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In the recent decade, marketing literature has acknowledged the advantages of applying an evolutionary lens to understand consumer behavior in different domains. Food choice context is one such domain, having implications for societal well-being, especially for public health and addressing environmental issues. In this thesis, I investigate how mechanisms that have emerged as adaptations to food scarcity—frequent throughout human history—affect modern consumers’ food preferences, potentially leading to maladaptive outcomes. In Paper I, we highlight that selection pressures adjusted humans to forage in ancestral, hostile environments when they were wandering between periods of food scarcity and food sufficiency. Consequently, consumers often fail to choose foods appropriate to their current needs in contemporary retail contexts. Rather than attempting to override these hardwired and evolutionarily outdated food preferences, we recommend policymakers leverage them in such a way that facilitates healthier food choices. A series of studies reported in Paper II show that exposing people to climate change-induced food scarcity distant in time and space shifts their current food preferences. Specifically, people exposed to such video content exhibit a stronger preference toward energy-dense (vs. low-calorie) foods than their peers exposed to a control video. In Paper III, we aimed to account for potential confounds stemming from the control video used in studies reported in Paper II. Additionally, we strived to conceptually replicate these earlier findings by exposing participants to subtle cues to food scarcity—a winter forest walk. Although not all studies yielded significant results at conventional levels, this empirical package—when taken together—corroborated the earlier findings. Despite that studies described in Papers II–III provided a shred of empirical evidence showing a potency of food scarcity cues in increasing preferences toward energy-dense (vs. low-calorie) products, it was still unclear what drove such a shift in food liking. Thus, in Paper IV, we have developed and psychometrically validated the Anticipated Food Scarcity Scale (AFSS), measuring the degree to which people perceive food resources as becoming less available in the future. Aside from being a candidate mechanism partially explaining findings reported in Papers II–III, anticipated food scarcity (AFS) is also related to some aspects of prosociality. Studies presented in this thesis suggest that when environmental cues to food scarcity are present, people show a stronger preference toward energy-dense (vs. low-calorie) foods than their peers unexposed to such cues. Policymakers should consider these results when designing climate change and other similar campaigns, as such communication often depicts food scarcity. Additional research may explore the possibility that exposure to food scarcity cues affects food choices. Considering that we found AFS correlated with certain prosocial attitudes, it is a new psychological construct that warrants future investigation through multidisciplinary research., The research associated with the Four Academic Papers reported in this Thesis was funded by the Icelandic Research Fund (Doctoral Student Grant toMichał Folwarczny number 206880-051)., Accepted

Publisher's version (útgefin grein), Iodine is an essential nutrient for growth and development during infancy. Data on iodine status of exclusively (EBF) and partially breastfed (PBF) infants as well as breast milk iodine concentration (BMIC) are scarce. We aimed to assess (a) infant iodine nutrition at the age of 5.5 months by measuring urinary iodine concentration (UIC) in EBF (n = 32) and PBF (n = 28) infants and (b) mothers' breast milk iodine concentration (n = 57). Sixty mother–infant pairs from three primary health care centres in Reykjavik and vicinities provided urine and breast milk samples for iodine analysis and information on mothers' habitual diet. The mother–infant pairs were participants of the IceAge2 study, which focuses on factors contributing to infant growth and development, including body composition and breast-milk energy content. The median (25th–75th percentiles) UIC was 152 (79–239) μg/L, with no significant difference between EBF and PBF infants. The estimated median iodine intake ranged from 52 to 86 μg/day, based on urinary data (assuming an average urine volume of 300–500 ml/day and UIC from the present study). The median (25th–75th percentiles) BMIC was 84 (48–114) μg/L. It is difficult to conclude whether iodine status is adequate in the present study, as no ranges for median UIC reflecting optimal iodine nutrition exist for infants. However, the results add important information to the relatively sparse literature on UIC, BMIC, and iodine intake of breastfed infants., We would like to thank all the infants and their mothers for participat-ing in the study. Furthermore, we are grateful to the primary healthcare centres for their part in the recruitment process. The Iceage2study (Growth and Body Composition in Breastfed Infants: Study onAge of Introduction of Complementary Foods in Iceland, clinicaltrials.gov identifier NCT02586571) was funded by the University of Iceland Research fund. Analysis of UIC and BMIC was funded by NordicWorking Group for Diet, Food & Toxicology (NKMT), and EUthyroidproject (funded by the Horizon 2020 Framework Programme forResearch and Innovation) with Grant agreement 634453.

Publisher's version (útgefin grein), Importance: Diet may play a role in testicular function, but data on how adherence to different diet patterns influences human testicular function are scarce. Objective: To determine whether adherence to specific dietary patterns is associated with testicular function in young men. Design, Setting, and Participants: This cross-sectional study included 2935 young Danish men unselected regarding fertility status who were enrolled from April 1, 2008, through May 31, 2017. Data were analyzed from July 1, 2017, to January 30, 2019. Exposures: Dietary patterns identified with principal component analysis based on responses to a validated food frequency questionnaire. Main Outcomes and Measures: Standard semen quality assessment; serum concentrations of testosterone, free testosterone, estradiol, inhibin B, follicle-stimulating hormone, luteinizing hormone, and sex hormone-binding globulin; and testicular volume measured with ultrasonography. Results: Among the 2935 participants included in the analysis, median age was 19 (interquartile range, 19-20) years and 2290 (78.0%) had normal body mass index. The 4 dietary patterns identified included Western, prudent, open-sandwich (a traditional Danish eating pattern), and vegetarianlike. The greatest adherence to the prudent pattern was associated with the highest total sperm count (median, 167 [95% CI, 146-183] million), followed by adherence to vegetarianlike (median, 151 [95% CI, 134-168] million) and open-sandwich (median, 146 [95% CI, 131-163] million) patterns. Adherence to the Western pattern was associated with the lowest total sperm count (median, 122 [95% CI, 109-138] million), which was significantly lower than sperm count in the other 3 diet patterns. After adjusting for confounders, the median total sperm count for men in the highest quintile of adherence to the Western pattern was 26 million lower (95% CI, -42 to -9 million) than for men in the lowest quintile of adherence to this pattern. Conversely, the median total sperm count of men in the highest quintile of adherence to the prudent pattern was 43 million (95% CI, 23-63 million) higher than that of men in the lowest quintile. Men with the highest adherence to the Western pattern had a lower median ratio of inhibin B to follicle-stimulating hormone (-12 [95% CI, -20 to -3]) and higher median ratio of free testosterone to luteinizing hormone (10 [95% CI, 2-19]) compared with men with lowest adherence to this pattern. Conclusions and Relevance: In this cross-sectional study, adherence to generally healthy diet patterns was associated with better semen quality, with potentially more favorable fertility potential among adult men., This work was supported by project 2101-08-0058 from the Danish Council for Strategic Research, Program Commission on Health, Food and Welfare, grant 8020-00218B from the Independent Research Fund Denmark, grant 212844 from the European Union, DEER, the Danish Ministry of Health, the Danish Environmental Protection Agency, grant 95-103-72087 from the Kirsten and Freddy Johansen Foundation, and grant P30DK046200 from the National Institutes of Health.

Background and aims : Previous studies have provided evidence for the importance of early life environment on breast cancer development. The aim of this study was to advance knowledge on the association of growth rate in early life and lifelong dietary habits and on breast cancer later in life . Materials and methods: Three papers form the foundation of this thesis. In the first one, data from t he population - based Reykjavik Study and AGES - Reykjavik cohort was used. The Reykjavik Study was established in 1967, and for this study, 9,340 women born between 1908 and 1935, who had information on early residence and were not diagnosed with breast cance r were included. Among extensive data on numerous health related factors, participants provided information on early life residenc e, here used as a proxy for dietary habits in early life, at study entry. Also, from the Reykjavik Study, a total of 991 parti cipants had information on growth rate in adolescence, used for analysis in the third paper. In the first and second paper, data from the sub - cohort AGES - Reykjavik Study was used. Between the years 2002 – 2006, a total of 3,326 women entered the study. Fo r dietary analyses in the study, information on dietary habits in adolescence, midlife and late life was available for approximately 2800 women, who were free of breast cancer at study entry. The main emphasis was on common food items in Iceland in the ear ly 20 th century, such as fish, milk, meat and whole grain products. For all analyses, Cox regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (95% CI) and adjustments were made for potential covariates. Principal compon ent analysis was used to identify dietary patterns. Breast cancer diagnosis was ascertained through the nationwide Icelandic Cancer Registry. Information on cause of death was obtained from Directorate of Health. Participants were followed from either stud y entry or time of height measurement until diagnosis of breast cancer, death, or until the end of the observation period December 31 st, 2013 for study I, 2014 for study II and 2015 for study III ), whichever occurred first. Results: For the residence analy sis, 744 women were diagnosed with breast cancer for an average follow - up of 27.3 years in the Reykjavik Study. A 22% lower risk of breast cancer was observed among women who lived through vi the puberty period in coastal villages, when compared with women wh o were raised in the capital area (95% CI: 0.6, 1 . 0 ). For the AGES - Reykjavik cohort, 91 women were diagnosed with breast cancer during an average follow - up of 8.2 years throughout 2013 . An indication of lower risk of breast cancer among women with high fi sh consumption (more than 4 portions per week) was observed for the adolescence period (HR 0.7, 95% CI, 0.4, 1.1) . In addition, a marginal inverse association was observed for women with high adherence with dietary pattern that included fish (HR 0.6, 95% C I 0.4, 1.0) . For the midlife period, a statistically significant risk reduction was observed for women with high fish consumption (HR 0 . 46, 95% CI 0 . 22, 0 . 97) compared to those with lower fish consumption . For analysis of other dietary factors in the AGES - Reykjavik study, the follow - up was through 2014, and here, a total of 97 women were diagnosed with breast cancer. For both adolescence and midlife, daily consumption of rye bread was positively associated with breast cancer (HR 1.7, 95% CI 1.1 , 2.6 ; 1.8, 9 5% CI 1.1 , 2.9, respectively). In contrast, persistent high consumption of oatmeal was inversely associated with breast cancer ( HR 0.4, 95% CI 0.2 , 0.9 ). No single type of food in late life was associated with breast cancer risk. However, women with high a dherence to a dietary pattern characterized by pastries, sweets and soda had a 60% increased risk of breast cancer when compared with women with lower adherence (HR 1 . 6 , 95% CI 1. 0 , 2.7 ) . A total of 991 women had available information on height at age 13 ( paper III). Of them, 117 women were diagnosed with breast cancer d uring a mean follow - up of 66 years . Women in the highest tertile of growth rate from age 13 until adult height (7 , 8 cm mean annual increase) had an increased risk of breast cancer (HR 2.3, 9 5% CI 1.3 , 4.1 ) when compared with women in the lowest tertile (2 , 6 cm mean annual increase). Conclusion: The result of this population - based data suggest that residence, diet and fast growth rate in adolescence are associated with the risk of breast cance r later in life. While fast growth rate and high consumption of rye bread in adolescence (and midlife) may increase the risk of breast cancer, consumption of fish and oatmeal seem to reduce this risk. These results highlight the importance of environmental exposures throughout the life course in the development of the disease, particularly in early life. Breast cancer, adolescence, diet, fish, fish oil, milk, meat, whole grains, oatmeal, rye bread, growth rate, height, Bakgrunnur og markmið: Fyrri rannsóknir hafa gefið vísbendingar um mikilvægi lífshátta snemma á ævinni í þróun brjóstakrabbameins. Markmið þessarar rannsóknar var að efla þekkingu tengslum vaxtarhraða í æsku og mataræðis á lífsleiðinni við brjóstakrabbameinsáhættu. Efniviður og aðferðir: Þrjár vísindagreinar liggja að baki þessari ritgerð. Í fyrstu greininni var notast við gögn úr bæði Reykjavíkur- og Öldrunarrannsókn Hjartaverndar. Reykjavíkurrannsóknin, sem hófst árið 1967, beindist hér að 9,340 konum, fæddum á árunum 1908 – 1935, sem gáfu upplýsingar um búsetu í æsku við komu í rannsóknina og höfðu ekki áður greinst með brjóstakrabbamein. Búseta í æsku var hér notuð sem vísbending um matarvenjur í æsku, sem voru mjög breytilegar eftir landshlutum á fyrri hluta 20.aldar. Upplýsingar um vaxtarhraða frá unglingsaldri fram á fullorðinsár var auk þess að finna fyrir 991 konu (fæddar 1915 – 1935) úr Reykjavíkurrannsókninni og stuðst var við þau gögn í þriðju greininni. Í fyrstu og annarri grein voru nýtt gögn úr Öldrunarrannsókn Hjartaverndar þar sem alls tóku þátt 3,326 konur á árunum 2002 – 2006. Þessi rannsókn takmarkaðist við um það bil 2800 konur, sem ekki voru greindar áður með brjóstakrabbamein og gáfu upplýsingar um fæðuvenjur sínar á unglingsaldri, á miðjum aldri og efri árum. Hér var megin áhersla lögð á algeng matvæli á Íslandi á fyrri hluta 20. aldar, eða fisk, mjólk, kjöt og heilkornavörur. Í öllum þremur greinunum voru Cox aðhvörfslíkön notuð til að reikna út áhættuhlutföll (HR) og 95% öryggismörk (95% CI), og leiðrétt var fyrir mögulegum gruggunarþáttum. Notast við meginþáttagreiningu (e. principal component analysis) til að greina mismunandi fæðumynstur. Með samtengingu við Krabbameinsskrá var þátttakendum fylgt eftir, með tilliti til greiningar og dánarorsakar vegna brjóstakrabbameins, frá komu í rannsókn eða vaxtarmælingu út rannsóknartímann (út árið 2013 fyrir grein I, 2014 fyrir grein II og 2015 fyrir grein III). Upplýsingar um dánarorsök voru fengnar hjá Embætti landlæknis. Niðurstöður: Í fyrstu greininni var eftirfylgni þátttakenda í Reykjavíkurransókninni að meðalatali 27,3 ár og á því tímabili greindust 744 konur með brjóstakrabbamein. Helstu niðurstöður voru að 22% minni hætta iv var á brjóstakrabbameini hjá konum sem bjuggu í sjávarþorpum fram á fullorðinsár, samanborið við konur sem ólust upp á höfuðborgarsvæðinu (95% CI 0.6, 1.0). Í Öldrunarrannsókninni greindist 91 kona með brjóstakrabbamein á eftirfylgnitímanum sem náði út árið 2013, og spannaði að meðaltali í 8,2 ár. Konur sem borðuðu mikinn fisk um miðjan aldur, eða meira en fjóra skammta á viku voru í 54% minni áhættu á að fá brjóstakrabbamein borið saman við þær sem borðuðu fisk sjaldnar, eða minna en tvo skammta á viku (95% CI 0.2, 1.0). Einnig komu fram vísbendingar um að há fiskineysla á unglingsárum gæti tengst lægri áhættu á brjóstakrabbameini, bæði hjá konum sem borðuðu meira en fjóra skammta á viku (HR 0.7, 95% CI 0.4, 1.1) og hjá þeim sem voru með háa fylgni við fæðumynstur sem meðal annars einkenndist af fiskneyslu (HR 0.6, 95% CI 0.4, 1.0). Við tölfræðiúrvinnslu í grein II náði eftirfylgnin í Öldrunarrannsókninni út árið 2014, og á því tímabili voru alls 97 konur greindar með brjóstakrabbamein. Helstu niðurstöður voru að dagleg neysla á rúgbrauði á unglingsárum og miðjum aldri tengdist aukinni áhættu á brjóstakrabbameini (HR 1.7, 95% CI 1.1, 2.6; HR 1.8, 95% CI 1.1, 2.9) borið saman við neyslu á rúgbrauði sjaldnar en daglega. Aftur á móti reyndist viðvarandi mikil neysla á haframjöli vera verndandi gegn meininu (HR 0.4, 95% CI 0.2, 0.9). Ekki fundust nein tengsl á milli neyslu á einstaka fæðutegundum á efri árum við brjóstakrabbamein. Hins vegar voru konur sem höfðu háa fylgni við fæðumynstur sem einkenndist af mikilli neyslu af kökum, sætindum og gosdrykkjum á efri árum í 60% aukinni áhættu á að greinast með brjóstakrabbamein (HR 1.6, 95% CI 1.0, 2.7) á miðað við þær sem voru með lægstu fylgnina. Til voru upplýsingar um hæð 991 kvenna við 13 ára aldur og af þeim greindust 117 konur með brjóstakrabbamein á eftirfylgdartímanum (grein III). Eftirfylgd spannaði frá hæðarmælingu 13 ára fram til loka árs 2015, eða að meðaltali í 66 ár. Konur sem uxu hraðast frá 13 ára aldri þar til fullorðinshæð var náð (7,8 cm að meðaltali á ári) reyndust í aukinni áhættu á brjóstakrabbameini (HR 2.3, 95% CI 1.3, 4.1) samanborið við konur sem uxu hægast frá 13 ára aldri fram að fullorðinshæð (2,6 cm að meðaltali á ári). Ályktun: Niðurstöður þessara lýðgrunduðu rannsókna benda til að búseta, mataræði og vaxtarhraði tengist á brjóstakrabbameinsáhættu síðar á ævinni. Þannig tengist hraður vaxtarhraði á unglingsárum og rúgbrauðsneysla (sem og á miðjum aldri) aukinni áhættu en fiskneysla og haframjöl öllu jafnan lægri áhættu. Þessar niðurstöður undirstrika þannig mikilvægi lífshátta yfir ævina í þróun meinsins, og þá sérstaklega fyrri hluta hennar., This work was also supported by the Icelandic Centre for Research, RANNIS grant number: 152495051, http://en.rannis.is/ (to A. Haraldsdottir), and the Public Health Fund of the Icelandic Directorate of Health (to A. Haraldsdottir).

Publisher's version (útgefin grein), The critical role of indigenous crops in the socioeconomic growth of developing nations has necessitated calls for accelerated exploitation of staples. Cocoyam, Xanthosoma sagittifolium, is food for over 400 million people worldwide and is the most consumed aroid in West Africa. However, it remains an underexploited food resource. This study reviews existing literature and also makes use of primary data from interviews with indigenous cocoyam farmers, processors, consumers, and cocoyam scientists in the research Institutes of Ghana, to provide insight into existing nomenclature of the species, indigenous knowledge on food uses, nutritional value, and potential novel food applications of cocoyam. Adaptable technologies in conformity to new trends in food science that could be employed for in‐depth molecular studies and further exploitation of the crop are also discussed. It is envisaged that the provided information would contribute to global efforts aimed at exploiting the full potential of indigenous crops for sustainable food and nutrition security., DANIDA (12-PO8-GH): Strengthening Roots and Tuber Value Chains in Ghana

Obesity, low levels of physical fitness, and unhealthy eating patterns are responsible for part of the health problems of adolescents today. The current study aimed at examining the association between the adherence to the Mediterranean diet (MD), through each answer to the items of the Adherence to the MD Questionnaire (KIDMED), and physical fitness with body composition parameters (body mass index (BMI), percentage of body fat, and waist circumference) in 1717 European adolescents (N = 900 boys, N = 817 girls). Data of body composition, physical fitness results, and the answers to KIDMED were analyzed by the Student&rsquo, s t-test. Additionally, the effect size (ES) was calculated and a Chi-square test analyzed the proportion of participants with and without over waist circumference, overfat, and overweight in each KIDMED question. The relative risk of suffering over waist circumference, overfat and overweight in relation to the responses was calculated by Odd-Ratio. Adherence to the MD did not influence the condition of over waist circumference, overfat and overweight, although certain dietary habits were identified as risk factors for their development. Over waist circumference, overfat, and overweight boys and girls presented higher levels of body mass, waist circumference, body fat percentage, and BMI (p &lt, 0.001, ES = 1.73&ndash, 3.38), as well as lower levels of all the parameters of the physical fitness analyzed (p &lt, ES = 0.45&ndash, 1.08), except the handgrip test. A direct relationship between fitness and over waist circumference, overfat, and overweight was found.

Objectives A multi‐isotope study was conducted on individuals buried at Skriðuklaustur monastery (AD 1493–1554) to investigate their geographic origins and dietary composition. Comparative material from individuals excavated from Skeljastaðir, an inland farm site was also analyzed. Materials and methods Bone collagen was extracted from 50 humans (Skriðuklaustur and Skeljastaðir) and 25 animals (Skriðuklaustur) and analyzed for δ13C, δ15N, and δ34S. Dental enamel samples from 31 individuals (Skriðuklaustur) were also analyzed for 87Sr/86Sr, δ18O, δ13C, and trace elements (Pb, Sr, Zn, Ba). Results The mean value determined from individuals from Skriðuklaustur (n = 36) was δ13C = −18.7 ± 0.8‰, δ15N = 12.8 ± 1.1‰, and δ34S = 9.0 ± 1.6‰, whereas at Skeljastaðir (n = 14), it was δ13C = −20.5 ± 0.8‰, δ15N = 7.8 ± 0.9‰, and δ34S = 9.4 ± 1.6‰. At Skriðuklaustur, human dental enamel samples (n = 31) provided a 87Sr/86Sr range of 0.7060–0.7088, δ18Ophosphate from 13.9 to 16.1‰ and δ13Ccarbonate from −16.6 to −12.9‰. Inferred drinking water (δ18Odw) values range from −12.3 to −8.9‰. Sr concentrations range from 25.8 to 156.7 ppm, Ba from 0.11 to 0.81 ppm, Zn from 43.8 to 145.8 ppm, and Pb from 0.13 to 9.40 ppm. Discussion A combination of results indicates that the people from Skriðuklaustur were born in Iceland, but some lived inland during childhood while others lived closer to the coast. Since Skriðuklaustur was a hospital, these individuals may have sought medical treatment at the monastery. The δ13C and δ15N values determined from bone collagen indicate that the people residing at Skriðuklaustur consumed a diet high in marine protein, while those residing at Skeljastaðir exhibit values more consistent with terrestrial resources., This research was financed by Fornminjasjóður (the Archaeology Fund), Háskólasjóður Eimskipafélags Íslands (the Eimskip University Fund), and the Stable Isotope Biogeochemistry Laboratory (SIBL).

Unhealthy lifestyles, low levels of physical fitness, and adherence to the Mediterranean diet (MD) are associated with bad quality of life and the development of a wide range of non-communicable diseases (NCDs). The current study aimed to evaluate the level of adherence to the MD in physical fitness performance and body composition parameters in children and adolescents of Estonia. Therefore, 413 adolescents (56% boys) from the city of Tartu completed the Mediterranean Diet Questionnaire (KIDMED) for analyzing the adherence to MD and performed the Alpha Fitness Test for measuring physical fitness and body composition. A 41.67% of low, 44.05% of average, and 14.28% of high adherence to MD was detected, without difference between genders (p = 0.747). In the Alpha Fitness battery, a higher performance was observed in all tests for boys vs. girls (p &lt, 0.05). In relation to body composition, higher height, weight, and waist values were observed in boys (p &lt, 0.05) and a lower body fat percentage (p &lt, 0.01) without differences in body mass index (BMI, p = 0.906). The adherence to the MD is classified as average/low. Gender significantly influences all variables of the Alpha Fitness battery and anthropometrics measures excepting BMI. According the levels of adherence to the MD, no statistically different prevalence was observed for Non-Overweight (N-Oweight), Non-Overfat (N-Ofat), or Non-Overwaist (N-Owaist). Still, a risk factor for Overweight (Oweight) in boys with low adherence was observed in comparison to those with a mid-level of adherence to the MD.

Publisher's version (útgefin grein), "The Nordic diet" is an umbrella term that encompasses any interpretation that combines Food-Based Dietary Guidelines (FBDGs) with local Nordic foods. The five Nordic countries have collaborated on Nordic Nutrition Recommendations for forty years, including FBDGs, so their national guidelines are similar. The countries also share similar public health issues, including widespread nonconformity to the guidelines, although in different ways. The aim of this concept paper is to discuss environmental sustainability aspects of the Nordic diet, describe the status of and make suggestions for the inclusion of sustainability in future work on the Nordic diet. We exploit the sustainability-health synergy. A food intake more in line with the current FBDGs, which emphasises more plant-based and less animal-based foods, is necessary for high environmental sustainability. In turn, sustainability is an important motivator for health-promoting dietary shifts. Policy development requires long-term efforts. Since the Nordic diet can be considered a further development and improvement of old, traditional diets, there is huge potential to formulate a Nordic diet that benefits both human and planetary health. It is time for concerted engagement and actions-a new Nordic nutrition transition., This research received no external funding

Publisher's version (útgefin grein), Background: The Developmental Origins of Health and Disease (DOHaD) hypothesis postulates that exposures during early life, such as maternal dietary intake during pregnancy, may have a lifelong impact on the individual's susceptibility to diseases. The individual's own lifestyle habits are obviously an additional factor, but we have only limited knowledge regarding how it may interact with prenatal exposures in determining later disease. To gain further insight into these potentially complex relationships, we examined the longitudinal association between maternal diet quality during pregnancy and diet quality in early adolescence in a contemporary cohort. Methods and findings: From 1996 to 2003, the Danish National Birth Cohort (DNBC) was established. Women from across the country were enrolled, and dietary intake in midpregnancy was assessed concurrently with a 360-item food frequency questionnaire (FFQ) (https://www.dnbc.dk/-/ media/arkiv/projekt-sites/dnbc/kodeboeger/dnbc-food-frequency-questionnaire/dnbc-foodfrequency- questionnaire-pdf.pdf?la=en). During 2013-2018, dietary intake was assessed at age 14 years with a 150-item FFQ (https://www.dnbc.dk/-/media/arkiv/projekt-sites/dnbc/ kodeboeger/ffq-14/dnbc-ffq-14-english-translation.pdf?la=en) in the DNBC children. Among the 19,582 mother-offspring pairs included in the analyses, the mean age (±standard deviation [SD]) was 30.7 (±4.1) years and 14.0 (±0.0) years for mothers and offspring, respectively. The majority of both mothers (67%) and offspring (76%) were classified as normal weight. For both questionnaires, a Healthy Eating Index (HEI) was developed as an indicator for diet quality based on current Danish Food-Based Dietary Guidelines (FBDG) including eight components: fruits and vegetables, fish, dietary fibres, red meat, saturated fatty acids (SFAs), sodium, sugar-sweetened beverages (SSBs), and added sugar. The HEI score was divided into quartiles; individuals in the highest quartile represented those with the most optimal diet. The maternal HEI score was correlated positively with offspring HEI score (Pearson r = 0.22, p < 0.001). A log-linear binomial model was used to estimate the relative risk of the offspring being in the highest quartile of HEI at age 14 years if the mother was ranked in quartile 4 during pregnancy. Results showed that offspring born to mothers who were in the highest HEI quartile during pregnancy were more likely themselves to be located in the highest HEI quartile at age 14 years (risk ratio [RR]: 2.1, 95% confidence interval [CI]: 2.0, 2.3, p < 0.001). Adjusting for maternal prepregnancy body mass index (BMI), parity, education, alcohol intake, physical activity, smoking, and breastfeeding, as well as offspring total energy intake and sex, did not influence the effect estimates. The limitations of our study include that some attrition bias towards more healthy participants was observed when comparing participants with nonparticipants. Bias in the FFQ method may also have resulted in underrepresentation of adolescents with poorer diet quality. Conclusions: In this study using data from a large national birth cohort, we observed that maternal diet quality during pregnancy was associated with diet quality of the offspring at age 14 years. These findings indicate the importance of separating early dietary exposures from later dietary exposures when studying dietary aetiologies of diseases postulated to have developmental origins such as, for instance, obesity or asthma in observational settings., SFO received the Awards. This work was supported by grants from The Danish Council for Strategic Research, now Innovation Fund Denmark [09-067124 (Centre for Fetal Programming)] and [09-075611]; and by Nordea-fonden (https:// nordeafonden.dk/) [02-2013-2014]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Gestational diabetes mellitus (GDM) is predominantly a lifestyle disease, with diet being an important modifiable risk factor. A major obstacle for the prevention in clinical practice is the complexity of assessing diet. In a cohort of 1651 Icelandic women, this study examined whether a short 40-item dietary screening questionnaire administered in the 1st trimester could identify dietary habits associated with GDM. The dietary variables were aggregated into predefined binary factors reflecting inadequate or optimal intake and stepwise backward elimination was used to identify a reduced set of factors that best predicted GDM. Those binary factors were then aggregated into a risk score (range: 0&ndash, 7), that was mostly characterised by frequent consumption of soft drinks, sweets, cookies, ice creams and processed meat. The women with poor dietary habits (score &ge, 5, n = 302), had a higher risk of GDM (RR = 1.38, 95%CI = 3, 85) compared with women with a more optimal diet (score &le, 2, n = 407). In parallel, a pilot (n = 100) intervention was conducted among overweight and obese women examining the effect of internet-based personalized feedback on diet quality. Simple feedback was given in accordance with the answers provided in the screening questionnaire in 1st trimester. At the endpoint, the improvements in diet quality were observed by, as an example, soft drink consumption being reduced by ~1 L/week on average in the intervention group compared to the controls. Our results suggest that a simple dietary screening tool administered in the 1st trimester could identify dietary habits associated with GMD. This tool should be easy to use in a clinical setting, and with simple individualized feedback, improvements in diet may be achieved.

Nordic Nutrition Recommendations (NNR) recommend exclusive breastfeeding until 6 months, partial breastfeeding until 1 year or longer and irrespective of breastfeeding, avoiding solid foods before 4 months. Strong evidence was found for benefits of breastfeeding regarding growth and infections but limited/inconclusive evidence regarding atopic disease and asthma. Vitamin D is of special interest in the Nordic diet. The aim of this prospective study was to compare infant feeding and vitamin D between immunoglobulin E (IgE) sensitized (n = 14) and non-sensitized (n = 130) children at 6 years. Information on diet and vitamin D supplement use were collected with dietary recall (&lt, 5 months), 1-d food records (5 and 6 months) and 3-d weighed food records (12 months and 6 years). Serum-specific IgE-antibodies against milk, egg, cod, wheat, soy and peanut (cut-off specific IgE &ge, 0.35 kUA/L) were measured at 6 years and serum 25-hydroxyvitamin D at 12 months and 6 years. At 4 months, 57% of IgE sensitized vs. 23% of non-sensitized children (p &lt, 0.01) had received solid food. At 12 months, IgE sensitized children had a lower intake of vitamin D (median (25th, 75th percentiles): 3.9 &mu, g/d (3.2, 7.2) vs. 8.1 &mu, g/d (4.4, 12.3), p = 0.03) and at 6 years, fewer used vitamin D supplements regularly (23% vs. 56%, p = 0.03). Introduction of solid foods prior to 4 months increased the odds of IgE-sensitization, OR = 4.9 (95%, CI = 1.4&ndash, 16.6) and vitamin D supplement at 6 years decreased the odds of IgE-sensitization, OR = 0.2 (95%, CI = 0.1&ndash, 0.98), adjusting for maternal smoking. These observations support the NNR in their recommendation against introducing complementary solid foods before the age of 4 months. Furthermore, they support encouraging vitamin D intake for young children at northern latitudes.

Publisher's version (útgefin grein)., A healthy dietary pattern is associated with a lower risk of metabolic syndrome (MetS) and reduced inflammation. To explore this at the molecular level, we investigated the effect of a Nordic diet (ND) on changes in the gene expression profiles of inflammatory and lipid-related genes in peripheral blood mononuclear cells (PBMCs) of individuals with MetS. We hypothesized that the intake of an ND compared to a control diet (CD) would alter the expression of inflammatory genes and genes involved in lipid metabolism. The individuals with MetS underwent an 18/24-week randomized intervention to compare a ND with a CD. Eighty-eight participants (66% women) were included in this sub-study of the larger SYSDIET study. Fasting PBMCs were collected before and after the intervention and changes in gene expression levels were measured using TaqMan Array Micro Fluidic Cards. Forty-eight pre-determined inflammatory and lipid related gene transcripts were analyzed. The expression level of the gene tumor necrosis factor (TNF) receptor superfamily member 1A (TNFRSF1A) was down-regulated (p = 0.004), whereas the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) subunit, RELA proto-oncogene, was up-regulated (p = 0.016) in the ND group compared to the CD group. In conclusion, intake of an ND in individuals with the MetS may affect immune function., Funding: This research was funded by the NordForsk Nordic Centre of Excellence in Food, Nutrition and Health project 070014 [SYSDIET (Systems Biology in Controlled Dietary Interventions and Cohort Studies)] and further, the University of Oslo (Norway), Throne Holst Foundation (Norway), Academy of Finland, Swedish Research council, Svenska Diabetesförbundet, SRP Diabetes, Finnish Diabetes Research Foundation, Finnish Foundation for Cardiovascular Research, the Sigrid Juselius Foundation, EVO funding from Kuopio University Hospital (Finland), the Druvan Foundation, Skåne University Hospital, the Heart-Lung Foundation, Diabetesfonden and Foundation Cerealia (Sweden), the Agricultural Productivity Fund, and the Research Fund of the University of Iceland (Iceland). Acknowledgments: We thank Maritta Siloaho for their excellent expertise and advice for biochemical measurements and Marika Rönnholm for their excellent technical assistance.

The growing interest in potential health effects of long-chain polyunsaturated fatty acids (PUFAs) makes it important to evaluate the method used to assess the fatty acid intake in nutrition research studies. We aimed to validate the questionnaire-based dietary intake of selected PUFAs: eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), &alpha, linolenic acid (ALA), linoleic acid (LA), and arachidonic acid (AA) within the Danish National Birth Cohort (DNBC), by comparing 345 women&rsquo, s reported intake with concentration of plasma biomarkers. The applied questionnaire- and biomarker data reflect dietary intake from around the same time point in mid-pregnancy and relationships were investigated by use of Pearson and Spearman correlation and linear regression statistics. We demonstrated moderate but consistent adjusted correlations between dietary intake estimates and the corresponding plasma biomarker concentrations (differences in plasma concentration per 100 mg/day greater intake of 0.05 (95% CI: 0.02, 0.08)) and 0.05 (95% CI: 0.01, 0.08) percentage of total plasma fatty acids for EPA and DHA, respectively). The associations strengthened when restricting the analyses to women with ALA intake below the median intake. We found a weak correlation between the dietary intake of ALA and its plasma biomarker with a difference in plasma concentration of 0.07 (95% CI: 0.03, 0.10) percent of total plasma fatty acids per 1 g/day greater intake, while the dietary intake of LA and AA did not correlate with their corresponding biomarkers.

Publisher's version (útgefin grein), Oily fish, an important source of marine n-3 long-chain polyunsaturated fatty acids (LCPUFA), has shown to reduce cardiometabolic risk in adults. Whether maternal fish intake affects offspring metabolic health is less established, especially among high-risk pregnancies. We aimed to examine the association of fish intake in pregnancy with offspring metabolic health who were either exposed or unexposed to gestational diabetes mellitus (GDM). Our study included 1234 mother-offspring dyads (608 with a GDM index pregnancy and 626 control dyads) nested within the Danish National Birth Cohort, which is a prebirth cohort. Maternal seafood and marine n-3 LCPUFA consumption was quantified by a food frequency questionnaire (gestational week 25) and a sub-sample with interview data (weeks 12 and 30). The offspring were clinically examined at 9–16 years, including a Dual energy X-ray Absorptiometry (DXA) scan and a fasting blood sample. We calculated multivariable effect estimates and 95% confidence intervals (CI) for anthropometric, adiposity, and metabolic parameters. The median (IQR) intake of total seafood was 23(24) g/day. We found largely no association for total seafood and marine n-3 LCPUFA with offspring metabolic parameters in either group. Using interview data, GDM-exposed women reporting no fish in week 12 and 30 (versus intake >2 times/week) had offspring with a higher Body Mass Index (BMI) (ratio of geometric means (RGM): 1.28, 95% CI: 1.06, 1.55), waist circumference (RGM: 1.22, 95% CI: 1.05, 1.40), triglycerides (RGM: 1.77, 95% CI: 1.03, 3.03), and homeostatic model assessment of insulin resistance HOMA-IR (RGM: 2.16, 95% CI: 1.17, 3.97). We found no associations of n-3 LCPUFA and seafood intake with offspring metabolic outcomes. However, GDM-exposed women who consistently reported eating no fish had offspring with a poorer metabolic profile. Fish intake in pregnancy may mitigate some adverse effects of intrauterine hyperglycemia, however, these findings need replication in better powered studies., This work was part of the project “Long-term effects of early nutrition on later health” supported by the European Commission (Project No.: FP7-289346-EarlyNutrition). E.M. was supported by a fellowship grant from the Danish Diabetes Academy supported by the Novo Nordisk Foundation. Further funding for the data collections was provided by grants from the Danish Council for Strategic Research (09-067124 (Centre for Fetal Programming) and 09-075611); the Innovation Fund Denmark (11-115923) and Rigshospitalet, Copenhagen University Hospital.

Publisher's version (útgefin grein), Excessive gestational weight gain (GWG) is a risk factor for several adverse pregnancy outcomes, including macrosomia. Diet is one of the few modifiable risk factors identified. However, most dietary assessment methods are impractical for use in maternal care. This study evaluated whether a short dietary screening questionnaire could be used as a predictor of excessive GWG in a cohort of Icelandic women. The dietary data were collected in gestational weeks 11–14, using a 40-item food frequency screening questionnaire. The dietary data were transformed into 13 predefined dietary risk factors for an inadequate diet. Stepwise backward elimination was used to identify a reduced set of factors that best predicted excessive GWG. This set of variables was then used to calculate a combined dietary risk score (range 0–5). Information regarding outcomes, GWG (n = 1,326) and birth weight (n = 1,651), was extracted from maternal hospital records. In total, 36% had excessive GWG (Icelandic criteria), and 5% of infants were macrosomic (≥4,500 g). A high dietary risk score (characterized by a nonvaried diet, nonadequate frequency of consumption of fruits/vegetables, dairy, and whole grain intake, and excessive intake of sugar/artificially sweetened beverages and dairy) was associated with a higher risk of excessive GWG. Women with a high (≥4) versus low (≤2) risk score had higher risk of excessive GWG (relative risk = 1.23, 95% confidence interval, CI [1.002, 1.50]) and higher odds of delivering a macrosomic offspring (odds ratio = 2.20, 95% CI [1.14, 4.25]). The results indicate that asking simple questions about women's dietary intake early in pregnancy could identify women who should be prioritized for further dietary counselling and support., We are particularly grateful to the women who participated in the study. We would also like to acknowledge the work of the PREWICE staff and the great staff at the Ultrasound Department at Landspitali National University Hospital who made the study possible.

Background: With increased focus on dietary intake among youth and risk of diseases later in life, it is of importance, prior to assessing diet-disease relationships, to examine the validity of the dietary assessment tool. This study’s objective was to evaluate the relative validity of a self-administered web-based FFQ among Danish children aged 12 to 15 years. Methods: From a nested sub-cohort within the Danish National Birth Cohort, 124 adolescents participated. Four weeks after completion of the FFQ, adolescents were invited to complete three telephone-based 24HRs; administered 4 weeks apart. Mean or median intakes of nutrients and food groups estimated from the FFQ were compared with the mean of 3x24HRs. To assess the level of ranking we calculated the proportion of correctly classified into the same quartile, and the proportion of misclassified (into the opposite quartile). Spearman’s correlation coefficients and de-attenuated coefficients were calculated to assess agreement between the FFQ and 24HRs. Results: The mean percentage of all food groups, for adolescents classified into the same and opposite quartile was 35 and 7.5%, respectively. Mean Spearman’s correlation was 0.28 for food groups and 0.35 for nutrients, respectively. Adjustment for energy and within-person variation in the 24HRs had little effect on the magnitude of the correlations for food groups and nutrients. We found overestimation by the FFQ compared with the 24HRs for fish, fruits, vegetables, oils and dressing and underestimation by the FFQ for meat/poultry and sweets. Median intake of beverages, dairy, bread, cereals, the mean total energy and carbohydrate intake did not differ significantly between the two methods. Conclusion: The relative validity of the FFQ compared with the 3x24HRs showed that the ranking ability differed across food groups and nutrients with best ranking for estimated intake of dairy, fruits, and oils and dressing. Larger variation was observed for fish, sweets and vegetables. For nutrients, the ranking ability was acceptable for fatty acids and iron. When evaluating estimates from the FFQ among Danish adolescents these findings should be considered., The study was supported by grants from The Danish Research Council 09–067124 (Center for Fetal Programming), 09–075611; and the Intramural Research Program of The Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (contract # HHSN275201000020C). The funding bodies had no role in the design of the study, collection, analysis, interpretation of data or in writing the manuscript.

Aim: The aim of this Ph.D. thesis is to enhance understanding of the relation between maternal diet, gestational weight gain (GWG), and offspring’s cardio-metabolic factors. Moreover, the objective is to identify dietary predictors for excessive GWG. Methods: This thesis comprises four research papers from two different prospective observational cohorts. Papers I-III were based on data from the observational Danish Fetal Origins Cohort (DaFO88), which was established in 1988-1989 in Aarhus (n=965), with a 20-year follow up. On the other hand, paper IV was based on recently collected data from an Icelandic pregnancy cohort, PREgnant Women of ICEland (PREWICE) (n=2113). Offspring of mothers in the DaFO88 cohort participated in a clinical examination at 20 years of age (n=434). The follow-up data included: anthropometry, blood pressure measurements, and cardiovascular biomarkers. Information regarding the maternal diet was collected in gestational week 30 with an FFQ combined with a dietary interview. Maternal markers of inflammation were also quantified in serum from week 30. Taking advantage of epidemiological findings can be difficult in clinical practice, partially because the dietary assessments used can be very detailed and time-consuming. However, the data from the Icelandic PREWICE study was collected using a short dietary screening questionnaire (40 items) to get a snapshot of the participant’s general diet (weeks 11-14 of gestation). Information on maternal weight measurements and birth outcomes was retrieved from maternal records. Data on covariates were obtained from questionnaires and maternal records. Associations were assessed using multivariable linear, Poisson log-linear and logistic regression models. Results: In the first phase of the project, the DaFO88 cohort was used to examine the relationship between maternal GWG and diet with offspring long-term outcomes. Paper I: In adjusted models, GWG was relatively strongly associated with offspring leptin and insulin levels 20 years later. Hence, a 1-kg increase in GWG was associated with 3.7% (95% CI: 1.4, 6.2) higher insulin and 10.7% (95% CI: 5.7, 15.9) higher leptin levels in male offspring. However, GWG was inversely associated with levels of total cholesterol and low-density lipoprotein (LDL) levels among female offspring. Differences in lifestyle habits may account for these sex differences. Paper II: Higher intake of protein during pregnancy, at the expense of carbohydrates, was associated with slightly higher offspring diastolic blood pressure (highest compared to the lowest quintile of protein intake: Δ=2.4 mm Hg; 95% CI: 0.4, 4.4; p=0.03 for trend). Similar differences, although not significant, were found for systolic blood pressure. Paper III: In cross-sectional analysis, both excessive GWG and high maternal protein intake were associated with higher concentrations of inflammatory factors during pregnancy. Each 1-kg increase in GWG was associated with 3% (95% CI: 1, 5) higher C-reactive protein (CRP) and 3% (95% CI: 1, 4) higher serum amyloid A (SAA) concentrations, which corre-sponded to an increase of ~18% to 25% in these inflammatory factors among women with excessive weight gain in pregnancy. With respect to diet, women in the highest compared to the lowest quintile of protein intake had 26% (95% CI: 3, 54) higher CRP concentrations. Intake of animal protein appeared to drive this increase. Paper IV: The results from the PREWICE study showed that a dietary risk score (range 0-5), characterized by a non-varied diet, inadequate fruits/vegetables, milk and whole grain intake, as well as excessive intake of sugar/artificially sweetened beverages and dairy, was associated with excessive GWG and macrosomia. Women with poor dietary habits, i.e., with a high dietary risk score (≥4 scores), had higher risk of excessive GWG (RR=1.24; 95% CI: 1.01, 1.52) and higher odds of delivering macrosomic offspring (OR=2.28; 95% CI: 1.18, 4.38), compared to women with the lowest scores (≤2 scores). Conclusion: The results indicate that maternal diet and GWG may affect levels of inflammatory factors during pregnancy and offspring cardio-metabolic factors at young adult age. Although the observed associations with offspring’s long-term outcomes were modest, we cannot exclude the possibility that these modest shifts may become more apparent later in life. The results from the PREWICE cohort also indicate that by asking simple questions about women’s dietary habits early in pregnancy, we may be able to identify women in more need of support and counseling to meet the GWG recommendations and find women at higher risk of giving birth to a macrosomic infant. Together, the studies highlight the importance of balanced diet and weight gain during pregnancy in terms of short- and long-term health., Markmið: Markmið þessa doktorsverkefnis er að bæta vísindalega þekkingu hvað varðar tengsl næringar verðandi móður, þyngdaraukningar á meðgöngu og efnaskiptaþátta barna. Enn fremur er markmiðið að greina fæðuþætti sem hafa forspárgildi þegar kemur að óhóflegri þyngdaraukningu á meðgöngu. Aðferðir: Þessi ritgerð er byggð á fjórum vísindagreinum þar sem notast var við tvær ólíkar framvirkar ferilrannsóknir. Greinar I-III voru byggðar á gögnum frá áhorfsrannsókninni Danish Fetal Origins Cohort (DaFO88), sem hófst 1988-1989 í Árósum (n=965) og var með 20 ára eftirfylgni. Grein IV var aftur á móti byggð á nýlegum gögnum frá íslensku þýði, þ.e. PREgnant Women of ICEland (PREWICE) (n=2113). Börn mæðra í DaFO88 þýðinu tóku þátt í klínískri skoðun við 20 ára aldur. Upplýsingum var þá safnað um líkamssamsetningu, blóðþrýsting og lífvísa sem tengjast hjarta- og æðakerfinu. Fæðuval mæðranna var metið á 30. viku meðgöngu, bæði með fæðutíðnispurningalista og viðtali um fæðuvenjur. Lífvísar fyrir bólgumyndun móður voru einnig magngreindir úr sermi í 30. viku. Það getur verið erfitt að nýta niðurstöður áhorfsrannsókna í klínískum aðstæðum. Að hluta til vegna þess að aðferðir sem eru notaðar til að meta fæðuval í þessum rannsóknum eru oft mjög ítarlegar og tímafrekar. Upplýsingum um mataræði í íslensku PREWICE rannsókninni var aftur á móti safnað með því að nota stuttan skimunarlista fyrir fæðuval sem gaf mynd af almennu fæðuvali þátttakenda (á 11.-14. viku meðgöngu). Þyngdarmælingar á meðgöngu og fæðingaútkomur voru fengnar úr mæðraskrám. Upplýsingar um mögulegar skýribreytur voru fengnar úr spurningalistum og mæðraskrám. Tengsl voru metin með fjölþátta línulegri, Poisson og lógístískri aðhvarfsgreiningu. Niðurstöður: Í fyrri hluta verkefnisins var DaFO88 þýðið nýtt til að kanna tengsl þyngdaraukningar á meðgöngu, mataræðis og langtímaútkoma hjá afkvæmum. Grein I: Í leiðréttu módeli var þyngdaraukning á meðgöngu tengd við leptín- og insúlíngildi afkvæma 20 árum síðar. Það er, hvert kg af þyngdaraukningu var tengt við 3,7% (95% CI: 1,4, 6,2) hærri insúlíngildi og 10,7% (95% CI: 5,7, 15,9) hærri leptíngildi hjá karlkyns afkvæmum. Neikvæð tengsl voru aftur á móti milli þyngdaraukningar á meðgöngu og kólesteróls og lágþéttni fitupróteins (low-density lipoprotein, LDL) gilda meðal kvenkyns afkvæma. Þennan kynjamun má mögulega rekja til mismunandi lífsvenja. 8 Grein II: Hærri próteinneysla kvenna á meðgöngu, á kostnað kolvetna, var tengd við lítillega hækkaðan hlébilsþrýsting hjá afkvæmum (hæsti fimmtungur borinn saman við þann lægsta: ∆=2,4 mmHg; 95% CI: 0,4, 4,4; p-gildi =0,03 (p for trend)). Svipaðar niðurstöður, þó ekki marktækar, fengust fyrir slagbilsþrýsting. Grein III: Þversniðsgreiningar bentu til þess að óhófleg þyngdaraukning og mikil próteinneysla á meðgöngu gæti mögulega ýtt undir bólgumyndun. Hvert kg af þyngdaraukningu var þannig tengt 3% (95% CI: 1, 5) hærri C-reactive protein (CRP) og 3% (95% CI: 1, 4) hærri serum amyloid A (SAA) gildum, sem samsvaraði ~18% til 25% aukningar á þessum bólguþáttum hjá þeim konum sem þyngdust óhóflega mikið á meðgöngu. Konur sem voru í hæsta fimmtungi próteinneyslu voru með 26% (95% CI: 3, 54) hærri CRP gildi miðað við konur í lægsta fimmtungi. Þessi aukning virtist stafa af neyslu dýrapróteina. Grein IV: Niðurstöður úr PREWICE rannsókninni sýndu að áhættufæðuskor (sem var á bilinu 0-5), sem einkenndist af lítilli fjölbreytni, ónægri ávaxta-/grænmetis, mjólkur- og heilkornaneyslu, ásamt mikilli neyslu á annars vegar drykkjum sem innihalda sykur/sætuefni og hins vegar mjólkurneyslu, var tengt við aukna áhættu á þyngdaraukningu umfram ráðleggingar og auknum líkum á þungburafæðingum. Konur með óheilsusamlegasta mataræðið, það er með hátt áhættufæðuskor (≥4 stig), voru þannig í aukinni áhættu á þyngdaraukningu umfram ráðleggingar (RR=1,24; 95% CI: 1,01, 1,52) og auknar líkur voru á þungburafæðingum (OR=2,28; 95% CI: 1,18, 4,38) meðal þeirra miðað við konur með lægstu áhættufæðuskorin (≤2 stig). Ályktun: Niðurstöðurnar benda til þess að næring kvenna á meðgöngu og þyngdaraukning umfram ráðleggingar geti mögulega haft áhrif á gildi bólguþátta á meðgöngu og efnaskiptaþætti barna snemma á fullorðinsaldri. Þrátt fyrir að tengsl við langtímaútkomur barna væru hófleg, er ekki hægt að útiloka að þessar lítilvægu breytingar geti orðið greinilegri síðar á ævinni. Niðurstöðurnar frá PREWICE þýðinu benda einnig til þess að með því að spyrja einfaldra spurninga um fæðuval í upphafi meðgöngu, sé mögulega unnt að finna konur sem þurfa aukinn stuðning og ráðgjöf til að þyngjast í samræmi við ráðleggingar og finna konur í aukinni áhættu á því að fæða þungbura. Saman undirstrika rannsóknirnar mikilvægi jafnvægis þegar kemur að mataræði og þyngdaraukning, The project was funded by the Doctoral Grants of the UoI Research Fund and The Technology Development Fund / The Icelandic Centre for Research (RANNIS).

Publisher's version (útgefin grein), The etiology of monoclonal gammopathy of undetermined significance (MGUS), the precursor state of multiple myeloma (MM), is mostly unknown and no studies have been conducted on the effect of diet on MGUS or progression from MGUS to MM. We aimed to explore the association between common foods and MGUS and progression to MM. Data from the population-based AGES Study (N = 5,764) were utilized. Food frequency questionnaire was used to assess dietary intake during adolescence, midlife, and late life. Serum protein electrophoresis and serum free light-chain assay was performed to identify MGUS (n = 300) and LC-MGUS cases (n = 275). We cross linked our data with the Icelandic Cancer Registry to find cases of MM in the study group. We found that intake of fruit at least three times per week during adolescence was associated with lower risk of MGUS when compared to lower fruit consumption (OR = 0.62, 95% CI 0.41–0.95). We additionally found that intake of fruit at least three times per week during the late life period was associated with decreased risk of progressing from MGUS to MM (HR = 0.34, 95% CI 0.13–0.89) when compared to lower intake. Adolescent intake of fruit may reduce risk of MGUS, whereas fruit intake after MGUS onset may reduce risk of progressing to MM. Our findings suggest that diet might alter the risk of developing MGUS and progression to MM., The AGES-Reykjavik Study was funded by NIH contract N01-AG-012100, the Intramural Research Program of the National Institute on Aging, by the Icelandic Heart Association, and the Icelandic Parliament. This work was supported by the Icelandic Centre for Research, RANNIS (S.Y. Kristinsson), the Landspitali University Hospital Research Fund (S.Y. Kristinsson), the Karolinska Instituted Foundations (S.Y. Kristinsson), the Marie Curie CIG (S.Y. Kristinsson), and the Memorial Sloan Kettering Core Grant (P30 CA008748) from the National Cancer Institute (O.Landgren). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Tilgangur: Tíðni lífsstílssjúkdóma er hærri meðal einstaklinga með geð- rofssjúkdóma en almennings. Tilgangur rannsóknarinnar var að kanna fæðuval ungs fólks með geðrofssjúkdóma, en fæðuval þessa hóps hefur aldrei verið kannað hérlendis áður. Efniviður og aðferðir: Þátttakendur voru þjónustuþegar Laugarássins (n=48, 18-30 ára), sem sóttu þjónustu á því tímabili sem gagnaöflun fór fram (júlí- ágúst 2016). Fæðuval og næringargildi fæðu var metið með sólarhringsupprifjun á mataræði. Niðurstöður voru bornar saman við ráð- leggingar Embættis landlæknis og niðurstöður landskönnunar á mataræði 2010-2011 fyrir sama aldurshóp (n=250). Þróun líkamsþyngdar síðastliðna 8-12 mánuði var metin út frá skráðum upplýsingum í sjúkraskrá (Sögu). Niðurstöður: Neysla á ávöxtum, fiski, mjólkurvörum, jurtaolíum og lýsi var marktækt lægri meðal þjónustuþega en hjá þátttakendum í landskönnun 2010-2011, en neysla á sælgæti og gosdrykkjum hærri (p5% af upphafs- þyngd sinni á 8-12 mánaða tímabili. Ályktanir: Fæðuval ungs fólks með geðrofssjúkdóma samræmist ekki opinberum ráðleggingum um fæðuval og er lakara en fæðuval viðmiðunarhópsins. Mikilvægt er að þróa leiðir til að bæta fæðuval og þar með næringargildi fæðu hópsins., Introduction: The prevalence of lifestyle related diseases is higher among people with psychotic disorders than the general population. The aim was to assess dietary intake of young people with psychotic disorders for the first time in Iceland. Material and methods: Subjects were young people (n=48, age 18-30y) with psychotic disorders. Dietary intake was assessed by a 24-hour recall in July-August 2016, and compared with official recommendations and intake of the general public (n=250, age 18-30y). Body weight in the past eight to 12 months, was retrieved from medical records. Results: Consumption of fruits, fish, dairy products, vegetable and fish oil was significantly lower among subjects when compared with the general public, while their soft drink and sweets consumption was higher (p5% of their initial body weight in the past 8-2 months. Conclusion: Diet of young people with psychotic disorders is not consistent with recommendations and is worse than the diet of their peers in the general population. It is important to find ways to improve the diet and thereby nutrient intake of the group.

Background Results from 2 cohort studies in Scotland established in the 1940s and 1950s (Aberdeen and Motherwell) suggested that a high protein diet during pregnancy might adversely influence offspring blood pressure at adult age. Our objective was to examine this association in the Danish Fetal Origins Cohort (DaFO88). Methods and Results This was a prospective birth cohort of 965 women who gave birth in 1988–1989 in Aarhus, Denmark, and whose offspring (n=434) participated in a clinical examination ≈20 years later. Macronutrient intake was assessed in gestational week 30. Multivariable adjusted linear regression was used to examine the relation between higher maternal protein intake, at the expense of carbohydrates, and offspring blood pressure (isocaloric substitution). Main analyses were adjusted for mother's age during pregnancy, prepregnancy body mass index, parity, smoking during pregnancy, educational level, and offspring's sex. The mean total energy intake was 8.7 MJ/day (SD 2.3 MJ/day). The mean energy from carbohydrate, fat, and protein intake was 51, 31, and 16 of total energy, respectively. The results showed that after adjustment, higher maternal protein intake was associated with slightly higher offspring diastolic blood pressure (highest compared with the lowest quintile of protein intake: ∆=2.4 mm Hg; 95% CI 0.4–4.4; P=0.03 for trend). Similar differences, although not significant, were found for systolic blood pressure (∆=2.6 mm Hg; 95% CI −0.0 to 5.3; P=0.08 for trend). Conclusions Higher maternal dietary protein intake at the expense of carbohydrates was associated with a modest increase in offspring blood pressure in young adulthood., Danish Council for Strategic Research University of Iceland Research Fund

Data Availability: Data in this study is third party data, that originates from the Norwegian Mother Child cohort (MoBa). Data is regulated by the MoBa Scientific Management Group. All MoBa used for research is subject to legal restricting which prohibits the authors from making minimal data set publicly available. Data requests that meet the guidelines described in the link below, can be addressed to the MoBa Scientific Management Group. For further information about data access please contact; datatilgang@fhi.no, or Professor Per Magnus mail address: per.magnus@fhi.no. See specific guidelines for research with MoBa data; https://www.fhi.no/globalassets/dokumenterfiler/retningslinjer-moba-eng.pdf., Background Dietary habits are linked to high maternal glucose levels, associated with preterm delivery. The aim of this study was to examine the associations between meal frequency and glycemic properties of maternal diet in relation to preterm delivery. Methods This prospective cohort study included 66,000 women from the Norwegian Mother and Child Cohort Study (MoBa). Meal frequency and food intake data were obtained from a validated food frequency questionnaire during mid-pregnancy. Principal component factor analysis was used with a data-driven approach, and three meal frequency patterns were identified: “snack meal”, “main meal”, and “evening meal”. Pattern scores were ranked in quartiles. Glycemic index and glycemic load were estimated from table values. Intakes of carbohydrates, added sugar, and fiber were reported in grams per day and divided into quartiles. Gestational age was obtained from the Medical Birth Registry of Norway. Preterm delivery was defined as birth at, This work was supported by Freemanson’s Directorate Board for Children, ES236011, MD Linda Englund Ögge; Adlerbertska Foundation, MD Linda Englund Ögge; the Norwegian Research Council, FUGE 183220/S10, MD Linda Englund Ögge; Norwegian Research Council, FRIMEDKLI-05 ES236011, MD Linda Englund Ögge; Jane and Dan Olsson Foundation, MD Linda Englund Ögge; Swedish Medical Society, SLS 2008-21198, MD Linda Englund Ögge; Swedish government grants to researchers in public health service, ALFGBG-2863, MD Linda Englund Ögge; Swedish government grants to researchers in public health service, ALFGBG-11522, MD Linda Englund Ögge; the Norwegian Ministry of Health and the Ministry of Education and Research, N01-ES-75558; NIH/NINDS, UO1 NS 047537-01; NIH/NINDS, UO1 NS 047537-06A1; Norwegian Research Council/FUGE, 151918/S10. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Aim. Understanding the forces shaping biodiversity patterns, particularly for groups of organisms with key functional roles, will help predict ecosystem responses to environmental changes. Our aim was to evaluate the relative role of different drivers in shaping diversity patterns of vertebrate herbivores, a group of organisms exerting a strong trophic influence in terrestrial Arctic ecosystems. This biome, traditionally perceived as homogeneous and low in biodiversity, includes wide variation in biotic and physical conditions and is currently undergoing major environmental change. Location. Arctic (including High Arctic, Low Arctic and Subarctic) Methods. We compiled available data on vertebrate (bird and mammal) herbivore distribution at a pan-Arctic scale, and used eight variables that represent the most relevant hypotheses to explain patterns of species richness. We used range maps rasterized on a 100 x 100 km equal-area grid to analyse richness patterns of all vertebrate herbivore species combined, and birds and mammalian herbivores separately. Results. Overall, patterns of herbivore species richness in the Arctic were positively related to plant productivity (measured with Normalized Difference Vegetation Index) and to the species richness of predators. Greater species richness of herbivores was also linked to areas with higher mean annual temperature. Species richness of bird and mammalian herbivores were related to the distance from the coast, with highest bird richness in coastal areas and mammal richness peaking further inland. Main conclusions. Herbivore richness in the Arctic is most strongly linked to primary productivity and the species richness of predators. Our results suggest that biotic interactions, with either higher or lower trophic levels or both, can drive patterns of species richness at a biome-wide scale. Rapid ongoing environmental changes in the Arctic are likely to affect herbivore diversity through both impacts on primary productivity and changes in predator communities via range expansion of predators from lower latitudes., Birdlife International and NatureServe. I.C.B. was supported bya post-doctoral fellowship funded by the Icelandic ResearchFund (Rannsóknasjóður, grant no. 152468-051), E.M.S. and V.T.R. by the Fram Centre through the Climate-EcologicalObservatory for Arctic Tundra (COAT). Funding was also avail-able through the Natural Sciences and Engineering ResearchCouncil (Canada) to D.S.H, final submission

Publisher's version (útgefin grein), Childhood and adolescent obesity are currently among the greatest challenges for public health. Physical activity, physical fitness, and adherence to the Mediterranean diet (MD), representing powerful indicators of healthy lifestyles, are shown as determinant factors in the prevention and treatment of obesity. The aim of the present study has been to analyse the relationship between health-related physical fitness components, body composition, and adherence to MD in 387 Icelandic adolescents of 13–16-years old (54% boys). The ALPHA Fitness Test was used to measure physical fitness and body composition. The KIDMED questionnaire was used to assess the adherence to MD among participants. Associations between variables were tested according to gender and age using linear regression models and analysis of variance. Participants with high/medium adherence to MD showed significantly higher endurance scores in both the boys and the girls. Gender differences were found. The boys in high/medium MD categories had significantly lower fat percentages and ran a 4 × 10 m sprint faster than the girls. The girls scored higher than the boys in endurance and speed-agility tests. It can be concluded that a high and medium adherence to MD is associated with high and very high endurance in both the girls and the boys., This work was supported by the fifth Research Programme 2013-2016 (PPI2015-IV.5 / PP2016-EBRV) of the University of Seville, Seville, Spain and the University of Iceland Research Fund, Reykjavik, Iceland.

Publisher's version (útgefin grein), Recent studies indicate that lifestyle factors in early life affect breast cancer risk. We therefore explored the association of high consumption of meat, milk, and whole grain products in adolescence and midlife, on breast cancer risk. We used data from the population based AGES-Reykjavik cohort (2002–2006), where 3,326 women with a mean age of 77 years (SD 6.0) participated. For food items and principal component derived dietary patterns we used Cox proportional models to calculate multivariate hazard ratios (HR) with 95% confidence intervals (95% CI). During a mean follow-up of 8.8 years, 97 women were diagnosed with breast cancer. For both adolescence and midlife, daily consumption of rye bread was positively associated with breast cancer (HR 1.7, 95% CI 1.1–2.6 and HR 1.8, 95% CI 1.1–2.9, respectively). In contrast, persistent high consumption of oatmeal was negatively associated with breast cancer (0.4, 95% CI 0.2–0.9). No association was found for other food items or dietary patterns that included rye bread. High rye bread consumption in adolescence and midlife may increase risk of late-life breast cancer whilst persistent consumption of oatmeal may reduce the risk., The AGES-Reykjavik Study was funded by NIH contract N01-AG-12100, the Intramural Research Program of the National Institute on Aging, by the Icelandic Heart Association and the Icelandic Parliament. This work was supported by the The Icelandic Centre for Research, RANNIS grant number: 152495051, (http://en.rannis.is/) (A. Haraldsdottir) and the Public Health Fund of the Icelandic Directorate of Health (A. Haraldsdottir). The funding agencies (National Institute on Aging, Icelandic Heart Association and Icelandic Parlament,) for the AGES-Reykjavik Study, RANNIS, or Directorate of Health had no role in the design, analysis or writing of this article.