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  • 1.
    Almqvist-Tangen, Gerd
    et al.
    Child Health Care Team, County Council Halland, Sweden & Department of Paediatrics, University of Gothenburg, Gothenburg, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult Hospital, Oskarström, Sweden.
    Dahlgren, Jovanna
    Department of Paediatrics, University of Gothenburg, Gothenburg, Sweden.
    Roswall, Josefine
    Department of Paediatrics, County Hospital, Halmstad, Sweden & Department of Paediatrics, University of Gothenburg, Gothenburg, Sweden.
    Alm, Bernt
    Child Health Care Team, County Council Halland, Sweden & Department of Paediatrics, University of Gothenburg, Gothenburg, Sweden.
    Factors associated with discontinuation of breastfeeding before 1 month of age2012Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 101, nr 1, s. 55-60Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Breastfeeding is associated with many benefits for both mother and child. Initiation rates are high in Sweden. Recently a slight decline is seen.

    AIM: The aim of this study was to assess factors associated with discontinuation of breastfeeding during the first 4 weeks.

    METHOD: A population-based longitudinal birth cohort study recruiting from 2007 to 2008 in south-western Sweden. At the first visit to the child health centre, parents were asked to complete a questionnaire. Also, the infants' height, weight, head and waist circumference were collected. Response rate was 69.2%.

    RESULTS: Twenty-seven per cent of mothers had breastfeeding problems. In a multivariate analysis, there was a negative correlation between breastfeeding and use of pacifier (OR 3.72; CI 2.09-6.63), maternal smoking (OR 2.09; CI 1.08-4.05) and breastfeeding problems (OR 2.54; CI 1.73-3.71). Breastfeeding problems were correlated with poor sucking technique (OR 2.96; CI 2.14-4.07), support from maternity ward (OR 2.56; CI 2.05-3.19) and perceived poor weight gain (OR 1.37; CI 1.00-1.86).

    CONCLUSION: Many mothers reported breastfeeding problems that are associated with an early cessation. This is preventable with support, but the timing is crucial. To promote breastfeeding, the support from the child health centres must be tailored with the maternal perspective in mind.

    © 2011 Foundation Acta Pædiatrica

  • 2.
    Backman, Ellen
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). Region Halland, Halmstad, Sweden.
    Karlsson, Ann-Kristin
    Department of Research and Development, Region Halland, Halmstad, Sweden.
    Sjögreen, Lotta
    Mun-H-Center Orofacial Resource Center for Rare diseases, Gothenburg, Sweden.
    The use of gastrostomy in Swedish children – indications, and trends between 2005 and 20152017Konferensbidrag (Refereegranskat)
    Abstract [en]

    Children with complex medical needs requiring nutritional support are growing in number. This presentation will add new knowledge regarding gastrostomy in children by reporting primary diagnosis, and indications for the use of gastrostomy. Furthermore, the presentation will discuss and analyse data evolution trends from 2005 to 2015 in Sweden.

    Methods: The first part of the study used national statistics to provide a broad picture of gastrostomy use in Swedish children. The second part applied a retrospective observational study design, reviewing medical charts in order to obtain an in-depth picture of the children in need for gastrostomy, and its use in a five-year perspective.

    Results: The number of gastrostomy cases recorded in the national database was 3 946, 53% male, and 47% female. The distribution of age groups was: 0-4 years: 61% , 5-9 years: 17%, 10-14 years: 12%, and 15-19: years 10%.  When observing trends on a national level, the number of children receiving gastrostomy increased in average by 13% per year. Changes in the separate age groups were analysed. An increase was noted for children aged 0-4 years and for children aged 5-9 years. In the age groups 10-14 years and 15-19 years, there was no progressive increase. The results from the national statistics database will be discussed in relation to the medical chart-analyses of 75 children receiving gastrostomy in one Swedish administrative region between 2005 and 2015. 

    Conclusions: As in many parts of Europe, the number of children in need for gastrostomy is also growing in Sweden, with the youngest children seeming to be the group increasing most.

    Clinical implications: Nutritional support in Sweden is publicly financed, therefore these findings may be useful when planning both monetary and human resources in meeting the future challenges of paediatric health care.

  • 3.
    Bramsved, Rebecka
    et al.
    The Queen Silvia Children’s Hospital, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Regber, Susann
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Novak, Daniel
    The Queen Silvia Children’s Hospital, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Mehlig, Kirsten
    Institute of Medicine, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Lissner, Lauren
    Institute of Medicine, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Mårild, Staffan
    The Queen Silvia Children’s Hospital, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Parental education and family income affect birthweight, early longitudinal growth and body mass index development differently2018Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, nr 11, s. 1946-1952Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: This study investigated the effects of two parental socio-economic characteristics, education and income, on growth and risk of obesity in children from birth to 8 years of age.

    METHODS: Longitudinal growth data and national register-based information on socio-economic characteristics were available for 3,030 Swedish children. The development of body mass index (BMI) and height was compared in groups dichotomised by parental education and income.

    RESULTS: Low parental education was associated with a higher BMI from 4 years of age, independent of income, immigrant background, maternal BMI and smoking during pregnancy. Low family income was associated with a lower birthweight, but did not independently predict BMI development. At 8 years of age, children from less educated families had a three times higher risk of obesity, independent of parental income. Children whose parents had fewer years of education but high income had significantly higher height than all other children.

    CONCLUSION: Parental education protected against childhood obesity, even after adjusting for income and other important parental characteristics. Income-related differences in height, despite similar BMIs, raise questions about body composition and metabolic risk profiles. The dominant role of education underscores the value of health literacy initiatives for the parents of young children. ©2018 Foundation Acta Pædiatrica.

  • 4.
    Brantmark, Anna
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Karlsson, Rebecca
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Föräldrars påverkan i utvecklingen av övervikt och fetma hos barn2011Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Övervikt och fetma hos barn är ett allvarligt och växande problem. Det är ett tillstånd som för med sig många olika sjukdomar och i och med att antalet överviktiga barn ökar hastigt kommer det att vara en stor belastning för den framtida hälso- och sjukvården. Prevalensen är särskilt stor i vissa delar av världen och inom vissa grupper i samhället. Föräldrar spelar en väsentlig roll i huruvida barnen lever hälsosamma liv eftersom de bär ansvaret för barnen. Syftet med denna litteraturstudie var att undersöka föräldrars påverkan i utvecklingen av övervikt och fetma hos barn och genom en systematisk bearbetning av litteraturen granskades och bearbetades slutligen 19 vetenskapliga artiklar till resultatdelen i studien. Socioekonomiska faktorer, faktorer inom familjen och föräldrars roll var tre teman som utmärkte sig där det under varje rubrik beskrivs hur föräldrar påverkar med att bidra till eller motverka riskfaktorer till en ohälsosam viktstatus hos barn. Föräldrar har ett behov av stöd i form av information och kunskap och hälso- och sjukvården bär ett stort ansvar i att stödja föräldrar, förebygga sjukdom och främja hälsa.

     

  • 5.
    Bäckhed, Fredrik
    et al.
    The Wallenberg Laboratory, Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden & Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Receptology and Enteroendocrinology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
    Roswall, Josefine
    Department of Pediatrics, Hallands Hospital Halmstad, Halmstad, Sweden & Göteborg Paediatric Growth Research Center, Department of Paediatrics, the University of Gothenburg, Queen Silvia Children’s Hospital, Gothenburg, Sweden.
    Peng, Yangqing
    BGI-Shenzhen, Shenzhen, China.
    Feng, Qiang
    BGI-Shenzhen, Shenzhen, China &Department of Biology, University of Copenhagen, Copenhagen, Denmark.
    Jia, Huijue
    BGI-Shenzhen, Shenzhen, China.
    Kovatcheva-Datchary, Petia
    The Wallenberg Laboratory, Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden.
    Li, Yin
    BGI-Shenzhen, Shenzhen, China.
    Xia, Yan
    BGI-Shenzhen, Shenzhen, China.
    Xie, Hailiang
    BGI-Shenzhen, Shenzhen, China.
    Zhong, Huanzi
    BGI-Shenzhen, Shenzhen, China.
    Khan, Muhammad Tanweer
    The Wallenberg Laboratory, Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden.
    Zhang, Jianfeng
    BGI-Shenzhen, Shenzhen, China.
    Li, Junhua
    BGI-Shenzhen, Shenzhen, China.
    Xiao, Liang
    BGI-Shenzhen, Shenzhen, China.
    Al-Aama, Jumana
    BGI-Shenzhen, Shenzhen, China & Princess Al Jawhara Albrahim Center of Excellence in the Research of Hereditary Disorders, King Abdulaziz University, Saudi Arabia.
    Zhang, Dongya
    BGI-Shenzhen, Shenzhen, China.
    Lee, Ying Shiuan
    The Wallenberg Laboratory, Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden.
    Kotowska, Dorota
    Department of Biology, University of Copenhagen, Copenhagen, Denmark.
    Colding, Camilla
    Department of Biology, University of Copenhagen, Copenhagen, Denmark.
    Tremaroli, Valentina
    The Wallenberg Laboratory, Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden.
    Yin, Ye
    BGI-Shenzhen, Shenzhen, China.
    Bergman, Stefan
    Göteborg Paediatric Growth Research Center, Department of Paediatrics, the University of Gothenburg, Queen Silvia Children’s Hospital, Gothenburg & Research and Development Center Spenshult, Oskarström, Sweden.
    Xu, Xun
    BGI-Shenzhen, Shenzhen, China.
    Madsen, Lise
    Department of Biology, University of Copenhagen, Copenhagen, Denmark & National Institute of Nutrition and Seafood Research, Bergen, Norway.
    Kristiansen, Karsten
    BGI-Shenzhen, Shenzhen, China & Department of Biology, University of Copenhagen, Copenhagen, Denmark.
    Dahlgren, Jovanna
    Göteborg Paediatric Growth Research Center, Department of Paediatrics, the University of Gothenburg, Queen Silvia Children’s Hospital, Gothenburg & .
    Wang, Jun
    BGI-Shenzhen, Shenzhen, China, Department of Biology, University of Copenhagen, Copenhagen, Denmark, Princess Al Jawhara Albrahim Center of Excellence in the Research of Hereditary Disorders, King Abdulaziz University, Saudi Arabia, Macau University of Science and Technology, Avenida Wai long, Taipa, China & Department of Medicine and State Key Laboratory of Pharmaceutical Biotechnology, University of Hong Kong, Hong Kong.
    Dynamics and Stabilization of the Human Gut Microbiome during the First Year of Life2015Ingår i: Cell Host and Microbe, ISSN 1931-3128, E-ISSN 1934-6069, Vol. 17, nr 5, s. 690-703Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The gut microbiota is central to human health, but its establishment in early life has not been quantitatively and functionally examined. Applying metagenomic analysis on fecal samples from a large cohort of Swedish infants and their mothers, we characterized the gut microbiome during the first year of life and assessed the impact of mode of delivery and feeding on its establishment. In contrast to vaginally delivered infants, the gut microbiota of infants delivered by C-section showed significantly less resemblance to their mothers. Nutrition had a major impact on early microbiota composition and function, with cessation of breast-feeding, rather than introduction of solid food, being required for maturation into an adult-like microbiota. Microbiota composition and ecological network had distinctive features at each sampled stage, in accordance with functional maturation of the microbiome. Our findings establish a framework for understanding the interplay between the gut microbiome and the human body in early life. © 2015 Elsevier Inc.

  • 6.
    Börnhorst, Claudia
    et al.
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    Siani, Alfonso
    Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy.
    Russo, Paola
    Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy.
    Kourides, Yannis
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Sion, Isabelle
    Department of Public Health, Ghent University, Ghent, Belgium.
    Molnár, Denés
    Department of Pediatrics, University of Pécs, Pécs, Hungary.
    Moreno, Luis A.
    Rodríguez, Gerardo
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.
    Ben-Shlomo, Yoav
    School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
    Howe, Laura
    School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom, MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom.
    Lissner, Lauren
    Section for Epidemiology and Social Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Mehlig, Kirsten
    Section for Epidemiology and Social Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Regber, Susann
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Bammann, Karin
    Institute for Public Health and Nursing Research (IPP), Faculty for Human and Health Sciences, University Bremen, Bremen, Germany.
    Foraita, Ronja
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    Ahrens, Wolfgang
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany.
    Tilling, Kate
    School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
    Early Life Factors and Inter-Country Heterogeneity in BMI Growth Trajectories of European Children: The IDEFICS Study2016Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, nr 2, artikel-id e0149268Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Starting from birth, this explorative study aimed to investigate between-country differences in body mass index (BMI) trajectories and whether early life factors explain these differences.

    Methods

    The sample included 7,644 children from seven European countries (Belgium, Cyprus, Germany, Hungary, Italy, Spain, Sweden) participating in the multi-centre IDEFICS study. Information on early life factors and in total 53,409 repeated measurements of height and weight from 0 to <12 years of age were collected during the baseline (2007/2008) and follow-up examination (2009/2010) supplemented by records of routine child health visits. Country-specific BMI growth curves were estimated using fractional polynomial mixed effects models. Several covariates focussing on early life factors were added to the models to investigate their role in the between-countries differences.

    Results

    Large between-country differences were observed with Italian children showing significantly higher mean BMI values at all ages ≥ 3 years compared to the other countries. For instance, at age 11 years mean BMI values in Italian boys and girls were 22.3 [21.9;22.8; 99% confidence interval] and 22.0 [21.5;22.4], respectively, compared to a range of 18.4 [18.1;18.8] to 20.3 [19.8;20.7] in boys and 18.2 [17.8;18.6] to 20.3 [19.8;20.7] in girls in the other countries. After adjustment for early life factors, differences between country-specific BMI curves became smaller. Maternal BMI was the factor being most strongly associated with BMI growth (p<0.01 in all countries) with associations increasing during childhood. Gestational weight gain (GWG) was weakly associated with BMI at birth in all countries. In some countries, positive associations between BMI growth and children not being breastfed, mothers’ smoking during pregnancy and low educational level of parents were found.

    Conclusion

    Early life factors seem to explain only some of the inter-country variation in growth. Maternal BMI showed the strongest association with children’s BMI growth.

  • 7.
    Börnhorst, Claudia
    et al.
    a Biometry and Data Management, Leibniz Institute for Epidemiology and Prevention Research, BIPS, Bremen, Germany.
    Siani, Alfonso
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Tornaritis, M.
    c Research and Education Institute of Child Health, Research and Education Institute of Child Health, Strovolos, Cyprus.
    Molnár, D.
    Department of Pediatrics, University of Pécs, Pécs, Hungary.
    Lissner, Lauren
    Section for Epidemiology and Social Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Regber, Susann
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Potential selection effects when estimating associations between the infancy peak or adiposity rebound and later body mass index in children2018Ingår i: Revue d'épidémiologie et de santé publique, ISSN 0398-7620, E-ISSN 1773-0627, Vol. 66, nr Suppl. 5, s. S422-S423Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: Lots of research has been conducted to identify early life factors or growth characteristics in infancy and childhood related to an unfavorable weight development. For instance, a late age at infancy peak (IP), an early age at adiposity rebound (AR) as well as body mass index (BMI) at IP and AR were shown to be positively associated with later adiposity status. The present study aims to investigate the usefulness of the IP and AR in comparison to other measures of BMI growth as indicators of later weight status. For the first time, the selection effect possibly occurring when excluding children with non-identifiable IP or AR will be explored.

    Methods: Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants (IDEFICS)/I. Family is an ongoing cohort study conducted in eight European countries with 16,229 children participating in the baseline survey in 2006/2007 [1]. In a subset of 4744 children with at least four repeated measurements of height and weight in the age interval from 0 to 8 years (37,998 measurements in total; survey data supplemented with records of routine child visits), fractional polynomial mixed-effects models were used to derive individual BMI trajectories. Based on these trajectories, age and BMI at IP and AR, BMI values and growth velocities at selected ages as well as the area under the BMI curve were estimated. The BMI growth measures were standardized and related to later BMI z-scores (mean age at outcome assessment: 9.2 years).

    Results: Age and BMI at IP and AR were not identifiable in 5.4% and 7.8% of the children, respectively. These groups of children showed a significantly higher BMI growth during infancy and childhood. In the remaining sample, BMI at IP correlated almost perfectly (r ≥ 0.99) with BMI at ages 0.5, 1 and 1.5 years, whereas BMI at AR correlated perfectly with BMI at ages 4–6 years (r ≥ 0.98). In the total study group, BMI values in infancy and childhood were positively associated with later BMI z-scores where associations increased with age. Associations between BMI velocities and later BMI z-scores were largest at ages 5 and 6 years. Results markedly differed for children with non-identifiable IP and AR, demonstrating a selection effect.

    Conclusions: IP and AR may not be estimable in children with higher-than-average BMI growth. Excluding these children from analyses may result in a selection bias that distorts effect estimates. BMI values at ages 1 and 5 years might be more appropriate to use as predictors for later weight status instead.

    © 2018 Published by Elsevier Masson SAS

  • 8.
    Lilleberg, Nanna
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd.
    Brevigh, Ida
    Högskolan i Halmstad, Akademin för hälsa och välfärd.
    Haahr, Viktoria
    Högskolan i Halmstad, Akademin för hälsa och välfärd.
    Diabetes mellitus typ 2: Det dagliga stödet till barn och ungdomar: En litteraturöversikt2019Självständigt arbete på avancerad nivå (magisterexamen), 40 poäng / 60 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: År 2018 diagnostiserades 7630 barn och ungdomar med diabetes mellitus i Sverige. Diabetes mellitus typ 2 var tidigare en sällsynt diagnos hos barn och ungdomar men har ökat i takt med övervikt, fetma och fysisk inaktivitet. Barnkonventionen ger barn och ungdomar rättigheten att stödjas av familjen samt hälso- och sjukvården för att hantera sjukdomen på bästa sätt. Syfte: Var att belysa hur barn och ungdomar med diabetes mellitus typ 2 kan stödjas i sin sjukdom. Metod: Litteraturöversikt som genomfördes med systematisk sökning, granskning och analys av kvalitativa och kvantitativa artiklar. Sökningarna utfördes i databaserna Academic Search Elite, CINAHL, MEDLINE, PsycINFO och Scopus. Litteraturöversikten bestod av nio vetenskapliga artiklar. Resultat: Barn och ungdomar med diabetes mellitus typ 2 var i stort behov av ett fungerande nätverk. Positivt och uppmuntrande stöd var en hörnsten i självhantering av sjukdomen. Emotionellt och praktiskt stöd från familjen och vännerna hade stor betydelse för individens diabeteshantering. Även barnsjuksköterskan hade en viktig roll i att stödjande barnet eller ungdomen genom att informera, undervisa och skapa ett bra samarbete och en god relation runt individen. Slutsats: När barn och ungdomar med diabetes mellitus typ 2 fick stöd från omgivningen underlättades diabeteshanteringen.

  • 9.
    Lindholm, Annelie
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). Spenshult Research and Development Center, Halmstad, Sweden.
    Overweight and Obesity in Preschool Children: Early Risk Factors and Early Identification2019Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    BACKGROUND: Overweight and obesity in children has reached epidemic proportions in recent decades, and even the youngest age groups are affected. Excess weight during childhood often follows the child into adulthood and is associated with diseases such as cardiovascular diseases and type 2 diabetes mellitus. In addition, excess weight often leads to health problems already during childhood. Childhood obesity is therefore one of the greatest public health challenges of the 21st century.

    AIM: The overall aim was to study growth patterns and early risk factors for overweight, obesity and an elevated waist-to-height ratio (WHtR) in preschool children. The specific aims were to: examine early body mass index (BMI) and WHtR growth patterns and their ability to predict overweight or obesity in children at 5 years of age (Paper I); examine if BMI and WHtR growth patterns from an early age could identify children with an elevated WHtR at 5 years of age by using standard deviation score(s) (SDS) in children classified according to WHtRSDS at 5 years of age. Another aim was to study the association between BMISDS and WHtRSDS at 5 years of age (Paper II); examine nutrition- and feeding practice-related risk factors for rapid weight gain during the first 0–6 months and the following 6–12 months (Paper III); examine the association between potential early risk factors and an elevated WHtR, defined as WHtRSDS ≥ 1 at 5 years of age, and examine whether similar associations also were found for overweight or obesity at the same age (Paper IV).

    METHODS: This project was part of the population-based birth cohort study the Halland Health and Growth Study, including 2,666 children born in the county of Halland in the southwestern part of Sweden between October 2007 and December 2008. Weight, height and waist circumference were measured at nine time points starting at birth. At every measurement point the parents filled in questionnaires regarding their child’s nutrition, health and lifestyle and also background information about the family.

    RESULTS: We found that children with overweight or obesity at 5 years of age could be identified already from an early age by significantly higher mean BMISDS and WHtRSDS than corresponding values in children with normal weight or underweight. BMI was sufficient for predicting overweight or obesity at 5 years of age and WHtR did not add any further information in this prediction.

    Children with a WHtRSDS ≥ 1 at 5 years of age could be identified already from an early age by significantly higher mean BMISDS and WHtRSDS than corresponding values in children with a WHtRSDS < 1. When comparing WHtRSDS and BMISDS at 5 years of age, 55% of the children with an elevated WHtRSDS had normal BMISDS.

    Rapid weight gain was more common during the first 6 months of the first year than during the next 6 months. Bottle-feeding and nighttime meals containing formula milk were associated with rapid weight gain between 0 and 6 months. Breastfeeding was negatively associated with rapid weight gain during the same period.

    Rapid weight gain during 0–6 months and also maternal pre-pregnancy BMI and paternal BMI were associated with a WHtRSDS ≥ 1 at 5 years of age. Rapid weight gain during both 0–6 and 6–12 months and also maternal pre-pregnancy BMI, were associated with overweight or obesity at 5 years of age.

    CONCLUSION: This thesis showed that BMI was sufficient for predicting overweight or obesity at 5 years of age, and WHtR did not add any further information to this prediction. For identification of children with an elevated WHtR, BMI classification missed every second child, indicating that WHtR adds value in children who may need further investigation regarding cardiometabolic risk factors. Risk factors operating before pregnancy and early in life increase the risk of early rapid weight gain, an elevated WHtR and overweight or obesity at 5 years of age and bottle feeding, nighttime meals, early rapid weight gain as well as parental overweight are potential modifiable risk factors in this development.

  • 10.
    Lindholm, Annelie
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). Research and Development Center Spenshult, Halmstad, Sweden.
    Bergman, Stefan
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). Research and Development Center Spenshult, Halmstad, Sweden & Department of Public Health and Community Medicine, The Primary Health Care Unit at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Alm, Bernt
    Department of Pediatrics, The Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Almquist-Tangen, Gerd
    Department of Pediatrics, The Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden & Child Health Care Unit, Region Halland, Kungsbacka, Sweden.
    Dahlgren, Jovanna
    Department of Pediatrics, The Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Roswall, Josefine
    Department of Pediatrics, The Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden & Department of Pediatrics, County Hospital, Halmstad, Sweden.
    Infant body mass index growth patterns predicted overweight at five years, waist-to-height ratio did not add to this predictivity2019Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, nr 5, s. 945-953Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: The aim of the present study was to examine body mass index (BMI) and waist‐to‐height ratio (WHtR) growth patterns from birth until five years regarding their ability to predict overweight or obesity in children at five years of age.

    Methods: Population‐based longitudinal birth cohort study of 1540 children from the south‐west region of Sweden, recruited at the first visit to the child health care centres in 2007–2008. The children were followed for five years and classified into two weight groups according to the 2012 International Obesity Task Force criteria. BMI and WHtR standard deviation scores (SDS) were analysed with Student's t‐tests and multiple logistic regression models. ©2018 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd

    Results: BMI‐SDS and WHtR‐SDS growth patterns were from an early age different in children with overweight or obesity, compared to in children with normal weight or underweight. Overweight or obesity was significantly predicted by BMI‐SDS at 0–1 month (p < 0.001), ΔBMI‐SDS between 0–1 and 12 months (p < 0.001) and between 18 and 48 months (p < 0.001), but not by WHtR‐SDS, except for a negative association between 18 and 48 months in the boys (p = 0.040).

    Conclusion: Overweight or obesity at five years could be predicted by early BMI‐SDS growth patterns, and WHtR‐SDS did not add to the predictivity with regard to BMI‐SDS. ©2018 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd

  • 11.
    Lindholm, Annelie
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Roswall, Josefine
    Department of Pediatrics, The Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Alm, Bernt
    Department of Pediatrics, The Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Almquist-Tangen, Gerd
    Department of Pediatrics, The Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Bremander, Ann
    Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, Rydberglaboratoriet för tillämpad naturvetenskap (RLAS).
    Dahlgren, Jovanna
    Department of Pediatrics, The Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Staland Nyman, Carin
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Bergman, Stefan
    Department of Public Health and Community Medicine, The Primary Health Care Unit at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Body mass index classification misses to identify children with an elevated waist-to-height ratio at 5 years of age2019Ingår i: Pediatric Research, ISSN 0031-3998, E-ISSN 1530-0447, Vol. 85, nr 1, s. 30-32Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:  Abdominal adiposity is an important risk factor in the metabolic syndrome. Since BMI does not reveal fat distribution, waist-to-height ratio (WHtR) has been suggested as a better measure of abdominal adiposity in children, but only a few studies cover the preschool population. The aim of the present study was to examine BMI and WHtR growth patterns and their association regarding their ability to identify children with an elevated WHtR at 5 years of age.

    Methods: A population-based longitudinal birth cohort study of 1540 children, followed from 0 to 5 years with nine measurement points. The children were classified as having WHtR standard deviation scores (WHtRSDS) <1 or ≥1 at 5 years. Student’s t-tests and Chi-squared tests were used in the analyses.

    Results: Association between BMISDS and WHtRSDS at 5 years showed that 55% of children with WHtRSDS ≥1 at 5 years had normal BMISDS (p < 0.001). Children with WHtRSDS ≥1 at 5 years had from an early age significantly higher mean BMISDS and WHtRSDS than children with values <1.

    Conclusions: BMI classification misses every second child with WHtRSDS ≥1 at 5 years, suggesting that WHtR adds value in identifying children with abdominal adiposity who may need further investigation regarding cardiometabolic risk factors.

    © 2018, International Pediatric Research Foundation, Inc.

  • 12.
    Lindholm, Annelie
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). Research and Development Centre Spenshult, Halmstad, Sweden.
    Roswall, Josefine
    The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden & Halland Hospital, Halmstad, Sweden.
    Almqvist-Tangen, Gerd
    The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden & Child Health Care Unit, Region Halland, Sweden.
    Alm, Bernt
    The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden & Child Health Care Unit, Region Halland, Sweden.
    Dahlgren, Jovanna
    The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Bergman, Stefan
    Research and Development Centre Spenshult, Halmstad, Sweden & The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Changes in Waist-to-Height Ratio during Preschool Years Differ between Children being Obese or Overweight at Five Years of Age Compared with not Overweight Children2016Ingår i: Hormone Research in Paediatrics, ISSN 1663-2818, E-ISSN 1663-2826, Vol. 86, nr Suppl. 1, s. 308-308, artikel-id P1-P465Artikel i tidskrift (Övrigt vetenskapligt)
  • 13.
    Linge, Lotta
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Joyful and serious intentions in the work of hospital clowns: A meta-analysis based on a 7-year research project conducted in three parts2013Ingår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 8, artikel-id 18907Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The present meta-analysis focuses on a 7-year research project entitled "Hospital clowns-in encounters with ailing children" and funded by the Swedish Childhood Cancer Foundation. The aim of the meta-analysis, which is based on the project's three studies, was to attempt to achieve a deeper psychological and more nuanced understanding of the unique encounters taking place between the hospital clowns and ailing children in the study. The methodological procedures were qualitative and included 51 interviews with four informant groups: the clowns, staff, children, and their parents. The meta-analysis revealed the unique aspects of hospital clowns' work with respect to: a) a quality of care that transcends boundaries, that is, a magical safe area where demands and adjustment were temporarily set aside and where the lighter side of life took precedence; b) a non-demanding quality of care, where joy could be experienced without requiring something in return, where the child's terms mattered and where the child perspective was clearly in focus; and c) a defusing quality of care, which is expressed as a positive counterweight that was otherwise lacking in medical care, where the hospital clowns used different solutions that bypassed regular hospital routines by temporarily distracting and making things easier for the children, parents, and staff in various care situations. Finally, the aim of the theoretical framework, in its synthesizing form, was to promote further psychological understanding of the area of humor that exists between fantasy and reality-an intermediate or transitional area that the hospital clowns created together with the children. In this transitional area, the hospital clowns' unique contribution can be interpreted, in psychological terms, as being available as a vicarious therapeutic clown figure in a magical world that parallels reality.

  • 14.
    Mårild, Staffan
    et al.
    Department of Pediatrics, Institute of Clinical Sciences, The Queen Silvia Children’s Hospital, The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
    Regber, Susann
    Nordic School of Public Health, Göteborg, Sweden.
    Novak, M.
    Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Eiben, G.
    Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Bammann, K.
    BIPS-Institute, Bremen, Germany.
    De Henauw, S.
    Ghent University, Ghent, Belgium.
    Fernández-Alvira, J.M.
    University of Zaragoza, Zaragoza, Spain.
    Gwozdz, W.
    Copenhagen Business School, Frederiksberg, Denmark.
    Kourides, Y.
    Research & Education Institute of Child Health, Strovolos, Cyprus.
    Moreno, L.
    University of Zaragoza, Zaragoza, Spain.
    Molnár, D.
    University of Pécs, Pécs, Hungary.
    Reisch, L.
    Copenhagen Business School, Frederiksberg, Denmark.
    Russo, P.
    CNR, Avellino, Italy.
    Veidebaum, T.
    National Institute for Health Development, Tallinn, Estonia.
    Borup, I.
    Nordic School of Public Health, Gothenburg, Sweden.
    Pigeot, I.
    BIPS-Institute, Bremen, Germany.
    Parental perceptions of and concerns about child´s body weight in eight European countries - the IDEFICS study2014Ingår i: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 15, nr S2, s. 105-105Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Few studies have studied parental perceptions in different settings of their children's weight in relation to objective measurements.

    Aim: To evaluate parental perceptions of their child's weight category in relation to anthropometric measurements.

    Key Methods: This was cross-sectional study of 16 220 children, 2–9 year of age, from eight European countries. Parents completed a questionnaire on their perception of the children's weight and concern for future weight deviations. Objective children's weight categories from the International Obesity Task Force were used.

    Results: Parental weight perception corresponded overall to children's mean body mass index (BMI) z-scores, but there were exceptions, e.g. 63% of parents to children with overweight marked ‘proper weight’. One-third of the total indicated concern for future underweight, most often in parents of children in the overweight category. The strongest predictor for accurate parental weight perception for children with overweight and obesity was BMI z-score (odds ratio [OR] 7.2, 95% confidence interval [CI] 6.1–8.7). Compared to Southern Europe, ORs for accurate parental weight perception were 4.4 (95% CI 3.3–6.0) in Northern Europe and 3.4 (95% CI 2.7–4.2) in Central Europe.

    Conclusion: Parents of children categorized as being overweight or obese systematically underestimated weight category. Parents differed regionally in accurate perception of weight.

  • 15.
    Parmvi, Jannie
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Ottosson, Carola
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    ”Skada inte vår framtid”: Kännetecken för sjuksköterskan att uppmärksamma vid misstanke om fysisk barnmisshandel2010Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Identifiering av fysisk barnmisshandel är en komplicerad uppgift och många misshandelsfall upptäcks inte av sjukvården. Det har skett en attitydförändring i samhället över tid, vilket har bidragit till en ökad anmälningsfrekvens av barnmisshandel. Fysisk barnmisshandel är när en vuxen vållar ett barn skada med eller utan tillhygge. Syftet med denna litteraturstudie var att belysa vilka kännetecken sjuksköterskan ska uppmärksamma vid kontakt med familjer för att upptäcka om barnet har utsatts för fysiskt våld. Med hjälp av tretton artiklar och en avhandling formades litteraturstudien. Resultatet visar att det finns ett stort antal varningssignaler som sjuksköterskan ska vara observant på vid misstanke av barnmisshandel. Dessa kännetecken varierar och kan vara allt från somatiska skador på barnet till föräldrarnas beteende i sociala sammanhang. Genom erfarenhet och utbildning inom området barnmisshandel, underlättas sjuksköterskans arbete i att särskilja situationer där ett barn blir misshandlat från en situation där ett barn skadas i samband med lek. Vidare forskning i ämnet barnmisshandel krävs för att stärka sjuksköterskeprofessionen och därmed fånga upp fler utsatta barn.

  • 16.
    Regber, Susann
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Jormfeldt, Henrika
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Foster homes for neglected children with severe obesity— Debated but rarely studied2019Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, nr 11, s. 1955-1964Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To explore current research and theoretical articles on foster home placement of children with severe obesity.

    Methods: An integrative literature review. Literature searches in six electronic databases included theoretical, quantitative and qualitative articles and case reports published in English (2008‐2018) on the topic of severe childhood obesity and foster home placement.

    Results: Seventeen selected papers included six theoretical articles, nine quantitative studies, one qualitative study and one case report. Eight of the nine quantitative studies did not specify the grading of obesity in children in foster care. The case report and the qualitative study showed distinct and sustainable body mass index (BMI) reductions after a child had been placed in foster care. Five theoretical articles justified foster care placement when chronic parental neglect led to severe obesity in the child, while one article emphasised the opposite.

    Conclusion: Parental and societal neglect of children with severe obesity placed in a foster home is rarely studied or the exclusive aim of research. The views of the chil‐dren themselves are lacking in research articles, as well as the child’s right to health obligations concerning children with severe obesity. © 2019 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd.

  • 17.
    Samuelsson, Carolina
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd.
    Törnqvist, Amanda
    Högskolan i Halmstad, Akademin för hälsa och välfärd.
    Föräldrars hopp i upplevelsen av att ha ett barn med diagnosen cancer2015Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Varje år drabbas ca 300 barn av någon form av cancer i Sverige. Att ett barn insjuknar i cancer påverkar inte bara det sjuka barnet utan även föräldrarna. Cancerdiagnosen skapar en krissituation hos hela familjen. I samband med denna krissituation uppkommer även begreppet hopp. Föräldrars hopp i upplevelsen av att ha ett barn med cancer. För att föräldrarna ska kunna ha en chans att klara av den krävande situationen är det av betydelse att belysa de faktorer som kan påverka hoppet hos föräldrarna på ett positivt eller negativt sätt. Vad kan sjukvårdspersonalen göra för att eliminera de faktorer som utgör ett hot mot hoppet samt hur hopp ska upprätthållas. Vilket svarar mot litteraturstudiens syfte. Fem kategorier har identifieras som speglar resultatet för att beskriva faktorer som främjar och hotar hoppet; Kunskap ger hopp, Socialt stöd ger hopp, Familjecentrerad vård ger hopp, Hot mot hoppet och Framtidstro ger hopp. Är föräldrarna väl informerade, får socialt stöd från familj, vänner och andra föräldrar i liknande situation och har framtidstro gör det att föräldrarna har goda möjligheter att bibehålla hoppet. Dock finns det faktorer som kan hota känslan och upplevelsen av hopp.

  • 18.
    Svedberg, Petra
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsa och omvårdnad.
    Arvidsson, Susann
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsa och omvårdnad.
    Larsson, Ingrid
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsa och omvårdnad.
    Carlsson, Ing-Marie
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Nygren, Jens M.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsa och omvårdnad.
    Barriers and Enablers Affecting Successful Implementation of the Electronic Health Service Sisom: Multicenter Study of Child Participation in Pediatric Care2019Ingår i: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 21, nr 11, s. 1-15, artikel-id 14271Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Children's participation in health care is one of the most important components in the management of their disease. Electronic health (eHealth) services that are adapted to the needs of children have the potential for restructuring how children and professionals work together. Therefore, a digital interactive assessment and communication tool, Sisom, was developed to give children aged between 6 and 12 years a voice in their own health care. However, the implementation of eHealth services such as Sisom in daily practice in pediatric health care is rarely investigated. OBJECTIVE: The aim of this study was to explore the process of implementing Sisom for children in pediatric care in Sweden. More specifically, the study aimed to (1) evaluate whether the implementation strategy was conducted as planned, (2) understand the barriers and facilitators of the implementation strategy in pediatric care settings, (3) gain insight into how professionals work with the specific intervention, and (4) gain insight into the usefulness and effects of the intervention from the professionals' perspectives. METHODS: A process evaluation design was used to study the implementation of Sisom at 4 pediatric care centers in Sweden. An extensive amount of qualitative and quantitative data was collected before, during, and after the intervention through self-report checklists, memos, and interviews with professionals. In total, 46 children, aged between 6 and 13 years, participated. The children used Sisom on two occasions during 6 months. When they used Sisom, a printed report formed the basis for a forthcoming dialogue between professionals, children, and their parents. RESULTS: To our knowledge, this is the first implementation study of an eHealth communication tool aimed at strengthening children's participation in pediatric health care. Key factors for successful implementation were alignment of the solution with the values and goals of the organization, health care professionals' beliefs in the usefulness and usability of the solution, and health care professionals' willingness to change their professional roles guided by the solution. CONCLUSIONS: The results from the study show that it is possible to restructure health care delivery toward a child-centered approach, if there is a willingness and preparedness in the organization to implement an eHealth solution with the aim of restructuring the way of working with children's participation. ©Petra Svedberg, Susann Arvidsson, Ingrid Larsson, Ing-Marie Carlsson, Jens M Nygren.

  • 19.
    Sällfors, Christina
    et al.
    The Nordic School of Public Health, Göteborg University, Sweden.
    Hallberg, Lillemor R.-M.
    The Nordic School of Public Health, Göteborg University, Göteborg, Sweden.
    Fasth, Anders L.
    Department of Paediatrics, Göteborg University, Göteborg, Sweden.
    Well-being in children with juvenile chronic arthritis2004Ingår i: Clinical and Experimental Rheumatology, ISSN 0392-856X, E-ISSN 1593-098X, Vol. 22, nr 1, s. 125-130Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: The aim of this study was to describe a model for predicting well-being in children with juvenile chronic arthritis (JCA). METHODS: 125 children (43 boys) (median age 14.1 yrs; range 10.3-17.8) rated disability and discomfort (Childhood Health Assessment Questionnaire). Pain control, pain reduction and fatigue were evaluated (visual analogue scales). In addition, variation of pain intensity was rated by a pain intensity scale. Analysis by the stepwise regression technique was used to explain the variability in well-being. Eight independent variables were included as possible predictors in the model (p < 0.1). RESULTS: The analyses indicated that well-being in children with JCA is related to three clusters of variables; pain "as it normally is", number of pain-free days and attending physical education classes. The analysis explained a substantial portion of the total variance in the children's well-being (55.1%). CONCLUSION: Pain is a robust predictor of well-being in children with JCA. This supports the concept of the benefits of reducing chronic joint pain as a major goal in caring of these children.

  • 20.
    Önnerfält, Jenny
    et al.
    Department of Paediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden & Vårdalinstitutet, Swedish Institute for Health Sciences, Lund University, Lund, Sweden & Department of Paediatrics, Lund University, Lund, Sweden & Skåne University Hospital, Lund, Sweden.
    Erlandsson, Lena-Karin
    Vårdalinstitutet, Swedish Institute for Health Sciences, Lund University, Lund, Sweden & Department of Health Sciences, Faculty of medicine, Lund University, Lund, Sweden.
    Orban, Kristina
    Vårdalinstitutet, Swedish Institute for Health Sciences, Lund University, Lund, Sweden & Department of Health Sciences, Faculty of medicine, Lund University, Lund, Sweden.
    Broberg Olsson, Malin
    Vårdalinstitutet, Swedish Institute for Health Sciences, Lund University, Lund, Sweden & Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
    Thorngren-Jerneck, Kristina
    Department of Paediatrics, Clinical Sciences, Lund University, Lund, Sweden & Vårdalinstitutet, Swedish Institute for Health Sciences, Lund University, Lund, Sweden & Skåne University Hospital, Lund, Sweden.
    A family-based intervention targeting parents of preschool children with overweight and obesity: Conceptual framework and study design of LOOPS- Lund Overweight and Obesity Preschool Study2012Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 12, nr 1, artikel-id 879Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: As the rate of overweight among children is rising there is a need for evidence-based research that will clarify what the best interventional strategies to normalize weight development are. The overall aim of the Lund Overweight and Obesity Preschool Study (LOOPS) is to evaluate if a family-based intervention, targeting parents of preschool children with overweight and obesity, has a long-term positive effect on weight development of the children. The hypothesis is that preschool children with overweight and obesity, whose parents participate in a one-year intervention, both at completion of the one-year intervention and at long term follow up (2-, 3- and 5-years) will have reduced their BMI-for-age z-score.

    Methods/Design: The study is a randomized controlled trial, including overweight (n=160) and obese (n=80) children 4-6-years-old. The intervention is targeting the parents, who get general information about nutrition and exercise recommendations through a website and are invited to participate in a group intervention with the purpose of supporting them to accomplish preferred lifestyle changes, both in the short and long term. To evaluate the effect of various supports, the parents are randomized to different interventions with the main focus of: 1) supporting the parents in limit setting by emphasizing the importance of positive interactions between parents and children and 2) influencing the patterns of daily activities to induce alterations of everyday life that will lead to healthier lifestyle. The primary outcome variable, child BMI-for-age z-score will be measured at referral, inclusion, after 6 months, at the end of intervention and at 2-, 3- and 5-years post intervention. Secondary outcome variables, measured at inclusion and at the end of intervention, are child activity pattern, eating habits and biochemical markers as well as parent BMI, exercise habits, perception of health, experience of parenthood and level of parental stress.

    Discussion: The LOOPS project will provide valuable information on how to build effective interventions to influence an unhealthy weight development to prevent the negative long-term effects of childhood obesity.

    Trial registration: ClinicalTrials.gov NCT00916318

    © 2012 Önnerfält et al.; licensee BioMed Central Ltd.

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