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Overconsumption of energy provided by energy-dense, nutrient-poor (EDNP) food and drinks increases the risk of unhealthy weight gain and of obesity-related health outcomes. The aim of this study was to develop a nutrient profiling model for classifying EDNP food and drinks and to estimate the amount of discretionary energy for EDNP food and drinks in a recommended diet. A stepwise approach was used first to develop a nutrient profiling model for classifying EDNP food and drinks and then to estimate the amount of discretionary energy in a recommended diet using diet modeling. The nutrition profiling model comprised 24 macro- and micronutrients and energy density. The model classified 67% of 1482 foods and 73% of 161 drinks correctly as EDNP food and drinks compared with an expert-adjusted model. Sweets, chocolate, cake, cookies and biscuits, sweet and salty snacks, sugar-sweetened and artificially sweetened drinks, and alcoholic drinks were classified as EDNP food and drinks. The estimated amount of discretionary energy for EDNP food and drinks was 4-6% of the energy requirements for 4-75-year-old Danes. It seems prudent to have special attention on EDNP food and drinks in dietary guidelines and future public health initiatives to avoid overconsumption of energy.

Objective: To compare dietary intake and physical activity (PA) between days of the week in a large sample of the Danish population; furthermore, to investigate the influence of gender and age as determinants for weekly variation., Design: Analysis was based on cross-sectional data from the Danish National Survey of Diet and Physical Activity 2011-2013. Dietary intake and PA were assessed by 7 d of pre-coded food diaries and pedometer-determined step counts. Dietary intake and PA on weekdays (Monday-Thursday), Friday, and weekend days (Saturday and Sunday) were compared using linear mixed models., Setting: Survey with national representation, conducted in Denmark between 2011 and 2013., Participants: A random sample of 4-75-year-old Danes, n 3934 and n 3530 in analysis of dietary intake and PA, respectively., Results: Energy intake during Friday and weekend days was 7-20 % higher compared with weekdays, while step counts were 10 and 17 % lower on Saturday and Sunday, respectively (all P < 0·001). Energy density of liquids and solids, consumption of added sugar, alcohol, discretionary foods, beer, wine and sugar-sweetened beverages were substantially higher, and consumption of dietary fibre, vegetables, fruit and wholegrain products were lower, during Friday and weekend days compared with weekdays (all P < 0·001). The observed patterns were present across gender and age, although weekly variation was most pronounced among children and relatively modest among the elderly., Conclusions: Weekend health behaviours of Danes display less favourable eating and PA behaviour compared with weekdays, making the weekend an important target for public health interventions aiming to improve dietary intake and PA behaviour.

Under-reporting of energy intake (EI) is a well-known problem when measuring dietary intake in free-living populations. The present study aimed at quantifying misreporting by comparing EI estimated from the Danish pre-coded food diary against energy expenditure (EE) measured with a validated position-and-motion instrument (ActiReg). Further, the influence of recording length on EI:BMR, percentage consumers, the number of meal occasions and recorded food items per meal was examined. A total of 138 Danish volunteers aged 20-59 years wore the ActiReg and recorded their food intake for 7 consecutive days. Data for 2504 participants from the National Dietary Survey 2000-2 were used for comparison of characteristics and recording length. The results showed that EI was underestimated by 12 % on average compared with EE measured by ActiReg (PreMed AS, Oslo, Norway). The 95 % limits of agreement for EI and EE were - 6.29 and 3.09 MJ/d. Of the participants, 73 % were classified as acceptable reporters, 26 % as under-reporters and 1 % as over-reporters. EI:BMR was significantly lower on 1-3 consecutive recording days compared with 4-7 recording days (P < 0.03). Percentage consumers of selected food items increased with number of recording days. When recording length was 7 d, the number of reported food items per meal differed between acceptable reporters and under-reporters. EI:BMR was the same on 4 and 7 consecutive recording days. This was, however, a result of under-reporting in the beginning and the end of the 7 d reporting. Together, the results indicate that EI was underestimated at group level and that a 7 d recording is preferable to a 4 d recording period.

Early nutrition may program obesity and cardiovascular risk later in life, and one of the potential agents is (n-3) long-chain PUFA (LCPUFA). In this study, our objective was to examine whether fish oil (FO) supplementation during lactation affects blood pressure and body composition of children. Danish mothers (n = 122) were randomized to FO [1.5 g/d (n-3) LCPUFA] or olive oil (OO) supplementations during the first 4 mo of lactation. The trial also included a high-fish intake reference group (n = 53). Ninety-eight children were followed-up with blood pressure and anthropometry measurements at 7 y. Diet and physical activity level (PAL) were assessed by 4-d weighed dietary records and ActiReg. The PAL value was 4% lower (P = 0.048) and energy intake (EI) of the boys was 1.1 +/- 0.4 MJ/d higher (P = 0.014) in the FO group than in the OO group. Starch intake was 15 +/- 6 g/d higher (P = 0.012) in the FO group, but there were no other differences in diet. Body composition did not differ between the randomized groups with or without adjustment for starch intake, EI, and PAL. FO boys had 6 mm Hg higher diastolic and mean arterial blood pressure than OO boys (P < 0.01), but girls did not differ. Within the randomized groups, blood pressure was not correlated with maternal RBC (n-3) LCPUFA after the intervention, but PAL values were (r = -0.277; P = 0.038). We previously found higher BMI at 2.5 y in the FO group, but the difference did not persist. The differences in blood pressure, EI, and PAL, particularly among boys, suggest that early (n-3) LCPUFA intake may have adverse effects, which should be investigated in future studies.

Objective: To characterise misreporters of energy intake (EI) and energy expenditure (EE)., Design: Cross-sectional study, using a validated position and motion instrument, ActiReg, as the reference method to study misreporters of EI and of EE. EI was measured using a dietary record and EE using a physical activity questionnaire (PAQ). Misreporters were defined as subjects outside the 95% confidence limits of agreement between EI or EE reported/EE measured., Setting: Free-living Danish volunteers., Subjects: One hundred and thirty-eight volunteers aged between 20 and 59 years., Results: Body mass index, smoking, 'try to eat healthily' and worries about weight were related to degree of under-reported EI. The percentage energy from added sugar was lowest (P < 0.001) and the percentage energy from protein (P < 0.001) highest in under-reporters compared with acceptable reporters. Subjects who reported being very physically active at work or in leisure time reported a higher EE than measured EE compared with less physically active subjects (P < 0.05). Likewise, subjects who regard themselves as fit or very fit reported a higher EE than subjects who regard themselves as moderately fit (P < 0.05). Possible over-reporters reported less time as very light activity (P = 0.007), more time as moderate activity (P = 0.01) and more time as vigorous activity (P = 0.02) than acceptable reporters., Conclusions: Under-reporting of EI should always be taken into consideration; however, only a few characteristics of under-reporters are consistent among studies. Misreporting of EI was more prevalent than misreporting of EE. The level of physical activity more than the time spent involved in various activities was misreported.

Objective: To elucidate status and trends in portion size of foods rich in fat and/or added sugars during the past decades, and to bring portion size into perspective in its role in obesity and dietary guidelines in Denmark., Data Sources: Information about portion sizes of low-fat and full-fat food items was obtained from a 4-day weighed food record (Study 1). Trends in portion sizes of commercial foods were examined by gathering information from major food manufacturers and fast food chains (Study 2). Data on intakes and sales of sugar-sweetened soft drinks and confectionery were obtained through nation-wide dietary surveys and official sales statistics (Study 3)., Results: Study 1: Subjects ate and drank significantly more when they chose low-fat food and meal items (milk used as a drink, sauce and sliced cold meat), compared with their counterparts who chose food and meal items with a higher fat content. As a result, almost the same amounts of energy and fat were consumed both ways, with the exception of sliced cold meat (energy and fat) and milk (fat). Study 2: Portion sizes of commercial energy-dense foods and beverages, and fast food meals rich in fat and/or added sugars, seem to have increased over time, and in particular in the last 10 years. Study 3: The development in portion sizes of commercial foods has been paralleled by a sharp increase of more than 50% in the sales of sugar-sweetened soft drinks and confectionery like sweets, chocolate and ice creams since the 1970s., Conclusions: Larger portion sizes of foods low in fat and commercial energy-dense foods and beverages could be important factors in maintaining a high energy intake, causing over-consumption and enhancing the prevalence of obesity in the population. In light of this development, portion size ought to take central place in dietary guidelines and public campaigns.