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Objective: Evaluate the effectiveness of the multicomponent intervention trial "Are You Too Sweet?" in reducing discretionary foods and drinks intake among young schoolchildren. Design: The study was a 3.5-month two-arm cluster randomised controlled trial among primary school children and their families. School health nurses provided guidance to families regarding discretionary foods and drinks for the children. Moreover, families were given a variety of knowledge- and capability-building materials to utilize at home. Dietary intake was assessed using a web-based seven-day dietary record. Linear mixed regression models were used to estimate intervention effects as changes in child intake of discretionary foods and drinks and sugar between groups. Setting: Six schools from a Danish municipality were randomised to the intervention group (n 4) or the control group (n 2). Participants: A total of 153 children aged 5-7 years. Results: No significant reduction in the children's intake of total discretionary foods and drinks or discretionary foods alone was observed between the intervention and control group, while a decreased intake of discretionary drinks of 40.9% (p = 0.045) was observed compared to control. Secondary subgroup analysis showed that children of parents with shorter educational level significantly reduced their intake of added sugar by 2.9 E% (p = 0.002). Conclusion: The results of this study indicate that multicomponent interventions involving school health nurses may have some effects in reducing, especially, discretionary drinks.

I de senere år har der været en stigende interesse for at leve bæredygtigt og spise mindre kød. Men i hvor høj grad slår intentionerne igennem, når man ser på danskernes indkøbsvaner? Denne E-artikel gennemgår data for danskernes indkøb af kød, frugt, grøntsager, mejeriprodukter, plantebaserede alternativer til kød og mejeriprodukter, bælgfrugter, nødder m.m.

Danish children have a much larger intake of sugar-rich foods and drinks than recommended. This study aimed to (1) explore social aspects and practices of pre-school children's intake of sugar-rich foods and drinks and (2) evaluate barriers and parental strategies to reduce their children's intake of sugar-rich foods and drinks employed in connection with the 3.5-month family-centred intervention trial 'Are you too sweet?'. Intervention components included communication of the recommended maximum intake and reduction strategies, supported by resources encouraging and facilitating behavioural changes. A random sample of families (n = 24) from intervention schools participated in post-intervention semi-structured interviews. A thematic content analysis was conducted, revealing three main domains of social practices: (1) 'family treats', including the weekly Danish concept 'Friday sweets', (2) 'everyday treats', such as sweet snacks in lunch packs, between-meals snacks and soft drink habits and (3) 'socialized treats', including treats at special occasions. Parents employed several strategies, most often substitution and portion-size reduction, but also limiting home availability. Families most frequently made changes that were easily adoptable and close to existing routines at home. In conclusion, the intervention components provided families with knowledge and strategies that facilitated behavioural changes towards reducing the intake of sugar-rich foods and drinks.

The aim of this memo is to provide the scientific background for updating the recommendation for whole-grain (WG) intake in Denmark in order to take the latest knowledge about health and sustainability into account.

Knowledge is needed about effective tools that reach public health objectives focused on reducing the intake of sugar-rich foods and drinks. The purpose of this study was to assess the parental acceptability, use and motivational potential of intervention components developed in the randomized family-based trial ‘Are you too sweet?’ aimed at reducing the intake of sugar-rich foods and drinks among children (5–7 y). Intervention components included guidance on sugar-rich foods and drinks at a school health nurse consultation, a box with home-use materials and a digital platform. The methods used were a questionnaire among intervention families (n = 83) and semi-structured interviews with parents in selected intervention families (n = 24). Results showed the good acceptability and usefulness of the components, with reported frequencies of use of materials ranging from 48% to 94% and a high satisfaction rate with the school health nurse consultation. Personalized feedback and guidance from the school health nurse seemed to be a motivational trigger, and components that were compatible with existing practices were most frequently used. However, the components were not considered engaging by all families. Overall, intervention components were well received and hold the potential for enhancing parental knowledge and parenting practices regarding limiting the intake of sugar-rich foods and drinks.

A high consumption of discretionary foods and drinks has been associated with increased risk of multiple adverse health outcomes, including risk of overweight and dental caries. The family-based cluster randomized intervention study "Are you too sweet?" aimed at reducing the intake of discretionary foods and drinks in a population of children starting pre-school. As part of the intervention a new short web-based sugar-rich food screener (SRFS), was developed to make the parents and the school health nurses aware of the children's intake of discretionary foods and drinks. In addition to the short assessment tool the parents also completed a validated web-based 7-day dietary record for the children. In the present study, estimates for intake of discretionary foods and drinks from the two assessment tools were compared (n = 80). There was significant correlation between estimates from the two assessment tools, but the SRFS provided lower estimates for intake of discretionary foods and drinks compared to the 7-day dietary record. The correlation coefficient between the two assessment tools was 0.49 (p < 0.001) and Kappa coefficient was 0.33. It is concluded that the SRFS can provide a fairly ranking of participants according to their intake of discretionary foods and drinks when compared to a validated 7-day dietary record. The screener may be a useful tool in practical settings, such as school health nurse consultations, in order to gain insight into the child's sweet intake habits.

Meat intake has been linked to increased risk of colorectal cancer (CRC) and mortality. However, diet composition may affect the risks. We aimed to estimate associations between red and processed meat and poultry intake and risk of CRC and all-cause mortality and if they are modified by dietary quality using Cox regression analyses. Baseline dietary data were obtained from three survey rounds of the Danish National Survey on Diet and Physical Activity. Data on CRC and all-cause mortality were extracted from national registers. The cohort was followed from date of survey interview-or for CRC, from age 50 years, whichever came last, until 31 December 2017. Meat intake was analysed categorically and continuously, and stratified by dietary quality for 15-75-year-old Danes at baseline, n 6282 for CRC and n 9848 for mortality analyses. We found no significant association between red and processed meat intake and CRC risk. For poultry, increased CRC risk for high versus low intake (HR 1.62; 95%CI 1.13-2.31) was found, but not when examining risk change per 100 g increased intake. We showed no association between meat intake and all-cause mortality. The association between meat intake and CRC or mortality risk was not modified by dietary quality.

Danmark har som resten af verden forsøgt at begrænse COVID-19 pandemien siden foråret 2020 gennem en række tiltag. Et af dem var den nationale nedlukning af samfundet i marts 2020, hvor undervisning gik online, og mange danskere måtte arbejde hjemmefra eller blev sendt hjem fra arbejdet. Den markant ændrede hverdag påvirkede vores kost- og aktivitetsvaner. DTU Fødevareinstituttet har undersøgt, hvordan ændringerne har påvirket danskerne og har fundet, at voksne danskere generelt har spist mindre sundt og bevæget sig betydeligt mindre under nedlukningen end i perioden før. Data for indtag og salg af fødevarer peger på, at vores forbrug af søde sager og søde drikke har været højere under nedlukningen end før. Hver femte voksne dansker har haft en stillesiddende fritid under nedlukningen, og det er markant højere, end hvad der er fundet i tidligere undersøgelser før nedlukningen. Gruppen med kort uddannelse og lav indkomst har haft de mest usunde kost- og aktivitetsvaner, Danmark har som resten af verden forsøgt at begrænse COVID-19 pandemien siden foråret 2020 gennem en række tiltag. Et af dem var den nationale nedlukning af samfundet i marts 2020, hvor undervisning gik online, og mange danskere måtte arbejde hjemmefra eller blev sendt hjem fra arbejdet. Den markant ændrede hverdag påvirkede vores kost- og aktivitetsvaner. DTU Fødevareinstituttet har undersøgt, hvordan ændringerne har påvirket danskerne og har fundet, at voksne danskere generelt har spist mindre sundt og bevæget sig betydeligt mindre under nedlukningen end i perioden før. Data for indtag og salg af fødevarer peger på, at vores forbrug af søde sager og søde drikke har været højere under nedlukningen end før. Hver femte voksne dansker har haft en stillesiddende fritid under nedlukningen, og det er markant højere, end hvad der er fundet i tidligere undersøgelser før nedlukningen. Gruppen med kort uddannelse og lav indkomst har haft de mest usunde kost- og aktivitetsvaner.

Associations between meat consumption and heart disease have been assessed in several studies but it has been suggested that other dietary factors influence these associations. The aim of this study was to assess whether meat consumption is associated with ischemic heart disease (IHD), and if the association is modified by dietary quality. The analyses were based on the cohort of adult participants in The Danish National Survey on Diet and Physical Activity in 2000-2002, 2003-2008, and 2011-2013. From these surveys, information on meat consumption and dietary quality were extracted. The cohort was followed in national registers to identify incident IHD. Associations were estimated using Cox regression analyses adjusting for sociodemographic and lifestyle factors. Analyses of associations between meat consumption and IHD stratified by dietary quality were subsequently evaluated. Among the 8,007 participants, the median follow-up was 9.8 years and 439 cases of IHD were recorded. The results suggested a trend between consumption increments of 100g/day of red meat (HR=1.23; 95%CI:0.99-1.53) or of 50 g/day of processed meat (HR=1.09; 95%CI:0.93-1.29) and higher risk of IHD. The trends were, however, not statistically significant. Stratification by dietary quality did not suggest that associations between meat consumption and risk of IHD were modified by dietary quality. This population-based cohort study with detailed dietary information, suggested a trend with higher meat consumption being associated with higher risk of IHD, but the association was not statistically significant. Results did not indicate that dietary quality modifies such associations.

A high consumption of sugar-rich discretionary food and drinks has several health implications, which have been traced from childhood into adulthood. Parents act as primary mediators shaping children’s dietary habits, and interventions that engage parents have shown to result in positive outcomes. Further, collaboration with local school health nurses and dentists provides an effective structural frame to support behaviour change and anchor new initiatives. The multicomponent 3.5-month cluster randomised family-focused intervention “Are you too Sweet?” aims to evaluate the effectiveness of communicating new Danish guidelines for sugar-rich discretionary food and drinks for school starters (5–7 years). This paper describes the development, outcomes and process evaluation of the intervention that includes three main components: extended dialogue during a school health nurse consultation, a box with home-use materials, and a social media platform to facilitate interaction among participants. Children (n = 160) and their parents were scheduled for a baseline interview at six different schools. The intervention was developed to increase self-efficacy, knowledge about guidelines, observational learning and reduce impediments for behavioural change. The desired primary outcome was a reduction in intake of sugar-rich food measured through a 7-day dietary record. The results contribute to the evidence on effective health promotion strategies.

Der er stor forskel på danskernes kost- og aktivitetsvaner på hverdage og weekenddage. Danskere spiser mest usundt om lørdagen med 20% højere energiindtag og 39% flere søde sager samt mindre frugt, grønt og fuldkorn end på hverdage. De bevæger sig mindst om søndagen, hvor de tager 20% færre skridt end på hverdage. Det viser en undersøgelse baseret på data fra Den nationale undersøgelse af danskernes kost og fysiske aktivitet 2011-2013. Weekendvanerne er således et oplagt mål, hvis danskernes kost- og aktivitetsvaner skal blive sundere.

DTU Fødevareinstituttet gennemfører med jævne mellemrum de nationale undersøgelser af danskernes kost og fysiske aktivitet for at sikre et forskningsbaseret grundlag for instituttets arbejde med at vurdere forskellige fødevarerelaterede risici samt for instituttets forskning i folkesundhed. Formålet er at undersøge indtag af fødevarer, næringsstoffer og uønskede stoffer samt det fysiske aktivitetsniveau i den danske befolkning. Resultaterne bruger forskere og myndigheder til at vurdere fødevaresikkerheden, folkesundheden og kostens klimabelastning i Danmark. Denne e-artikel giver et indblik i planlægningen og udviklingen af 2020-2021 undersøgelsen.

Et højt indtag af søde sager og søde drikke hos børn kan lede til både overvægt, dårlig tandsundhed og til, at vigtige vitaminer og mineraler bliver skubbet ud af kosten. På den baggrund er forskningsprojektet Er du for sød? blevet til med en ambition om at formulere konkrete anbefalinger og tiltag og derved bane vejen for et lavere indtag af søde sager og søde drikke blandt børn. Denne e-artikel gennemgår de videnskabelige grunde til at arbejde hen imod, at børn mindsker deres indtag af søde sager og søde drikke.

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. 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. Survey with national representation, conducted in Denmark between 2011 and 2013. A random sample of 4-75-year-old Danes, n 3934 and n 3530 in analysis of dietary intake and PA, respectively. 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. 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.

Mange børn og unge efterlever ikke de officielle danske kostråd. Sunde mad- og måltidsvaner er vigtige for et godt fysisk og mentalt helbred, og hos børn og unge har det desuden betydning for læring og trivsel [1]. Usunde mad- og måltidsvaner er en væsentlig årsag til overvægt og svær overvægt, som WHO vurderer som en af de største trusler mod folkesundheden [2]. Forekomsten af overvægt og svær overvægt blandt børn og unge har i Danmark været et stigende problem frem til for 10-15 år siden, hvorefter udviklingen er stagneret [1]. En relativt stor andel af de danske børn og unge har problemer med caries og syreskader i tænderne pga. højt indtag af sukker og ikke mindst sukkersødede læskedrikke [3]. Denne artikel er baseret på en rapport fra Vidensråd for Forebyggelse [1], hvor man beskriver status og udvikling i 3-18-åriges kostvaner samt samler og vurderer, hvilke indsatser der skal til for at forbedre mad- og måltidsvanerne i denne gruppe.

Carcinogenic effects in humans are ascribed to processed meat by organisations such as International Agency for Research on Cancer, World Cancer Research Fund and American Institute for Cancer Research. However, the term ‘processed meat’ covers a heterogenic group of products whose content of potential hazards differ considerably. To improve estimates of associations between processed meat intake and cancer risk we investigated ways to divide processed meat into subgroups that more precisely reflects its carcinogenic characteristics. We collected ingredient lists and declarations of salt content for >1000 processed meat products on the Danish market and combined the information with knowledge related to processing parameters. Some compounds that could affect the products' carcinogenic characteristics, alone or in combination, were evaluated and compared for 12 types of processed meat products, and we suggest subgrouping of processed meat with similar level of carcinogenic potential, which could improve the understanding of the cancer risk associated with processed meat intake in scientific human studies.

Fødevarestyrelsen har bedt DTU Fødevareinstituttet vurdere, om studiet af Lundsgaard et al. Mechanisms preserving insulin action during high dietary fat intake. Cell Metabol 2019;29:1-14, har betydning for kostrådene om fedt.

Ministeren er stillet følgende spørgsmål af Miljø- og Fødevareudvalget: Vil ministeren kommentere på studiet foretaget af Julia Baudry fra Institut National de la Sante et de la Recherche Medicale i Paris, omtalt i Politikens artikel ”Økologisk kost reducerer risiko for visse kræftformer” fra den 26. oktober 2018? Vil ministeren herunder vurdere, om det er korrekt, at økologisk kost reducerer risikoen for visse kræftformer? Fødevarestyrelsen har bedt DTU, Fødevareinstituttet om at give en vurdering af studiet og ovennævnte spørgsmål.

Ifølge bekendtgørelsen om tilsætning af vitaminer og mineraler til fødevarer1 er det i Danmark tilladt at berige fødevarer i visse fødevarekategorier med disse næringsstoffer. DTU Fødevareinstituttet har gennemført et projekt, hvis formål var at optimere datagrundlaget og de beregninger, der anvendes i en revideret model til vurdering af tilsætning af vitaminer og mineraler til fødevarer. I den reviderede model er der behov for at estimere danskernes samlede indtag af vitaminer og mineraler, herunder bidraget fra berigede fødevarer. Der er ikke i de hidtil udførte danske kostundersøgelser mulighed for at estimere danskernes indtag af berigede fødevarer pga. manglende information om mærkevarer. Til at estimere indtaget af berigede fødevarer i de fødevarekategorier, som kan beriges i Danmark, og som der er indtagsdata på, benyttes derfor p.t. hollandske data for, hvor stor en andel af indtaget af forskellige fødevarer i Holland, der er beriget2. Ved de danske beregninger anvendes derfor de hollandske berigelsesandele til at estimere hvor meget af den enkeltes indtag af de relevante fødevarekategorier, der er beriget med den tilladte mængde af næringsstof ifølge bekendtgørelsen. I projektet blev det undersøgt om indkøbs- og salgsdata fra Growth for Knowledge (GfK) kombineret med lister over notifikationer og anmeldelser af berigede fødevarer kunne danne grundlag for en estimering af de berigede produkters bidrag til det samlede indtag af vitaminer og mineraler i danskernes kost. I det følgende redegøres for fordele og ulemper ved hhv. de hollandske og de danske data, hvilket danner grundlag for valget af hollandske data til estimering af indtaget af berigede fødevarer i den danske befolkning.

Fødevarestyrelsen har bedt om hjælp til at udforme en kort test til et svar på Facebook om proteiners rolle i en antiinflammatorisk kost, specifikt spørgsmålene: ”Er der forskel på proteiner? Altså, jeg tænker: "kvaliteten"? Er nogle proteiner mere inflammatoriske end andre? Hvilke proteiner er sværest at nedbryde/ hvilke er nemmest?”

Visual aids, such as food photographs, are widely used in estimating food quantities in dietary surveys. The present study aimed to assess how accurately Danish adults and children can estimate food portion sizes using 37 series of photographs illustrating four to six different portion sizes under real-life conditions; determine whether adults were more accurate than children; and estimate the error caused by using portion size photographs to estimate weights of foods consumed in macronutrient calculation. Six hundred and twenty-two adults and 109 children were recruited in three workplace canteens and in two schools, respectively, to estimate their lunchtime portions based on photographs. Participants were instructed to keep the foods separated on their plate when taking lunch. Participants thereafter estimated their own portions by looking at the relevant series of photographs. The actual food portions were then weighed. The proportion of correct estimations was 42% overall (range 19-77%). The mean difference (%) between estimated and actual weight was 17% (range 1-111%). Small portion size photographs were more often used correctly compared to larger portion photographs. Children had as many correct estimations as adults, although they overestimated portions more. Participants using fractions of (or more than) one photograph to estimate the portion of a food had significantly larger errors. When calculating the macronutrient content of a weekly menu using the estimated portion sizes, protein had the largest error (29%). When used in a real-life situation, the portion size photographs validated in the present study showed a certain inaccuracy compared to the actual weights.

Der er stigende fokus på danskernes kødindtag i debatten om klima og sundhed, og ofte bliver meget forskellige tal fremhævet. Tallene afspejler forskellige måder at opgøre danskernes kødforbrug på. Den mest retvisende kilde til at belyse danskernes reelle indtag af kød er De nationale kostundersøgelser, som viser, hvem der spiser hvad. E-artiklen beskriver de datakilder, der findes om danskernes kødforbrug. Den belyser også kort data om antallet af vegetarer og veganere i Danmark.

Breakfast is considered by many to be the most important meal of the day. This study examined the intake of nutrients and foods at breakfast among Danes and the relation to the overall dietary quality. Data were derived from the Danish National Survey on Diet and Physical Activity 2011⁻2013, a cross-sectional national food consumption study. A total of 3680 participants aged 6⁻75 years were included in the analyses of breakfast consumption. The Nutrient Rich Food Index 9.3 method was used to examine the overall dietary quality of the diet. The intake of nutrients and foods at breakfast were compared across dietary quality score tertiles by ANCOVA adjusted for energy and socio economic status. Breakfast was eaten frequently by children and adults and contributed with 18⁻20% of total energy intake. Breakfast was relatively high in dietary fibre, B vitamins, calcium and magnesium and low in added sugar, total fat, sodium, vitamin A and D. A decrease in the intake of added sugar, total fat and saturated fat and an increase in the intake of dietary fibre and most micronutrients were seen across tertiles of dietary quality scores. Commonly consumed foods provided at breakfast in Denmark included bread, breakfast cereals and dairy products as well as water, coffee and juice, while intakes of fruits, vegetables, cakes and soft drinks were low.

Background: Whole-grain consumption seems to be cardioprotective in adults, but evidence in children is limited.Objective: We investigated whether intakes of total whole grain and dietary fiber as well as specific whole grains were associated with fat mass and cardiometabolic risk profile in children.Methods: We collected cross-sectional data on parental education, puberty, diet by 7-d records, and physical activity by accelerometry and measured anthropometry, fat mass index by dual-energy X-ray absorptiometry, and blood pressure in 713 Danish children aged 8-11 y. Fasting blood samples were obtained and analyzed for alkylresorcinols, biomarkers of whole-grain wheat and rye intake, HDL and LDL cholesterol, triacylglycerols, insulin, and glucose. Linear mixed models included puberty, parental education, physical activity, and intakes of energy, fruit and vegetables, saturated fat, and n-3 (ω-3) polyunsaturated fatty acids.Results: Median (IQR) whole-grain and dietary fiber intakes were 52 g/d (35-72 g/d) and 17 g/d (14-22 g/d), respectively. Fourteen percent of children were overweight or obese and most had low-risk cardiometabolic profiles. Dietary whole-grain and fiber intakes were not associated with fat mass index but were inversely associated with serum insulin [both P <0.01; e.g., with 0.68 pmol/L (95% CI: 0.26, 1.10 pmol/L) lower insulin · g whole grain-1 · MJ-1]. Whole-grain oat intake was inversely associated with fat mass index, systolic blood pressure, and LDL cholesterol (all P <0.05) as well as insulin (P = 0.003), which also tended to be inversely associated with whole-grain rye intake (P = 0.11). Adjustment for fat mass index did not change the associations. The C17-to-C21 alkylresorcinol ratio, reflecting whole-grain rye to wheat intake, was inversely associated with insulin (P <0.001).Conclusions: Higher whole-grain intake was associated with lower serum insulin independently of fat mass in 8- to 11-y-old Danish children. Whole-grain oat int

The objective of this study was to compare the content of selected nutrients of fast foods determined by chemical analysis versus estimated by recipe calculation based on data from two versions of the Danish food composition databank, FOODCOMP and the latest FRIDA. A total of 155 samples of ready-to-eat fast foods were collected from fast food outlets, separated into their components and weighed. Typical components were bread, French fries, vegetables, meat and dressings. The fast foods were analyzed, and energy, protein, saturated fat, iron, thiamin, potassium and sodium contents were compared to recipe calculation. When using the FOODCOMP in recipe calculation, the error percentage was largest for saturated fat (28%). When using FRIDA, the error percentage for saturated fat decreased to 11% and was below 15% for all nutrients. The correlations ranged from 0.49 to 0.89 with both databanks. For the individual fast foods, the error percentages were both acceptable (<15%) and large (>50%). Future challenges for the databank in relation to recipe calculation are to include more varieties, a better coverage of foods used as ingredients, and inclusion of analytical values of mixed dishes if they are commonly eaten from fast food outlets.