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Background: Probiotics are known to stimulate the immune system but the effect on thymus size in late infancy is unknown. We examined the effect of probiotics on thymus size and C-reactive protein (CRP) in healthy Danish infants starting daycare. We further examined associations between thymus size, CRP and recent infections.Methods: The study included 186 children randomized to a combination of Lactobacillus rhamnosus, LGG® and Bifidobacterium animalis spp. lactis, BB-12® or placebo for 6 months. Thymus size, assessed as thymus index (TI) and thymus weight index (TWI), was measured by ultrasound at baseline and at endpoint. Blood samples were drawn to measure CRP. Infections were parent-reported.Results: There was no significant difference in thymus size between the probiotic group and placebo (p ≥ 0.248) but TWI tended to be higher in the probiotic group corresponding to 5% higher than placebo (p = 0.068) in an adjusted model. There was no effect of probiotics on CRP (p = 0.331). At the endpoint, thymus size was inversely associated with CRP (p ≤ 0.040), diarrhea (p ≤ 0.050), and TI was also associated with the absence from daycare due to respiratory or gastrointestinal infections (p = 0.010).Conclusion: The probiotic intervention had no effect on thymus size or CRP in Danish children at the age of starting daycare.Impact: Overall there was no effect on thymus size of a combination of Lactobacillus rhamnosus, LGG® and Bifidobacterium animalis spp. lactis, BB-12® administered to Danish children starting daycare.This study examines the effect of probiotics on thymus size in healthy children when they start daycare thus exposed for infections while their immune system is still developing. This has to our knowledge not been described before.We found no significant difference in thymus size between the probiotic and placebo groups, but for th

In the original article, there was a mistake in the legend for Table 2 as published. The measurement “nmol/L” was used instead of “nmol/ml.” The correct legend appears below. The authors apologize for this error and state that this does not change the scientific conclusions of the article in any way. The original article has been updated.

Background: Allergic diseases are common and represent a considerable health and economic burden worldwide. We aimed to examine the effect of a combination of two probiotic strains administered in late infancy and early childhood on the development of allergic diseases and sensitization.Methods: In this double-blind, placebo-controlled intervention trial, participants were randomized to receive a daily mixture of Lactobacillus rhamnosus and Bifidobacterium animalis subsp lactis or placebo-starting prior to attending day care. The intervention period was 6 months, and the parents answered web-based questionnaires on allergic symptoms and doctor's diagnosed allergic disease monthly. IgE was measured at baseline and follow-up.Results: A total of 290 participants were randomized: 144 in the probiotic group and 146 in the placebo group. Mean age at intervention start was 10.1 months. At follow-up (mean age 16.1 months), the incidence of eczema was 4.2% in the probiotic group and 11.5% in the placebo group (P = 0.036). The incidence of asthma and conjunctivitis did not differ between groups, and no children presented with rhinitis. Sensitization was equal in the two groups at intervention start (7.5% and 9.5%, respectively), and two children in each group were sensitized during the intervention.Conclusions: We observed a significantly lower incidence of eczema in the probiotic group compared to the placebo group. The probiotics were administered in late infancy-prior to attending day care-suggesting a broader window of opportunity using probiotics in the prevention of eczema. The incidence of asthma, rhinitis, conjunctivitis, and sensitization did not differ.

Background: Some infants experience excessive weight gain during exclusive breastfeeding. The cause is unknown, but variation in human milk composition might play a role. Several human milk koligosaccharides (HMOs) have been associated with growth velocity in breastfed infants, and it has been suggested that the mechanism could be through an effect on infant gut microbiota composition. Objective: The purpose of this exploratory study was to evaluate if HMO composition was different in milk fed to infants with excessive weight gain compared to infants with normal weight gain. Furthermore, we aimed to examine if HMO composition was associated with growth velocity and change in body composition and if there were maternal determinants of HMO composition. Materials and Methods: We recruited 13 high weight-gain (HW) and 17 normal weight-gain (NW) breastfed infants, collected human milk and anthropometry data at 5 and 9 months, and analyzed HMO composition by high performance liquid chromatography. Results: In the HW group eight out of 11 infants received milk from secretor mothers and in the NW group 15 out of 17. Comparing milk from Secretor mothers only, four HMO's were significantly different between the HW and NW group at 5 months and two remained significant at 9 months. Total HMO concentrations as well as total HMO-bound fucose at 5 months were positively associated with both fat mass index (FMI) and weight velocity from 0 to 5 months (all p < 0.025). 2'-fucosyllactose (2'-FL) was positively associated with weight velocity from 0 to 5 months and FMI at 5 months. In contrast, lacto-N-neotetraose was lower in the HW group (p = 0.012) and negatively associated with height-for-age Z-scores (p = 0.008), weight velocity from 0 to 5 months (p = 0.009) and FMI (p = 0.033). Maternal BMI at 5 months was negatively associated with 6'-sialy

Background: Respiratory and gastrointestinal infections are common during childhood, especially in young infants < 2 years of age. Although these common infections are rarely fatal inhigh-income countries as Denmark, they are a source of significant morbidity burden to thechildren and their families, and lead to a substantial economic burden on society. Childrenattending daycare have an increased risk of infections, mainly due to an increased exposure topathogens through social interaction between children, and due to a not yet fully developedimmune system. Strategies to prevent infections in daycare settings are of great importance in acountry like Denmark, where 90 % of children are cared for outside the home in daycare facilitiesby the age of 2 years. Probiotics, defined as live microorganisms that when administered inadequate amounts, confer a health benefit on the host have been suggested in prevention ofrespiratory and gastrointestinal infections in children. Objective: The main objective of this PhD thesis was to examine the effect of probiotics inreducing absence from daycare due to respiratory and gastrointestinal infections in Danish infantsduring their first months in a daycare setting, and to explore potential factors modifying the riskof infections. Further, the current evidence on the use of probiotics in prevention of respiratoryinfections in children attending daycare was systematically reviewed. Methods: Paper I reports on a randomized, placebo-controlled trial investigating the effect ofprobiotics on absence from daycare due to respiratory and gastrointestinal infections in Danishinfants (The ProbiComp study). A total of 290 infants were randomly allocated to receive placeboor a combination of Bifidobacterium animalis subsp. lactis BB-12 and Lactobacillus rhamnosusGG in a dose of 109 colony-forming units per day of each for a 6-month intervention period. Absence from daycare, symptoms of illness, and doctors visits were registered by the parents

Background Research on the health effects of probiotics continues to grow, but less is known about consumers’ perceptions of probiotic products and their health effects, and the impact of these perceptions on consumption. Particularly little is known about the way parents perceive probiotic consumption by small children, and whether parental willingness to use probiotics as a treatment differs from their willingness to use them preventively. The aim of this study was to explore how parents perceive probiotic consumption by their small children, and their willingness to use such products in treatment and prevention. Methods Semi-structured qualitative interviews with 17 Danish parents with at least one child aged 8–18 months. The interview guide centered on parental consumer practices and health-related attitudes both in general and in relation to probiotics. The data were coded in Nvivo and analyzed in a four-step analytical approach. Results Parents are willing to use probiotics as a treatment but are skeptical about preventive use. Some parents define probiotics as a kind of medicine they use only if their child is ill. Probiotics also conflict with parental understandings of their children as small, perfect parts of nature. Parents worry that probiotics may cause an imbalance in the vulnerable perfection of a small child. Conclusion The study shows that parental probiotic consumption practices are embedded in a cultural understanding of the child as both a perfect example of nature and vulnerable. Health authorities need to take this understanding into account if parents are to be successfully encouraged to use probiotics preventively., Background Research on the health effects of probiotics continues to grow, but less is known about consumers’ perceptions of probiotic products and their health effects, and the impact of these perceptions on consumption. Particularly little is known about the way parents perceive probiotic consumption by small children, and whether parental willingness to use probiotics as a treatment differs from their willingness to use them preventively. The aim of this study was to explore how parents perceive probiotic consumption by their small children, and their willingness to use such products in treatment and prevention. Methods Semi-structured qualitative interviews with 17 Danish parents with at least one child aged 8–18 months. The interview guide centered on parental consumer practices and health-related attitudes both in general and in relation to probiotics. The data were coded in Nvivo and analyzed in a four-step analytical approach. Results Parents are willing to use probiotics as a treatment but are skeptical about preventive use. Some parents define probiotics as a kind of medicine they use only if their child is ill. Probiotics also conflict with parental understandings of their children as small, perfect parts of nature. Parents worry that probiotics may cause an imbalance in the vulnerable perfection of a small child. Conclusion The study shows that parental probiotic consumption practices are embedded in a cultural understanding of the child as both a perfect example of nature and vulnerable. Health authorities need to take this understanding into account if parents are to be successfully encouraged to use probiotics preventively.

Probiotics have been suggested to have a preventive effect on respiratory tract infections (RTIs), but limited evidence exist on strain-specific effects. The main aim of this systematic review and meta-analysis was to evaluate strain-specific probiotic effects on RTIs in children attending day care. We included 15 RCTs with 5121 children in day care settings (aged 3 months to 7 years), but due to high diversity in reported outcomes, different number of RCTs were available for evaluated outcomes. Twelve RCTs (n = 4527) reported results which could be compared in at least one outcome of the meta-analysis. Compared to placebo, Lactobacillus rhamnosus GG (LGG) significantly reduced duration of RTIs (three RCTs, n = 1295, mean difference − 0.78 days, 95% confidence interval (CI) − 1.46; − 0.09), whereas no effect was found on other evaluated outcomes. Based on the results from two studies (n = 343), Bifidobacterium animalis subsp. lactis BB-12 showed no effect on duration of RTIs or on absence from day care. Meta-analyses on other strains or their combination were not possible due to limited data and different outcome measures. Conclusion: LGG is modestly effective in decreasing the duration of RTIs. More RCTs investigating specific probiotic strains or their combinations in prevention of RTIs are needed. (Table presented)

Aim: We examined the frequency and potential risk factors for respiratory infections, diarrhoea and absences in infants during their first months in day care.Methods: This prospective cohort study comprised 269 Danish infants aged 8-14 months and was part of a study that examined how probiotics affected absences from day care due to respiratory and gastrointestinal infections. The risk factors examined were the household, child characteristics and type of day care facility. Parents registered upper respiratory tract infections (URTIs), lower respiratory tract infections (LRTIs), diarrhoea and day care absences on web-based questionnaires.Results: Over a mean of 5.6 months in day care, 36% and 20% of the infants had at least one URTI or LRTI and 60% had diarrhoeal episodes. The risk of at least one URTI was increased by previous respiratory infections, with an odds ratio (OR) of 2.65, but was inversely associated with having a pet (OR 0.43), being cared for by registered child minders compared to day care centres (OR 0.36), birth weight (OR 0.40) and age at day care enrolment (OR 0.64). No significant risk factors for LRTIs and diarrhoea were found.Conclusions: Infection risks were associated with environmental factors and factors related to the child. This article is protected by copyright. All rights reserved.

Faecalibacterium prausnitzii is a highly abundant human gut microbe in healthy individuals, but it is present at reduced levels in individuals with gastrointestinal inflammatory diseases. It has therefore been suggested to constitute a marker of a healthy gut and is associated with anti-inflammatory properties. However, factors affecting the colonization of F. prausnitzii in the human gut during early life are very poorly understood. By analysis of 16S rRNA amplicon sequencing data from three separate infant study populations, we determined the colonization dynamics of Faecalibacterium and factors affecting its establishment in the gut. We found that in particular, the presence of older siblings was consistently associated with Faecalibacterium gut colonization during late infancy and conclude that acquisition of Faecalibacterium is very likely to be accelerated through transfer between siblings. IMPORTANCEFaecalibacterium prausnitzii has been suggested to constitute a key marker of a healthy gut, yet the factors shaping the colonization of this highly oxygen-sensitive, non-spore-forming species in the intestinal environment remain poorly understood. Here, we provide evidence from three separate infant study populations that F. prausnitzii colonization in the gut happens during late infancy and is affected by the number of older siblings in the family. We conclude that Faecalibacterium acquisition is highly likely to be accelerated by contact between siblings. Bearing in mind the immunoregulatory properties of F. prausnitzii and the well-established protective effects against allergic disorders related to the presence of older siblings, early colonization of this species may have profound consequences for child health.

BACKGROUND: Probiotics are increasingly applied to prevent and treat a range of infectious, immune related and gastrointestinal diseases. Despite this, the mechanisms behind the putative effects of probiotics are poorly understood. One of the suggested modes of probiotic action is modulation of the endogenous gut microbiota, however probiotic intervention studies in adults have failed to show significant effects on gut microbiota composition. The gut microbiota of young children is known to be unstable and more responsive to external factors than that of adults. Therefore, potential effects of probiotic intervention on gut microbiota may be easier detectable in early life. We thus investigated the effects of a 6 month placebo-controlled probiotic intervention with Bifidobacterium animalis subsp. lactis (BB-12®) and Lactobacillus rhamnosus (LGG®) on gut microbiota composition and diversity in more than 200 Danish infants (N = 290 enrolled; N = 201 all samples analyzed), as assessed by 16S rRNA amplicon sequencing. Further, we evaluated probiotic presence and proliferation by use of specific quantitative polymerase chain reaction (qPCR).RESULTS: Probiotic administration did not significantly alter gut microbiota community structure or diversity as compared to placebo. The probiotic strains were detected in 91.3% of the fecal samples from children receiving probiotics and in 1% of the placebo treated children. Baseline gut microbiota was not found to predict the ability of probiotics to establish in the gut after the 6 month intervention. Within the probiotics group, proliferation of the strains LGG® and BB-12® in the gut was detected in 44.7% and 83.5% of the participants, respectively. A sub-analysis of the gut microbiota including only individuals with detected growth of the probiotics LGG® or BB-12® and comparing these to placebo revealed no differences in community structure or diversity.CONCLUSION: Six months of probiotic administration during ea

OBJECTIVES: The risk of infections is higher in children attending child care compared with children cared for at home. This study examined the effect of a combination of probiotics on absence from child care because of respiratory and gastrointestinal infections in healthy infants aged 8 to 14 months at the time of enrollment in child care.METHODS: The ProbiComp study was a randomized, double-blind, placebo-controlled study. A total of 290 infants were randomly allocated to receive a placebo or a combination of Bifidobacterium animalis subsp lactis and Lactobacillus rhamnosus in a dose of 10(9) colony-forming units of each daily for a 6-month intervention period. Absence from child care, occurrence of infant symptoms of illness, and doctor visits were registered by the parents using daily and weekly Web-based questionnaires.RESULTS: Median absence from child care was 11 days (interquartile range: 6-16). Intention-to-treat analysis showed no difference between the probiotics and placebo groups (P = .19). Additionally, there was no difference in any of the secondary outcomes between groups; the number of children with doctor-diagnosed upper or lower respiratory tract infections, the number of doctor visits, antibiotic treatments, occurrence and duration of diarrhea, and days with common cold symptoms, fever, vomiting, or caregivers' absence from work.CONCLUSIONS: A daily administration of a combination of B animalis subsp lactis and L rhamnosus for 6 months did not reduce the number of days absent from child care in healthy infants at the time of enrollment in child care.

Introduktion: I de senere år har forskning vist, at miljømæssige risici, herunder ernæringsmæssige eksponeringer i tidlige og følsomme perioder af livet, kan forårsage permanente ændringer i mange fysiologiske processer såsom organudvikling. Thymus er et lymfatisk organ, som skaber miljøet til modning af T-lymfocytter, som spiller en vigtig rolle i det menneskelige immunsystem. Det skønnes at thymus har den største immunologiske aktivitet hos spædbørn i en alder af 6 måneder, hvor thymus indeholder det højest samlede antal lymfocytter under udvikling. Formål: Formålet med dette speciale var at undersøge hvad der influerer på størrelsen af thymus i raske danske børn i alderen 8 – 14 måneder. Metode: Et tværsnitsstudie med baseline data fra 256 danske børn (135 drenge og 121 piger) i alderen 8 – 14 måneder var inkluderet i analyserne. Antropometriske målinger (vægt og længde) blev målt på hvert barn. Ultralyds scanninger af thymus blev foretaget. Information vedrørende fødselsvægt og fødselslængde, samt længde på amning, hvis der blev ammet og amnings status (udelukkende amning og delvis amning) blev indsamlet gennem baggrunds spørgeskemaer og interviews ved baseline undersøgelsen. Resultater: Vægt var positivt associeret med thymus størrelse (p<0.001 i alle analyser). Længde var positivt associeret med thymus størrelse i den univariate analyse, men når der blev justeret for vægt, forsvandt associationen (p=0.97). Drenge havde større thymuser sammenlignet med piger (p=0.01). I de univariate analyser var både fødselsvægt og fødselslængde positiv associeret med thymus størrelse, men ingen associationer blev observeret i den multiple regressionsanalyse (p=0.56, p=0.72), henholdsvis. Ingen associationer blev fundet mellem thymus størrelse og længde af amning eller nuværende amnings status. Konklusion: I dette studie, var thymus størrelse positivt associeret med vægt og køn, hvor drenge havde en større thymus størrelse sammenlignet med pigerne. Hverken amnings status el, Introduction: In later years, research has shown that environmental exposures, including nutritional exposures during early and sensitive periods of life, can cause permanent changes in many physiological processes e.g. organ development. The thymus is a lymphoid organ that provides the environment for T-lymphocyte maturation, which plays an important role in the human immune system. The thymus is implied to have the highest immunological activity in infants at the age of 6 months, where it contains the highest overall numbers of developing lymphocytes. Objective: The objective of this master thesis was to examine what influences the thymus size in healthy Danish children aged 8 – 14 months. Method: A cross-sectional study with baseline data from 256 Danish children (135 boys and 121 girls) aged 8 – 14 months was included in the analyses. Anthropometric measurements (weight and length) were measured on each child. Ultrasound of the thymus was performed. Information about birth weight and birth length, duration of breastfeeding and exclusively and fully breastfeeding status at baseline examination were obtained from background questionnaires and interviews. Results: Weight was positively associated with thymus size (p<0.001 for all analyses). Length was positively associated with thymus size in the univariate analysis, however, when adjusting for weight the association disappeared (p=0.97). Boys had larger thymuses compared to girls (p=0.01). In univariate analyses birth weight and birth length were both positively associated with thymus size, but no associations were observed in the multiple regression analyses (p=0.56, p=0.72), respectively. No associations were found between thymus size and breastfeeding duration or current breastfeeding status. Conclusion: In this study, thymus size was positively associated with weight and gender, with boys having a larger thymus size compared to the girls. Neither breastfeeding status nor duration was associated with thymus

Background/Objectives:A nutritionally adequate diet in childhood is important for health and resistance of allergies and infections. This study explored the effects of school meals rich in fish, vegetables and fibre on school attendance, asthma, allergies and illness in 797 Danish 8- to 11-year-old children. No comparable studies conducted in high-income settings have been identified.Subjects/Methods:The OPUS School Meal Study was a cluster-randomised cross-over trial. Children from third and fourth grades at nine Danish schools received school meals or usual packed lunch (control) for two 3-month periods. Occurrence and duration of illnesses, asthma and allergies during the last 14 days were recorded by parental questionnaires at baseline and after each 3-month period. Self-reported well-being was assessed by visual analogue scales.Results:The school meals did not affect school attendance, parent-reported occurrence or duration of asthma and allergies or self-reported well-being. The most common symptoms of illness were stomach pain (24%), headache (28%) and cold (24%). A slightly higher number of children experienced headaches in the school meal (27%) compared with the control period (22%) (P=0.02). However, subgroup analyses showed that this effect was only seen in children eating school meals in the classroom (P=0.007), and not in common dining areas (P=0.2). No effect was found on other symptoms of illness.Conclusions:Provision of nutritionally balanced school meals did not affect school attendance, asthma, allergies, illness or well-being in 8- to 11-year-old children. The slight increase in occurrence of headaches seems to be related to the physical eating environment.European Journal of Clinical Nutrition advance online publication, 10 December 2014; doi:10.1038/ejcn.2014.263.

Background/Objectives:Transformation of outcomes is frequently used in the analysis of studies in clinical nutrition. However, back-transformation of estimated treatment means and differences is complicated by the nonlinear nature of the transformations. It is not straightforward to obtain an estimated treatment difference that can be interpreted without any reference to the additional predictors included in the statistical model; and moreover, standard errors are not easily available. The aim of this work was to provide a generally applicable, yet operational procedure for obtaining back-transformed estimated differences, and corresponding standard errors and 95% confidence intervals.Subjects/Methods:Based on data from two randomized controlled studies and an exemplary data set that had all previously been published, we evaluated our approximate procedure by comparing results for different approaches for showing back-transformed estimated treatment differences.Results:Estimated differences obtained on logarithm, square root and reciprocal square root-transformed scales were back-transformed into estimated differences on the original scales, and these estimates were in good agreement with the results reported by the original studies.Conclusions:The proposed approximate procedure provides a flexible approach for obtaining quite accurate back-transformed estimated differences in terms of medians and for deriving the corresponding standard errors.European Journal of Clinical Nutrition advance online publication, 11 December 2013; doi:10.1038/ejcn.2013.259.

An increasing number of children are exhibiting features of the metabolic syndrome (MetS) including abdominal fatness, hypertension, adverse lipid profile and insulin resistance. Healthy eating practices during school hours may improve the cardiometabolic profile, but there is a lack of evidence. In the present study, the effect of provision of school meals rich in fish, vegetables and fibre on a MetS score (primary outcome) and on individual cardiometabolic markers and body composition (secondary outcomes) was investigated in 834 Danish school children. The study was carried out as a cluster-randomised, controlled, non-blinded, cross-over trial at nine schools. Children aged 8-11 years received freshly prepared school lunch and snacks or usual packed lunch from home (control) each for 3 months. Dietary intake, physical activity, cardiometabolic markers and body composition were measured at baseline and after each dietary period. The school meals did not affect the MetS score (P= 1·00). However, it was found that mean arterial pressure was reduced by 0·4 (95 % CI 0·0, 0·8) mmHg (P= 0·04), fasting total cholesterol concentrations by 0·05 (95 % CI 0·02, 0·08) mmol/l (P= 0·001), HDL-cholesterol concentrations by 0·02 (95 % CI 0·00, 0·03) mmol/l, TAG concentrations by 0·02 (95 % CI 0·00, 0·04) mmol/l (both P< 0·05), and homeostasis model of assessment-insulin resistance by 0·10 (95 % CI 0·04, 0·16) points (P= 0·001) compared with the control diet in the intention-to-treat analyses. Waist circumference increased 0·5 (95 % CI 0·3, 0·7) cm (P< 0·001), but BMI z-score remained unaffected. Complete-case analyses and analyses adjusted for household educational level, pubertal status and physical activity confirmed the results. In conclusion, the school meals did not affect the MetS score in 8-11-year-olds, as small improvements in blood pressure, TAG concentrations and insulin resistance were counterbalanced by slight undesired effects on waist circumference and HDL

Introduktion: Overvægt og fedme i barndommen er et stort folkesundhedsmæssigt problem verden over. Udviklingen i fedme hos børn bør derfor monitoreres, og standard definitioner og mål for vurdering af overvægt og fedme er således vigtige. Verdenssundhedsorganisationen WHO har defineret fedme som en forøget mængde fedt i kroppen, til en grad der skader helbredet; en definition som knytter sundhedsmæssige problemer forbundet med fedme til kropssammensætning, og ikke blot til forhøjet vægt. De metoder der anvendes til vurdering af overvægt og fedme hos børn skal derfor afspejle fedtmængden i kroppen. Formål: Formålet med dette speciale var at evaluere brugen af body mass index (BMI) og taljeomkreds (TO) som markører for total fedt og abdominal fedt hos en gruppe 8-11 årige raske danske børn. Metode: Et tværsnitsstudie med baseline data fra 78 danske børn (47 piger og 31 drenge) i alderen 8-11 år. Antropometriske målinger (vægt, højde og TO) blev foretaget på alle børn. Dual-energy x-ray absorptiometry (DXA) blev anvendt til at kvantificere total fedtmasse (FM), mager legemsmasse (LM), abdominal fedtmasse (AFM) og både total og abdominal fedtmasse angivet som procent (% TFM og % AF). FM og LM blev yderligere standardiseret for højde, ved udregning af fedtmasse index (FMI = FM (kg)/højde (m)2) og mager legemsmasse-index (LMI = LM (kg)/højde (m)2). Resultater: BMI var positivt korreleret med %TFM, FMI og LMI for både drenge (Spearman korrelation (rs) = 0.77, 0.86, 0.60) og piger (rs = 0.88, 0.93, 0.57) (p < 0.001 for alle analyser). Multiple regressionsanalyser, justeret for mulige konfoundere, gav R2 på 0.79, 0.90, og 0.44 for henholdsvis % TFM, FMI, og LMI. Piger havde en højere % TFM og FMI end drenge, hvorimod drenge havde en højere LMI end piger for et givent BMI. Ved opdeling af BMI i tertiler, var korrelationen mellem BMI og både % TFM og FMI kun signifikant i 2. og 3.tertil af BMI, hvorimod korrelationer mellem BMI og LMI kun var signifikant i 1.te, Introduction: Overweight and obesity in childhood is a serious public health problem worldwide. Trends in childhood obesity should therefore be monitored, and in order to do this, standard definitions and measures for determining overweight and obesity are important. The World Health Organization has defined obesity as an excess accumulation of fat in adipose tissues, to an extent that impairs health; a definition that links the health consequences of obesity to body composition rather than just body weight. Thus, methods used for determining overweight and obesity in children should reflect body fat. Objective: The objective of this master thesis was to evaluate the use of body mass index (BMI) and waist circumference (WC) as surrogate markers of total body fat and abdominal fat in a group of healthy 8-11-year-old Danish children. Methods: A cross-sectional study with baseline data from 78 Danish children (47 girls and 31 boys) aged 8-11 years. Anthropometric measurements (weight, height, and WC) were measured on each child. Dual-energy x-ray absorptiometry was used to quantify total fat mass (FM), lean mass (LM), abdominal fat mass (AFM), and both total and abdominal fat expressed as a percentage (%BF and %AF). FM and LM were further standardized for height by calculating fat mass index (FMI = FM (kg)/height (m)2) and lean mass index (LMI = LM (kg)/height (m)2). Results: BMI was positively correlated to %BF, FMI, and LMI in both boys (spearman correlation (rs) = 0.77, 0.86, 0.60) and girls (rs = 0.88, 0.93, 0.57) (p < 0.001 for all analyses). Multiple regression analyses, adjusting for possible confounding variables yielded R2 of 0.79, 0.90, and 0.44 for %BF, FMI, and LMI, respectively. Girls had a higher %BF and FMI than boys, whereas boys had a higher LMI than girls for a given BMI. When dividing BMI into tertiles, correlations between BMI and both %BF and FMI were only significant in the 2nd and 3rd BMI tertiles, whereas correlations for LMI w

Nutrition's impact on an individual's health and sustainable consumption of food are issues that have long been on both the public and political agenda but are often viewed as two separate debates. This is surprising since many innovation projects in food service systems are concerned with both healthy eating and sustainable consumption (organic food). The relationship between them forms the background in this study. Evidence has shown that caterers serving organic food tend to also serve healthier meals than their non-organic counterparts but, so far, no studies have been carried out in school food environments. The aim of this report was to investigate and develop appropriate methods for studying the link between healthy eating practices and organic food procurement policies using Danish public elementary schools as a setting. Based on relevant scientific literature, the Danish Dietary Recommendations, and inspired by other successful studies, a self-administered questionnaire investigating children‟s eating habits was designed. After testing by an Expert Evaluation Panel and Think Aloud Interviews adjustments were integrated. Conclusion: If special attention is given to literacy skills and cognitive development, children in Danish 6th grade classes can be used as respondents in studies of the relation between food procurement policies and eating practice.