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BackgroundTo date, the evaluation of diet has mostly been based on questionnaires and diaries that have their limitations in terms of being time and resource intensive, and a tendency toward social desirability. Loyalty card data obtained in retailing provides timely and objective information on diet-related behaviors. In Finland, the market is highly concentrated, which provides a unique opportunity to investigate diet through grocery purchases. ObjectiveThe aims of this study were as follows: (1) to investigate and quantify the selection bias in large-scale (n=47,066) loyalty card (LoCard) data and correct the bias by developing weighting schemes and (2) to investigate how the degree of loyalty relates to food purchases. MethodsMembers of a loyalty card program from a large retailer in Finland were contacted via email and invited to take part in the study, which involved consenting to the release of their grocery purchase data for research purposes. Participants’ sociodemographic background was obtained through a web-based questionnaire and was compared to that of the general Finnish adult population obtained via Statistics Finland. To match the distributions of sociodemographic variables, poststratification weights were constructed by using the raking method. The degree of loyalty was self-estimated on a 5-point rating scale. ResultsOn comparing our study sample with the general Finnish adult population, in our sample, there were more women (65.25%, 30,696/47,045 vs 51.12%, 2,273,139/4,446,869), individuals with higher education (56.91%, 20,684/36,348 vs 32.21%, 1,432,276/4,446,869), and employed individuals (60.53%, 22,086/36,487 vs 52.35%, 2,327,730/4,446,869). Additionally, in our sample, there was underrepresentation of individuals aged under 30 years (14.44%, 6,791/47,045 vs 18.04%, 802,295/4,446,869) and over 70 years (7.94%, 3,735/47,045 vs 18.20%, 809,317/4,446,869), as well as retired individuals (23.51%, 8,578/36,487 vs 31.82%, 1,414,785/4,446,869). Food purchases differed by the degree of loyalty, with higher shares of vegetable, red meat & processed meat, and fat spread purchases in the higher loyalty groups. ConclusionsIndividuals who consented to the use of their loyalty card data for research purposes tended to diverge from the general Finnish adult population. However, the high volume of data enabled the inclusion of sociodemographically diverse subgroups and successful correction of the differences found in the distributions of sociodemographic variables. In addition, it seems that food purchases differ according to the degree of loyalty, which should be taken into account when researching loyalty card data. Despite the limitations, loyalty card data provide a cost-effective approach to reach large groups of people, including hard-to-reach population subgroups.

Objective: To assess milk feeding on the maternity ward and during infancy, and their relationship to sociodemographic determinants. The validity of our 3-month questionnaire in measuring hospital feeding was assessed.Design: A prospective Finnish birth cohort with increased risk to type 1 diabetes recruited between 1996 and 2004. The families completed a follow-up form on the age at introduction of new foods and age-specific dietary questionnaires.Setting: Type 1 Diabetes Prediction and Prevention (DIPP) project, Finland.Subjects: A cohort of 5993 children (77 % of those invited) participated in the main study, and 117 randomly selected infants in the validation study.Results: Breast milk was the predominant milk on the maternity ward given to 99 % of the infants. Altogether, 80 % of the women recalled their child being fed supplementary milk (donated breast milk or infant formula) on the maternity ward. The median duration of exclusive breast-feeding was 1.4 months (range 0-8) and that of total breast-feeding 7.0 months (0-25). Additional milk feeding on the maternity ward, short parental education, maternal smoking during pregnancy, small gestational age and having no siblings were associated with a risk of short duration of both exclusive and total breast-feeding. In the validation study, 78 % of the milk types given on the maternity ward fell into the same category, according to the questionnaire and hospital records.Conclusions: The recommendations for infant feeding were not achieved. Infant feeding is strongly influenced by sociodemographic determinants and feeding practices on the maternity wards. Long-term breast-feeding may be supported by active promotion on the maternity ward. [ABSTRACT FROM AUTHOR]

Objective: To investigate the association between food insecurity (FI) and diet quality in private sector service workers., Design: Data were collected via electronic questionnaires (2019) and the national register data (2018-2019). FI was measured using Household Food Insecurity Access Scale (HFIAS), and diet quality using a food frequency questionnaire and a modified Healthy Food Intake Index (mHFII). The associations between HFIAS and mHFII were studied using ANOVA and ordinal regression analysis., Setting: Cross-sectional survey and register data for all municipalities in Finland in 2018 - 2019., Participants: Individuals (n=6435) belonging to the Finnish Service Union United (PAM). The members are predominantly women and work mainly in retail trade, tourism, restaurant and leisure services, property maintenance, and security services., Results: Overall diet quality, measured by mHFII, was significantly lower in those experiencing severe FI than in those who were food secure (8.0 vs. 9.1). Additionally, those with severe FI were less likely to have higher (more optimal) scores in sugar-sweetened beverages (OR: 0.67), fibre-rich grains (OR: 0.79), vegetables (OR: 0.54), fruits and berries (OR: 0.61), vegetable oil (OR: 0.80), fish (OR: 0.65), milk (OR: 0.89), and nuts and seeds (OR: 0.66) than food-secure participants. Severe FI was associated with higher odds for less frequent consumption of red and processed meat (OR: 1.15, higher score represents less frequent consumption)., Conclusions: Severe FI was linked to both lower overall diet quality and suboptimal consumption of several food groups. Individuals experiencing severe FI may be predisposed to accumulating dietary risk factors for chronic diseases.

Background: The increase in allergic diseases in children has coincided with the westernization of lifestyles. Although clustering of modifiable lifestyles has been frequently reported in children, there is limited research on how lifestyle factors collectively contribute to allergic conditions. Our aim was to identify lifestyle clusters among Finnish school-aged children and explore their associations with the prevalence of allergic disease symptoms and sensitization., Methods: We used cross-sectional data from the international ISCOLE survey and its Finnish ancillary allergy study conducted in 2012-2013. We studied 148-461 children aged 9-11 years living in the metropolitan area of Finland. Parents completed a questionnaire on their child's allergic disease symptoms, and specific IgE responses from blood samples were analyzed to determine allergic sensitization. Lifestyle factors considered in clustering were moderate-to-vigorous-physical activity (MVPA) and nighttime sleep recorded by accelerometers, screen time inquired via a questionnaire, and healthy and unhealthy dietary patterns from food frequency questionnaire data. Lifestyle clusters were identified using K-means cluster analysis, and their associations with allergic disease symptoms and sensitization were explored using logistic regression models., Results: Two distinct and stable clusters were identified: 'healthier lifestyle & lower MVPA' and 'unhealthier lifestyle & higher MVPA'. After adjustments, children in the 'unhealthier lifestyle & higher MVPA' cluster did not show significantly different odds for symptoms of asthma (OR: 0.80, 95% CI: 0.46-1.37), allergic rhinitis (OR: 1.32, 95% CI: 0.77-2.24), or eczema (OR: 0.89, 95% CI: 0.43-1.77) as compared to those in the 'healthier lifestyle & lower MVPA' cluster. Similar results were observed for sensitization to ≥ 1 inhaled allergen (OR: 1.27, 95% CI: 0.53-3.10) and sensitization to ≥ 1 food allergen (OR: 0.91, 95% CI: 0.30-2.60)., Conclusions: The results suggest that modifiable lifestyle factors may not play a significant role in allergic conditions within the examined age group. Lifestyle behaviors established in earlier childhood may serve as more credible predictors of allergic outcomes., Competing Interests: Declarations Ethics approval and consent to participate The present study was conducted according to the Declaration of Helsinki and approved by the Helsinki and Uusimaa Hospital District Ethics Committees. Informed parental consent and child assent were obtained for each participant. Consent for publication Not applicable. Competing interests The authors declare that they have no competing interests. The ISCOLE survey was funded by The Coca-Cola Company. The funder had no role in the design, data collection, data analysis, or manuscript preparation of this study., (© 2024. The Author(s).)

This scoping review examines environmental impacts related to food production and consumption in Nordic and Baltic countries. The overarching advice to all Nordic and Baltic countries, in line with the current body of scientific literature, is to shift to a more plant-based dietary pattern and avoid food waste. Taking into account current consumption patterns, there is a high potential and necessity to shift food consumption across the countries to minimise its environmental impact. More specifically, a substantial reduction in meat and dairy consumption and increased consumption of legumes/pulses, whole grains, vegetables, fruits, nuts, and seeds are suggested as a priority intervention. Reducing the environmental impacts of seafoods is also key and suggestions include a shift to seafoods with lower environmental impacts such as seaweed and bivalves. As part of the suggested transition to a more plant-based diet, the scope for increasing the provision of plant-based foods through increasing the cultivation of legumes/pulses, vegetables, and grains and through feed-to-food shifts within the region should be explored., (© 2024 Helen Harwatt et al.)

The overall aim of this paper was to provide background knowledge to the Nordic Nutrition Recommendations 2023 Committee for integrating environmental sustainability in a framework for national Food-Based Dietary Guidelines (FBDG) within the Nordics and Baltics. Additionally, this paper aims to give an overview of recent Nordic scientific literature on environmental impact of foods and dietary patterns and of the FBDG of the Nordics. Finally, we suggest methods for developing national sustainable FBDG. Nordic and Baltic studies on sustainability of diets were searched in August 2022 and complemented with additional relevant literature. The studies show that current diets are far from environmentally sustainable, exceeding planetary boundaries for most impact categories; meat and dairy products being the largest contributors to dietary greenhouse gas emissions (GHGEs) and land use. Scenario, modelling, optimisation and intervention studies confirm the potential of shifting towards more plant-based diets to improve overall diet quality in terms of both health and environmental sustainability. Such diets comprised of vegetables, fruits, legumes, potatoes, whole grain and refined cereal products, nuts, seeds and vegetable oils, with animal foods in moderate or limited amounts. The FBDG in the Nordics promotes more plant-based diets than the current average diet but could improve from further integration of environmental sustainability. To form basis for sustainable FBDG dietary modelling at the national level, prioritising health outcomes and nutritional adequacy is essential. Second, integrating environmental sustainability involves estimating the impact of food choices and amounts on GHGE, land and water use, eutrophication and biodiversity loss. Exploring positive and negative implications of fortified foods and supplementation in relation to nutrient intake, health and environmental sustainability may be needed. Implementing dietary transition requires solutions beyond FBDG to ensure affordability, acceptability and ease of adaption., Competing Interests: This study was funded by the Nordic Council of Ministers, and food and health authorities in Nordic countries. They had no role in the design of the paper, interpretation of results or in the writing of the manuscript. The authors state no conflict of interests. Comments from the public hearing were considered, and references checked for scientific relevance before they were taken into account. The authors solely performed and take full responsibility for interpretation of data and preparation of this manuscript., (© 2024 Ellen Trolle et al.)