Adolescents' capacity to take action on obesity: A concurrent controlled before-and-after study of the European CO-CREATE project

This study evaluated the effect on reported readiness for action and attitudes toward obesity prevention among older adolescents (mean age 17) who took part in a youth-led participatory action research European initiative (CO-CREATE Youth Alliances) compared with a comparison group that acted as controls. This was a concurrent before-and-after controlled study across five countries and took place between September 2019 and October 2020. Adolescents (n = 159) recruited from schools and youth organizations came together with researchers and formed 15 Youth Alliances. An online questionnaire measuring their readiness for action and attitudes toward obesity prevention was administered. Alliance members (n = 62) who filled in the questionnaire at both baseline and postinitiative, and adolescents from the comparison group (n = 132) who completed the questionnaire twice were included in the main analysis. Two-level linear mixed models controlling for country-related variance were fitted. Alliance members scored significantly higher than the comparison group on two factors in each of the readiness for action, responsibility, and drivers of behavior concepts. The findings suggest that involving youth in co-creating policies to prevent obesity may increase adolescents' readiness for action and promote a shift in adolescents' conceptualization of obesity from an individual perspective to a societal responsibility and drivers of behavior

System mapping with adolescents: Using group model building to map the complexity of obesity

Public health research and practice is increasingly employing systems thinking to help grapple with complex issues, from obesity to HIV treatment. At the same time, there is growing recognition that to address a given problem it is essential collaborate with those most at risk of or affected by it. Group model building (GMB), a process grounded in system dynamics, combines systems thinking and participatory methods to structure and address complex issues. As part of the CO-CREATE project we conducted GMB sessions with young people in six countries to create causal loop diagrams showing the factors that they believe drive obesity. This paper describes the background to GMB and the process we used to construct causal loop diagrams; it discusses how GMB contributed to generating noteworthy and useful findings, and the strengths and limitations of the method. Using GMB, we identified areas of concern to adolescents in relation to obesity that have so far had little attention in obesity research and policy: mental health and online activity. In using GMB, we also helped answer calls for a more participatory approach to youth involvement in research and policy development

Iodine status and thyroid function among lactating women in Saharawi refugee camps, Algeria

BACKGROUND: Insufficient iodine intake as well as excess iodine intake may cause thyroid diseases. Endemic goitre and high urinary iodine concentration (UIC), probably caused by excess iodine, has been reported among Saharawi refugees. To what extent long-term excess iodine intake have influenced the thyroid function of the refugees is unknown. OBJECTIVE: The main objective was to assess iodine status and thyroid function among lactating women in the Saharawi refugee camps. METHOD: A baseline for a cohort study was performed among 111 lactating Saharawi women (18-50 years) living in the Algerian desert. Samples of casual urine, breast milk, public drinking water, goat - and camel milk were collected for determination of iodine concentrations. Dietary iodine intake through intake of water and milk was registered using 24-h recall. Thyroid function was assessed through serum levels of thyroid stimulating hormone (TSH), thyroglobulin (Tg), tyroxin (T4), thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb). In selected samples triiodothyronine (T3) and thyrotropin receptor antibody (TRAb) were determined. RESULTS: Median UIC was 350 µg/L. The breast milk iodine concentration (BMIC) showed a median concentration of 479 µg/L. Median iodine concentrations in public drinking water, goat - and camel milk was 102, 952 and 2020 µg/L, respectively. The median dietary intake of iodine among the women was 407 µg/day. Thyroid function abnormalities were found in 23.4 % of the women: 12.6 % had subclinical hypothyroidism, 5.4 % autoimmune thyroiditis, 5.4 % subclinical hyperthyroidism, 3.6 % clinical hypothyroidism and 0.9 % clinical hyperthyroidism. Further, 17.1 % of the women had elevated serum Tg levels and positive TgAb was detected in 14.4 %. The age distribution was higher among women with thyroid abnormalities (p = 0.01). Dietary iodine intake correlated well with UIC (rs = 0.24, p = 0.01) and BMIC (rs = 0.47, p < 0.001). The prevalence of thyroid function abnormalities increased with higher UIC, although no significant correlation between UIC and TSH or UIC and Tg was found. CONCLUSION: The lactating women had high levels of iodine in urine and breast milk, probably caused by excessive dietary iodine intake with public drinking water as a major contributor and animal milk presumably increasing the iodine intake when consumed. The high prevalence of thyroid abnormalities indicates that the long-term excess iodine intake might have influenced the thyroid function negatively

Iodine status and thyroid function among lactating women in Saharawi refugee camps, Algeria

BACKGROUND: Insufficient iodine intake as well as excess iodine intake may cause thyroid diseases. Endemic goitre and high urinary iodine concentration (UIC), probably caused by excess iodine, has been reported among Saharawi refugees. To what extent long-term excess iodine intake have influenced the thyroid function of the refugees is unknown. OBJECTIVE: The main objective was to assess iodine status and thyroid function among lactating women in the Saharawi refugee camps. METHOD: A baseline for a cohort study was performed among 111 lactating Saharawi women (18-50 years) living in the Algerian desert. Samples of casual urine, breast milk, public drinking water, goat - and camel milk were collected for determination of iodine concentrations. Dietary iodine intake through intake of water and milk was registered using 24-h recall. Thyroid function was assessed through serum levels of thyroid stimulating hormone (TSH), thyroglobulin (Tg), tyroxin (T4), thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb). In selected samples triiodothyronine (T3) and thyrotropin receptor antibody (TRAb) were determined. RESULTS: Median UIC was 350 µg/L. The breast milk iodine concentration (BMIC) showed a median concentration of 479 µg/L. Median iodine concentrations in public drinking water, goat - and camel milk was 102, 952 and 2020 µg/L, respectively. The median dietary intake of iodine among the women was 407 µg/day. Thyroid function abnormalities were found in 23.4 % of the women: 12.6 % had subclinical hypothyroidism, 5.4 % autoimmune thyroiditis, 5.4 % subclinical hyperthyroidism, 3.6 % clinical hypothyroidism and 0.9 % clinical hyperthyroidism. Further, 17.1 % of the women had elevated serum Tg levels and positive TgAb was detected in 14.4 %. The age distribution was higher among women with thyroid abnormalities (p = 0.01). Dietary iodine intake correlated well with UIC (rs = 0.24, p = 0.01) and BMIC (rs = 0.47, p < 0.001). The prevalence of thyroid function abnormalities increased with higher UIC, although no significant correlation between UIC and TSH or UIC and Tg was found. CONCLUSION: The lactating women had high levels of iodine in urine and breast milk, probably caused by excessive dietary iodine intake with public drinking water as a major contributor and animal milk presumably increasing the iodine intake when consumed. The high prevalence of thyroid abnormalities indicates that the long-term excess iodine intake might have influenced the thyroid function negatively.Master i samfunnsernærin

Infant feeding practices among Norwegian-Somali and Norwegian-Iraqi infants

Adequate nutrition during the first year of life is essential for optimal growth and health. Previous studies from various countries have shown disparities in infant feeding practices among subgroups in a population. In Norway, national dietary surveys have indicated that the majority of Norwegian infants are fed in accordance with infant feeding recommendations. These surveys have, however, not included infants of foreign-born mothers, and the Norwegian Directorate of Health has called for separate studies on this group of children. The InnBaKost study was initiated in 2012 to reduce the knowledge gap. The work presented in this thesis is a part of this study, and the present work aimed to generate knowledge about infant feeding practices among Norwegian-Somali and Norwegian-Iraqi infants at 6 and 12 months of age. In addition, the work presented focused on developing suitable methods in order to obtain these data. Two cross-sectional surveys were performed in eastern Norway, when the infants were 6 and 12 months of age. The convenience sampling method was used to recruit eligible mothers. A semi-quantitative food frequency questionnaire (FFQ) adapted from the national dietary survey was used at 6 months. The FFQ was designed to estimate breastfeeding and complementary feeding practices at 6 months of age and, retrospectively, from birth up to the given age. A repeated 24-hour multiple-pass recall method was developed and tested, and thereafter used to describe food and nutrient intake among 12-month-old Norwegian-Somali and Norwegian-Iraqi infants. Nutrient intake from the two recalls was compared to the recommended daily ranges and intakes of macro- and micronutrients. Parental and child background characteristics were provided in all surveys. In the 6-month survey, 107 mothers/infants of Somali origin and 80 mothers/infants of Iraqi origin participated. Breastfeeding was almost universally initiated, but only 7% of the Norwegian-Somali and 10% of the Norwegian-Iraqi infants were exclusively breastfed at 4 months of age. More than half of the infants were introduced to infant formula and water during the first three months of life. Solid and/or semi-solid foods had been introduced to 54% of the Norwegian-Somali infants and 68% of the Norwegian-Iraqi infants at 4 months of age. A higher proportion of Norwegian-Somali infants (79%) were breastfed at 6 months of age compared to Norwegian-Iraqi infants (58%). None of the background characteristics analysed were significantly associated with exclusive breastfeeding at 3.5 months of age, while maternal country of origin (Somalia) and parity (>2 children) was positively associated with breastfeeding at 6 months of age. Prior to the 12-month survey, a pilot survey was performed on 12 mothers of Somali and Iraqi origin to develop and test tools for the 24-hour multiple-pass recall method that was to be used in the 12-month survey. The method was described as feasible and the visual tools useful by participating mothers and field workers, although some improvements were recommended. In the 12-month survey, 89 mothers/infants of Somali origin and 77 mothers/infants of Iraqi origin participated. At this age, 40% of Norwegian-Somali and 47% of Norwegian-Iraqi infants were still breastfed. Median energy percentages (E%) from macronutrients were within the recommended daily intake ranges, except the level of saturated fats, which was 12- 13 E%. Median intakes of almost all micronutrients were above the recommended daily intake. The majority of infants received iron-enriched products and vitamin D supplements. Infants not receiving iron-enriched products had a low median intake of iron compared to infants receiving such products (3.7 mg/day vs. 8.1 mg/day, respectively). Infants not receiving vitamin D supplements had a low median intake of vitamin D compared to infants receiving such supplements (4.1 µg/day vs. 14.5 µg/day). In conclusion, breastfeeding initiation was common, but the duration of exclusive breastfeeding was short among both infants of Somali and Iraqi origin, and much shorter than what was found among native Norwegian infants in the national dietary surveys. The proportion of Norwegian-Somali and Norwegian-Iraqi infants still breastfed at 12 months of age was similar to the proportion found in the national dietary surveys. Large proportions of the Norwegian-Somali and Norwegian-Iraqi infants were fed in accordance with the Norwegian infant feeding recommendations at 12 months of age, however, potential for improvement exists. From a public health perspective, this thesis underlines that culturespecific approaches should be promoted to support infant feeding practices among foreignborn mothers in Norway. Research to better understand social inequalities and research to explore infant feeding practices among other immigrant populations in the society are needed. Validity studies should also be performed to provide validity evidence of the methods used

InnBaKost 6 måneder 2013-2014: En undersøkelse av ammepraksis og kosthold blant norsk-somaliske og norsk-irakiske 6 måneder gamle barn i østlandsområdet

Utgivelsesdata Tittel: InnBaKost 6 måneder 2013-2014. En undersøkelse av ammepraksis og kosthold blant norsk-somaliske og norsk-irakiske 6 måneder gamle barn i østlandsområdet Forfatter(e): Cathrine Solheim Kolve, Navnit Kaur Grewal, Laura Terragni, Liv Elin Torheim Serie: HiOA rapport Issn: 1892-9648 Nr: 2016 nr 11 Utgiver: HiOA Avdeling/fakultet: HF Sider: 100 Pris: 225,– ISBN-print: 978-82-8364-034-2 ISBN-pdf: 978-82-8364-035-