energy intake, such as children.

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

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

• Rai, Anam Shakil; Sletner, Line; Jenum, Anne Karen; Øverby, Nina Cecilie; Stafne, Signe Nilssen & Qvigstad, Elisabeth [Show all 8 contributors for this article] (2023). Employing fasting plasma glucose to safely limit the use of oral glucose tolerance tests in pregnancy: a pooled analysis of four Norwegian studies. Frontiers in Endocrinology. 14. doi: 10.3389/fendo.2023.1278523. Full text in Research Archive Show summary

  Background/objective: There is no international consensus about the optimal approach to screening and diagnosis of gestational diabetes mellitus (GDM). Fasting plasma glucose (FPG) has been proposed as an alternative universal screening test to simplify the diagnosis of GDM. We investigate the ability of the FPG to predict a 2-hour glucose value below the cut-off for GDM, thereby “ruling out” the necessity of a full OGTT and assess the proportion of GDM-related complications associated with the identified FPG level. Materials and methods: This study included secondary data from four Norwegian pregnancy cohorts (2002-2013), encompassing 2960 women universally screened with late mid-pregnancy 75g OGTT measuring FPG and 2-hour glucose. For a range of FPG thresholds, we calculated sensitivity to predict elevated 2-hour glucose, number of OGTTs needed and percentage of GDM cases missed, applying modified World Health Organization (WHO) 2013 criteria (2013WHO) and 2017 Norwegian criteria (2017Norwegian). We analyzed pregnancy outcomes for women above and below our selected threshold. Results: The prevalence of GDM was 16.6% (2013WHO) and 10.1% (2017Norwegian). A FPG threshold of 4.7 mmol/L had a sensitivity of 76% (2013WHO) and 80% (2017Norwegian) for detecting elevated 2-hour glucose, with few missed GDM cases (2.0% of those ruled out and 7.5% of all GDM cases for 2013WHO, and 1.1% of those ruled out and 7% of all GDM cases for 2017Norwegian). When excluding women with FPG <4.7mmol/l and those with GDM based on FPG, only 24% (2013WHO) and 29% (2017Norwegian) would require OGTT. Women with FPG <4.7mmol/l, including missed GDM cases, had low risk of large-for-gestational-age newborns, cesarean section and operative vaginal delivery. Conclusion: A FPG threshold of 4.7mmol/l as a first step when screening for GDM could potentially eliminate the need for OGTT in 70-77% of pregnancies. Women with FPG below this threshold appear to carry low risk of GDM-associated adverse pregnancy outcomes.

• 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.

• Bjørkkjær, Tormod & Øverby, Nina Cecilie (2023). Betydningen av mat og måltider for læring i grunnskolen. In Ruge, Dorte; Vik, Frøydis Nordgård; Björklund, Johanna & Frödén, Sara (Ed.), Læring gennem mad og måltider i grundskolen Teori og praksis fra Danmark, Sverige og Norge. Cappelen Damm Akademisk. ISSN 9788202797744. p. 215–235. doi: 10.23865/noasp.182.ch3.2. Full text in Research Archive Show summary

  While primary and lower secondary school students in Norway have a relatively healthy diet, there are some weaknesses. Not all students eat breakfast at home/school or lunch at school. The school is an important arena for universal food and meal efforts targeting all students, which is important for their learning in the short and long term. Through a narrative/traditional review, this article investigates the research question: What impact do food and meals have on learning in primary and lower secondary schools? We focus on how food and meals affect concentration, school performance/results and social learning. Systematic reviews show that breakfast is important for short-term concentration and school results. Likewise, school lunch is associated with improved dietary quality, school attendance and academic achievement. School meals also impact social learning, e.g. eating routines, communication/friendship and broader societal issues of identity and connection to the community. Possibilities for promoting these outcomes in the Norwegian school system are presented, focusing on current curricula and policy documents. There is potential to strengthen the focus on food and meals, as well as the connection between food and learning in schools.

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

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

• Rai, Anam Shakil; Sletner, Line; Jenum, Anne Karen; Øverby, Nina Cecilie; Stafne, Signe Nilssen & Qvigstad, Elisabeth [Show all 8 contributors for this article] (2023). Adverse pregnancy outcomes among women in Norway with gestational diabetes using three diagnostic criteria. PLOS ONE. 18(7). doi: 10.1371/journal.pone.0280750. Full text in Research Archive Show summary

  Introduction The aim of this study was to examine the risk of adverse perinatal outcomes in women diagnosed with GDM by the World Health Organization (WHO) 1999 criteria, and in those retrospectively identified by the Norwegian-2017 and WHO-2013 criteria but not by WHO-1999 criteria. We also examine the effect of maternal overweight/obesity and ethnicity. Material and methods We used pooled data from four Norwegian cohorts (2002–2013), encompassing 2970 mother-child pairs. Results from universally offered 75-g oral glucose tolerance tests measuring fasting plasma glucose (FPG) and 2-hour glucose (2HG) were used to assign women into three diagnostic groups: Diagnosed and treated by WHO-1999 (FPG≥7.0 or (2HG ≥7.8 mmol/L), identified by WHO-2013 (FPG ≥5.1 or 2HG ≥8.5 mmol/L), and identified by Norwegian-2017 criteria (FPG ≥5.3 or 2HG ≥9.0 mmol/L). Perinatal outcomes included large-for-gestational-age (LGA) infants, cesarean section, operative vaginal delivery, preterm birth and preeclampsia. Results Compared to the non-GDM group, women diagnosed with GDM by either of the three criteria had an increased risk of large-for-gestational-age infants (adjusted odds ratios (OR) 1.7–2.2). Those identified by the WHO-2013 and Norwegian-2017 criteria but not diagnosed and treated by WHO-1999 criteria had an additional increased risk of cesarean section (OR 1.36, 95% CI 1.02,1.83 and 1.44, 95% CI 1.03,2.02, respectively) and operative vaginal delivery (OR 1.35, 95% CI 1.1,1.7 and 1.5, 95% CI 1.1,2.0, respectively). The proportions of LGA neonates and cesarean section were higher for women with GDM in both normal-weight and overweight/obese women. Asians had a lower risk of delivering large-for-gestational-age infants than Europeans applying national birthweight references, but maternal glucose values were similarly positively associated with birthweight in all ethnic groups. Conclusions Women who met the WHO-2013 and Norwegian-2017 criteria, but were not diagnosed by the WHO-1999 criteria and therefore not treated, had an increased risk of LGA, cesarean section and operative vaginal delivery compared to women without GDM.

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• O’Reilly, Sharleen L.; McDonnell, Thérèse; Sagedal, Linda Reme; Bermúdez, Mercedes G.; Herrmann, Florian & Jasiak-Jóźwik, Hanna [Show all 22 contributors for this article] (2026). Bump2Baby & Me+ (B2B&Me+): Protocol for a multi-country, European hybrid type 3 implementation-effectiveness study to reduce the incidence of gestational diabetes mellitus and improve maternal and child health. doi: 10.1371/journal.pone.0354394. Full text in Research Archive Show summary

  Background Gestational diabetes mellitus (GDM) affects 1-in-7 pregnancies globally and is associated with significant short- and long-term health consequences. Although health behaviour change interventions can effectively reduce these risks, a significant implementation gap exists in translating this evidence into routine practice. Bump2Baby and Me (B2B&Me) was a mobile health (mHealth) coaching intervention provided to women at-risk of GDM from early pregnancy through to 1-year postpartum. B2B&Me Plus (B2B&Me+) aims to refine, implement and evaluate the implementation of this personalised intervention across 4 countries (Ireland, Spain, Poland and Norway) with differing health systems and population profiles. Methods This study employs a hybrid type 3 implementation-effectiveness design using a non-randomised ABA block approach within a longitudinal cohort. Participants will be screened using the Monash machine learning GDM screening tool (MMLGDST). During the intervention (Block B), women at risk of developing GDM will be offered access to a smartphone-based coaching application featuring 1:1 synchronous sessions, asynchronous text and video messaging along with a Bluetooth-enabled weighing scale for self-monitoring. Support continues from early pregnancy through to nine months postpartum. The study’s primary objective is to evaluate reach, adoption, implementation and maintenance of the B2B&Me+ intervention programme when delivered within routine maternity care. Implementation success will be assessed using the RE-AIM framework, while secondary outcomes will assess intervention effectiveness. The study will examine population-level uptake at each site, evaluate the benefits and costs of implementation across varying contexts, and analyse how four different referral methods, randomised at the site level, affect uptake. In addition, a European implementation toolkit will be developed to provide health services with scalable strategies to bridge the evidence-to-practice gap. Discussion This study will contribute to a growing literature on the implementation of a successfully trialled mHealth intervention in a real-world context. Understanding variation in both intervention and implementation success within a routine maternity care context across diverse settings will inform the development of an implementation toolkit to support health services in reducing the incidence of GDM and improving maternal and child health outcomes. This study was registered with ClinicalTrials.gov (NCT07189221) on 28 August 2025 ( https://clinicaltrials.gov/study/NCT07189221?cond=diabetes ).

• Magnussen, Karima Elisabeth & Øverby, Nina Cecilie (2026). Urolige barn: Dette bør foreldre være oppmerksomme på. [Journal]. Dagbladet. Full text in Research Archive Show summary

  Uro hos barn kan være vanskelig å forstå, og årsakene kan være mange. To eksperter forklarer hva foreldre bør være oppmerksomme på, hvordan de kan møte uroen, og når det kan være grunn til å undersøke nærmere.

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

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

• Øverby, Nina Cecilie (2025). UiA-forskere: Foreldretiltak virker ikke på spedbarns vekt – NRK Sørlandet – Lokale nyheter, TV og radio. [Internet]. nrk.no. Full text in Research Archive Show summary

  Forskere ved Universitetet i Agder (UiA) har deltatt i den internasjonale TOPCHILD-studien, som undersøker om tiltak rettet mot foreldre i barnas første leveår kan forebygge overvekt. Overvekt hos barn og unge er ifølge Verdens helseorganisasjon (WHO) nå en global helsekrise. Studien omfatter 9000 barn i ti land, inkludert tre norske studier der UiA bidro med data fra norske barn. Resultatene viser at tiltakene hadde liten effekt på barnas vekt. Den eneste forskjellen som ble målt, var ti minutter mindre skjermtid per dag. – Dette viser at informasjon til foreldre alene ikke er nok for å forebygge barnefedme, og at bredere systemtiltak er nødvendig, sier professor Nina Cecilie Øverby ved UiA.

• Øverby, Nina Cecilie (2025). Global studie: Ingen effekt av tiltak mot overvekt i barns første leveår - adressa.no. [Internet]. adressa.no. Full text in Research Archive Show summary

  Norske forskere er skuffet etter at en studie med 9000 smårollinger fra ti land viste at tiltak for å forebygge overvekt hos barna, ikke fungerte.

• Øverby, Nina Cecilie (2025). (+) Global studie: Ingen effekt av tiltak mot overvekt i barns første leveår. [Internet]. Dagens medisin. Full text in Research Archive Show summary

  Norske forskere er skuffet etter at en studie med 9000 smårollinger fra ti land viste at tiltak for å forebygge overvekt hos barna, ikke fungerte.

• Øverby, Nina Cecilie (2025). Norske barn har stabilisert den farlige økningen av overvekt og fedme. [Internet]. vg.no. doi: https:/www.vg.no/helse/i/XMlr37/norske-barn-har-stabilisert-den-farlige-oekningen-av-overvekt-og-fedme. Full text in Research Archive Show summary

  Norske barn har stabilisert den farlige økningen i overvekt og fedme. – Supergledelig, mener Folkehelseinstituttet.

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

  – Vi må tenke nytt, sier forsker.

• Medin, Anine Christine & Øverby, Nina Cecilie (2025). Matnyttig – hva skal til for at implementering lykkes? Full text in Research Archive
• Øverby, Nina Cecilie (2025). Mat og folkehelse. Full text in Research Archive
• Øverby, Nina Cecilie (2025). Ni prosjekter får 107 millioner til forskning på miljø, klima, mat og folkehelse. [Journal]. Khrono. Full text in Research Archive
• Øverby, Nina Cecilie (2025). Matnyttig- hva er det og hva har vi funnet ut av? Full text in Research Archive
• Øverby, Nina Cecilie (2025). Barn som spiser nok fisk, er snillere enn andre. [Internet]. psykologisk.no. Full text in Research Archive
• Øverby, Nina Cecilie (2025). Effectiveness of a web-based dietary intervention program targeting young adults prior to parenthood: lessons learned from a randomized controlled trial. Full text in Research Archive
• Øverby, Nina Cecilie; Helle, Christine & Wee, Emilie (2025). Fødselsdepresjon hos mor kan gjøre at barn overspiser. [Internet]. Forskning.no. Full text in Research Archive
• Wehus, Walter Norman & Øverby, Nina Cecilie (2024). Unge skal samskape fremtidens kosthold - Universitetet i Agder. [Internet]. uia.no. Full text in Research Archive
• Øverby, Nina Cecilie (2024). Mat og ernæring i et livsløpsperspektiv. Full text in Research Archive
• Øverby, Nina Cecilie; Helle, Christine & Helland, Sissel Heidi (2024). Forskerfokus: Den lange veien mot (noe) Matnyttig. Full text in Research Archive
• Lian, Henrik; Helland, Sissel Heidi & Øverby, Nina Cecilie (2024). Implementation strategies: Lessons learned during an e-learning intervention to improve dietary behaviors and feeding practices in Early Childhood Education and Care. Full text in Research Archive
• Valand, Ida Ulrikke; Bjørkkjær, Tormod; Kiland, Charlotte; Hillesund, Elisabet Rudjord; Vik, Frøydis Nordgård & Øverby, Nina Cecilie (2024). Feasibility of a dietary life skills course aiming to foster cooking skills and healthy diet among university students. Full text in Research Archive
• Valand, Ida Ulrikke; Bjørkkjær, Tormod; Kiland, Charlotte; Hillesund, Elisabet Rudjord; Vik, Frøydis Nordgård & Øverby, Nina Cecilie (2024). Feasibility of a dietary life skills course aiming to foster cooking skills and healthy diet among university students. Norsk tidsskrift for ernæring (NTFE). ISSN 1503-5034. doi: 10.18261/ntfe.22.5.35. Full text in Research Archive
• Osorio, Natalie Garzon; Vik, Frøydis Nordgård; Øverby, Nina Cecilie & Medin, Anine Christine (2024). Determinanter for implementering av Matnyttig blant helsestasjonsansatte. Full text in Research Archive
• Osorio, Natalie Garzon; Vik, Frøydis Nordgård; Øverby, Nina Cecilie & Medin, Anine Christine (2024). Facilitators & barriers in implementing early life nutrition interventions in Norwegian primary care: a qualitative assessment using the CFIR. Full text in Research Archive
• Helle, Christine & Øverby, Nina Cecilie (2024). Hvordan fremme gode spisevaner blant barn gjennom helsestasjonen. Christine Helle og Nina Cecilie Øverby fra UIA presenterer Matnyttig –forskningsprosjekt som skal fremme god ernæring tidlig i livet. Full text in Research Archive
• Vik, Frøydis Nordgård & Øverby, Nina Cecilie (2024). Mat og måltidsglede. Full text in Research Archive
• Øverby, Nina Cecilie (2024). Nutrition now – intervention to enhance early-life nutrition by focusing on the essential first 1000 days. Full text in Research Archive
• Øverby, Nina Cecilie; Helle, Christine & Humberset, Kathrine (2023). Forskere fant sterk sammen­heng mellom kosthold og barns person­lighet: – Viser seg å være enda klarere enn vi tidli­gere har trodd. [Journal]. Varden; varden.no. Full text in Research Archive
• Øverby, Nina Cecilie; Helle, Christine & Humberset, Kathrine (2023). Godt kosthold kan gi mer robust personlighet. [Journal]. Aftenposten. Full text in Research Archive
• Øverby, Nina Cecilie; Helle, Christine & Humberset, Kathrine (2023). Forskere fant sammenheng mellom kosthold og barns personlighet: – Viser seg å være enda klarere enn vi tidligere har trodd. [Journal]. Aftenposten.no/foreldreliv. Full text in Research Archive
• Øverby, Nina Cecilie; Helle, Christine & Wehus, Walter Norman (2023). Slik påvirker kostholdet personligheten din. [Internet]. Forskning.no. Full text in Research Archive
• Øverby, Nina Cecilie; Helle, Christine & Humberset, Kathrine (2023). Forskere fant sammenheng mellom kosthold og barns personlighet: – Viser seg å være enda klarere enn vi tidligere har trodd. [Journal]. Fædrelandsvennen; fvn.no. Full text in Research Archive
• Øverby, Nina Cecilie; Helle, Christine & Humberset, Kathrine (2023). Forskere fant sammenheng mellom kosthold og barns personlighet: – Viser seg å være enda klarere enn vi tidligere har trodd. [Journal]. Romsdals Budstikke; rbnett.no. Full text in Research Archive
• Øverby, Nina Cecilie; Helle, Christine & Humberset, Kathrine (2023). Forskere fant sammenheng mellom kosthold og barns personlighet: – Viser seg å være enda klarere enn vi tidligere har trodd. [Journal]. Bergens Tidene; bt.no. Full text in Research Archive
• Øverby, Nina Cecilie; Helle, Christine & Humberset, Kathrine (2023). Forskere fant sammenheng mellom kosthold og barns personlighet: – Viser seg å være enda klarere enn vi tidligere har trodd. [Journal]. iTromsø; iTromsø.no. Full text in Research Archive
• Øverby, Nina Cecilie; Helle, Christine & Humberset, Kathrine (2023). Forskere fant sammenheng mellom kosthold og barns personlighet: – Viser seg å være enda klarere enn vi tidligere har trodd. [Journal]. Sunnmørsposten; smp.no. Full text in Research Archive
• Vik, Frøydis Nordgård; Rutter, Harry; Medin, Anine Christine; Hillesund, Elisabet Rudjord & Øverby, Nina Cecilie (2023). Implementering av Matnyttig – en digital kostholdsressurs de første 1000 dagene. Full text in Research Archive
• Øverby, Nina Cecilie & Helle, Christine (2023). Er det sammenhenger mellom kosthold tidlig i livet og senere pykisk helse og personlighet? Full text in Research Archive
• Øverby, Nina Cecilie & Helle, Christine (2023). Sammenhenger mellom kosthold tidlig i livet, psykisk helse og personlighet. Full text in Research Archive
• Osorio, Natalie Garzon; Vik, Frøydis Nordgård; Medin, Anine Christine & Øverby, Nina Cecilie (2023). The selection and operationalization of implementation strategies in the Nutrition Now project. Full text in Research Archive
• Øverby, Nina Cecilie (2023). Hvordan arbeide for å bli et prioritert forskningssenter? Hvordan drive et senter og opparbeide en portefølje med mange eksterne prosjekter? Full text in Research Archive
• Ostojic, Sergej & Øverby, Nina Cecilie (2023). Editorial: Scientific integrity in nutritional research. Frontiers in Nutrition. 10. doi: 10.3389/fnut.2023.1323265. Full text in Research Archive
• Valand, Ida Ulrikke & Øverby, Nina Cecilie (2023). Skills for life-podden, episode 2: Mat og ernæring i et livsløpsperspektiv: Hva forsker vi på, og hvorfor synes vi det er viktig? [Internet]. Spotify, Google Podcasts, Apple Podcasts. Full text in Research Archive Show summary

  Professor Nina Øverby forteller om mat og ernæring i et livsløpsperspektiv og om hvorfor vi synes dette er viktig å forske på!

• Øverby, Nina Cecilie (2023). UiA-prosjektet Matnyttig skal nå lanseres i 400 barnehager. [Radio]. NRK, Sørlandssendingen. Full text in Research Archive
• Valand, Ida Ulrikke; Øverby, Nina Cecilie; Kiland, Charlotte; Bjørkkjær, Tormod; Bjornes, Camilla & Nordli, Julie [Show all 9 contributors for this article] (2023). The development of course content for a dietary life skills course targeting students – co-creation with future users. Full text in Research Archive
• Stiansen, Yngve; Øverby, Nina Cecilie & Helle, Christine (2023). Barne-kosthold påvirker psyken. [Radio]. NRK Sørlandssendinga. Full text in Research Archive
• Øverby, Nina Cecilie (2023). Skolemelk: Tine gjør hel(melk)-omvending. [Internet]. TV2.no. Full text in Research Archive
• Medin, Anine Christine; Vik, Frøydis Nordgård; Hillesund, Elisabet Rudjord & Øverby, Nina Cecilie (2023). A hybrid 3 study evaluating the scale-up of evidence-based early-life nutrition interventions in a community setting - the Nutrition Now project protocol for phase 2. Full text in Research Archive
• Øverby, Nina Cecilie (2023). Ekspertgruppe bidro til nye kostråd. Nå kjenner flere av dem ikke igjen rådene: – Jeg vil ikke ha navnet mitt på dette. [Internet]. Aftenposten. Full text in Research Archive
• Øverby, Nina Cecilie (2023). The Nutrition Now project- implementing digital dietary interventions in Norway targeting diet in the first 1000 days of life. Full text in Research Archive
• Helland, Sissel Heidi; Bjørkkjær, Tormod; Vejrup, Kristine & Øverby, Nina Cecilie (2023). Facilitators and barriers related to the forthcoming implementation of a web-based “healthy eating” resource to support ECEC staff: A qualitative interview study with teachers. Full text in Research Archive
• Øverby, Nina Cecilie & Helland, Sissel Heidi (2023). Matnyttig- å fremme gode matvaner og matomsorg de første 1000 dagene av livet. Full text in Research Archive
• Øverby, Nina Cecilie & Helland, Sissel Heidi (2023). Matnyttig- Å fremme gode matvaner og matomsorg de første 1000 dagene av et barns liv. Full text in Research Archive
• Medin, Anine Christine & Øverby, Nina Cecilie (2023). Matnyttig - tidlig innsats - de første 1000 dagene. Full text in Research Archive
• Vik, Frøydis Nordgård & Øverby, Nina Cecilie (2023). Presentasjon av NFR-prosjektet Matnyttig. Full text in Research Archive
• Vik, Frøydis Nordgård & Øverby, Nina Cecilie (2023). Matnyttig - tidlig innsats med fokus på de første 1000 dagene. Full text in Research Archive
• Helle, Christine; Hillesund, Elisabet Rudjord & Øverby, Nina Cecilie (2023). Public health nurses' wishes, needs and expectations for the development and use of a new online resource on early nutrition – A qualitative study in the Nutrition Now project. Full text in Research Archive
• Vik, Frøydis Nordgård & Øverby, Nina Cecilie (2023). Matnyttig - en digital ressurs med fokus på de 1000 første dagene. Full text in Research Archive
• Vik, Frøydis Nordgård & Øverby, Nina Cecilie (2023). Presentasjon av Matnyttig. Full text in Research Archive
• Vik, Frøydis Nordgård & Øverby, Nina Cecilie (2023). Matnyttig - tidlig innsats - de første 1000 dagene. Full text in Research Archive
• Vik, Frøydis Nordgård & Øverby, Nina Cecilie (2023). Matnyttig - Hvordan fremme gode matvaner de første 1000 dagene? Full text in Research Archive Show summary

  Matnyttig er et samarbeidsprosjekt mellom UiA, Agder Fylkeskommune, Arendal kommune og Agder kommuner hvor implementering av ny forskningsbasert kunnskap omkring matvaner tidlig i livet er sentralt. Målgruppene er gravide, foreldre til barn 0-2 år og barnehageansatte. Arenaene hvor Matnyttig kan brukes er barnehagen og helsestasjon. Matnyttig er støttet av Norges Forskningsråd.

• Øverby, Nina Cecilie & Vik, Frøydis Nordgård (2023). Matnyttig - en digital ressurs til bruk i barnehager og helsestasjoner i Agder. Full text in Research Archive
• Øverby, Nina Cecilie (2023). Rewilding our First Foods: Healthier and Sustainable Diets in Early Life Have Implications for Mental Health and Positive Personality Traits. Full text in Research Archive
• Øverby, Nina Cecilie; Helle, Christine & Baksaas, Jenny Marie (2023). Kan barns kosthold påvirke personligheten deres? [Internet]. Psykologisk.no. Full text in Research Archive
• Øverby, Nina Cecilie; Hillesund, Elisabet Rudjord; Helland, Sissel Heidi; Helle, Christine; Wills, Andrew Keith & Lamu, Admassu Nadew [Show all 23 contributors for this article] (2023). Evaluating the effectiveness and implementation of evidence-based early-life nutrition interventions in a community setting a hybrid type 1 non-randomized trial – the Nutrition Now project protocol. Frontiers in Endocrinology. 13. doi: 10.3389/fendo.2022.1071489. Full text in Research Archive Show summary

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

• Bjørkkjær, Tormod & Øverby, Nina Cecilie (2023). Hvilken betydning har mat og måltider for læring i grunnskolen? Full text in Research Archive
• Agnihotri, Neha; Øverby, Nina Cecilie; Hillesund, Elisabet Rudjord & Bere, Elling (2023). A healthy and potentially sustainable Nordic diet in early life and aspects of child growth and development. Universitetet i Agder. ISSN 9788284271323. Full text in Research Archive Show summary

  Healthy diets optimize our developmental potential starting from life in womb and can promote longevity, well-being and healthy lives. On the other hand, diets of poor quality were attributable to one in five deaths globally in 2017, mainly caused by cardiovascular disease followed by cancer and diabetes. Moreover, 39 million children under the age of five were overweight or obese in 2020, being at increased future risk of non-communicable diseases. Not only are unhealthy diets detrimental to public health, but more so, they negatively impact the global environment. What we eat directly impacts public health, food systems, environment, economy and the future. However, all healthy foods do not directly translate to being environmentally sustainable. Besides, our dietary habits tend to be influenced by culture, palatability, availability and affordability. Sustainable diets are defined as being health-enhancing with a low environmental impact, while also being culturally appropriate and economically viable. The New Nordic Diet (NND) has been proposed as a regionally appropriate and sustainable diet to the Nordic countries. Consequently, the potential health benefits of the NND have been increasingly investigated in different samples and populations, but there is as yet limited knowledge on the effects of adherence to the NND from fetal life through maternal diet and into childhood. The first 1000 days of life represent a vulnerable phase from the time of conception to child age two years. Healthy child growth and development resulting from a nutritionally adequate maternal and child diet during this phase and beyond, has the potential to impact both present and future health. In the current thesis, we wanted to investigate whether a dietary pattern in line with the NND could be beneficial for aspects of growth and development in children, while also being healthy and potentially sustainable. Three research aims were put forth to investigate this overarching purpose, which also correspond to the three research papers included in this thesis. First, we aimed to develop child diet scores reflecting adherence to the NND, based on a maternal pregnancy NND-score comprising of ten subscales, which was developed in an earlier related project. The subscales of the score intended to capture foods with a Nordic identity that are locally available, traditionally consumed or have an importance as a food source in the Nordic countries, and that have a healthier potential compared to similar foods in the same food group. Second, we aimed to assess potential associations with the NND-scores and weight status at eight years of age. Third, we wanted to investigate potential associations with the NND-scores and measures of child development up to five years of age.

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