Ingun Toftemo

• Toftemo, Ingun; Brænd, Anja Maria; Jenum, Anne Karen & Sletner, Line (2025). Overweight prevalence increases from 2 to 8 years of age among children with immigrant background in a Norwegian multiethnic population. Scandinavian Journal of Public Health. ISSN 1403-4948. 53(8), p. 889–897. doi: 10.1177/14034948251356059. Full text in Research Archive Show summary

  Aims: Little is known about ethnic disparities in childhood obesity in Europe. We explored the development of ethnic differences in overweight (including obesity) from age 2 to 8 years. Methods: We collected routine weight and height measures for 604 children from the Norwegian multiethnic, population-based STORK Groruddalen pregnancy and birth cohort (52.6% European, 26.8% south Asian, and 20.5% Middle East/north African ethnic background). Using chi-square tests for trend and binominal logistic regression analyses adjusted for sex and maternal factors, we explored the development of ethnic differences in overweight. For children with south Asian origin, we performed body mass index adjustments considering their relatively higher adiposity. Results: From age 2 to 8 years, prevalence of overweight was stable in European children (13.1% at 2 years, and 15.1% at 8 years). In children with immigrant background, prevalence increased; from 5.4% to 17.2% in children with south Asian origin, and from 16.2% to 35.8% in children with Middle East/north African background ( p for trend < 0.001 in both groups). At age 8 years, the latter group had almost a threefold higher risk of overweight (odds ratio (OR) 2.89; 95% confidence interval 1.54–5.42) compared with European-origin children, while ethnic south Asian children had a double risk (OR 2.07; 1.19–3.59) after adjustments for body composition. Conclusions: From 2 to 8 years of age, prevalence of childhood overweight increased in children with immigrant background but remained stable in ethnic Europeans. To reduce ethnic disparities in health, effective efforts to prevent obesity in children with immigrant background should start very early in life.

• Toftemo, Ingun; Jenum, Anne Karen & Sletner, Line (2020). Body mass index trajectories up to preschool age in a multi-ethnic population; relations with maternal gestational diabetes, BMI and gestational weight gain. Acta Paediatrica. ISSN 0803-5253. doi: 10.1111/apa.15637. Full text in Research Archive
• Toftemo, Ingun; Jenum, Anne Karen; Lagerløv, Per; Juliusson, Petur Benedikt; Falk, Ragnhild Sørum & Sletner, Line (2018). Contrasting patterns of overweight and thinness among preschool children of different ethnic groups in Norway, and relations with maternal and early life factors. BMC Public Health. 18:1056, p. 1–10. doi: 10.1186/s12889-018-5952-1. Full text in Research Archive Show summary

  Background: Childhood obesity is a worldwide health challenge and risk factor for adult life obesity, which predisposes to development of type 2 diabetes and cardiovascular diseases. However, also thinness in early life has been related to these diseases, especially if followed by fat gain. In European countries, susceptibility to cardio-metabolic diseases varies considerably between ethnic groups. We investigated ethnic differences in overweight and thinness in a multi-ethnic, population-based cohort of preschool children in Norway, and associations with maternal and early postnatal factors. Methods: Participants were children aged 4–5 years (n = 570) drawn from the population-based STORK Groruddalen cohort of healthy women and offspring followed from early pregnancy. Ethnic groups were: European (n = 298), South Asian (n = 154), and Middle East/North African (n = 118). Children’s growth data were provided from routine visits at local Child Health Clinics. Weight status was defined by the International Obesity Task Force. Using multinomial logistic regression analysis, we explored ethnic differences in overweight and thinness, and associations with maternal-, pre, − and postnatal factors. Results: Children of Middle East/North African origin had higher prevalence of overweight (22.0%) compared to European (12.8%) children, and in adjusted logistic regression analysis almost the double risk (OR 1.98; 95%CI: 1.08–3.63). Prevalence was lower in children of South Asian origin (5.2%). Children with South Asian background had higher prevalence of thinness (26.0%) compared to ethnic Europeans (10.4%), and the double risk (OR 2.20; 95%CI: 1.25–3.87) in adjusted models. Applying newly suggested BMI adjustments in South Asian children, taking into account their relatively increased adiposity, markedly increased the prevalence of overweight, and decreased the prevalence of thinness in this subgroup. Birthweight and maternal prepregnant overweight were strongly, positively associated with overweight, and inversely associated with thinness. Lower maternal age was associated with overweight only. Conclusions: In a multi-ethnic cohort we found strikingly different patterns of overweight and thinness among children of different ethnic groups at age 4–5 years, and a strong association between maternal BMI and their children’s weight status. More knowledge is needed on what characterizes and what promotes healthy growth patterns in multi-ethnic populations.

• Seierstad, Tori Guldahl; Brekke, Mette; Toftemo, Ingun & Haavet, Ole Rikard (2017). GPs' and child and adolescent psychiatry specialists' experiences of joint consultations in the GP's office: a qualitative study. BMC Research Notes. 10. doi: 10.1186/s13104-017-2766-7. Full text in Research Archive Show summary

  BACKGROUND: The study is an exploration of a joint consultation model, a collaboration between general practitioners (GPs) and specialists from child and adolescent mental health services (CAMHS) in Lillehammer, Norway. METHODS: A qualitative study based on two focus group interviews, one with participating GPs and one with participating specialists from the local CAMHS. Participants were five GPs, with work experience varying from 6 months to 20 years (four of them specialists in general medicine) and two CAMHS specialists-a psychiatrist and a psychologist-both with more than 20 years of experience. RESULTS: The focus group discussions revealed that both GPs and CAMHS specialists saw the joint consultations as a good teaching method for improving GPs' skills in child and adolescent psychiatry. Both groups believed that this low-threshold service benefits the patients and that the joint consultation is especially suited to sort problems and determine the level of help required. CONCLUSIONS: The GPs and CAMHS specialists shared the impression that the collaboration model is beneficial for both patients and health care providers. Close collaboration with primary health care is recommended in the guidelines for child and adolescent psychiatry outpatient clinics. We suggest that the joint consultation model could be a good way for GPs and CAMHS specialists to collaborate

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• Toftemo, Ingun (2024). Increasing ethnic disparities in overweight and obesity in children from two through eight years of age. Full text in Research Archive
• Toftemo, Ingun (2024). Increasing ethnic disparities in overweight and obesity in children from two to eight years of age in a population-based cohort in Oslo. Full text in Research Archive
• Toftemo, Ingun (2024). Håndbok for helsestasjoner. In Misvær, Nina & Brænd, Anja Maria Lyche (Ed.), Håndbok for helsestasjoner 0-5 år. Kommuneforlaget AS. ISSN 9788244624459. Full text in Research Archive
• Waage, Christin; Toftemo, Ingun; Brænd, Anja Maria; Sletner, Line; Sommer, Christine & Birkeland, Kåre Inge [Show all 10 contributors for this article] (2023). Cohort profile update: the Norwegian STORK Groruddalen (STORK G) pregnancy and birth cohort—the role of ethnicity and causal pathways for obesity, type 2 diabetes, cardiovascular disease and other health issues. BMJ Open. 13(10), p. 1–11. doi: 10.1136/bmjopen-2023-076251. Full text in Research Archive Show summary

  Purpose The STORK Groruddalen cohort was set up in 2008 to explore ethnic differences in: (1) maternal health, primarily gestational diabetes (GDM) and related health issues during pregnancy and post partum, and effects of exposures on risk for type 2 diabetes, cardiovascular disease and other health issues, and (2) offspring’s growth and body composition, overweight/obesity and effects of early life exposures. Participants 823 women (74% of invited) were followed from gestational week (GW) 15. Data were collected from 618 fathers. In total, 59% of women and 53% of fathers had origin from non-Western countries. Maternal mean age was 29.9 years (SD 4.9), and body mass index (BMI) 25.3 kg/m 2 (4.9). Data were obtained from 772 women (94%) at GW 28, and 662 women (80%) 14 weeks post partum. Eleven years post partum, 385 women (53% of eligible/47% of original cohort) attended, age was 42.0 years (4.8) and BMI 27.1 kg/m 2 (5.1). We have data for 783 children at birth, and for 586 at last time point, mean age 8.6 (0.5) years, weight 30.7 (6.8) kg and length 133.9 (6.3) cm. Findings to date We collected questionnaire data from parents, clinical measurements and blood samples from mothers, and data on children’s growth (mid-pregnancy to 8 years). Our biobank includes maternal blood and urine samples, biopsy material from placentas and umbilical venous cord blood. We found several clinically important differences in maternal health, with higher risk in ethnic minority groups for GDM, insulin resistance, vitamin D and iron deficiency, depressive symptoms and physical inactivity. Contrasting patterns of fetal growth and risk of overweight/thinness at preschool age were observed across ethnic groups. Maternal GDM, obesity and high gestational weight gain were associated with children’s BMI trajectories. Future plans We will examine the impact of maternal and fetal health and development during pregnancy on long- term outcomes for mothers and offspring.

• Toftemo, Ingun; Jenum, Anne Karen; Sletner, Line; Richardsen, Kåre Rønn & Brænd, Anja Maria (2022). Does exposure to gestational diabetes cause obesity in pre-pubertal children? Full text in Research Archive
• Toftemo, Ingun (2020). BMI trajectories in children from birth to 4-5 years in a Norwegian multi-ethnic population. Full text in Research Archive
• Toftemo, Ingun (2019). BMI trajectories from birth to 4-5 years in a Norwegian Multi-Ethnic population; Associations with maternal gestational diabetes, prepregnant obesity and gestational weight gain. Full text in Research Archive
• Toftemo, Ingun (2019). GROWTH PATTERNS IN A NORWEGIAN MULTI-ETHNIC COHORT OF PREESCHOOL CHILDREN; ASSOCIATIONS WITH IN UTERO EXPOSURE TO GESTATIONAL DIABETES MELLITUS. Full text in Research Archive
• Toftemo, Ingun (2017). Prevalence of overweight and thinness in a multi-ethnic cohort of 4 years old children in Norway. Associations with ethnicity, maternal- and early life factors. Full text in Research Archive

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