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BACKGROUND/OBJECTIVES: Diet during pregnancy and lactation may have a role in the development of allergic diseases. There are few human studies on the topic, especially focusing on food allergies. We sought to study the associations between maternal diet during pregnancy and lactation and cow's milk allergy (CMA) in offspring. SUBJECTS/METHODS: A population-based birth cohort with human leukocyte antigen-conferred susceptibility to type 1 diabetes was recruited in Finland between 1997 and 2004 (n = 6288). Maternal diet during pregnancy and lactation was assessed by a validated, 181item semi-quantitative food frequency questionnaire. Register-based information on diagnosed CMA was obtained from the Social Insurance Institution and completed with parental reports. The associations between maternal food consumption and CMA were assessed using logistic regression, comparing the highest and the lowest quarters to the middle half of consumption. RESULTS: Consumption of milk products in the highest quarter during pregnancy was associated with a lower risk of CMA in offspring (odds ratio (OR) 0.56, 95% confidence interval (CI) 0.37-0.86;P < 0.01). When stratified by maternal allergic rhinitis and asthma, there was evidence of an inverse association between high use of milk products and CMA in offspring of non-allergic mothers (OR 0.30, 95% CI 0.13-0.69, P < 0.001). Cord blood IgA correlated positively with the consumption of milk products during pregnancy, indicating exposure to CMA and activation of antigen-specific immunity in the infant during pregnancy. CONCLUSIONS: High maternal consumption of milk products during pregnancy may protect children from developing CMA, especially in offspring of non-allergic mothers. European Journal of Clinical Nutrition (2016) 70, 554-559; doi: 10.1038/ejcn.2015.223; published online 13 January 2016, INTRODUCTION Very little is known about dietary determinants of food allergies, but there is some evidence that early nutrition has a role in the development of other allergic diseases and [...]

Objective: To examine the efficacy and safety of foods fortified with calcium in the adult population in Finland.Design: A simulation study based on the FINDIET 2002 Survey, which estimated habitual food consumption, dietary supplement use and nutrient intakes using 48-hour recall and two 3-day food records, and an Internet survey of the consumption of fortified foods and dietary supplements.Setting/participants: Participants of FINDIET 2002 were 25-64 years old from five areas (n = 2007). Participants of the Internet-based survey (n = 1537) were over 15 years of age from all over the country.Results: If all potentially fortifiable foods were to be fortified with calcium, the proportion of participants with calcium intake below the recommended level (< 800 mg day(-1)) would decrease from 20.3% to 3.0% in men and from 27.8% to 5.6% in women compared with the situation where no foods were fortified. At the same time, the proportion of participants with calcium intake above the tolerable upper intake level (UL, > 2500 mg day(-1)) would increase from 0.6% to 12.7% in men and from 0.1% to 3.8% in women. However, in a probability-based model (11% of all fortifiable foods to be fortified with calcium) the proportion of participants with calcium intake below the recommended level would be 15.7% in men and 23.2% in women. The proportion with intake above the UL in this model would be 1.2% in men and 0.7% in women.Conclusions: Food fortification would be a relatively effective and safe way to increase the calcium intake of the Finnish adult population. [ABSTRACT FROM AUTHOR]

Background: 80% of Finnish men fill their civic duty and complete military service. Conscripts' dietary habits have been studied limitedly.Objective: The aim was to determine conscripts' nutrient intake and food use in garrison, on leave, and in encampment conditions.Methods: This study examined volunteer conscripts in: (1) garrison and leave conditions (n=47) and (2) encampment conditions (n=31). Data were collected using food diaries.Results: The proportion of energy derived from fat was 32.9% at garrison and 36.5% at encampment and on leave. Saturated fat constituted 12.5 energy % at garrison, 15.0 energy % at encampment, and 15.3 energy % on leave. Sucrose intake was high at encampment (17.7 energy %) and on leave (13.0 energy %). Salt, vitamin, and mineral intakes exceeded national recommendations in all conditions. Fiber intakes did not reach recommendations.Conclusions: At garrison and encampment, nutrient intakes reached recommendations. In free time, conscripts favored energy-rich nutrient-poor foods, which warrants intervening and dietary education. [ABSTRACT FROM AUTHOR]

Background & Aims: Maternal gluten intake in relation to child's risk of type 1 diabetes has been studied in few prospective studies considering the diet during pregnancy but none during lactation. Our aim was to study whether gluten, cereals, or dietary fiber in maternal diet during pregnancy and lactation is associated with the risk of islet autoimmunity or type 1 diabetes in the offspring., Methods: We included 4943 children with genetic susceptibility to type 1 diabetes from the Finnish Type 1 Diabetes Prediction and Prevention (DIPP) Study, born between 1996 and 2004. Maternal intake of gluten, different types of cereals, and dietary fiber were derived from a semi-quantitative validated food frequency questionnaire covering the eighth month of pregnancy and the third month of lactation. Children were monitored for islet autoantibodies up to age of 15 years and type 1 diabetes until year 2017. Risk of islet autoimmunity and clinical type 1 diabetes were estimated using Cox regression model, adjusted for energy intake, child's sex, HLA genotype, and familial diabetes., Results: Altogether 312 children (6.4%) developed islet autoimmunity at median age of 3.5 (IQR 1.7, 6.6) years and 178 children (3.6%) developed type 1 diabetes at median age of 7.1 (IQR 4.3, 10.6) years. Gluten intake during pregnancy was not associated with islet autoimmunity (HR 0.96; 95% CI 0.68, 1.35), per 1 g/MJ increase in intake nor type 1 diabetes (HR 0.96; 95% CI 0.62, 1.50) in the offspring. Higher barley consumption during lactation was associated with increased risk of type 1 diabetes (HR 3.25; 95% CI 1.21, 8.70) per 1 g/MJ increase in intake. Maternal intake of other cereals or dietary fiber was not associated with the offspring outcomes., Conclusions: We observed no association between maternal intake of gluten, most consumed cereals, or dietary fiber during pregnancy or lactation and the risk of islet autoimmunity or type 1 diabetes in children from a high-risk population., Competing Interests: Declaration of competing interest Authors declare no conflicts of interest., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Dietary changes form an important component of the sustainability transition of food systems but could be hindered by the cost of sustainable diets., Objectives: This study aimed to characterize the cost of nutritionally adequate and culturally acceptable diets with low-greenhouse gas emissions (GHGEs) in Finland., Methods: Two optimization models were built to find diets complying with nutritional and emissions requirements. The first model minimizes diet cost and the second one deviation from current diets. Both are calibrated to Finnish sociodemographic groups using dietary intake data, household budget survey data (for prices), and life cycle assessment coefficients (for GHGE). Three scenarios are simulated: "Health only" imposes only compliance with nutritional constraints, whereas "Health and GHGE-33%" and "Health and GHGE-50%" impose, in addition, minimum reductions in GHGE., Results: Minimum cost diets have a low-carbon footprint [-65% (-73%) for females (males)] and low cost [-69% (-73%) for females (males)] when compared with current diets but lack diversity and cultural acceptability. The more culturally acceptable health-only minimum deviation diets are marginally less costly and have a lower climate impact than baseline diets across all population groups. Reducing GHGE results in a substantial decrease in the cost of the minimum deviation diets. The lower cost of the minimum deviation diets with reduced GHGE results from both intercategory and intracategory substitutions., Conclusions: Affordability is not the key obstacle to the adoption of nutritionally adequate and lower GHGE diets, but cultural acceptability is. Reducing the climate footprint of diets can generate side benefits in terms of nutrition and affordability, which confirms that dietary change should be central to the sustainability transition of the Finnish food system. However, more attention should be paid to the issues of taste, convenience, social norms, and other aspects determining the cultural acceptability of sustainable diets., (© 2024 The Authors.)

Objectives: Shifting from animal-based to plant-based diets could reduce colorectal cancer (CRC) incidence. Currently, the impacts of these dietary shifts on CRC risk are ill-defined. Therefore, we examined partial substitutions of red or processed meat with whole grains, vegetables, fruits or a combination of these in relation to CRC risk in Finnish adults., Methods: We pooled five Finnish cohorts, resulting in 43 788 participants aged ≥ 25 years (79% men). Diet was assessed by validated food frequency questionnaires at study enrolment. We modelled partial substitutions of red (100 g/week) or processed meat (50 g/week) with corresponding amounts of plant-based foods. Cohort-specific hazard ratios (HR) for CRC were calculated using Cox proportional hazards models and pooled together using random-effects models. Adjustments included age, sex, energy intake and other relevant confounders., Results: During the median follow-up of 28.8 years, 1124 CRCs were diagnosed. We observed small risk reductions when red meat was substituted with vegetables (HR 0.97, 95% CI 0.95 - 0.99), fruits (0.97, 0.94 - 0.99), or whole grains, vegetables and fruits combined (0.97, 0.95 - 0.99). For processed meat, these substitutions yielded 1% risk reductions. Substituting red or processed meat with whole grains was associated with a decreased CRC risk only in participants with < median whole grain intake (0.92, 0.86 - 0.98; 0.96, 0.93 - 0.99, respectively; p interaction =0.001)., Conclusions: Even small, easily implemented substitutions of red or processed meat with whole grains, vegetables or fruits could lower CRC risk in a population with high meat consumption. These findings broaden our insight into dietary modifications that could foster CRC primary prevention., (© 2024. The Author(s).)

Objectives: To characterise nutritionally adequate, climate-friendly diets that are culturally acceptable across socio-demographic groups. To identify potential equity issues linked to more climate-friendly and nutritionally adequate dietary changes., Design: An optimisation model minimises distance from observed diets subject to nutritional, greenhouse gas emissions (GHGE) and food-habit constraints. It is calibrated to socio-demographic groups differentiated by sex, education and income levels using dietary intake data. The environmental coefficients are derived from life cycle analysis and an environmentally extended input-output model., Setting: Finland., Participants: Adult population., Results: Across all population groups, we find large synergies between improvements in nutritional adequacy and reductions in GHGE, set at one-third or half of the current level. Those reductions result mainly from the substitution of meat with cereals, potatoes and roots and the intra-category substitution of foods, such as beef with poultry in the meat category. The simulated more climate-friendly diets are thus flexitarian. Moving towards reduced-impact diets would not create major inadequacies related to protein and fatty acid intakes, but Fe could be an issue for pre-menopausal females. The initial socio-economic gradient in the GHGE of diets is small, and the patterns of adjustments to more climate-friendly diets are similar across socio-demographic groups., Conclusions: A one-third reduction in GHGE of diets is achievable through moderate behavioural adjustments, but achieving larger reductions may be difficult. The required changes are similar across socio-demographic groups and do not raise equity issues. A population-wide policy to promote behavioural change for diet sustainability would be appropriate.

Objectives: Increased gut permeability and gut inflammation have been linked to the development of type 1 diabetes. Little is known on whether and how intake of different foods is linked to these mechanisms in infancy. We investigated whether the amount of breast milk and intake of other foods are associated with gut inflammation marker concentrations and permeability., Methods: Seventy-three infants were followed from birth to 12 months of age. Their diet was assessed with structured questionnaires and 3-day weighed food records at the age of 3, 6, 9, and 12 months. Gut permeability was assessed with the lactulose/mannitol test and fecal calprotectin and human β-defensin-2 (HBD-2) concentrations were analyzed from stool samples at the age of 3, 6, 9, and 12 months. The associations between foods and gut inflammation marker concentrations and permeability were analyzed using generalized estimating equations., Results: Gut permeability and gut inflammation marker concentrations decreased during the first year of life. Intake of hydrolyzed infant formula ( P = 0.003) and intake of fruits and juices ( P = 0.001) were associated with lower intestinal permeability. Intake of fruits and juices ( P < 0.001), vegetables ( P < 0.001), and oats ( P = 0.003) were associated with lower concentrations of HBD-2. Higher intake of breast milk was associated with higher fecal calprotectin concentrations ( P < 0.001), while intake of fruits and juices ( P < 0.001), vegetables ( P < 0.001), and potatoes ( P = 0.007) were associated with lower calprotectin concentrations., Conclusions: Higher intake of breast milk may contribute to higher calprotectin concentration, whereas several complementary foods may decrease gut permeability and concentrations of calprotectin and HBD-2 in infant gut., Competing Interests: K.K. started as employee at BIOMILQ during writing the manuscript (unrelated to the present study). The remaining authors report no conflicts of interest., (Copyright © 2023 by European Society for European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)

Objectives: Challenges in estimating total whole grain intake have led to the use of surrogate estimates, of which accuracy has not been assessed. We examined the suitability of five potential surrogates (dietary fiber; bread; rye bread; rye, oat and barley combined; rye) and a whole grain food definition to measure total whole grain intake in the Finnish adult population., Methods: Our data comprised 5094 Finnish adults participating in the national FinHealth 2017 Study. Dietary intake was assessed by a validated FFQ. Food and nutrient intakes, including total whole grain, were calculated utilizing the Finnish Food Composition Database. The Healthgrain Forum whole grain food definition was applied to examine definition-based whole grain intake. Spearman correlations and quintile cross-classifications were calculated., Results: Definition-based whole grain intake and consumption of rye, oat and barley combined had consistently the strongest correspondence with total whole grain intake. Rye and rye bread consumption also corresponded well with total whole grain intake. The correspondences of dietary fiber and bread with total whole grain were lower and more affected by the exclusion of energy under-reporters. Furthermore, their correlations with total whole grain intake varied the most between population subgroups., Conclusions: Rye-based estimates, especially rye, oat and barley combined, and definition-based whole grain intake appeared suitable surrogate estimates of total whole grain intake for epidemiological research of Finnish adults. The variation between surrogate estimates in their correspondence with total whole grain intake demonstrated the need for further evaluation of their accuracy in different populations and regarding specific health outcomes., (© 2023. The Author(s).)

High consumption of red and processed meat has been associated with increased type 2 diabetes (T2D) risk. These kinds of diets are also environmentally unsustainable. We examined a modeled association between a partial substitution of red meat or processed meat with plant-based foods (legumes, vegetables, fruit, cereals, or a combination of these) and T2D risk among Finnish adults. We used pooled data from five Finnish cohorts (n = 41,662, 22% women, aged ≥ 25 years, 10.9 years median follow-up with 1750 incident T2D cases). Diet was assessed by a validated food frequency questionnaire. In the substitution models, 100 g/week of red meat or 50 g/week of processed meat were substituted with similar amounts of plant-based substitutes. Cohort-specific hazard ratios (HRs) were estimated by Cox proportional hazards multivariable model and pooled using a two-staged random-effects model. We observed small, but statistically significant, reductions in T2D risk in men when red or processed meat were partially substituted with fruits (red meat: HR 0.98, 95% CI 0.97-1.00, P = 0.049, processed meat: 0.99, 0.98-1.00, P = 0.005), cereals (red meat: 0.97, 0.95-0.99, P = 0.005, processed meat: 0.99, 0.98-1.00, P = 0.004) or combination of plant-based foods (only processed meat: 0.99, 0.98-1.00, P = 0.004) but not with legumes or vegetables. The findings of women were similar but not statistically significant. Our findings suggest that even small, easily implemented, shifts towards more sustainable diets may reduce T2D risk particularly in men., (© 2023. The Author(s).)

Background: Fruit and vegetable consumption has been linked to a decreased risk of asthma, but prospective evidence on longitudinal consumption in childhood is scarce. We aimed to investigate the association between fruit and vegetable consumption in childhood and the risk of asthma by the age of 5 years, and to explore the role of processing of fruits and vegetables in the Finnish Type 1 Diabetes Prediction and Prevention Allergy Study., Methods: Child's food consumption was assessed by 3-day food records completed at the age of 3 and 6 months, and 1, 2, 3, 4, and 5 years, and asthma and allergies by a validated modified version of the ISAAC questionnaire at the age of 5 years. Consumption of processed and unprocessed fruits and vegetables was calculated. Joint models with a current value association structure for longitudinal and time-to-event data were used for statistical analyses., Results: Of the 3053 children, 184 (6%) developed asthma by the age of 5 years. The risk of asthma was not associated with the consumption of all fruits and vegetables together (HR 1.00, 95%CI 0.99-1.01 per consumption of 1 g/MJ, adjusted for energy and other covariates), or with most subgroups. Weak inverse associations were seen between all leafy vegetables and asthma (HR = 0.87, 0.77-0.99), and unprocessed vegetables and nonatopic asthma (HR = 0.90, 95% CI 0.81-0.98)., Conclusion: Total consumption of fruits and vegetables in childhood was not associated with the development of asthma by the age of 5 years. Weak inverse associations found for vegetables need to be confirmed or rejected in future studies., (© 2023 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.)

Objective: The shift towards plant-based diets with less meat and more legumes is a global target and requires an understanding of the consequences of dietary adequacy on the population level. Our aim was to model the impact of partial replacement of red and processed meat with legumes on nutrient intakes and population shares below dietary reference intakes., Design: Modelling study with three scenarios anchored in meat cut-offs: ≤ 70 g/d (Finnish dietary guideline); ≤ 50 g/d (Danish dietary guideline); ≤ 30 g/d (EAT-Lancet recommendation). In all subjects, the amount of meat in grams over the cut-off was replaced with the same amount of legumes. The SPADE method was used to model usual intake distributions. Meaningful differences in average intakes and in population shares below dietary reference intakes compared to the reference (FinDiet) were evaluated based on non-overlapping 95 % CI., Setting: Finnish national food consumption survey (FinDiet 2017)., Subjects: Finnish adults ( n 1655) aged18-74 years (47 % men)., Results: The scenarios introduced increases in the average intakes of fibre, folate, K, Mg, Cu and Fe, and decreases in intakes of saturated fat, niacin, vitamin B 12 , Se and Zn. Meaningful shifts of the usual intake distributions of fibre and folate towards improvement in intakes emerged already in 'scenario 70 g'. Overall, distribution shifts towards a higher probability of inadequate intakes of the studied nutrients were not observed., Conclusions: These results support the public health message to partly replace meat with legumes and may benefit nutrition policy actions towards sustainable diets in the Nordic countries and beyond.

Background: A shift towards more plant-based diets is considered healthy and environmentally sustainable but may cause a concern regarding protein and amino acid intakes. This modelling study aimed to assess the impacts of partial replacement of red and processed meat with legumes or cereals on the protein and indispensable amino acid intakes in the Finnish adult population., Materials and Methods: We used the cross-sectional data of the National FinDiet 2017 Survey (two non-consecutive 24-h recalls, n  = 1655, 47% men, aged 18-74 years). Six replacement scenarios were created in which the amount of red and processed meat exceeding 70 g/day (Finnish nutrition recommendation), or 30 g/day (EAT-Lancet recommendation) was replaced with the same amounts of legumes, cereals or their combination. Differences to the reference diet were evaluated based on non-overlapping 95% confidence intervals. Population shares (%) below estimated average requirements (EAR) were calculated using the usual intake modelling methodology (SPADE)., Results: The replacement scenarios decreased the protein and indispensable amino acid intakes depending on gender and age. At the 70-g level, decreases were observed only in men aged 18-64 years. At the 30-g level, decreases were observed in other gender and age groups except women aged 65-74 years. In the scenarios, the mean daily protein intake was 15-18% of total energy intake (E%) (reference 17-18 E%), and the proportions below the EAR were 7-10% in men and 8-10% in women aged 18-64 years (reference 5-7%) and 20-25% in men and 16-20% in women aged 65-74 years (reference 14-17%). For total indispensable amino acids, the proportions below the EAR were <5% in the reference diet and the scenarios., Conclusions: The mean daily protein intake remained sufficient when red and processed meat was partially replaced with legumes or cereals in the Finnish adult population. However, protein adequacy in the elderly population warrants attention and more research.

Cows' milk allergy (CMA) is one of the earliest manifestations of allergic diseases. Early dietary factors, like maternal diet during pregnancy, may play a role in the development of allergic diseases in the offspring. We aimed to investigate the association between maternal intake of fatty acids during pregnancy and the risk of CMA in the offspring. Our study was conducted in a population-based cohort, the Finnish Type 1 Diabetes Prediction and Prevention study. We collected the maternal dietary data by a validated FFQ. We obtained the information on CMA in the study participants ( n 448) from registers and from the parents. Dietary data and information on CMA were available for 4921 children. We used logistic regression in the analyses, and fatty acid intakes were energy adjusted. The maternal intake of SFA, MUFA, PUFA, n -3 PUFA, n -6 PUFA, trans fatty acids, ratio of n -3 PUFA to n -6 PUFA or ratio of linoleic acid to α -linolenic acid was not associated with the risk of CMA in the offspring when adjusted for perinatal factors, background factors, parental history of asthma or allergic rhinitis and infant animal contacts. The intake of α -linolenic acid was associated with a decreased risk (OR 0·72; 95 % CI 0·56, 0·93) of CMA in the offspring of mothers without a history of allergic rhinitis or asthma. In conclusion, the maternal intake of fatty acids during pregnancy is not associated with the risk of CMA in the offspring.

Information on dietary adequacy is needed to assess food and nutrition security in a modern society, especially in the transition towards climate-friendly food systems. In this study, differences in the nutritional adequacy of diets among Finnish adults were evaluated in population groups of different education, income and urbanisation levels. The study used data from the FinDiet 2017 Survey ( n = 1655, 18-74 years). Modelled usual intakes of foods and nutrients were evaluated relative to food-based dietary guidelines issued by the National Nutrition Council of Finland (FNNC) and with respect to nutrient adequacy following the Nordic Nutrition Recommendations and FNNC. For about half of the nutrients studied, intakes were found to be adequate. Intakes of protein, fat, saturated fatty acids and salt were estimated to be high. By contrast, inadequate intakes were seen in folate and vitamins A, D, B1, B2 and C in almost all groups studied. Groups with a higher education and income, groups that lived in urban areas and, in particular, women adhered more closely to recommended food consumption and nutrient intakes than others. However, major challenges posed by the Finnish diet are common to all groups studied, and only certain dietary features evaluated in view of nutritional adequacy are associated with socioeconomic differences.

Physical activity and protein intake are associated with ageing-related outcomes, including loss of muscle strength and functional decline, so may contribute to strategies to improve healthy ageing. We investigated the cross-sectional associations between physical activity or sedentary behaviour and protein intake patterns in community-dwelling older adults across five countries. Self-reported physical activity and dietary intake data were obtained from two cohort studies (Newcastle 85+ Study, UK; LiLACS, New Zealand Māori and Non-Māori) and three national food consumption surveys (DNFCS, The Netherlands; FINDIET, Finland; INRAN-SCAI, Italy). Associations between physical activity and total protein intake, number of eating occasions providing protein, number of meals with specified protein thresholds, and protein intake distribution over the day (calculated as a coefficient of variance) were assessed by regression and repeated measures ANOVA models adjusting for covariates. Greater physical activity was associated with higher total protein intake and more eating occasions containing protein, although associations were mostly explained by higher energy intake. Comparable associations were observed for sedentary behaviour in older adults in Italy. Evidence for older people with higher physical activity or less sedentary behaviour achieving more meals with specified protein levels was mixed across the five countries. A skewed protein distribution was observed, with most protein consumed at midday and evening meals without significant differences between physical activity or sedentary behaviour levels. Findings from this multi-study analysis indicate there is little evidence that total protein and protein intake patterns, irrespective of energy intake, differ by physical activity or sedentary behaviour levels in older adults.

Cows' milk allergy (CMA) is the most common food allergy in young children, and it is often the first manifestation of atopic diseases. Accordingly, very early environmental factors, such as maternal diet during pregnancy, may play a role in the development of CMA, but the evidence is limited. The aim of this study was to investigate the association between maternal intake of antioxidant nutrients during pregnancy and the subsequent development of CMA in the offspring in a prospective, population-based birth cohort within the Finnish Type 1 Diabetes Prediction and Prevention Study. Maternal dietary information during pregnancy was collected with a detailed, validated FFQ. The maternal dietary information and the information on putative confounding factors were available for 4403 children. Information on diagnosed CMA (n 448) was obtained from a medical registry and queried from the parents up to child's age of 3 years. The Finnish food composition database was used to calculate the average daily intake of nutrients. Logistic regression was applied for statistical analyses, and the nutrient intakes were adjusted for energy intake. OR are presented per 1 sd increment of the particular nutrient intake. Maternal total and dietary intake of β-carotene was associated with an increased risk of CMA in the offspring when adjusted for the putative confounding factors (total OR 1·10, 95 % CI 1·02, 1·20; dietary OR 1·10; 95 % CI 1·01, 1·19). Using dietary supplements containing antioxidants in addition to a balanced diet may not confer any additional benefits.

Our aim was to study the associations between maternal vitamin C and iron intake during pregnancy and the offspring's risk of developing islet autoimmunity and type 1 diabetes. The study was a part of the Finnish Type 1 Diabetes Prediction and Prevention (DIPP) prospective birth cohort including children genetically at risk of type 1 diabetes born between 1997-2004. The diets of 4879 mothers in late pregnancy were assessed with a validated food frequency questionnaire. The outcomes were islet autoimmunity and type 1 diabetes. Cox proportional hazards regression analysis adjusted for energy, family history of diabetes, human leukocyte antigen (HLA) genotype and sex was used for statistical analyses. Total intake of vitamin C or iron from food and supplements was not associated with the risk of islet autoimmunity (vitamin C: HR 0.91: 95% CI (0.80, 1.03), iron: 0.98 (0.87, 1.10)) or type 1 diabetes (vitamin C: 1.01 (0.87, 1.17), iron: 0.92 (0.78, 1.08)), neither was the use of vitamin C or iron supplements associated with the outcomes. In conclusion, no association was found between maternal vitamin C or iron intake during pregnancy and the risk of islet autoimmunity or type 1 diabetes in the offspring.

Background: High dietary intake of nitrate and nitrite might increase the risk of type 1 diabetes. To our knowledge, no earlier prospective study has explored whether maternal dietary intake of nitrate and nitrite during pregnancy is associated with the risk of type 1 diabetes in the offspring., Objective: Our aim was to study association between maternal intake of nitrate and nitrite during pregnancy and the risk of islet autoimmunity and type 1 diabetes in the offspring., Design: Children born between 1997 and 2004 at Oulu and Tampere University Hospitals in Finland and carrying increased human leukocyte antigen (HLA)-conferred risk for type 1 diabetes were followed in the Type 1 Diabetes Prediction and Prevention (DIPP) study from 3 mo of age. Islet autoantibodies were screened at 3- to 12-mo intervals from serum samples. Of 4879 children, 312 developed islet autoimmunity and 178 developed type 1 diabetes during a 15-y follow-up. Maternal intake of nitrate and nitrite during the eighth month of pregnancy was assessed after birth using a validated self-administered FFQ. Cox proportional hazards regression was used for the statistical analyses., Results: Maternal intake of nitrate and nitrite during pregnancy was not associated with the child's risk of islet autoimmunity [nitrate: HR 0.99 (95% CI: 0.88, 1.11); nitrite: HR 1.03 (95% CI: 0.92, 1.15)] or type 1 diabetes [nitrate: HR 1.02 (95% CI: 0.88, 1.17); nitrite: HR 0.97 (95% CI: 0.83, 1.12)] when adjusted for energy (residual method), sex, HLA risk group, and family history of diabetes. Further adjustment for dietary antioxidants (vitamin C, vitamin E, and selenium) did not change the results., Conclusion: Maternal dietary intake of nitrate or nitrite during pregnancy is not associated with the risk of islet autoimmunity or type 1 diabetes in the offspring genetically at risk for type 1 diabetes., (Copyright © The Author(s) on behalf of the American Society for Nutrition 2020.)

Background: Lower protein intake in older adults is associated with loss of muscle mass and strength. The present study aimed to provide a pooled estimate of the overall prevalence of protein intake below recommended (according to different cut-off values) among community-dwelling older adults, both within the general older population and within specific subgroups., Methods: As part of the PRevention Of Malnutrition In Senior Subjects in the EU (PROMISS) project, a meta-analysis was performed using data from four cohorts (from the Netherlands, UK, Canada, and USA) and four national surveys [from the Netherlands, Finland (two), and Italy]. Within those studies, data on protein and energy intake of community-dwelling men and women aged ≥55 years were obtained by either a food frequency questionnaire, 24 h recalls administered on 2 or 3 days, or food diaries administered on 3 days. Protein intake below recommended was based on the recommended dietary allowance of 0.8 g/kg body weight (BW)/d, by using adjusted BW (aBW) instead of actual BW. Cut-off values of 1.0 and 1.2 were applied in additional analyses. Prevalences were also examined for subgroups according to sex, age, body mass index (BMI), education level, appetite, living status, and recent weight loss., Results: The study sample comprised 8107 older persons. Mean ± standard deviation protein intake ranged from 64.3 ± 22.3 (UK) to 80.6 ± 23.7 g/d [the Netherlands (cohort)] or from 0.94 ± 0.38 (USA) to 1.17z ± 0.30 g/kg aBW/d (Italy) when related to BW. The overall pooled prevalence of protein intake below recommended was 21.5% (95% confidence interval: 14.0-30.1), 46.7% (38.3-55.3), and 70.8% (65.1-76.3) using the 0.8, 1.0, and 1.2 cut-off value, respectively. A higher prevalence was observed among women, individuals with higher BMI, and individuals with poor appetite. The prevalence differed only marginally by age, education level, living status, and recent weight loss., Conclusions: In community-dwelling older adults, the prevalence of protein intake below the current recommendation of 0.8 g/kg aBW/d is substantial (14-30%) and increases to 65-76% according to a cut-off value of 1.2 g/kg aBW/d. To what extent the protein intakes are below the requirements of these older people warrants further investigation., (© 2020 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of Society on Sarcopenia, Cachexia and Wasting Disorders.)

Listeria monocytogenes causes severe consequences especially for persons belonging to risk groups. Finland is among the countries with highest number of listeriosis cases in the European Union. Although most reported cases appear to be sporadic and the maximum bacterial concentration of 100 cfu/g is not usually exceeded at retail, cold smoked and salt-cured fish products have been noted as those products with great risk especially for the elderly. In order to investigate the listeriosis risk more carefully, an exposure assessment was developed, and laboratory results for cold smoked and salt-cured salmon products were exploited. L. monocytogenes exposure was modeled for consumers in two age groups, the elderly population as a risk group and the working-age population as a reference. Incidence was assessed by estimating bacterial growth in the food products at three temperatures. Bayesian estimation of the risk was based on bacterial occurrence and product consumption data and epidemiological population data. The model builds on a two-state Markov chain describing repeated consumption on consecutive days. The cumulative exposure is probabilistically governed by the daily decreasing likelihood of continued consumption and the increasing bacterial concentrations due to growth. The population risk was then predicted with a Poisson distribution accounting for the daily probabilities of purchasing a contaminated product and the cumulative total probability of infection from its use. According to the model presented in this article, elderly Finns are at a greater risk of acquiring listeriosis than healthy adults. The risk for the elderly does not fully diminish even if the products have been stored at the recommended temperature (between 0 and 3 °C). It can be concluded that the stage after retail, i.e. food handling and storage by consumer or professional kitchens, is essential to protection against listeriosis. The estimation model provides means for assessing the joint impacts of these effects., (Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved.)

Fruit and vegetable intake has been associated with a reduced risk of many chronic diseases. These foods are the main dietary source of carotenoids. The aim of the present study was to evaluate the associations between dietary intake and serum concentrations of α- and β-carotene in a sample of young Finnish children from the population-based birth cohort of the Type 1 Diabetes Prediction and Prevention (DIPP) Study. The current analysis comprised 3-day food records and serum samples from 207 children aged 1, 2 and 3 years. Spearman and partial correlations, as well as a cross-classification analyses, were used to assess the relationship between dietary intake and the corresponding biomarkers. Serum concentrations of α- and β-carotene were significantly higher among the 1-year-old compared to the 3-year-old children. Dietary intakes of α- and β-carotene correlated significantly with their respective serum concentrations in all age groups, the association being highest at the age of 1 year (α-carotene r = 0.48; p < 0.001 and β-carotene r = 0.47; p < 0.001), and lowest at the age of 3 years (α-carotene r = 0.44; p < 0.001 and β-carotene r = 0.30; p < 0.001). A cross-classification showed that 72⁻81% of the participants were correctly classified to the same or adjacent quartile, when comparing the reported dietary intakes and the concentrations of the corresponding carotenoid in serum. The 3-day food record seems to be reasonably valid in the assessment of root vegetable consumption among young Finnish children. Root vegetables were the main dietary source of both carotenoids in all age groups. The high consumption of commercial baby foods among the 1-year-old children was reflected in the relatively high dietary intake and serum concentration of both carotenoids.

Introduction and Aims: As alcohol use has decreased among Finnish adolescents, we aim to assess: (i) time trends in alcohol use, heavy episodic drinking (HED) and potential explanatory variables among adolescents; (ii) the relationship between trends of explanatory variables and trends in alcohol use and HED; and (iii) which of the explanatory variables can account for the temporal change in alcohol use and HED., Design and Methods: The analyses are based on European School Survey Project on Alcohol and Other Drugs data collected from 15- to 16-year-old Finnish adolescents in 1999, 2003, 2007, 2011 and 2015., Results: The decline in alcohol use and HED among underage youth in Finland is associated with at least three factors: (i) obtaining alcohol has become more difficult; (ii) parents know better than before where their children spend their Friday nights; and (iii) the risk attached to going out with friends on drinking has decreased., Discussion and Conclusions: Formal policy measures and adults' attitudes have probably affected the availability of alcohol for adolescents, and thus they partly explain the decline in youth drinking. This decline coincides with the introduction of new digital technologies, new forms of interaction within families and peer groups, and more conscientious teenagers. All these changes are not necessarily causes of the decline but are part of a similar broader change in adolescents' lives., (© 2018 Australasian Professional Society on Alcohol and other Drugs.)

Background: Due to vitamin D intake below recommendation (10 µg/day) and low (<50 nmol/l) serum 25-hydroxycholecalciferol (25(OH)D) concentration in Finnish population, the fortification of liquid dairy products with 0.5 µg vitamin D/100 g and fat spreads with 10 µg/100 g started in Finland in December 2002. In 2010, the fortification recommendation was doubled. The aim of this study was to investigate whether the vitamin D intake and status have improved among Finnish adults as a consequence of these nutrition policy actions. A further aim was to study the impact of vitamin supplement use to the total vitamin D intake., Methods: A cross-sectional survey was conducted every 5 years. The National FINDIET Survey was conducted in Finland as part of the National FINRISK health monitoring study. Dietary data were collected by using a computer-assisted 48-h dietary recall. In 2002, dietary data comprised 2007, in 2007, 1575 and 2012, 1295 working aged (25-64 years) Finns., Results: The mean D-vitamin intake increased from 5 µg/day to 17 µg/day in men and from 3 µg/day to 18 µg/day in women from 2002 to 2012. The most important food sources of vitamin D were milk products, fat spreads and fish dishes. The share of milk products was 39% among younger men and 38% among younger women, and 29% among older men and 28% among older women. Fat spreads covered on average 28% of vitamin D intake, except for younger men for which it covered 23%. Fish dishes provided 28% of vitamin D intake for older men and women, and approximately 18% for younger ones. In January-April 2012, the average serum 25-hydroxycholecalciferol (25(OH)D) concentration for men was 63 nmol/l for men and for women 67 nmol/l for women., Conclusions: The fortification of commonly used foods with vitamin D and vitamin D supplementation seems to be an efficient way to increase the vitamin D intake and the vitamin D status in the adult population., (© The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.)